Reddington Hospital Group Learning and Development.
KarieRyanPresentation41316v3
1. Development of a Clinical
Informatics Strategy in a Medical
Group Practice
KARIE RYAN, RN, MS
2. Clinical Informatics Defined
A team of clinicians who are experts in clinical workflow, systems
education and change processes; including system design,
implementation and adoption of technology in the clinical
setting.
3. Clinical Informatics Strategy
To develop a team of clinical experts to support clinical
workflow optimization, systems education, and change
management. In addition, the team will assist in system
optimization, implementation and adoption of technology in
the medical group practice. This will be accomplished in
cooperation with medical group leadership, medical group
providers and information technology leaders and associates.
The strategy will consist of three elements: process
development, education and human capital.
5. State of the Business
Medical Group
100 providers
Acquired large physician practice
Totaled 250 providers
2 distinct cultures
2 instances of same EMR
Variability in practice standards
Variability in practice by roles (MA, MD, ARNP, PA)
Generic onboarding education for all roles
6. Desired State
Merge into one instance of the EMR
Standardize practice
Standardize roles
Implement a change management process
Implement education standards and competencies
Implement role-based onboarding education
Implement standardized communication
7. State of the Department
CI Acute Care Team
Developed 3 years ago
Staff well known to clinicians
Well defined processes
Clearly defined roles (CI vs IT)
Standard communication
12 CIs, 5 Physician Educators, 7 Clinical Educators
Medical Group
IT team did full EMR support
Processes not well defined
Lack of role clarity among clinical support roles
8. 3 Elements of Informatics Strategy
Process
Development
Education
Human Capital
9. Process Development
Prioritization
• Service Request Intake
• Triage Committee
(service request review)
• Resource Planning
Change Process
• Communication
• Testing
• Release
Management
Incident Intake
• CTIs Developed
• Incident Management
• Separation of incidents
from service requests
10.
11. Education
Onboarding
• Role Based
Training
• Standard training
plans
• Competency
development
Rounding
• Geographic
assignments
• “Uniform”
Release Management
• Standard templates
• Communication
• reliable email
groups
12. Human Capital
Clinical Informatics
• Workflow design
• Adoption
• Test plan
development
Provider Education
• Onboarding
• Rounding
• Change
Management
FTEs
• 4 Clinical
Informaticists
• 5 Provider
Educators
13. Implementing the Strategy
Leadership: Acute and Medical Group
CNIO, Director, Manager
12 Cis in Acute: 4 were moved to Ambulatory
New Provider Educators (PEs) were hired
Lots of support!
Socialize the Plan with Medical Group leadership and IT Staff
Clarify Roles of CI and IT
Hire new PEs
14. Implementation Con't
Charter Triage Committee
Design Change Management workflow
Design Release Management workflow
Design Education Plan
Transition onboarding from IT staff to CI Education
Participate in System standardization teams
Standardize and initiate the Communication Plan
15.
16. Then What Happened...
Challenges
Culture
Technical challenges
CI and IT role- additional clarification
needed
Shifting organizational priorities
Lessons Learned
Role clarification throughout the
organization
Separate team leadership would be
ideal (competing priorities with acute
care)
Elevate the role of the CMIO in the
implementation strategy
Define clear expectation on the role of
the business unit
17.
18. Next Steps
Evaluate all processes and modify as needed
Engage the informaticists in more business and clinical processes (registration,
revenue cycle, care management)
Implement a business relationship role for the medical group
Transition more Acute CIs to Medical Group/cross functional
Right size the Provider Education group
Continue to standardize practice across locations and specialties
Each organization has their own definition of CI
It’s important to define the scope of CI in our organization.
With CI defined, I can now define the strategy.
It’s important to understand the make up of the entire organization to understand where this strategy fits in.
The State of the business at the time of developing the CI strategy is important as I will later describe some of the important challenges we encountered. But this sets the stage for the project itself.
Where were we headed? We went into the implementation after defining the desired state.
Describe…
To finish putting everything into context, it’s important to define further describe the state of the CI dept.
Success in the acute setting led to lots of organizational support for the provider educators
No one to train the CIs: used key staff to expose them to as many aspects of the business as possible.
