Focus on a Common Road
Healthcare is struggling with its basic terminology and nomenclature. No matter the reform strategy, the lack of standardized definitions is a legitimate problem that is quietly costing our national healthcare system in productivity and efficiency.
I'm referring to standardized definitions, designs and uses of common clinical tools like orders, order sets, protocols, guidelines, policies and other clinical tools used to deliver care. Because different organizations have slightly different definitions of these tools, they all have slightly varied interpretations of how to use them. The problem is that this costs us all in terms of developing, managing and training.
For example, a manager and front-line staff could spend weeks in meetings just to develop a common understanding of the term "protocol." Locums staff from Hospital A, used to fill shifts in Hospital B, may require extra training just to understand the differences in their "order sets." And, regulatory agencies looking to develop standards for "standing orders" may have a hard time gaining traction if the term is not well-defined.
To help address this problem, I recently started an all-volunteer, grassroots project to develop a CMIO's framework—a manual, of sorts, to establish some standardized definitions and a reference guide for these tools. Rather than develop a hard regulatory standard, I'm hoping we can develop a kinder, gentler approach to create a manual so simple and elegant that it becomes the de facto standard for hospitals looking to better manage these tools.
I've nicknamed this effort to build this framework the I91 Informatics project, which alludes to the interstate that runs from Vermont and New Hampshire down through Massachusetts and Connecticut. Rather than competing, I wanted to focus the project on a common road that connects us all. After all, roads are tools that connect us and provide a common good.
The workgroup has been formed, but thus far, the number of contributors has been relatively low. I attribute this to people being daunted by some of the questions. Asking to define exactly what an order is invariably leads to other challenging questions, such as what is an order set and what is a chart?
Still, a series of standardized definitions and support documents could help all of us manage the various tools we are converting for health IT purposes. Instead of spending a lot of time figuring out how to manage these tools, there could be one place to find expert opinions and best practices. I'm hoping the manual would then be a reference and educational guide for students and healthcare workers to have a better understanding of these tools, and gradually improve them through standardized safety design, management and use.
Another reason I've dubbed this project the CMIO's framework is to help healthcare better understand the role of a CMIO and to help manage these tools to make meaningful change in an organization.
Those interested in participating in the discussion may visit i91Informatics.com or email me at dirkstanley@gmail.com.
I'm referring to standardized definitions, designs and uses of common clinical tools like orders, order sets, protocols, guidelines, policies and other clinical tools used to deliver care. Because different organizations have slightly different definitions of these tools, they all have slightly varied interpretations of how to use them. The problem is that this costs us all in terms of developing, managing and training.
For example, a manager and front-line staff could spend weeks in meetings just to develop a common understanding of the term "protocol." Locums staff from Hospital A, used to fill shifts in Hospital B, may require extra training just to understand the differences in their "order sets." And, regulatory agencies looking to develop standards for "standing orders" may have a hard time gaining traction if the term is not well-defined.
To help address this problem, I recently started an all-volunteer, grassroots project to develop a CMIO's framework—a manual, of sorts, to establish some standardized definitions and a reference guide for these tools. Rather than develop a hard regulatory standard, I'm hoping we can develop a kinder, gentler approach to create a manual so simple and elegant that it becomes the de facto standard for hospitals looking to better manage these tools.
I've nicknamed this effort to build this framework the I91 Informatics project, which alludes to the interstate that runs from Vermont and New Hampshire down through Massachusetts and Connecticut. Rather than competing, I wanted to focus the project on a common road that connects us all. After all, roads are tools that connect us and provide a common good.
The workgroup has been formed, but thus far, the number of contributors has been relatively low. I attribute this to people being daunted by some of the questions. Asking to define exactly what an order is invariably leads to other challenging questions, such as what is an order set and what is a chart?
Still, a series of standardized definitions and support documents could help all of us manage the various tools we are converting for health IT purposes. Instead of spending a lot of time figuring out how to manage these tools, there could be one place to find expert opinions and best practices. I'm hoping the manual would then be a reference and educational guide for students and healthcare workers to have a better understanding of these tools, and gradually improve them through standardized safety design, management and use.
Another reason I've dubbed this project the CMIO's framework is to help healthcare better understand the role of a CMIO and to help manage these tools to make meaningful change in an organization.
Those interested in participating in the discussion may visit i91Informatics.com or email me at dirkstanley@gmail.com.