Medical Informatics: an Executive Primer, Third Edition

396 Pages·2016·26.515 MB·English

by  Kenneth K. Ong

N11594
ISBN 978-1-938904-76-9 90000
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Medical Informatics
An Executive Primer
Third Edition
Edited by
Ken Ong, MD, MPH, FACP, FIDSA, CPHIMS, FHIMSS
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2015 by Taylor & Francis Group, LLC
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Version Date: 20160512
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iii
About the Editor
Ken Ong, MD, MPH, FACP, FIDSA, CPHIMS, FHIMSS, Clinical Informatics Board
Certified, is the Chief Medical Informatics Officer of New York Hospital Queens, an
urban teaching hospital serving the most diverse county in the nation and an affiliate
of the New York-Presbyterian Health System. Dr. Ong serves as chief of the hospital’s
Clinical Informatics Department and chair of the Clinical Decision Support Commit-
tee. His past projects include developing and implementing the acute care electronic
health record (EHR) with computerized provider order entry (CPOE); clinical decision
support for the acute care and ambulatory EHR; a hospital pharmacy system; web-based
results review; medication reconciliation; a patient portal; and mobile physician charge
capture. Dr. Ong is a former Deputy Commissioner in the New York City Department
of Health and Mental Hygiene.
Active in a number of professional groups, Dr. Ong is a member of the board of
directors of the Healthcare Information and Management Systems Society (HIMSS),
Healthcare Association of New York State’s Health Information Strategy Group, Greater
New York Hospital Association Health IT Steering Committee, and also has served as
president of the New York State chapter of HIMSS and as president and current board
member of Medical Informatics New York.
Dr. Ong served as editor of the first and second editions of Medical Informatics: An
Executive Primer, which received the 2007 HIMSS Book of the Year Award. ExecSense
selected Dr. Ong’s Consumer-Patient Engagement presentation as one of the Top Talks
of 2013. Modern Healthcare chose Dr. Ong as one of the top 25 clinical informaticists
in 2012. He is also a previous recipient of the AMDIS Award in Applied Medical Infor-
matics and the Centers for Disease Control Charles C. Shepard Science Award.
Residency-trained and board certified in family practice, internal medicine, and
infectious diseases, Dr. Ong is a Fellow of the American College of Physicians, the
Infectious Disease Society of America, HIMSS, and the New York Academy of Medi-
cine. He received his MPH at Columbia University in New York, his MD at Wayne State
University in Detroit, Michigan, and his BS at the University of Michigan in Ann Arbor.
iv
About the Authors
Erika Abramson, MD, MS, is an assistant professor in the Departments of Health-
care Research and Policy and Pediatrics at Weill Cornell Medical College. She is also
the associate program director for Pediatric Graduate Medical Education and the co-
director of the Fellowship Program in Health Care Quality and Medical Informatics. Dr.
Abramson completed her undergraduate work at Yale University in 1999. She received
her medical degree at New York University School of Medicine in 2003, achieving
membership into the Alpha Omega Alpha Medical Honors Society. She completed her
residency in Pediatrics at New York-Presbyterian Hospital in 2006, serving as chief res-
ident from 2006 to 2007. She received her Masters of Science in Clinical Investigation
from Weill Cornell Medical College in 2009. Dr. Abramson’s research portfolio includes
a mixture of quantitative and qualitative evaluations. It is novel for its application of
rigorous methodologies to evaluate the implementation and effectiveness of health IT
both in academic and community-based settings. Her primary focus has been studying
the effects of health IT on safety. She has more than 40 peer-reviewed publications.
Dana Alexander, RN, MSN, MBA, FHIMSS, FAAN, brings more than 30 years of
healthcare system, executive management and clinical experience. Her past and current
experiences include roles in academic, integrated delivery network (IDN), and com-
munity health systems settings, with responsibilities that span the care continuum to
include long-term care, post-acute care, home health, hospice and other specialty ser-
vices. For the past 10+ years, she has been employed in the healthcare IT arena and cur-
rently serves as vice president of Integrated Care and chief nursing officer at Caradigm,
a health analytics and population health management company. She actively partici-
pates and represents leadership roles in a number of professional and industry orga-
nizations, including HIMSS Board of Directors, where she serves as chair-elect; NQF
Population Health Committee; Measure Application Partnership Hospital Workgroup;
Joint Commission International Standards Committee; CMS Technical Expert Panel
for Post-Acute Care; AONE; ANA; American Academy of Nursing Fellow; and other
national initiatives. She has contributed to healthcare, nursing, and the nursing infor-
matics field through support of research and numerous presentations and publications.
