The AMDIS Connection: At the Beginning of a Data Revolution
CMIOs have transformed the U.S. health IT system, and healthcare professionals have gone from oblivion to engagement with medical informatics. A recognized specialty has been formed and included in mainstream medical education. Now, young physicians interested in medical informatics careers also are playing an important role.Despite the progress, we can't rest on our laurels. The complexities of meaningful use and other initiatives are taking place during times of great economic upheaval. While medical informaticists are making some strides, providers aren't quite ready for the government expectations that accompany meaningful use and accountable care.
These desires require more data and the ability to mine that data.
Thus, Dana Womack, MS, RN, Rosemary Kennedy, RN, MBA, and I conducted a study to assess the role of clinical data analysis in hospital improvement initiatives. Using an online survey of AMDIS, ANIA-Caring, Alliance for Nursing Informatics and HIMSS Physician Workgroup, we examined the practice of clinical data analysis in the context of hospital improvement initiatives.
The top roles in these initiatives at the representative healthcare organizations were CIOs (37 percent), CMIOs (29 percent) and chief quality officers (CQOs) (22 percent).
Most of the organizations said that it would be more than five years before they implement a clinical data repository or data warehouse.
In terms of the functionality of their respective EHRs, respondents said that 97.7 percent of EHR functionality was used for lab and pharmacy information systems, followed by radiology information systems at 88.5 percent. Beyond that, EHRs included clinical decision support (50.6 percent), physician documentation with structured templates (41.4 percent), health information exchange (HIE) or standardized information sharing with authorization (24.3 percent) and controlled medical vocabulary, such as SNOMED and CT (25.3 percent).
The respondents who reported having a temporary clinical data analysis team structure (the largest segment of respondents) and those organizations with a permanent team had their teams in place for more than five years (66.7 percent). The permanent teams were led by a CQO or another quality leader (40.7 percent) and "other" at 20.4 percent. CMIOs oversaw permanent clinical data analysis teams only 14.8 percent of the time.
The more than 48 percent of respondents who have not created a permanent analysis team stated it was because of "a lack of staff resources with appropriate expertise."
The top responses for clinical targets over the past three years have focused on care delivery, including preventing ventilator associated pneumonia (81.6 percent), falls (80.5 percent) and blood stream infections (75.9 percent).
Physician ordering, which requires data to perform its analysis, came in at only 35.6 percent. Care transitions, a key part to some of the HIE activities taking place across the U.S., was noted in only 19.5 percent of the responses.
Based on our research, if data management is the ultimate change process for demonstrating and engaging medical professionals in the value of health IT, there is still much work to be done. Even in more advanced healthcare settings, we are only beginning the revolution in terms of organizational data based on quality and safety improvements.
Access to data
The public wants timelier access to their medical information, as well as better care coordination, information flow improvements between the patient and the physician, broader use of health information systems, health insurance administrative simplification and more information available on quality and costs, according to research by the Commonwealth Fund in its report, "A Call for New Direction."These desires require more data and the ability to mine that data.
Thus, Dana Womack, MS, RN, Rosemary Kennedy, RN, MBA, and I conducted a study to assess the role of clinical data analysis in hospital improvement initiatives. Using an online survey of AMDIS, ANIA-Caring, Alliance for Nursing Informatics and HIMSS Physician Workgroup, we examined the practice of clinical data analysis in the context of hospital improvement initiatives.
The top roles in these initiatives at the representative healthcare organizations were CIOs (37 percent), CMIOs (29 percent) and chief quality officers (CQOs) (22 percent).
Most of the organizations said that it would be more than five years before they implement a clinical data repository or data warehouse.
In terms of the functionality of their respective EHRs, respondents said that 97.7 percent of EHR functionality was used for lab and pharmacy information systems, followed by radiology information systems at 88.5 percent. Beyond that, EHRs included clinical decision support (50.6 percent), physician documentation with structured templates (41.4 percent), health information exchange (HIE) or standardized information sharing with authorization (24.3 percent) and controlled medical vocabulary, such as SNOMED and CT (25.3 percent).
The respondents who reported having a temporary clinical data analysis team structure (the largest segment of respondents) and those organizations with a permanent team had their teams in place for more than five years (66.7 percent). The permanent teams were led by a CQO or another quality leader (40.7 percent) and "other" at 20.4 percent. CMIOs oversaw permanent clinical data analysis teams only 14.8 percent of the time.
The more than 48 percent of respondents who have not created a permanent analysis team stated it was because of "a lack of staff resources with appropriate expertise."
The top responses for clinical targets over the past three years have focused on care delivery, including preventing ventilator associated pneumonia (81.6 percent), falls (80.5 percent) and blood stream infections (75.9 percent).
Physician ordering, which requires data to perform its analysis, came in at only 35.6 percent. Care transitions, a key part to some of the HIE activities taking place across the U.S., was noted in only 19.5 percent of the responses.
Based on our research, if data management is the ultimate change process for demonstrating and engaging medical professionals in the value of health IT, there is still much work to be done. Even in more advanced healthcare settings, we are only beginning the revolution in terms of organizational data based on quality and safety improvements.