There was an interesting post on linked in from one of our industry partners highlighting the complexity of health informatics and how it was hard to understand, vague, and fast moving, and how we need make it more accessible. Are we not accessable? and if we are what more do we need to do to help change this?
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I think the accessibility (or perceived lack of) might come hand-in-hand with not understanding what health informatics is and therefore not knowing where or when or who to reach out to? What are your thoughts on this Nathan?
Amongst my team and wider discussions in the AHST group we have touched on:
- how do we develop the community (i.e. get people into clinical informatics? It is quite a big leap - especially if people do not have an understanding of what informatics encompasses… I was fortunate to be seconded into a clinical informatics role when I stepped out of clinical so it felt a lot safer!)
- how do we educate the communities we work with on what we do?
No answers yet but keen to hear anyone else’s wisdom in this space!
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I’ve been pondering this thread off and on for a few days. I struggle with when I’ve created informatics architecture content not knowing how to share it with people who might want to contribute and feedback. We have our formal / traditional channels, and I have some informal ones… but I’d like to imagine a world where this could also easily include secondary clinicians, primary care, St John, LMC’s, etc… and I wouldn’t have to wait for it to be perfect before sharing it (I’d much prefer to share when it is in draft). It’s hard to overcome the fear of having something wrong…
Sorry, I don’t have answers but just echoing needs for collaboration and inclusion. Attached is an example of something I’m talking about - admittedly it’s oral health and could be a bit niche but is an example of the type of content. How do I share and get feedback?
Oral Health architecture-v07.pdf (2.5 MB)
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In my mind, this is the direction that the eHealth Forum really should go in. We are part way there already, in that we are a community of Health IT interested folk from all walks of life - including a small but valued group of health @consumers. We also have @dental, who in particular might find your Oral Health architecture document both interesting and helpful.
To extend the reach maximally, I’d like to throw at least some of the eHealth Forum open to the public. This would make forum posts discoverable via Google searches (and the like), and increase the chances that those who are interested and searching will stumble across it and contribute to the conversation constructively. This would certainly make the eHealth Forum more accessible, and potentially empower us to make our health informatics systems more accessible.
Would you be up for sharing that type of document (MoH logo and all) publicly? Maybe a redacted version? Or would it suit to restrict it to a trusted selection of folk such as all HiNZ members or all eHealth Forum users?
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Regarding opening some of eHealth Forum to the public… really interesting concept and I personally love the move towards greater transparency.
The current state issues, security content, design gaps would need to be carefully considered for potential misuse or media attention - perhaps some content removed, and we would need to accept that this might generate unwanted attention, but I think in the long term it would be a real win.
Sharing in draft is also a risk as content can change, so perhaps sharing only when it reached a level of certainty (to prevent perception of committing to something and then changing it).
I’ve asked my group for their thoughts on the matter as well.
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Feedback from my team is that the persona’s / user stories would be ideal to share with public but that we should probably separate out just those components and share them.
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@MelanieConsedine it is probably a combination of both.
I guess this relates to the historic project based nature of Informatics, with a majority informatic roles starting with delivering a piece of work, an upgrade or introduction of a new system/ new way of working.
Projects only really take off if they are funded and resourced well enough.
Secondments are great for that, giving people the opportunity to work on projects while maintaining clinical registration and workload. However, getting one is down to being in the right place at the right time.
We are however starting to see more clinical informatic roles being established which is great. We will need more of these roles to help prioritise what projects need to be done first and how to help address some of the issues we face as a result of piecemeal project by project approaches to change and dealing with technical debt and various silos we have in the sector.
This is potential another barrier to entry and the sheer frustration from other clinicians about the amount of effort to change something, which seems so simple. Getting people to understand this is hard
“Ward Cunningham in 2003. He said, 'technical debt is what you feel the next time you want to make a change.”
This is from a great book by Gene Kim the Unicorn project and a great way to understand potential ways forward for us in health.
Look forward to seeing others thoughts and discussion, sharing ideas and discussion is the best way to break those accessibility barriers.
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@david.vink thanks for sharing. Perfection is the enemy of the good and sometimes putting it out there is a good way to initiate discussion.
I think you just did, it is getting late and will try have a read through this later this week. Initial review highlights some really awesome UML diagrams, that look very well thought out and what is needed for a technical audience.
Also some wicked problems to address like maintaining intraoperability, and navigating a private/public funded delivery of care model.
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Great post Nathan. A wise man, i believe Einstein once said something along the lines of “if i cant explain it simply enough i dont know it well enough”. The art of simplifying the complex to make it understandable and meaningful is surely a skill we all as clinicians have… so if we arent achieving it, why?
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Just joined so trying to get up to speed on the narrative in this space.
I consider the demystification of informatics to be a priority. When there is a lack of comprehension as to what informatics entails how can we possibly engage with either end consumers or service providers in a meaningful and beneficial manner?
The socialisation of informatics and the appropriate adoption of co-design methodolgy therfore has to be considered. With that in mind I was pleased to see reference to transparency and sharing/promoting access through different platforms/forums.
Am liking what I am reading so far and look forward to see what eventuates collaboratively in this space.
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In further consideration of accessibility of Health Informatics I was wondering about improved communication pathways to evidence utility and therefore improve accessibility.
What came to mind was how we gather data for KPI’s. This information from a clinicians perspective can often seem to disappear into an abyss with no obvious correlation between the data gathering and submission process and daily clinical practice. The specific example that sprang to mind was Health of Nation Outcome Scales (HoNOS) used in mental health services. The broad understanding from service providers is that this KPI has a relationship to contract specifications and funding. Is that good enough given compliance reporting seems an ongoing challenge?
How can communication strategy be developed and used to better effect not only compliance with KPI reporting, this being an obvious short term goal, but more importantly improve service delivery and clinical outcomes?
Welcome Alex! A very welcome face on this forum 
Thanks. An incredible wealth of info to get my head around. Great to see some of this dialogue
