суббота, 15 сентября 2012 г.

President's message: career paths to clinical informatics. - CARING Newsletter

With the increasing number of major health information technology (HIT) initiatives many are wondering where they will find the skilled workforce to successfully implement and achieve meaningful use. At our first ANIA-CARING regional networking event in January a major theme was how can I prepare to be selected for a job in HIT? Fostering expertise in informatics is one of the major purposes of ANIA-CARINGTM. This month we are sharing how some of the board members became involved in informatics to give you some ideas for your career path.

The three strategies that were instrumental in my informatics career path are HIT experience, networking, and education. The following are short stories highlighting how these strategies played a major role in my early transition from a clinician leader to informatician.


As a Director of a busy emergency department/trauma center in the early 90's we had issues with patient boarding, and long ED lengths of stay (LOS)-sound familiar? We needed a better system than the current white board to communicate patient status and 'what needs to be done next?' Also I desperately needed data to determine what was really causing long LOS and where to focus our efforts. Was it related to slow turnaround of radiology, lab, consults, or what? We struggled with data collection: we asked staff to collect data, we asked charge nurses to collect data, and we hired medical students. Much time was spent doing these studies, trying to get enough data to understand causes and generate solutions. Each time we presented a proposal for additional resources, administration would question and/or want more data before they would approve.

A patient tracking system was needed to facilitate patient flow and to provide ongoing data to make departmental strategic decisions. We evaluated the various vendor applications and found them lacking. Our IT staff met someone at a user conference who agreed to share code from a system they built and we decided we would configure our own in the current registration and order entry system. Long story short I became the project lead and worked closely with IT staff to create an ED tracking system with many reports that was in place for 14 years. It was a big scary leap to move from a director position to a project lead position but I gained invaluable beginning knowledge and skills in system selection, design, implementation, report writing, evaluation. On future projects that were not as successful, I was able to appreciate how active participation of an interdisciplinary team, an integrated system and administrative support contributed to the success of my first IT project.

Networking and Education

At the suggestion of an HIT colleague I attended a conference called 'Project World' (1) . I discovered a whole new discipline of project management (PM) with its own curriculum, certification, education and consultants. While the nursing process and Kurt Lewin's change theory (unfreeze, change, freeze) worked well with the ED project I knew I needed something more robust for implementing CPOE in early 2000. I was so impressed with the keynote speaker, Doug DeCarlo (2), that I followed him back to his booth. I entered their drawing for a free Project Management Class and I won! But it was in Connecticut and I was in Kentucky. I really wanted to attend, so I used my vacation and frequent flyer miles. Do not think this one class made me into a PM expert. I invited Doug to UK to present a workshop to the entire CPOE team which gave us a robust foundation for leading this project to a successful implementation. Initiating and maintaining professional relationships has repeatedly added to my repertoire of knowledge and skills. Also the importance of looking outside of our discipline to find experiences and research that can be applied in healthcare.

As with PM, informatics has its own body of knowledge. As I did not receive informatics education in undergraduate or graduate school I obtained it through primarily through HIMSS conferences (3) (This was before I was aware of ANIA and CARING of course). Again, an IT colleague encouraged me to join. Our CIO supported my membership activities and funded conferences attendance. Invaluable knowledge was gained from attending classes, visiting the booths and networking at receptions and during breaks. As a committee volunteer I became involved in initiatives that increased my understanding of HIT and provided access to experts for advice and consultation.

Networking, continuing education and new experiences have served me well in achieving my career goals. But this is not the only path I would recommend as there are many formal informatics programs that are now available. I hope to hear from you how your networking, education and experiences in ANIA-CARING[TM] have helped you in the development of your informatics career or contributed to your projects success. If you would like to share 'your story' on the ANIA-CARING[TM] webpage (in 300 words or less) please send them to Webmaster@ANIACARING. org. Current stories are posted on our webpage under Communities--Getting Started.

(1) http://www.iirusa.com/projectworld-info/eventhome.xml

(2) http://dougdecarlo.com

(3) http://www.himss.org/ASP/index.asp

Victoria M. Bradley RN, DNP, FHIMSS