The increasing role of information technology (IT) in healthcare, or "healthcare informatics," is well established and continues to permeate healthcare interactions. While healthcare IT pioneers often
started within the hospital environment, mounting attention is now being given to informatics in medical groups, as well.
Front-line physicians in these groups are progressively turning to information technology to help them perform their clinical functions. With this transformation comes the need for physicians to take leadership roles in determining how information technologies will influence clinical work flow.
This role may range from serving as chief medical information officer or medical director of information systems to less formal positions, such as the "computer doc" for a small group. Whatever the title and time commitment, many of the essential duties will be the same.
On a role
A physician in an IT leadership position is, foremost, a "physician champion," representing and working with physicians when choosing, designing and implementing clinical systems. His or her main responsibilities include creating a strategic vision, winning executive support, helping obtain funding, supporting the tactical aspects of managing a project and getting physicians to effectively use the chosen system.
This physician-champion must oversee the formation and leadership of a clinical IT project team and clinical advisory groups; vendor selection and contract negotiations; subsequent system customization and implementation; and ongoing support.
Possibly the most difficult of these responsibilities involves physician adoption of clinical information systems. A physician IT leader must fully understand how to get his or her physicians to want to change and how to support them so changes are handled effectively.
Physician leaders need to understand the physicians working with them. Leaders should perform a needs and work flow analysis to assess hot topics such as time, money, quality and autonomy. These analyses will help in understanding both what physicians think they need and what they really need.
The long and short of it
Early on, physician IT leaders should be involved in creating cultural and technical foundations for using information technology in a clinical work flow; identifying the informational needs and errors suffered by their physicians; and stimulating interest in satisfying those needs and decreasing those errors by effectively using information technology.
Physician IT leaders should begin with these initial projects: ensure computers, applications and high-speed connections are available for all physicians; develop a physician-focused intranet site; and create an e-mail policy for physicians and patients.
Long-term projects will involve more sophisticated clinical IT applications such as electronic results reporting, computerized physician order entry and electronic medical records.
Wealth of resources
Physician IT leaders have multiple resources available to help them better perform their jobs. One of the most important of these is the Association of Medical Directors of Information Systems (www.amdis.org). The mission of AMDIS is to advance the field of applied medical informatics and encourage the direct use of information technology systems in the practice of medicine.
The Informatics Review (www.informatics-review.com), an associated Web site, provides a number of useful resources, including summaries and comments about the latest published information of interest to physicians responsible for information systems.
Other important organizations to consider include the American Medical Informatics Association (www.amia.org), a more academic organization dedicated to developing and using information technologies to improve healthcare; and the Healthcare Information and Management Systems Society (www.himss.org), one of the largest healthcare IT societies in the world.
Educational resources include short- and long-term informatics training programs (www.amia.org/resource/acad&training/f1. html), various IT courses taught by medical societies and distance learning courses, such as those offered by the Oregon Health Sciences University (www.ohsu.edu/bicc-informatics/distance/).
The role of physician leaders in creating and supporting clinical IT systems will continue to grow. This role will become increasingly well defined and expand in influence as information technology continues to spread to every facet of the clinical work flow.
Interested physicians should become educated and involved now so they can make an impact as projects move forward within their organizations.
Lyle Berkowitz, M.D., is a faculty member at Northwestern University Medical School in Chicago and practices internal medicine with Northwestern Memorial Physicians Group (NMPG), where he is medical director of clinical information systems. He is a member of the Modern Physician Editorial Advisory Board.