Transcript hi2 Presentation Template (Collaborate)

Health Informatics in the VA: Past, Present and Future
Objectives
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Discuss the definition of the term Health Informatics within the context of
health care delivery in VHA.
Describe how Health Informatics emerged as a practice discipline within the
VHA system.
Identify the objectives of the Health Informatics Competency, Career and
Community development groups of Work stream C within the VA Secretary’s
transformational initiative number 16 -“Transforming Health Care Delivery
through Health Informatics”.
What is Informatics?
www.dictionary.com (Based on the Random House Dictionary, © Random House, Inc. 2011. )
–noun ( used with a singular verb )
the study of information processing; computer science.
Origin:
translation of Russian informátika (1966); see information, -ics
World English Dictionary (Collins English Dictionary - Complete & Unabridged 10th Edition)
— n ( functioning as singular ) another term for information science
Medical Dictionary (Merriam-Webster's Medical Dictionary, © 2007 Merriam-Webster, Inc)
Function: noun plural but singular in construction
: the collection, classification, storage, retrieval, and dissemination of recorded knowledge see
BIOINFORMATICS
What is Informatics?
• A search reveals a wide use of the term. A few examples
from Wikipedia:
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Archival Informatics
Bioinformatics
Business Informatics
Ecoinformatics
Education Informatics
Forest Informatics
Music Informatics
Social Informatics
Used in context in the healthcare field?
• Health Informatics- generally used as a broader term
overarching sub-fields of practice
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Biomedical informatics
Clinical informatics
Clinical research informatics
Consumer health informatics
Dental informatics
Health care informatics
Imaging informatics
Nursing informatics
Pharmacy informatics
Public health informatics
Veterinary informatics
Sub-Specialties- varying degrees of formalization
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Scopes and Standards of Practice
Graduate degrees
Professional certification
Professional organizations
Fellowships, Internships
Networking groups
Communities of interest
So what does “informatics” mean in VHA?
• Informatics is hard to define in a top down manner
Who are “Informaticists” or “Informaticians?”
• Open to much debate
• The term “health informatics” is generally not well
understood within VHA or the private sector at this time.
• What kinds of things do people practicing Health
Informatics do?
We can better define Health Informatics by…
• Determining the high-level functions of real live VA informatics
practitioners.
• Drilling down into specific duties and tasks so that we can:
• Understand what Informatics functions and duties are when
developing position descriptions and functional descriptions.
• Know what Informatics functions and duties are when
designing and implementing training.
• Help identify VA Health Informatics community members who
may or may not have informatics in their title.
Hi2 Working definition
Health informatics is a discipline at the intersection of information science,
computer science, and health care that designs and delivers information to
improve clinical care, individual and public health and biomedical research.
Health informatics optimizes health-related information acquisition,
processing, and use with tools that include people and processes; hardware
and software; algorithms and data; and information and knowledge.
Health Informatics Functions
High Level Categories
1. Needs identification/assessment – Identify opportunities to improve
processes or outcomes using information & related technologies.
2. Solutions- Meets identified needs by identifying and implementing
appropriate solutions. Approaches may include: modifying, deleting
or developing innovative technologies, policies & processes.
3. SME- Consultation services.
4. Policy/Governance- design, develop, implement and oversight of
information & technology related policies.
5. Data gathering, analysis, synthesis & reporting.
6. Education- educates staff, leadership, trainees, etc. re: informatics
needs, solutions, principles and practice.
Health Informatics Functions cont…
7.
Evaluation-evaluates impact of information technologies, policies &
processes on safety, efficiency, efficacy, cost, quality, usability, work
flow, satisfaction & other key metrics.
8. Coordination & Liaison role among clinical, administrative, & technical
staff, and other stakeholders.
9. Information Stewardship- ensuring the ethical use of data as well as
data integrity, security, & confidentiality of PHI.
10. Leadership/administration/management as required to execute other
essential functions and solutions.
A little VA History
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Use of computers in care delivery began back in the 60’s and were used to
perform lab tests, keep drug inventories and capture and transmit EKGs.
In the 80’s and 90’s, VA blazed the electronic medical record trail and rapidly
gained recognition as a world leader.
