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Impact of Meaningful Use Requirements on Health IT Leadership

One legacy of HITECH will be the role of meaningful use requirements in driving the hiring of clinical informaticists.

By Kyle Murphy, PhD

- A new white paper by the AMIA Task Force credits the creation of the EHR Incentive Programs and meaningful use requirements with spurring demand for health IT leaders trained to keep pace with healthcare reform and health IT innovation.

AMIA Task Force credits meaningful use with driving clinical informatics

"Through financial incentives, MU increased EHR adoption with more clinicians interacting directly with clinical information systems. Subsequently, healthcare institutions increased efforts to address clinician reluctance and resistance in the adoption of clinical computing applications," the task force convened by the American Medical Informatics Association (AMIA) writes in an article published in Applied Clinical Informatics.

Enter chief clinical informatics officers (CCIOs).

"A medical informatics leader, familiar with clinical workflow and the impact of EHRs on communication and workload, understands and effectively promotes the advantages of HIT systems to patients, clinicians, and organizations, and can be an important component in the implementation and maintenance of EHRs and other HIT tools," the group continues. "Further, CCIOs have played a lead role in ensuring that technology supports the emerging and growing changes to healthcare payment models based on value and outcomes."

The task force defines the role of CCIOs — Chief Medical Informatics Officer (CMIO), Chief Nursing Informatics Officer (CNIO), Chief Pharmacy Informatics Officer (CPIO), and Chief Dental Informatics Officer (CDIO) — as working with healthcare CIOs to ensure the efficient and effective use of health IT by clinicians.

"With pervasive information technology affecting most patient care processes, health care organizations must pay attention to the knowledge, education, and skillset of CCIOs, who serve as vital links between CIO and the clinical communities," the group maintains.

Despite the importance placed on CCIOs, the task force calls attention to deficiencies in knowledge, education, and skillsets that could ultimately prevent these emerging health IT leaders from achieving those goals relative to technology, such as physician EHR use.

"As knowledge of the field of Clinical Informatics grows, it is imperative that leaders possess informatics knowledge as well as the leadership skills to assume the role of change agent needed to successfully implement knowledge in clinical practice," it claims.

According to the task force, many healthcare organizations moved quickly to fill leadership positions focused on clinical informatics following the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act and meaningful use requirements. The rush to do so is responsible for the diversity of individuals who fill the roles of CCIOs that has highlighted knowledge, education, and skillset gaps that healthcare organizations must address in order to meet regulatory requirements for quality reporting and other health IT initiatives successfully.

The AMIA Task Force recommends a handful of changes for healthcare organizations to implement. The first deals with "clearly defined and specified" education and training in clinical informatics.

"Formalized education and skillsets resulting in certification are becoming critical to all senior roles in Clinical Informatics (i.e., CCIOs). The complexity of implementations and optimizations required for Clinical Information Systems demands such education and training," it notes.

Second, healthcare organizations must place appropriate value on education and experience, both of which are contribute to the success of CCIOs.

Third, they should consider combination educational resources as a result of the commonalities shared by clinical informatics disciplines.

 "With the exception of the domain specific knowledge, the knowledge and skillset required for a successful CCIO are very congruent," the task force states. "As a result, it is feasible and desirable to combine some aspects of the education for future CCIOs to include all disciplines. Combined training will reduce costs, improve the quality of education, and will allow an early development of appreciation of the CCIOs in other domains."

Fourth, certain disciplines have more work than others to improve their education requirements, dental and pharmacy, so that these leaders can work with their peers in other areas on quality improvement.

Fifth, education requirements must adapt and evolve with the times. " Informatics by its nature is centered on rapidly changing technology and innovation that creates novel ways of conducting clinical care. For organizations training Informaticians this will require frequent reassessments and modifications to the curricula as would be true of any knowledge-based discipline," the group advises.

Lastly, the healthcare industry as a whole has the responsibility to share insight into CCIO knowledge, education, and skillsets to improve the hiring and retention of these health IT leaders.

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