Health Informatics Series Part 2: What types of Informaticists are there? Where do they work? What skills are needed?

Types of Informaticists 

Informaticists tend to have hybrid skill sets with expertise in healthcare, health information technology, and/or healthcare business, operations and management. Some enter the field starting out in healthcare and learn more about the tech aspects (like me) and some start out in tech and gain interest in health and healthcare. I’ve seen a lot of current CMIO’s who have Bachelor degrees in biomedical engineering, computer science, or computer engineering and later went to med school or those who did the traditional medical pathway and then worked at the VA or National Library of Medicine on informatics projects, or those who became project leads on hospitals transitioning from paper to EMR. These CMIO/CIO/CXO/Directors etc have 20, 30, 40 years of experience and helped shape what the field is today.

Informaticists coming in from the clinical side bring their medical expertise and real world clinical experience. They understand workflow and workflow challenges. They also understand the flow of information. Though not necessarily a biller, computer programmer or a health IT tech, they understand those roles and may have some of those skill sets and/or work with folks that have those roles.

From tech side I see folks with deep knowledge in analytics, programming, engineering and who are willing and able to learn about health and the delivery of healthcare. I also would add that everyone understands what it’s like to be a pt.

Clinical and nonclinical work experience are equally important. Technology is now a required pillar in every industry and it’s helpful to have people who are familiar with it and can help leverage it as a tool to solve healthcare’s most pressing and ominous issues.

Places to work 

Informaticists work in all areas of healthcare. I see informaticists in hospitals, outpatient settings, research, consulting, nonprofits, government, startups, Big Tech, academia, think tanks, medical societies, in public and global health, etc. Their titles may not explicitly say “informaticist” but the work they do is very much informatics.

Helpful skills to have:  

-Domain expertise-healthcare and/or tech

-Understanding technical and clinical concepts if starting as an expert in one domain (proficiency will develop as you grow)

-Work well with others and alone-You will interface with individuals from a variety of backgrounds

-Communication skills- You will be translating information for different audiences and teaching new concepts

-Change management-You will be working on new things that may never have been done before.

-Project Management

-Time management skills -often you might be the only one with this blended expertise and you will be involved in many projects, workgroups and activities

-Able to tolerate risk and rapidly changing environment.

-Leadership

-Commitment to Life long learning-The field changes rapidly and keeping up to speed involves reading, webinars, conferences, learning new tools and technologies, practicing informatics, and talking to others in the field. Plus keeping up with clinical guidelines.

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Health Informatics Series Part 1: What is Health Informatics? What is Clinical Informatics?

I’ve received a lot of emails, inquiries, LinkedIn requests, and conversational questions from folks about Informatics, my experiences, and pathways to entry so I’ve decided to write a series on the topic. I’m a physician informaticist with startup and public health experience but I will also include general content as well.

First, let’s start with some definitions:

Informatics (USF definition)

“At its core, informatics is the science of information and all its aspects – storage, how it’s processed, communicated and used. It is mainly thought of today as computerized information, but can also apply to information stored, communicated and used on paper, audio tape or even in someone’s brain.”

Biomedical Informatics (AMIA definition)

“BMI is the core scientific discipline that supports applied research and practice in several biomedical disciplines, including health informatics, which is composed of clinical informatics (including subfields such as medical, nursing, and dental informatics) and public health informatics (sometimes referred to more broadly as population informatics to capture its inclusion of global health informatics”

Health Informatics (US NLM definition)

Health informatics is the interdisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning.

There are also other breakouts in informatics including: bioinformatics, nursing informatics, pharmacy informatics, consumer health Informatics, research informatics, translational informatics etc.

I found this AMIA white paper to be very helpful when trying to understand the broader concepts and breakouts in informatics (first link is the paper, second is the diagram):

J Am Med Inform Assoc. 2012 Nov-Dec; 19(6): 931–938. https://dx.doi.org/10.1136%2Famiajnl-2012-001053

Health IT (Health IT.gov definition)

“is a broad concept that encompasses an array of technologies. Health IT is the use of computer hardware, software, or infrastructure to record, store, protect, and retrieve clinical, administrative, or financial information.”