Pioneered Bar Code Medication Administration
“Automated Data Processing Coordinators” (aka: ADPACs) – were communities
of health informatics practice (although nobody really used the term
“informatics” back then!) in VHA largely evolved out of the need for medical
center staff that were clinically proficient and had a technical skill set needed
to implement and manage discipline-specific Decentralized Hospital Computer
System (DHCP)software packages.
Read the whole history by Peter Groen in the document library at this website:
http://vista.med.va.gov/
You will also be able to see a recorded presentation by Peter on this subject in
October 2011.
A personal history of the speaker
• First taste of the power of computers for clinical practice in
grad school in the late 80’s and all I wanted from the
course was to learn to word process!
• Saw a VA ad for “Nursing ADP Coordinator” in 1991.
Nursing , teaching and computers all in one job? I’m in!
• No formal education for the job. Learned by reading
manuals, networking with peers and lots of trial and error.
• 1996, ANA first offered a certification in Nursing
Informatics. Studied books and scope and standards of
practice to prepare for the test.
Today in the VA
• “Informatics” is not currently formally recognized in the VA HR system
(except nurses use an HR assignment code for Informatics).
• Some health informatics professional communities are highly
formalized and offer academic degrees, internships and/or
certifications in health informatics.
• More commonly, staff is assigned to the role of implementing and
managing software packages and other major technologies which
automate clinical or health care processes with little or no formal
training in that role.
• We need, more than ever before, medical center staff that is clinically
proficient and has a technical skill set needed to implement and
manage the vast information and technology resources at every VA.
Create Health Informatics Capacities
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Transforming Health Care Delivery through Health Informatics (aka Health
Informatics Initiative or hi2) is a new VA Major Initiative that will assist with
VHA’s transition from a medical model of care to a patient-centered model of
care and to build a sustainable collaborative between the Veterans Health
Administration (VHA) and the VA Office of Information and Technology (OI&T).
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The Health Informatics Initiative is composed of three workstreams.
(Workstreams A, B and C).
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Workstream C, Create Health Informatics Capacities. Workstream C (WSC)
develops the Health Informatics workforce and enhances organizational
informatics capacity through competency, career and community
development.
And outside the VA…
"Because we are serious about transforming our system of health care to be
safe, efficient, timely, patient-centered, equitable, and effective, we must
invest not only in technology, but also in the education and training of
individuals to ensure our workforce is poised to meet this challenge. One of the
factors most important to the success of health care information technology
projects is the engagement and participation of clinicians. There must be a
cadre of health care professionals (physicians, nurses, and others) who have
knowledge and skills beyond their clinical training. Virtually every hospital,
clinic, physician office, or other health care provider organization will in some
way utilize information technology solutions in the coming years and will need
health care professionals versed in informatics to assist with the
implementation, use, and success of these systems."
Don E. Detmer, MD, MA
Senior Advisor & Former AMIA President & CEO
Workstream C
• Competency Development
• Enhance and/or develop the Informatics and Analytics knowledge
and abilities of VHA’s Health Informatics personnel
• Career Development
• Establishment of Informatics related jobs and job series that
support and require a natural progression of informatics skills and
responsibilities.
• Community Development
• Establishment and enhancement of social/professional networks of
informatics and analytics practitioners.
• Leverage those networks to collaborate on health informatics
issues affecting the delivery of care across the enterprise.
Competency Development Activities- FY 2011
• Health Informatics Training Plan
• Analytics Training Plan
• Goal– Increase the number of educational opportunities for
VA staff
– Promote memberships in professional informatics
organizations
– Encourage staff to obtain certifications from nationally
recognized bodies
VA Health Informatics Training Course
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Modeled after the American Medical Informatics Association 10x10 program
which has as a goal to train 10,000 health care professionals in applied health
and medical informatics by the year 2010.
Like the VA, AMIA “believes that strengthening the breadth and depth of the
biomedical and health informatics workforce is a critical component in the
transformation of the American health care system”
The content of the course is meant to represent the domain of Health
Informatics in a general sense, not specific to any particular subspecialty e.g.
Medicine or Nursing etc.
Participants who complete the coursework and skill building exercises will be
awarded an AMIA 10x10 certificate.
Some modules will have Pharmacy continuing education credits.