Janey Barnes, PhD, is a principal and human factors specialist at User-View, Inc. Dr.
Barnes leads client programs that encompass every aspect of human factors and usabil-
ity from design research, testing and evaluation, and user interface design to hardware
and workspace design. Throughout her career, Dr. Barnes has worked with clients in
the healthcare, medical device, automotive, consumer product, and financial industries
and has educated others about the field of human factors. She has developed and taught
human factors and psychology courses at a number of universities and for professional
organizations. Dr. Barnes is affiliated with several professional organizations and par-
v
ticipates in these organizations by making presentations and teaching workshops. Dr.
Barnes serves in the Office of the National Coordinator’s Implementation, Usability and
Safety Workgroup. She is active in the HIMSS User Experience Community and served
as chair of the HIMSS Usability Task for 2012–2013. In addition, Dr. Barnes serves on
the TriangleUXPA Advisory Board. She holds a PhD in cognitive psychology from the
University of Massachusetts, Amherst.
Adam D. Cheriff, MD, is chief medical information officer and associate professor
of Clinical Medicine and Health Policy and Research for the Weill Cornell Physician
Organization. Dr. Cheriff is a graduate of Harvard College. After receiving his medical
degree from Johns Hopkins School of Medicine, he completed a residency in Internal
Medicine at New York Presbyterian (Weill Cornell Campus). Dr. Cheriff joined the
faculty within the Department of Medicine at Weill Cornell in 2001. In 2009, he was
appointed chief medical information officer for the Weill Cornell Physician Organiza-
tion. He has maintained an active internal medicine practice while overseeing clinical
IT operations for the Weill Cornell Physician Organization. In addition to managing
the implementation and support of Weill Cornell’s shared ambulatory EHR and prac-
tice management system, Dr. Cheriff is responsible for Weill Cornell’s data warehouse,
data dictionary, online physician directory, and patient portal.
Curtis L. Cole, MD, FACP, is chief information officer for Weill Cornell Medical Col-
lege where he is also an associate professor of Clinical Medicine and Healthcare Policy
and Research. He practices internal medicine at Weill Cornell Internal Medicine Asso-
ciates at New York Presbyterian Hospital. After medical school at Cornell and residency
at New York Hospital, he was a clinical investigator in medical informatics. He has led
the implementation of several EMR systems. Dr. Cole is also responsible for the other
core information systems that support research, education, and administration at the
college. He is particularly interested in the secondary use of clinical data, integration
of research data with clinical data, terminology systems, and measuring the value of
information systems.
Sarah Collins, RN, PhD, is a nurse informatician in Clinical Informatics Partners
eCare at Partners Healthcare Systems and an instructor in medicine at Harvard Medi-
cal School and Brigham and Women’s Hospital Division of Internal Medicine and Pri-
mary Care. She holds a PhD in nursing informatics from Columbia University School
of Nursing and was a National Library of Medicine Post-doctoral Research Fellow at
Columbia University’s Department of Biomedical Informatics. She received her Bach-
elor of Science in Nursing from the University of Pennsylvania, where she minored in
Health Care Management. Dr. Collins is an experienced critical care nurse. Her research
as well as her applied clinical informatics work is focused on modeling, developing, and
evaluating standards-based, patient-centered collaborative informatics tools to further
patient safety, knowledge development, clinical decision support, and coordinated
patient-centered care. In 2012, Dr. Collins was selected as one of two national Emerg-
ing Leaders by the Alliance for Nursing Informatics and investigated models of nursing
informatics governance within healthcare organizations as part of that program. Her
research has been recognized and awarded by the American Medical Informatics Asso-
ciation (AMIA) and the 11th International Congress on Nursing Informatics.
