Section 2.1 Plan
IT Leadership
Use this tool to determine roles and specific activities for clinicians and others as you plan the
implementation of your local public health (LPH) department’s HIT projects.
Time needed: 2 hours
Suggested other tools: NA
Introduction
Successful electronic health record (EHR), health information exchange (HIE), and other health
information technology (HIT) projects require leadership from the clinicians who will use them.
Administrative and financial staff members also play key roles.
How to Use
Review the information about roles of clinicians and other staff members and apply it in ways that
best fit your department’s structure and specific HIT projects and needs.
Nurse Roles in HIT
Nurses are the primary users of EHR and HIE in LPH departments. EHRs provide many benefits to
nurses, including:

Streamlining and reducing documentation errors by eliminating repetitive transcription of lab
and other diagnostic study results, medications, and other information.

Improving outcomes through use of standard terminology and adherence to guidelines and
protocols.

Minimizing inefficiencies in workflow due to paper processing.

Reduce risk of medical and other errors that result from having to remember many details
required to coordinate care and services for clients.

Improve data analysis for continuous quality improvement initiatives.
For these reasons, nurses should be at the forefront in evaluating EHRs, HIE services, and other HIT
that they will use. They should be asked to play a leading role in workflow and process improvement,
implementation, training, and system maintenance. Specific roles that are a good fit for nurses
include workflow analysts, super users (individuals who have experience and/or aptitude with
technology and have learned how to use it), trainers, and nurse informaticists (individuals who
analyze and translate data into information to achieve quality, efficient and safe clinical outcomes).

A workflow analyst supports all users by describing current workflows, identifying
opportunities for improvement (with or without automation), redesigning workflows, and
supporting users as improvements are adopted.

A super user continues to perform existing duties but is provided release time during the
implementation and adoption phases of EHR to assist in system design, testing, workflow
and process improvement, and support during go-live.
Section 2 Plan—IT Leadership - 1

Trainers will learn the system—including tips on optimal workflows and processes—conduct
initial training with users, provide continual support, reinforce positive habits, overcome
negative workarounds, and train new staff.

Nurse informaticists may serve as EHR project managers, clinical domain experts, or both.
Clinical domain experts keep up to date on care guidelines and protocols, help manage the
integrity of data entered into the EHR, help customize screen designs, help create
documentation templates; and ensure that data meets reporting requirements. The nurse
informaticist assists in quality improvement benchmarking and works with a multidisciplinary team to ensure timely and accurate data entry.
LPH departments usually are not able to hire a trained nurse informaticist or health
informaticist solely to support HIT. However, an informaticist can support several LPH
departments as a consultant. The person who fills this role needs release time to perform
informatics duties, especially during the implementation and adoption phases and when
major system upgrades take place, such as those related to changes in regulatory
requirements and when new HIT modules are added.
Other Clinician Roles in HIT
You may find that laboratory staff members, pharmacists, medical social workers, behavioral health
specialists, or physicians are interested in becoming more directly involved in HIT—especially EHR.
These professionals often play the role of champions and/or steering committee members.
Other Roles in HIT
Administrative/financial staff members also play key roles in elements of HIT strategic planning,
selection, implementation, and use. Receptionists, who are often a client’s first point of contact with
the LPH department, can take on consumer advocate or client ombudsman roles as they engage
clients in using patient portals and signing up for secure email. While a client waits for an
appointment, the receptionist may have them complete health forms or questionnaires on mobile or
stationary kiosks. They may instruct clients calling for appointments or to report information how to
access the LPH department electronically. Receptionists may provide similar help to health care
providers and community service agencies
Health information management (HIM) professionals may play similar roles, as well as support
clients in obtaining authorizations and consents for release of information, explaining opt-in and optout arrangements for HIE, and assist in other aspects of HIE. HIM professionals are also
knowledgeable about electronic document management, terminologies and coding, and data
stewardship and analytics.
Involving representatives from different end user groups in HIT planning can accomplish the
following:

Educate them about what is broadly possible with the HIT, and how

EHR and HIE can help in their individual work.

Gather end users’ specific requirements for the HIT.

Ensure that proper attention is given to workflow and process improvement.

Begin the change management process, building desire for HIT.

Set expectations for success.
Section 2 Plan—IT Leadership - 2
Additional Resources
A number of professional associations and other organizations provide excellent resources on the
topic of clinical leadership in HIT planning. They include bodies of knowledge, distance learning
programs, Web seminars, blogs, and newsletters. The following organizations provide a start for your
exploration.
National Organizations
Minnesota Chapters
Public Health Informatics Institute (www.phii.org)
National Association of County & City Health
Officials (www.naccho.org)
Centers for Disease Control and Prevention
(www.cdc.gov)
Minnesota http://www.health.state.mn.us/ehealth/mnphin/
Minnesota Public Health Association
(www.mpha.net)
The Minnesota Omaha System Users Group
(http://omahasystemmn.org/index.php)
American Health Information Management
Association
www.ahima.org
Minnesota Information Management Association
http://www.mnhima.org/
American Medical Informatics Association
www.amia.org
American Nursing Informatics Association
https://www.ania.org/
Minnesota Nursing Informatics Group
http://www.miningonline.org/
Healthcare Information Management and Systems
Society (HIMSS)
www.himss.org
HIMSS Minnesota chapter
http://www.himss-mn.org/
Copyright © 2014 Stratis Health.
Section 2 Plan—IT Leadership - 3
Updated 03-12-14