Health Informatics training components
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Fundamentals
– Intro to Health Informatics
– The Health System
– History of DHCP and VistA
Clinical Decision Support
– Medical Decision Making
– Test Characteristics
– Types of Decision Support
– Users of Decision Support
– Implementing/Maintaining tools
– Knowledge Modeling and Maintenance
– Legal, Quality and Other Decision Support Issues
HI course continued…
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Evidence-based Patient Care
– Evidence sources, grading and guidelines
– Implementing guidelines as clinical algorithms
Clinical Workflow
– Methods of Workflow Analysis
– Principles of workflow re-engineering
– Quality Improvement principles and practice
Human Factors Engineering
– Models, Theories and Practices of HCI
– HCI Evaluation and Testing
– Interface Design Standards and Principles
HI course continued…
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Data standards
– Standards Development and Processes
– VA Data Standards Overview
Information System Lifecycle
– Clinical Information Needs Analysis
– System Implementation
– System Testing
– Disaster Recovery
– Clinical Information Systems Evaluation
Leading and Managing Change
– Leadership Models and Practices
– Teams
– Communications
– Project Management and Planning
– Change Management
Healthcare Analytics Training
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Leverage the VA Nebraska Western Iowa Health Care System (NWIHCS) Basic
Analytics Learning Modules and Healthcare Analytics Certificate Course to
provide analytics curriculum and training to VA staff nationally.
Develop and maintain a national VA staff that are proficient in the ability to
apply basic micro-analytics methods to their routine daily activities
Develop and maintain VA staff at every facility that have advanced analytics
capabilities
Healthcare Analytics Training (cont…)
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Develop and maintain a cadre of VA personnel who are trained to provide onsite education in essential micro-analytics knowledge to other staff
– These individuals not only must be trained in adult education theory and
basic analytics methods but also must have a strong operational
knowledge of the use of basic tools so as to provide mentoring support.
– The EMAK education specialists would be responsible for developing data
providers and information explorers.
Career Development Activities
• Identify Top 10 Informatics functions.
• Develop Duties that speak to the functions.
• Examine known position descriptions and functional statements to
identify existing, new and evolving duties.
• Identify Job Series and Job Family to enhance informatics capacities
and promote professional growth.
• Establish career paths that would guide educational offerings.
• Plan for Recruitment and Retention activities.
– identify existing informaticists
– utilize lessons learned by nursing service to assign codes to “tag”
informatics personnel in HR systems
Community Development
• Community Group Members- Diverse by design!
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Nursing Informatics Specialists
BCMA Coordinator
EES Representative
GHTAP Fellow
Office of Training Strategy Representative
Behavioral Health
HAS
Dental Informatics
Medicine
Pharmacy Informatics
Imaging
Emerging Health Technology Representatives
Nutrition
Pathology and Lab
Field CHIO
BioMed
Community Development Activities
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Provide hi2 orientation and ongoing communication and engagement efforts with
identified VHA health informatics communities.
Work with the Public Relations team and other Health Informatics Initiative (Hi2)
teams to create a clearer picture of what health informatics is, what value health
informatics personnel bring and to create new opportunities to build cohesive VHA
health informatics communities.
Take advantage of the services provided by the Office of Health Information
Product Effectiveness Team to gather demographic and descriptive information
about VHA Health Informatics communities and use that information to identify
current needs and actively plan strategies for future community growth and
development.
Leverage existing and emerging communication and collaboration tools (e.g. hi 2
Intranet portal and PR efforts, Outlook mail groups, VA Clinical Wiki, My VeHU
Campus).
Fully endorse the acquisition of an Enterprise collaborative tool set in FY 2011.
Pilot test any new tools that become available.
Community Development Activities (cont…)
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Work with Training Strategy group to deliver a virtual national Informatics
conference in Fall 2011 and a face to face conference in March 2012.
Engage the services of non-VA researchers/analysts/thought leaders on social
technology to:
 further educate hi2 staff about the risks and benefits of social technologies
 learn of use cases for social technology
 identify new strategies that might support the transformative efforts of the
initiative.
Participate in the larger discussion of strategic planning, policy setting, and
governance of social media use in the VA.
Can we do it? Yes we can!
• The Health Informatics Initiative (hi2) is a three year funded
project.
• Enthusiastically supported by VHA Leaders.
• Talented, motivated and experienced practitioners of
health informatics are everywhere in VA!
The future is bright and it’s all happening now.
Follow the initiative here: http://hi2.med.va.gov/
Questions?