What Does a Health Informatics Professional Really Do?

I’ve often been asked about the role of a health informaticist, and I must admit, it’s not easy to sum it up in a single statement. The challenge lies in the multidisciplinary nature of health informatics, which blends elements of computer science, information science, and health science. This complexity makes it difficult to capture the full scope of what an informaticist does in just a few words.

Data, Information, Knowledge, and Wisdom (DIKW) Model

Throughout my career, the DIKW model has been instrumental in shaping my understanding of health informatics. This framework illustrates that data is the foundation of every decision we make. However, data only becomes valuable when processed into actionable insights. At the heart of this profession, my work revolves around transforming data into wisdom. In short, we aim to improve healthcare services through data-driven decision-making.

There is no better way to manage data than through technology, which explains our deep reliance on it. Modern computers can systematically collect and store vast amounts of information, process complex datasets, and retrieve them efficiently. As health informaticists, we must be proficient in these technologies to seamlessly integrate them into the healthcare environment.

eHealth Components

One mental model I often use to integrate technology into healthcare is the eHealth Components framework developed by the World Health Organization (WHO) and the International Telecommunication Union (ITU). This framework is part of the WHO-ITU National eHealth Strategy Toolkit. While it was originally designed to achieve eHealth outcomes on a national scale, its principles are equally applicable to smaller informatics projects.

The eHealth components outline the essential building blocks needed to create an eHealth environment that enhances existing healthcare services. Having used this framework extensively, I’ve observed how the roles and responsibilities of a health informaticist align with the seven components of the framework. With this, I’d like to share some real-life job functions that highlight the practical application of these roles.

eMAR Implementation: A Real-Life Illustration of Informatics in Action

To illustrate the work of a health informaticist, I'll share my experience as a nursing informatics specialist implementing an Electronic Medication Administration Record (eMAR) system for a hospital. The eMAR system is designed to enhance medication administration by delivering accurate information directly at the point of care. It automates several manual tasks, including checking drug-to-drug interactions, calculating the next dose, and notifying staff of upcoming medications. This initiative required a multidisciplinary approach, involving close collaboration between the nursing, pharmacy, and IT departments.

Before implementing eMAR, pharmacists were stationed at nursing stations to work closely with nurses on patient medications. Nurses maintained a paper-based Medication Administration Record (MAR) for each patient, documenting the medications they needed to administer. Clinical pharmacists collaborated with nurses to initiate medications and perform medication reconciliation at the end of each shift.

With the introduction of eMAR, pharmacists moved out of nursing stations and into their own quarters. Instead of nurses transcribing doctors’ medication orders onto the MAR, pharmacists now perform this task directly in the eMAR system. The system automatically triggers the medication dispensing process, reducing the workload on nurses. During patient rounds, nurses now carry a single iPad instead of multiple MAR charts, improving both efficiency and safety by minimizing the need to shuffle through paperwork.

With this background, I’ll now discuss the roles and responsibilities of a nursing informaticist in relation to eMAR implementation. Although this example focuses on nursing informatics, the principles can be applied to other informatics subfields, such as public health informatics.

Leadership and Governance

Leadership and governance are the top priorities in the eHealth components framework because the success of an informatics project hinges on strong leadership. From my experience, nursing informatics professionals often take on leadership roles, championing patient safety and working to streamline processes, even when it means challenging established practices.

For instance, after implementing eMAR in selected nursing units, the hospital’s top management considered halting the initiative due to complaints and medication errors, which were being attributed to the new system. As an informatics professional, I was tasked with evaluating the system’s performance. Our analysis revealed that eMAR was not causing new errors but rather highlighting existing issues in current practices that had previously gone unrecorded. The system's visibility provided an opportunity for improvement rather than simply reflecting an increase in errors. We used these insights to enhance both the system and the skillsets of our nurses, ultimately leading to a successful hospital-wide implementation.

Strategy and Investment

Upon my promotion to nursing informatics manager, I took on responsibilities related to strategy and investment in informatics. Implementing technology comes with significant costs. For instance, our eMAR project was rolled out hospital-wide, equipping all nurses with dedicated iPads for their shifts. Given the wear and tear, these devices will eventually need replacement. Additionally, I was involved in selecting suitable bags for the iPads, considering both quality and cost as key factors in the decision-making process.

Services and Applications

As a nursing informaticist, a significant part of your role involves system analysis and design. I frequently translate issues and feedback from nurses into system features, drafting detailed specifications for developers. My responsibilities also include performing user acceptance testing in the staging environment, ensuring the system meets the needs of the nurses before the IT Department deploys updates to production. After deployment, I monitor the system for any issues and communicate these to the IT Department as needed.

Standards and Interoperability

Our eMAR was developed in-house and integrated with the Hospital Information System (HIS). At the time, we did not have a comprehensive Electronic Health Record (EHR) system for managing patient health information. Since the hospital had the flexibility to choose its architecture, it’s unlikely that HL7 messages were used for communication between systems. However, for informatics projects involving connections with external partners, I strongly recommend familiarizing yourself with both semantic standards (e.g., LOINC, SNOMED-CT, ICD-10) and syntactic standards (e.g., HL7 v2, FHIR) commonly used in healthcare.

Infrastructure

While setting up infrastructure is primarily the responsibility of IT professionals, nursing informaticists play a crucial role in ensuring that devices, such as iPads and Wi-Fi routers, function effectively. During nursing rounds, it’s important to check in with nurses to identify any issues they might be experiencing with the system. For instance, we found that one major complaint was inconsistent Wi-Fi connectivity in patient rooms. The hospital’s fireproof walls limited the signal strength. We addressed this by requesting additional Wi-Fi routers to be strategically placed in the areas with poor coverage. Although the IT department handled the installation, we initiated and coordinated the request.

Legislation, Policy, and Compliance

Before updating or implementing a new information system, it’s essential to assess its impact on existing processes. For the eMAR project, our department developed policies to set standards for using the system in medication administration. Having clear policies is crucial, as they serve as the guiding rules for system use. Any issues that arise should be addressed in accordance with these policies. Additionally, system enhancements must align with current policies; otherwise, they may be stalled or require amendments. If leadership supports a proposed enhancement, a new policy or memo may need to be created to formalize the change.

Workforce

As a nursing informatics specialist, you’ll be responsible for developing and updating training modules. This includes onboarding new nurses on how to use the eMAR system and providing refresher training for existing staff on any system updates. Additionally, you can enhance nurses' skills by creating specialized informatics programs. For instance, I led a project that established a training program for advanced nursing informatics, resulting in the creation of “nursing informatics liaisons.” These liaisons act as representatives within their nursing units, streamlining issue resolution by addressing common system problems directly and efficiently.

Conclusion

Understanding the role of a health informatics professional is crucial for anyone interested in how technology intersects with healthcare. Through the lens of real-life examples and detailed experiences, we've explored how these professionals navigate complex systems. Health informaticists play a vital role in enhancing patient care and streamlining operations by bridging the gap between technology and healthcare. Whether you're a student, a healthcare provider, or someone curious about the field, this blog provides a comprehensive view of what it means to work as a health informatics professional and the impact they have on healthcare systems.