vi Medical Informatics: An Executive Primer, Third Edition
Anuj Desai is currently vice president of Market Development for the New York eHealth
Collaborative (NYeC). In this role, he is responsible for developing and managing stra-
tegic relationships and alliances with the various vendors and partners that interact
with NYeC. He also leads the New York Digital Health Accelerator, the multistate/
multi-vendor EHR/HIE Interoperability Workgroup, work related to development of
an application programming interface (API), and the incubation of new capabilities
within the statewide network. Desai has more than 14 years of experience in business
development and healthcare strategy. He received his MBA from University of Mary-
land’s Robert H. Smith School of Business and his undergraduate degree in biotechnol-
ogy from Rutgers University. He was a member of Crain’s New York Business 2013 Class
of “40 Under 40” and Modern Healthcare’s Up and Comers 2013.
J. Travis Gossey, MD, serves many roles at Weill Cornell Medical College. In the sum-
mer of 2010, Dr. Gossey became the medical director of Information Services for the
Physician Organization. A large part of his duties revolve around the electronic med-
ical record (EMR) system and the research systems that interact with the EMR. Dr.
Gossey also serves as an internist specializing in primary care. In addition, he serves
as an assistant professor of Medicine. Dr. Gossey completed his undergraduate work
at Washington University in 1997. He received his medical degree from Northwestern
University Medical School in 2002. He received his MS degree from the University of
Texas at Houston Graduate School of Biomedical Sciences in 2010, followed one year
later by his MPH degree from the University of Texas School of Public Health.
Ray Hess, FHIMSS, RRT, MSA is the vice president for information management at
Penn Medicine Chester County Hospital in West Chester, Pennsylvania. His infor-
mation management and process improvement experience includes having overseen
business intelligence for 18 years, health information management for 6 years, and
workflow automation/clinical decision support efforts for 10 years. He is a Six Sigma
Green Belt. His clinical experience includes 10 years in patient care and rehabilitation,
and he has administrative experience from managing cardiology services for 4 years.
He holds a master’s degree in healthcare administration from West Chester University.
Hess has addressed audiences throughout the United States and internationally and
has published multiple articles and book chapters. Hess is a Fellow of HIMSS and is
involved in multiple HIMSS’ communities and projects.
David Jacobowitz is the managing director of The Health Innovators, a strategy and
business development firm dedicated to accelerating the success of start-up and growth
companies in the dynamic digital health market. Jacobowitz has over 30 years of experi-
ence in health IT/digital health/HIE strategic planning, business development, market-
ing, sales, product management, and implementation. He has held leadership positions
on diverse sides of healthcare, including hospital, payer, vendor, medical provider,
pharmaceutical, and consulting organizations. Jacobowitz has specialized in business
development and partnering, mobile and e-health, strategic marketing, and product
development and has deep experience identifying, evaluating, marketing and deploy-
ing digital solutions that offer compelling value propositions. Companies where he has
held leadership positions include the New York eHealth Collaborative, Bergen Regional
Medical Center, Mt. Sinai Medical Center, Memorial Sloan Kettering Cancer Center,
vii
MEDecision, Siemens Medical Solutions, Novartis, Philips, Empire Blue Cross, and
Booz and Company.
Rainu Kaushal, MD, MPH, is the Frances and John L. Loeb Professor of Medical Infor-
matics, chairman of the Department of Healthcare Policy and Research at Weill Cornell
Medical College, and Chief of Healthcare Policy and Research at New York-Presby-
terian Hospital/Weill Cornell Medical Center. Dr. Kaushal is an international leader
in the clinical effectiveness, cost effectiveness, and comparative effectiveness of novel
healthcare delivery interventions and models, particularly those based on health IT.
A Fellow of the American College of Medical Informatics, she currently leads a large
Patient-Centered Outcomes Research Institute-funded Clinical Data Research Net-
work, which connects the major academic institutions in New York City for the pur-
poses of patient-centered research and improvements in healthcare delivery systems.
