Competencies in Health Information Systems Farrokh Alemi, Ph.D. Competencies in Health Information Systems This is Dr. Alemi with a brief presentation about what does it take to prepare a manager of information technology.

Management of Electronic Health Records Focus on management Focus on information systems Let us be clear. Information system managers are not computer programmers. They do focus on information systems but not to write software. In healthcare, most managers focus on electronic health records. Obviously an electronic health record is a system organized to maintain patient information; to store data and to retrieve it when needed. An electronic health record also includes numerous other systems.

Focus on Management of Electronic Health Records This figure shows systems that are part of an electronic health record of one hospital. The green and yellow color show systems in maximum or moderate use; the blue and pink shows system in progress or purchased but not implemented. Note how many different systems are part of a hospital’s electronic heath record.

Focus on Management of Electronic Health Records It includes systems organized for decision support, e.g. drug-drug interactions. It includes systems for outcomes management and data warehousing.

Focus on Management of Electronic Health Records It includes billing as well as clinical systems. The core information management components includes patient accounting as well as order entry and result management.

Focus on Management of Electronic Health Records It includes systems for use by pharmacists, physicians and departmental support staff.

Focus on Management of Electronic Health Records When we talk of electronic health record we have in mind many different systems. The definition of terms such as electronic health record and health information systems are so broad that we use these terms interchangeably. In a sense, an electronic health record is a set of health information systems that are useful in managing patients and delivery systems. We want to prepare students who can manage this gigantic system of systems. Literally 100s of information systems. The question is what should be the skills that these managers need to have.

What skills do IT managers need to have? Accreditation What skills do IT managers need to have? Recently, the accreditation organization for programs in health care administration has emphasized that training of health administrators should cover specific competencies. One purpose of this presentation is to suggest a clear set of competencies that any manager of health information systems should have.

Competencies for Managers of Electronic Health Records Plan Implement Use The skills that managers of health information systems need are many. We divide these competencies into three broad areas: plan information systems, implement systems, and use of information systems.

Planning Skills Plan Implement Use IT managers need to plan well because they face large scale multi-year multi-unit complex capital projects.

Planning Skills System Analysis Assess information needs Write system specification Tie IT to process improvement Analyze return on investments Select vendors Analysis System For planning, managers need system analysis skills. Skills that help them assess information needs, write system specifications or tie IT specifications to process improvement.

Analyze return on investments Planning Skills Assess information needs Write system specification Tie IT to process improvement Analyze return on investments Select vendors Financial Analysis Skills IT managers need to have skills for financial analysis. They need to assess the business value of IT.

Consensus Building Skills Planning Skills Assess information needs Write system specification Tie IT to process improvement Analyze return on investments Select vendors They need group facilitation and consensus building skills in order to help a large number of clinicians select the features they want and the vendors that can best meet their needs. Consensus Building Skills

Implementation Skills Plan Implement Use IT managers need to also implement plans. This requires a clear set of other skills.

Implementation Skills Project Scheduling Project execution and control Project risk analysis Project communication and scope management Project Management Skills The skill that is most needed for implementing information systems is project management. Managers need to learn how to schedule tasks, how to anticipate delays and what to do to finish projects on time and under budget. They need to learn how to assess project risks and put together effective communication plans. They need to learn how to manage scope of information technology projects. In short, they need to learn project management as it applies to information technology.

Skills in Use of IT Plan Implement Use Finally, IT managers need a set of skills that are tied directly to effective use of information systems.

Statistical Process Control Skills in Use of IT Statistical Process Control Audit performance of IT Assess security and privacy risks Analyze comparative effectiveness of clinicians, interventions Now, the manager needs to worry about impact on productivity and quality of care. Technology managers need to audit performance of IT and verify that the technology has achieved its full potential. This means that they need skills in statistical process control.

Security Analysis Skills Skills in Use of IT Audit performance of IT Assess security and privacy risks Analyze comparative effectiveness of clinicians, interventions Security Analysis Skills They also need to worry about security and privacy of information. They should be concerned with not only information inside databases but also paper information and the gossip mill in social gatherings. IT managers need to monitor and assess how private information is getting out of the organization and plan for strategies to improve privacy and security.

Skills in Use of IT Data Analysis Skills Audit performance of IT Assess security and privacy risks Analyze comparative effectiveness of clinicians, interventions Finally, they need to be able to put the data in the information system to use. Of course, the data are used by the clinicians in care of patients but managers can use the data to benchmark performance of the organization, to understand comparative effectiveness of different management interventions, to report on process improvement and a host of other management activates. This means that the manager needs to be a data analyst as well. Data Analysis Skills

Competencies for Managers of Electronic Health Records Knowledge Skills Many training programs emphasize knowledge acquisition. Knowledge of types and history of information systems is not enough. Managers of electronic health records need to be able to do things. They need skills.

Take Home Lesson The take home lesson is simple. An IT manager has to play many different roles as a manager. To be effective, he or she needs to be a financial analyst, a group facilitator, a system analyst, a project management, a program evaluator, and a data analyst. All these skills are needed for a successful IT manager.