Digital Health (I’m quite fond of the Wiki definition)

“is the convergence of digital technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and make medicines more personalized and precise. The discipline involves the use of information and communication technologies to help address the health problems and challenges faced by people under treatment.These technologies include both hardware and software solutions and services, including telemedicine, web-based analysis, email, mobile phones and applications, text messages, wearable devices, and clinic or remote monitoring sensors. Generally, digital health is concerned about the development of interconnected health systems to improve the use of computational technologies, smart devices, computational analysis techniques, and communication media to aid healthcare professionals and their clients manage illnesses and health risks, as well as promote health and wellbeing.

A lot of people use these terms interchangeably and there is often overlap, so what I suggest is asking questions about the focus of work, what day-to-day work is like, population served, tools used, level of technical proficiency required, past projects and percentage of time spent in different domains of work.

Some helpful links to informatics societies that can offer a wealth of information:

Healthcare and Information Management and Systems Society (HIMSS) https://www.himss.org/

American Medical Informatics Association (AMIA) https://www.amia.org/

American Health Information Management Association (AHIMA) https://www.amia.org/

International Medical Informatics Association (IMIA) https://imia-medinfo.org/wp/

College of Healthcare Information Management Executives (CHIME) https://chimecentral.org/

As always, my blog posts reflect my opinions and experiences and not those of any of my employer or any affiliations.

 

My 2019 Reading List

I’m a bibliophile and I learn a lot from what I read. I read for fun, but I also read with a growth mindset. This year I want to learn more business concepts and refresh my memory on some old friends. I also am very interested in leadership concepts, tools and advice. If you have any recommendations, please feel free to share, I love learning from the best.

(Also kudos to the New York Public Library for supporting education and learning. I found all these books as texts or e-books.)

  • According to Kotler : the world’s foremost authority on marketing answers your questions / Philip Kotler.
  • Blogging for dummies / by Amy Lupold Bair.
  • Sometimes you win, sometimes you learn : life’s greatest lessons are gained from our losses / John C. Maxwell.
  • Shopper marketing : how to increase purchase decisions at the point of sale / editors: Markus Stahlberg & Ville Maila.
  • The checklist manifesto : how to get things right / Atul Gawande.
  • Build your dream network : forging powerful relationships in a hyper-connected world / J. Kelly Hoey.
  • MBA [electronic resource] : 10 instant MBA lessons / Infinite Ideas, with Nicholas Bate. / Infinite Ideas, with Nicholas Bate
  • Warren Buffett and the interpretation of financial statements : the search for the company with a durable competitive advantage / Mary Buffett and David Clark.
  • Understanding Michael Porter : the essential guide to competition and strategy / Joan Magretta.
  • The visual MBA : two years of business school packed into one priceless book of pure awesomeness / Jason Barron, MBA.
  • The real life MBA : your no-BS guide to winning the game, building a team, and growing your career / Jack and Suzy Welch.
  • The ten-day MBA : a step-by-step guide to mastering the skills taught in America’s top business schools / Steven Silbiger.
  • The Wall Street MBA : your personal crash course in corporate finance / Reuben Advani.
  • The 30 day MBA in international business : your fast track guide to business success / Colin Barrow
  • PM Crash Course, A guide to what REALLY matters when managing projects/ Rita Mulcahy

 

Connect with me on Twitter @doctorcharlene

Connect with me on Linkedin- Charlene Ngamwajasat

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A technical switch from ICD-9 to ICD-10, why it matters

Oct 1 marked the day when many healthcare institutions, insurers, CMS (Center for Medicare and Medicaid Services) switched over from International Classification of Diseases 9 (ICD-9) to International Classification of Diseases 10 (ICD-10). Much heralded in some circles (Europe, Asia and Africa implemented ICD-10 decades ago) and sometimes referred to as healthcare’s version of Y2K in others, it has come about with years of delay, angst, optimism and controversy.

