Clinical Informatics
Advancing Patient Care in a Digital Age
Clinical Informatics
The Division of Clinical Informatics at Nationwide Children’s Hospital works at the intersection of medicine, technology and people to improve care and support best outcomes for patients everywhere.
We partner with health care providers throughout Nationwide Children’s to:
- Provide up-to-date knowledge and expertise to our health care providers
- Make electronic health records (also called EHR) a valuable tool to provide the best care for your child
- Apply the latest technology to health care
Overview
Physician informaticists work with information services and health care providers to design clinical software and workflows. This collaborative relationship promotes patient safety, patient experience, efficiency and clinician satisfaction.
Part of our role is to ensure the electronic health record meets the needs of our health care providers and makes it easier for them to care for their patients.
Our faculty work on multidisciplinary teams and identify opportunities to optimize clinical processes by:
- Analyzing and mapping current state workflows
- Identifying barriers
- Developing solutions
Our physician informaticists possess a strong understanding of electronic health records, operational workflows and the governing policies and regulations related to the application of information technology in health care.
We are deeply involved in responding to provider feedback, customizing digital workflows and educating end users on how to use tools most effectively.
Safety
As the delivery of health care becomes more complex, the reliance on effective systems to prevent medical errors is increasingly critical. Evidence shows the application of information technology improves patient safety.
This reduction in errors occurs by:
- Improving health care provider communication
- Enhancing access to information
- Using computerized physician order entry
The Electronic Health Record (EHR) can automate and streamline a clinician’s workflow, ensuring all clinical information is communicated. It can also prevent delays in response that may result in gaps of patient care.
Examples
- Emergency Department/Inpatient Sepsis risk screening tools– Dr. Kathy Nuss is a member of the hospital multidisciplinary sepsis team that developed one of the most notable sepsis detection algorithms for pediatrics in the world. This system utilizes existing documentation in the electronic health record to identify patients at risk for sepsis and alert provider teams to take action. The sepsis screening tools have been so successful they are the standard of care in the Epic foundation system for pediatric hospitals around the world.
- Watchstander Program – Nationwide Children’s Hospital continues to cultivate our Situational Awareness efforts to focus on early recognition of patients at risk for clinical deterioration. Dr. Laura Rust has participated in developing The Watchstander Dashboard and other aspects of this program to enhance mindfulness regarding at risk patients on medical and surgical nursing units. In addition, Drs. Rust and Nuss are currently helping data scientists and other informatics specialists to develop a deterioration risk index (DRI) score to help predict when patients are at risk for deterioration while they are in the hospital.
Quality
Health care information technology teams are data caretakers, and health care organizations depend on data to accomplish quality initiatives. Data is the heart of any quality initiative. It establishes a baseline, determines what changes lead to improvement, allows for performance comparisons and evaluates procedural changes. We work hand in hand with our data analysts to ensure the data we track and use for quality improvement projects reflect the processes and outcomes we desire.
We also are heavily involved in improving and implementing decision support for our providers. We coordinate with clinical divisions to provide the latest clinical guidance to providers at the point of care. This occurs through various means, including pathways, protocols, order sets, alerts and data visualization.
Examples
- Penicillin Allergy Dose Graded Challenge Project – In partnership with the divisions of Allergy & Immunology and Infectious Diseases, we implemented a workflow to screen patients with reported penicillin allergies to expedite formal testing and confirm or remove these allergies. This allows use of more appropriate, narrower spectrum drugs: improving outcomes as well as reducing adverse effects.
- Intrusive Alert Reduction – Although alerts can be useful to notify providers when something needs to be addressed, when too many alarms go off, or the alarms are not useful to the provider, they are often ignored. We have implemented system-wide monitoring to improve the quality and targeting of our alerts to make sure that providers can be more secure that when there is an alert it is worth paying attention to.
- Controlled Substances Decision Support – Ohio is in the midst of an opioid epidemic. Dr. Laura Rust has spearheaded the effort to implement decision support to help providers access the OARRS prescription drug monitoring program more easily, as well as to provide guidance regarding the legal requirements for the prescribing of controlled substances.
Meet Our Team
Our team reflects a variety of clinical backgrounds and areas of academic interest. Our core faculty come from inpatient, ambulatory and emergency care backgrounds.
We also have a growing number of affiliated physician builders from an even broader array of specialties. Physician builders are physicians who spend a portion of their time working in the informatics field.
Resources For Professionals
