What is the problem statement?
Clinicians are not adequately engaged in decisions about IT systems.
The best health IT systems will be created by clinicians and IT professionals working together and understanding each others needs.
Lack of governance of clinical informatics
Lack of roles (informatics leads or informatics groups)
Lack of clear procurement process
IT is often not seen as an enabler for getting better clinical care.
Clinical silos for each cinical specialty spending money - lacking co-ordination of IT plans between specialties within one institution.
Require a big picture and clinicians need to be there and respected for influence.
Does anyone do this well or learned from things that have not gone well. Potential solutions: National, Regional, Local
Encourage CEOs to understand that we are in a technology/knowledge business as well as a people business.
Encourage clinicians to become more knowledgeable about health informatics
Encourage IT professionals working in healthcare to become more knowledgeable about clinical needs
Hi,
First, unpicking the problem statement, the reason we believe clinicians are not adequately engaged is twofold: 1) we’re the ones who are the end users; 2) as the historic masters of patient information (after all, we record it for our own benefit) we understand the data much better than someone outside the industry. This particularly relates to the relationships between data elements.
So the basic problem is that without the people who are going to have to deal with the result on a day to day basis, the chances of a useful system are much lower. The outcome of not engaging clinicians (end-users) is an IT system that’s designed with other components in mind that patient care: administrivia, audit, budgets, etc. Many modern IT systems demonstrate this adequately; the strategy seems to be put in a system designed by administrators, then remove some of the bits generating noise (Cerner in Australia being a really good example); you end up with clinicians doing coding and other tasks historically done by Medical Records.
However, because IS is seen as not related to clinical work, involving clinicians in health informatics is still optional enough that we had a talk on how clinicians were passengers on the IS bus last week at ETIH- and by the CIO of one of our DHB’s at that too.
Regarding the “doing it well” question, the successful projects around the country seem to have a clinical driver. I recently had a visit to the UK, and visited a couple of sites there that have rolled out software successfully recently; the take home message in both sites was get the right clinician in front of the project, and keep IS departments at arms’ length However, it’s important to note that someone has to make the decision to let the clinicians drive it, and so there is advocacy needed at a very high level to make this work.