The switch to ICD-10 from ICD-9 isn’t just an increase in the number of codes by tens of thousands (17,000->~68,000), it is an upgrade that is long overdue (ICD-10 was created in 1990). The benefits of ICD-10 include:

  • an improvement in clinical documentation- new updated terminology, inclusion of laterality, illness severity
  • better ability to capture the scope of clinical care and outcome indicators
  • more appropriate re-imbursement (electronic record and evidence of care)
  • added value to technology and health reform initiatives as healthcare moves towards coordinated care models and value-based cost-efficient care
  • better ability to conduct public health surveillance

The downsides of ICD-10 are the costs of implementation and that despite delays, some providers and institutions still aren’t prepared for the system upgrade, which can translate into coding errors, re-imbursement dips, delays in procedure or testing authorizations, and even insurance denials for patients. Fortunately enough, CMS has instituted a one year grace period for claims submitted on or after October 1, but only if the codes submitted for a particular diagnosis are classified under the correct family of codes. As for individual payers, they may have their own set of rules when it comes to incorrectly coded claims.

ICD-10 is a stepping stone into ICD-11, set to be released by 2017. Expectations of when the U.S. will adopt ICD-11 are to date, unknown.

The Founder’s Apprentice, CEO’s Take Note

magician-delete

Credit: CC Pixabay

The concept of apprenticeship isn’t new, in fact the concept of learning a trade from a master craftsmen is quite old (from sushi to stone masonry). What is new is it’s formal application and position in entrepreneurship.

To be clear, an apprentice isn’t necessarily an intern or someone who is 20 years old (though s/he could be). S/he may be forty and looking to change careers or pivot despite the associated challenges. S/he is someone who is interested in a trade and wants to learn the craft from someone with many years of experience (or a knowledge equivalency). S/he is willing to work hard, do any task that is given, and act as the eyes, ears, and hands for her boss-mentor-teacher. She’s passionate about the field, the job, and the opportunity to use her innate skill set and those she has acquired to ramp things up. She’s courageous and resilient, challenges are seen as opportunities, and intellectual curiosity takes precedence over status quo-based procedures. Titles don’t matter, the opportunity to learn, create and change the trajectory of her life and others does.

For founders and CEO’s (of companies large and small), it’s about the injection of fresh energy into the company. It’s about working with someone who has a lot to learn (teaching moments) but is highly motivated and excited about the work that is being done (something you can’t teach). It’s about having a sounding board that is distinct from the “only positive news” bubble. It’s also about paying things forward.

So how does one go about finding an apprentice? The likely case is that s/he will find you. An entrepreneurial apprentice will make you take note of her/him. S/he may not fit into any one job description or have a linear work history, but s/he will exude motivation, passion and purpose.

Put out an ad. Put out a challenge. Make the it known that the once-in-a-lifetime opportunity is available. Ask her questions. Why is she passionate about the field? Why does she want to work with you? What does she want to learn/what can you teach her? What has she noticed about what you’re doing (both good and bad) and how would she change things if she was in your position? What does she believe/know that no one else does?

Challenge yourself. Take on an apprentice. Great people are at the core of any great business, why not continue that legacy?

The Top 3 Innovation Discovery Festivals in NYC

education delete

Credit: CC Pixabay

I’ve always loved interacting with innovators, artists, musicians, techies, and academics and am the first person to try something new, be it a food or a new technology.When I first started my journey into the world of startups and technology, I didn’t know where to start and so I went to every event, meetup, fireside, festival, lecture I could to feed my ravenous curiosity. Along the way, I kept a list of my faves and want to share them with all of you.

NY Tech Day -April 23, 2015, Pier 92, (free to attend)

I was at the first NY Tech Day. I had signed up for a NYC events list and was like, hmmm…I’ve always liked technology, I’m on sabbatical, let me check it out. It’s where I first heard David Tisch (Box Group) and Charlie O’Donnell (Brooklyn Bridge Ventures) speak about the NY tech community. It’s also where I realized how much was happening in NYC and how fast it was growing. Today, there are over 400 exhibitors and 10,000+ people attend.

Why you should check it out:

1. Meet cool people from some of NYC’s most interesting startups. Today’s 2 person startup, could be the next unicorn.

2. Discover an app/tool that makes your life more fun, removes a pain point, or is just the right solution for someone you know.

3. On volume alone, it has one of the highest concentrations of startups in one place. I’ve seen education, health, food, game startups etc. Something for everyone.