Paul Kleeberg, MD, FAAFP, FHIMSS, is Chief Medical Informatics Officer for Stratis
Health, a non-profit quality improvement organization based in Bloomington Min-
nesota, and Clinical Director for the Regional Extension Assistance Center for HIT
(REACH) funded by the American Recovery and Reinvestment Act to assist small hos-
pitals and primary care providers in Minnesota and North Dakota to adopt and become
meaningful users of EHRs. Dr. Kleeberg has over 20 years of experience working in
health IT, implementing EHR systems and improving processes for electronic workflow
to enhance care delivery. Before coming to Stratis Health, he was Medical Director for
CDS for HealthEast Care System in St. Paul, Minnesota, and Allina Health in Minne-
apolis, the organization that won the Davies Award of Excellence for its EHR imple-
mentation in 2007. Dr. Kleeberg received his medical degree from Stanford University
and completed his residency in Family Medicine at the University of Minnesota. He is
board certified in Family Medicine and is a fellow in the American Academy of Family
Physicians (AAFP). He is also a Fellow of HIMSS, where he currently serves as chair
of the Board of Directors and also serves on the Board of Trustees for the Certification
Commission for Health Information Technology (CCHIT).
Gilad J. Kuperman, MD, PhD, is Director for Interoperability Informatics at New
York-Presbyterian Hospital. In this capacity, he assists the hospital in realizing the ben-
efits of interoperability internally, with its business partners, and through participat-
ing in regional data interchange efforts. From 2005 to 2011, Dr. Kuperman was Board
Chair and Executive Director of NYCLIX, Inc., a nonprofit corporation creating HIE
services in New York City. Dr. Kuperman has an extensive research record measuring
the impact of health IT information technology on the quality and efficiency of medical
care. He is Adjunct Professor of Biomedical Informatics at Columbia University Medi-
cal School. He has been an author on ninety articles related to medical informatics and
lead author on sixteen of those. He was Board Chair of the American Medical Infor-
matics Association (AMIA) in 2012–2013.
Naomi Levinthal is a senior consultant with The Advisory Board Company’s Health
Care IT Advisor and Meaningful Use Navigator. She specializes in medical informatics,
electronic health record (EHR) systems, the CMS EHR Incentive Program, and the
Office of the National Coordinator for Health Information Technology (ONC) certifi-
viii Medical Informatics: An Executive Primer, Third Edition
cation programs. Levinthal’s research interests include topics related to meaningful use,
population health management, and telehealth. Naomi joined the Advisory Board in
2012. Previously, Naomi served as certification manager for the Certification Commis-
sion for Health Information Technology (CCHIT), guiding EHR vendors and hospitals
with self-developed systems through testing and certification processes. Prior to her
tenure at CCHIT, she was the medical informatics specialist at the American Acad-
emy of Dermatology. Naomi received an MS from Northwestern University in Medical
Informatics, an MA from Loyola University Chicago, and is a Certified Professional in
Healthcare Information & Management Systems (CPHIMS).
Virginia Lorenzi has more than 24 years of experience in the field with vendor, con-
sultant, and provider experience. As IT manager and subject matter expert at New
York-Presbyterian Hospital, Lorenzi specializes in interoperability, health IT standards,
and health IT–related regulations including meaningful use. She is also on faculty
at Columbia University where she teaches segments of several courses and directs a
graduate certification program in health IT. Lorenzi has participated in health IT stan-
dards efforts, including co-chairing the Healthcare Information Technology Standards
(HITSP) ECO Webinar workgroup, and in long-term service to HL7, where she has
been honored as an HL7 Volunteer of the Year and as an HL7 Fellow. She has been
called to Washington to testify on topics related to health IT standards and meaningful
use. She is CPHIMS-certified and active in HIMSS. She authored numerous posters for
the AMIA annual conference and serves on the Mid-Atlantic AMIA Education Board.
