This week, I gave several presentations on the topic of clinical transformation, sharing results from our recently published survey that was jointly developed by HIMSS and McKesson. It’s interesting to note that while numerous healthcare organizations have been advancing clinical transformation initiatives for several years, to date, there is no widely adopted, standard definition.
The HIMSS Clinical Transformation Survey has the following definition, which we offer for industry use.
Clinical transformation: Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and IT implementation. By effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise.
The goal of this survey was to learn about the strategies that healthcare organizations are using to leverage clinical processes, organizational behavior and emerging technologies in the current healthcare environment to drive transformation. It’s clear from the survey results that clinical transformation is being implemented as an enterprise-wide effort. It’s a continual process, and, as one would hope, nurses and physicians are well represented on the transformation teams. It is also clear that organizations are challenged by the multitude of influencers driving the use of quality metrics including Meaningful Use/ARRA, other federal initiatives, The Joint Commission and the National Quality Forum.
Other key takeaways from the survey include the finding that while executive support is evident for clinical transformation efforts, human resources, though qualified to support the initiatives, are being stretched very thin.
Also, business intelligence tools and data repositories/warehouses are not yet being fully leveraged to extract the data necessary to analyze and improve care delivery and outcomes.
It’s easy to understand the role of technology, systems design and use for identifying inefficiencies and controlling costs, but clinical informatics competencies become necessary when an organization is evaluating clinical workflow, processes and measuring quality. Today’s workforce is challenged by the emerging demands of clinical transformation, not only as a result of barriers such as data not being defined consistently, or captured in discrete fields, but also by our own lack of competencies around data analysis and eliciting clinical and business intelligence.
The urgency we are experiencing to advance EHR implementations and realize financial incentives has created an environment where recruitment of “all hands on deck” is occurring to simply get the job done. On-the-job training remains a common strategy for achieving IT implementations in healthcare organizations today.
The majority of respondents in the 2003, 2007 and 2011 HIMSS Nursing Informatics Workforce Surveys indicated they have no formal informatics education or training. To be able to achieve the goals of clinical transformation to “…assess and continually improve the way patient care is delivered at all levels in a care delivery organization,” we need a workforce that is knowledgeable in data mining and predictive analysis, with skills in using clinical and business intelligence tools.
If you have those competencies, you will soon be in high demand.
The rest of us welcome your thoughts and ideas on where and how to go about getting them!