4. Fun atmosphere.

Newco New York , May 13-14, 2015, various cool locations

I was at the inaugural Newco New York and have gone every year since. It’s a great way to see the HQ of some of NYC’s hottest startups and meet the founders where they work (and even go up and shake hands). Year 1 I saw Jonah Peretti speak to a crowd of 50+ of us at Buzzfeed and Fred Wilson of Union Square Ventures speak at a panel talk at Simulmedia. Year 2, I saw Dennis Crowley speak to 40+ us about Foursquare and Swarm and saw a panel talk at Union Square Hospitality on their philosophy of enlightened hospitality (Danny Meyer was there and he gave us signed copies of his book, which is a good read BTW).

Why you should check it out:

1. Learn something new in an intimate setting. You can learn more about the company, see where and how people there work (architecture of the space often reflects the mission/brand), learn more about startups and entrepreneurship.The line-up of startups/organizations is amazing and it’s like taking a master class from people who are working to build something every day.

2. Go for the serendipity of meeting your next new friend, boss, co-worker or co-founder.

3. Visit the people and places you’ve only read about online/in the papers or whose products you use on a daily basis.

4. Be inspired and let it be the spark for your next great adventure.

Northside Festival  June 8-14, 2015, Brooklyn (Williamsburg)

The Northside Festival celebrates thinkers, innovators, and artists. It has something for everyone, as you can see bands, gallery exhibits, as well as tech/innovation events. They’ve even had panel talks on healthcare.

Why you should check it out:

1. Discover a new artist, band, film, startup.

2. Mingle with creatives, techies, musicians. This year hosts 150+ speakers (from Linkedin, Ello, Gothamist, ApartmentTherapy, Medium, Elite Daily etc). See tons of bands and films. There’s also a concurrent Brooklyn Live Summer Concert series.

3. Great event locations. Tons of stuff to do at the festival and afterwards too. Brooklyn has great restaurants, music venues, and lounges. You can also hop on the ferry to Manhattan.

4. Learn something new. Teach something to someone. Be a part of a creative community.

Digital Health for Women, by Women

Women'S Power, Specialist, Businesswoman, Woman, Female

credit: CC Pixabay

I’m committed to diversity when it comes to healthcare, technology and leadership. Saw a tweet quoting @JudyMurphyHIT today (#EqualPayDay) on the #HIMSS15 timeline which said that “$42M in greater healthcare firm value when women are represented at the executive level”. Indeed, Rock Health’s “State of Women in Healthcare” provides further data on the need and value for diversity in HIT, inclusive of the fact that not only do diverse teams raise more capital (besides being more capital efficient) but women tend to be the primary decision makers, caregivers and a majority of the workforce.

I could also talk about market opportunity and market size, but I’d rather say this, look to your left, look to your right, look in front of you, look in back of you, it’s likely at least 50% of the people around you, or the people that you know are affected by the biological life cycles of ovulation, menstruation, pregnancy, menopause etc.

I’d like to highlight female innovators who are working to build digital tools for women and girls and in the process, are inspiring them to become fellow innovators and leaders. Links are provided to you learn more about the companies and their teams.

BellaBeat– Pregnancy tracking

(female co-founder and COO: Urska Srsen)

HelloFlo– Ecommerce site for every stage in a woman’s life (menstruation —> to menopause)

(founder and CEO: Naama Bloom)

Celmatix– Personalized medicine company targeting infertility

(founder and CEO: Piraye Yurttas Beim)

Naia Health (Naia Mom)- Smart connected breast pump

(co-founder and CEO: Janica Alvarez)

CakeHealth– Personal healthcare spending management system

(founder and CEO: Rebecca Woodcock)

Eve Medical– Medical device company focused on women’s health (HerSwab: Self-collect HPV samples for cervical cancer screening at home).

(co-founder and CEO: Jessica Ching)

Honorable mention:

I also recognize the men who stand up for women. Great story from Fast Company about “The Menstrual Man”, who defied cultural norms, societal pressure, financial pressure, and lack of formal education, to create hygienic options for women in rural and economically disadvantaged areas: “An Indian Inventor Distrupts the Period Industry”. A must read.