Thursday, October 8, 2009

Should we rename "Informatics"?

Recently I was talking with some colleagues in healthcare IT, and the random discussion came up : "Should we rename the field of informatics?"

(This, after I'm happy to report that our Clinical Jedis just took a step forward to become what they really are - Clinical Informaticists.)

Let's first ask : WHAT IS INFORMATICS? WHY SHOULD I CARE?

Informatics, as defined by Princeton WordnetWeb (http://wordnetweb.princeton.edu), is "the sciences concerned with gathering, manipulating, storing, retrieving, and classifying recorded information".

The analytic tools of an informaticist, then, include :
  1. Artificial Intelligence
  2. Cognitive Science
  3. Computer Science
  4. Information Science
  5. Social Science
...all to accomplish certain goals, including :
  1. Workflow analysis
  2. Workflow redesign
  3. Electronic Decision Support
WHY SHOULD I CARE? Because the clinical benefits of an informatics team underscore the importance of early education. A clinical informatics team :
  1. Breaks down the "silo" effect (where different tribes / departments / committees "make their own decisions" but don't tell anyone, resulting in downstream chaos)
  2. Facilitates interdepartmental communication.
  3. Facilitates workflow analysis.
  4. Facilitates workflow redesign.
  5. Facilitates policy review/design (you will quickly discover which of your policies support your IT, and which don't.)
  6. Allows front-line clinical staff to have power to change their environments.
  7. Supports the design and implementation of your EMR.
So why rename informatics? Because often administrators and other clinical leaders have difficulty understanding what informatics is. Most common mistake : It often gets lumped together with IT. And while IT and Informatics have a wonderful symbiotic relationship, they are, in fact, very different.

The problem : No good alternative name to pick. Not yet, at least. Yes, I informally call them Clinical Jedis, but it's a little too campy for real use. I suppose there are some potential word candidates that someone could design, but they face the challenge of starting the education from square one.

I think the trick is, then, for your CMIO to educate your administrators about "What-is-informatics?" before and after you go-live with your EMR implementation. The earlier you prepare your leadership for such a group, the easier your acceptance will be of this new paradigm when your informatics team starts to assemble itself.

(If you don't or can't afford a CMIO, then there are good consultants who can help your administration prepare for your culture shift.)

Still, you'll be faced with the challenge: Okay. We accept that we'll need an informatics team. Where do we fit clinical informaticists into our hospital hierarchy? Answer : This is something every hospital administrator struggles with. Generally it ends up being a central part of your hospital's functioning. Your mileage may vary.

(All of this to support our EMR?!?! The vendors didn't tell us about this part, right??)

I think most vendors will say "We told you so!", and in fact they often try to explain this, but the truth is that most of us aren't ready or prepared to hear that message - So even if the vendor tries to explain it, we don't actually receive the message.

So I'm blogging about it to help spread the message before you go-live with your EMR or CPOE. (If you're not ready to tackle these issues, your EMR implementation is going to be challenging.)

(And people often wonder why so many IT/EMR implementations fail within the first year or so...)

2 comments:

I said...

I am still stuggling with educating our institution as to the definition of CI and have to thank you for this post. I am planning to develop a power point slide to use prior to everyone of my presentations -it will detail the definition of CI in big bold font-I may even put it at the end of every presentation too just to drive it home some more!

Dirk Stanley said...

Yes, I agree - Clinical informatics is TOO hard for most administrators / clinical staff to swallow. Good luck - It's an uphill battle.