Clinical Informatics, Partners eCare, Partners Healthcare System, Wellesley, Massachusetts, USA Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
Caradigm.
J Am Med Inform Assoc. 2015 May;22(3):697-706. doi: 10.1093/jamia/ocu001. Epub 2015 Feb 10.
There is a lack of recommended models for clinical informatics (CI) governance that can facilitate successful health information technology implementation.
To understand existing CI governance structures and provide a model with recommended roles, partnerships, and councils based on perspectives of nursing informatics leaders.
DESIGN, SETTING, PARTICIPANTS: We conducted a cross-sectional study through administering a survey via telephone to facilitate semistructured interviews from June 2012 through November 2012. We interviewed 12 nursing informatics leaders, across the United States, currently serving in executive- or director-level CI roles at integrated health care systems that have pioneered electronic health records implementation projects.
We found the following 4 themes emerge: (1) Interprofessional partnerships are essential. (2) Critical role-based levels of practice and competencies need to be defined. (3) Integration into existing clinical infrastructure facilitates success. (4) CI governance is an evolving process. We described specific lessons learned and a model of CI governance with recommended roles, partnerships, and councils from the perspective of nursing informatics leaders.
Applied CI work is highly interprofessional with patient safety implications that heighten the need for best practice models for governance structures, adequate resource allocation, and role-based competencies. Overall, there is a notable lack of a centralized CI group comprised of formally trained informaticians to provide expertise and promote adherence to informatics principles within EHR implementation governance structures. Our model of the nursing domain of CI governance with recommended roles, partnerships, and councils provides a starting point that should be further explored and validated. Not only can the model be used to understand, shape, and standardize roles, competencies, and structures within CI practice for nursing, it can be used within other clinical domains and by other informaticians.
缺乏推荐的临床信息学（CI）治理模型，以促进成功的健康信息技术实施。
了解现有的 CI 治理结构，并根据护理信息学领导者的观点提供一个具有推荐角色、合作伙伴和委员会的模型。
设计、地点、参与者：我们通过电话进行了一项横断面研究，以方便在 2012 年 6 月至 2012 年 11 月期间进行半结构化访谈。我们采访了 12 位护理信息学领导者，他们来自美国各地，目前在集成医疗保健系统中担任执行或主任级别的 CI 角色，这些系统率先实施了电子健康记录项目。
我们发现以下 4 个主题出现：（1） 跨专业的合作伙伴关系至关重要。（2） 需要定义基于关键角色的实践和能力。（3） 融入现有的临床基础设施有助于成功。（4） CI 治理是一个不断发展的过程。我们从护理信息学领导者的角度描述了具体的经验教训和 CI 治理模型，包括推荐的角色、合作伙伴和委员会。
应用的 CI 工作高度跨专业，涉及患者安全，这增加了对治理结构、充足资源分配和基于角色的能力的最佳实践模型的需求。总体而言，缺乏由受过正式培训的信息学家组成的集中式 CI 小组，以提供专业知识并促进在 EHR 实施治理结构中遵守信息学原则。我们提出的护理领域的 CI 治理模型，包括推荐的角色、合作伙伴和委员会，提供了一个起点，应该进一步探索和验证。该模型不仅可以用于理解、塑造和规范 CI 实践中的角色、能力和结构，还可以用于其他临床领域和其他信息学家。
