Population and Public Health

The pressure to shift to value-based care means providers must understand their patients more deeply than in the past. Achieving that as part of a population health management program demands rethinking existing processes.

The number of chief nursing informatics officers has increased in health systems over the past five years, with more designated CNIO-positions than ever before. The bump comes at a time when the need to bridge the gap between clinical and informatics increasing, according to a recent report commissioned by the workforce search firm Witt/Kieffer.   The research team surveyed 100 respondents from medical centers, independent hospitals and hospitals part of a larger health system to examine the evolving role of the CNIO and whether organizations are recruiting for the position to support the informatics landscape. These results were compared to a similar survey conducted in 2011.   Overall, there are 10 percent more CNIOs in place in organizations than compared to 2011, according to Chris Wierz, principal, Witt/Kieffer Information Technology Practice. While some organizations have created the position of CNIO, others have modified roles to incorporate the CNIO title.   "CNIOs now have a 'seat at the table," Wierz told Healthcare IT News. "From a CNIO perspective, it's so much about collaboration and consensus building; getting those groups of people together when it comes to IT. It's always been about trying to bring disparate groups together to understand the workflow around the electronic medical records and today's IT."   "Communication is a very large role, as well," she added, "acting as a translator between IT and my clinical staff. The ability to articulate your knowledge of IT and clinical is critical in this role."   Depending on the organization, the CNIO is responsible for EMR implementation, clinical IT, optimization of nursing strategy as it relates to IT, and creating a picture of day-to-day operation on clinical IT matters, Wierz said.   Despite the need to bridge these departments, Wierz said there are still many barriers to overcome before the role becomes more commonplace. "One of the reasons this role isn’t gaining enough traction is that there's an IT resistance to it."   Some organizations are lacking the funding for establishing the CNIO position, while other hospitals indicated their organization wasn't big enough to require one, according to the survey.   "Some people will say the reason why they're not implementing a CNIO is because then are you going to need even more "chief" roles," she added. "It's going to be interesting to see whether the CNIO turns into a chief clinical role to help with daily operations."   Twitter: @JessieFDavis Email the writer: jessica.davis@himssmedia.com

CIOs and innovation officers point to companies such as Ikea, Lego, Oxo -- and how they have conducted observational studies to effectively understand UX and deliver products accordingly. 

Lake Health, with 14 facilities, staffed by more than 600 physicians and 2,700 healthcare professionals, will be rolling out a Cerner EHR. The goal: support the Lake Health system and its employed providers, as well as create greater integration with its community physician network and to provide the best patient experience possible. Also, patients will benefit from a single health record accessible from a patient portal. “A strong relationship with our medical staff is the cornerstone of who we are, evidenced by their role in our mission and vision statements and in working with us to provide high-quality patient and family-centered health care in Lake County,” Jerry Peters, VP and CIO for Lake Health, said in a statement. The EHR will enable the health system to share and receive patient health records with affiliated providers, other area hospitals and participating healthcare entities nationally. Patient data is produced, managed and stored across multiple care organizations in Lake County, Peters noted, and Lake Health was focused on selecting an IT platform that could collect and analyze data from multiple disparate systems. “Lake Health determined that Cerner’s EHR and Healthelntent population health management platforms were the best choice to support its future initiatives and business model,” Peters said. “Understanding that this investment would most likely shape the future of Lake Health and the care we provide to patients, we completed a thorough evaluation of leading health IT suppliers and collaborated with our physicians and ultimately determined that Cerner was the right choice to support our needs now and into the future.” Peters did not reveal the anticipated cost of the technology. Cerner’s Healthelntent platform aggregates and normalizes data from various sources in near real time, regardless of EHR supplier and is designed to provide physicians and mid-level providers with meaningful data to identify and stratify populations to locate gaps in care.

At Healthcare IT News' inaugural Pop Health Forum 2016 in Boston May 19 and 20, clinicians, technology professionals and healthcare experts from across the country are gathered to explore the key enablers of effective population health management strategies: data and analytics, care coordination, patient engagement and more. Check back here for continuous updates.

Proponents of virtual care say it is the wave of the future. But while the healthcare industry might not find much disagreement with the practice in theory, it is in the potential limitations that skeptics might find flaws.

UC Health – the flagship University of Cincinnati Medical Center, as well as 167 of its affiliated practices – has reached the Stage 7 on the HIMSS Analytics EMR Adoption Model. HIMSS Analytics developed the EMRAM in 2005. Its eight stages (0-7) track a hospital’s implementation and use of health IT applications. In 2011, it launched the ambulatory model, meant to evaluate the progress and impact of EMRs for ambulatory facilities – physician practices, outpatient centers and specialty clinics – owned by hospitals in the HIMSS Analytics Database. Only 4.2 percent of more than 5,400 U.S. hospitals in HIMSS Analytics' database have attained Stage 7; just 7.9 percent of more than 34,000 ambulatory clinics have scored a Stage 7 Ambulatory Award. [Also: Benchmarks: Stage 7 success stories] UC Health, the University of Cincinnati’s affiliated health system is the region’s only academic health system.  It includes University of Cincinnati Medical Center, three additional hospitals, and the University of Cincinnati Physicians, Cincinnati’s largest multi-specialty practice group with more than 700 board-certified clinicians and surgeons. John H. Daniels, global vice president of HIMSS Analytics' healthcare advisory services group, said UC Health "has gone above and beyond the EMRAM Stage 7 criteria. They have already extended the closed-loop medication administration process to their infusion clinic and for interventional radiology cases. Combined with a strong population health program, the UC Health team is making a real difference in their community." "This accomplishment is due to our commitment to improved patient outcomes through the expanded use of information technology," said Jay Brown, UC Health's senior vice president and chief information officer, in a statement. "As the region’s only academic health system, we are surrounded by innovators and visionary leaders who have recognized the importance of leveraging these tools," he added. "The HIMSS Analytics Stage 7 Award highlights our dedication to delivering the highest quality of care and enhancing the experience of our patients."

Early returns from the Health Care Innovation Awards, a CMS initiative that tests new payment and service delivery models, already "show a wide range of experiences that have resulted in tangible benefits for patients" and have helped the agency develop better policies, said CMS Chief Medical Officer Patrick Conway, MD.

The Agency for Healthcare Research and Quality will dedicate nearly $2 million for the creation of the PCOR Clinical Decision Support Learning Network, aiming to address the barriers hindering the incorporation of patient-centered outcomes research into CDS tools.

After years of dwelling in the shadows of healthcare, the long-term and post-acute care industry may finally be ready to join its hospital colleagues in the IT spotlight.