It was an honor to be invited to present the Clinical Informatics keynote at the Health Informatics Society of Australia's #HIC16 conference on July 25, 2016. Here is an outline of the topics that I spoke about in greater depth with audience of Clinicians & IT execs. (In a separate presentation I spoke of the importance of engaging Patients in healthcare design, patient generated data, self-care, crowdsourcing, etc)

1. Clinical Informatics:
Lessons from the U.S.
Wen Dombrowski, MD, MBA
@HealthcareWen #HIC16

2. Clinical Informatics
Nurse
PhysicianPharmacist
Physio Psychologist
Allied
Health
Who’s here?
interdisciplinary &
work with nonclinicians @HealthcareWen #HIC16

3. Clinical Informatics
Healthcare I.T. is more than engineering
Value proposition – clinicians understand:
diseases, assessment, treatment, & clinical
workflow
patients & families – the human stories
@HealthcareWen #HIC16

4. Why involve clinicians early?
Lessons learned from…
@HealthcareWen #HIC16

5. Usability & Workflow
Many U.S. clinicians frustrated with EHR’s
Time-consuming data entry
Data not meaningful nor accessible
Not technology per se, but design
Happiest users when organizations…
Invest TIME to design UI’s & workflows
Involve CLINICIANS to select, design, implement
@HealthcareWen #HIC16

6. Understand what clinicians &
patients need  adapt tech
User Experience (UX): how person feels
when interacting with software or task
Usability: easy to use
Workflow: sequence of processes/steps
User-Centered Design: ask users, watch
users, see from their perspective
Psychology & Behavior @HealthcareWen #HIC16

7. Gov can hinder or catalyze
Policy, regulations
Funding, incentives
Convening
Example: U.S. 2009 HITECH Act (“Meaningful Use”)
$$Billions for hospitals & doctors to implement EHR
Pros: vision for digital communication & analytics
Cons: reality… @HealthcareWen #HIC16

8. Interop & Data Architecture
U.S. gov did not require interoperability
Hundreds of competing EHR’s developed
disparate systems  data silos
Costly workarounds: integration engines,
API’s, data warehouses, HIE’s @HealthcareWen #HIC16

9. Interop & Data Architecture
Need strategic foresight of end goals
while setting up systems
Interop is foundational prerequisite to all
data-dependent initiatives/activities:
Clinicians know what info useful
 Patient Care
 Quality Measurement
 Analytics
 Population Health
 Decision Support
 Research
@HealthcareWen #HIC16

10. Interop & Clinical Mapping:
Not easy to create Diabetes Report because…
Haemoglobin (Hb) ≠ Heamoglobin A1C (HbA1c)
and...
@HealthcareWen #HIC16
 Patient Care
 Quality Measurement
 Analytics
 Population Health
 Decision Support
 Research

11. Interop & Clinical Mapping:
Example of pitfalls when Non-clinicians set up
Clinical Information Systems
Automating thousands of errors
@HealthcareWen #HIC16

12. Health & Care beyond
hospitals and doctor’s offices
Home & Community-based care
Care coordination & communication tools
Telehealth remote monitoring
Telemedicine virtual visits
Online triage & Home diagnostics
Patient-generated data
Logistics & BPM platforms
@HealthcareWen #HIC16

13. Vendor Relations
Involve clinical + tech experts when evaluating
Understand your org’s needs  make checklist
Beware of sales pitch B.S.
Due diligence
Total cost of ownership
Contract obligations & pay contingent
Learning collaboratives
Incubate startups @HealthcareWen #HIC16

14. Clinical Informatics Roles
Executive Leadership: CMIO, CNIO, CHIO
Practitioner: Hands on, planning, implementing, managing
Researcher: Academia, EBM, safety & efficacy, theory
Translational science & disseminating best practices
Entrepreneurship (startups) or Industry (vendors)
Workforce development (courses & practicum)
Executive buy-in & dedicated time to do job
Organizational culture change (see http://bit.ly/dhinnovationdna )
@HealthcareWen #HIC16

15. Clinical Informatics Value
Healthcare I.T. is more than engineering
Clinicians understand:
diseases, assessment, treatment, & clinical
workflow
patients & families – the human stories
@HealthcareWen #HIC16