Sameer Malhotra, MD, MA, is the associate medical director of Informatics at the Phy-
sician Organization of Weill Cornell Medical College and is working on several projects
in the realm of medical informatics pertaining to improvement of healthcare delivery
and patient safety. Dr. Malhotra is the director for development and analytics of clinical
decision support systems (CDSS) of the institution’s outpatient EHR. Dr. Malhotra has
an academic faculty appointment as clinical instructor in the Department of Public
Health in the Division of Quality and Medical Informatics. His research focuses on
CDS, medication safety, adoption of interoperable health IT, and impact of HIE on
patient care. His research and publications have focused on healthcare technology and
quality of care. Dr. Malhotra cares for adult patients in the inpatient setting as an Inter-
nal Medicine Hospitalist. In his current role at the POIS of Weill Cornell Medical Col-
lege, Dr. Malhotra is closely involved with the ongoing deployment and optimization
of the institution’s ambulatory medical record. Dr. Malhotra attended medical school
at the All India Institute of Medical Sciences (AIIMS) in New Delhi, India and received
his MB, BS degree in 2003. He then pursued a Masters in Biomedical Informatics at
Columbia University, New York.
Geeta Nayyar, MD, MBA, is a nationally recognized leader in health IT and a board-
certified practicing physician. She brings an integrated perspective to physicians, hos-
pitals, pharmaceutical companies, and accountable care organizations that are facing
the challenges of the nation’s changing healthcare system. Dr. Nayyar was most recently
Chief Medical Information Officer at AT&T, where she provided a clinical perspective
to the AT&T ForHealthSM strategy and portfolio. She also served as CMIO at Patient
Point, principal medical officer at Vangent, Inc., and as the Chief Medical Officer of
ix
APCO Worldwide, a public affairs and strategic communications firm. A specialist in
rheumatology, she maintains an active practice while serving on the medical school fac-
ulty at Florida International University and George Washington University. Dr. Nayyar
received her MD and BS degrees from the University of Miami. She earned her MBA
from George Washington University. Dr. Nayyar holds memberships and committee
appointments in several professional organizations including the American College of
Rheumatology and the Association of Medical Directors of Information Systems. She is
a member of the HIMSS Advisory Board.
Jan Oldenburg is a senior manager in Ernst & Young’s Advisory Health Care Practice
focusing on advising clients how to create engaging consumer health solutions. She is
the former vice president of physician and patient engagement at Aetna Accountable
Care Solutions, working with physician groups in accountable care organizations to
create and implement population health and patient engagement programs. Prior to
Aetna, Oldenburg was a senior leader in Kaiser Permanente’s Digital Services Group.
She is a past president of the Northern California HIMSS Board, a HIMSS fellow and
vice chair of the National HIMSS Connected Patient Committee. She frequently speaks
and writes about patient and physician engagement. Oldenburg served as the primary
editor of Engage! Transforming Healthcare through Digital Patient Engagement, pub-
lished by HIMSS in March 2013. She is the author of the Patient Engagement chapter in
this 3rd edition of Medical Informatics, as well as numerous articles.
Anantachai (Tony) Panjamapirom, PhD, serves as a senior consultant and a subject
matter expert in the Meaningful Use Navigator practice at the Advisory Board Com-
pany. He provides policy analysis, strategic and operational guidance, and meaningful
use best practices. His other research focuses on the benefits of EMRs, IT performance
management, and IT implications in the accountable care environment. Panjamapi-
rom earned a PhD in Health Services Administration, an MBA from the University
of Alabama at Birmingham, and an MS in Information and Communication Sciences
from Ball State University. He is a Certified Professional in Healthcare Information &
Management Systems (CPHIMS).
Ryan Sandefer, MA, CPHIT, is assistant professor and chair at the College of St. Scho-
lastica in the Department of Health Informatics and Information Management. Pre-
viously, he was research coordinator for the Center for Healthcare Innovation at the
College of St. Scholastica. Sandefer has a master’s degree in political science and is com-
pleting a PhD in Health Informatics with a focus on consumer engagement in the use of
health information technology. He is on the editorial advisory board and review panel
for Perspectives in Health Information Management with AHIMA. He is an elected
Board member and the Chair-elect of the American Health Information Management
Association (AHIMA) Council for Excellence in Education, and is the Chair of its
Research and Periodicals Workgroup. He teaches research methods and healthcare data
analytics and participates in the Minnesota eHealth Advisory Workgroups.
Robert M. Schumacher, PhD, is the Executive Vice President of GfK User Experience.
Dr. Schumacher has more than 25 years of experience applying usability within cor-
porate and academic environments. He is active in the HIMSS Usability Community