Jerome A. Osheroff, MD, FACP, FACMI, is the principal and founder of TMIT Consulting, LLC, a firm focused on developing and implementing pathways to better healthcare outcomes for care delivery organizations, government agencies, quality improvement organizations and health IT vendor clients.
For the decade before starting TMIT, he was chief clinical informatics officer for Thomson Reuters Healthcare, where he ensured that the organization’s decision support offerings were optimally responsive to clinician, patient, and management information needs, and measurably improved healthcare outcomes.
Osheroff is a leader in helping provider organizations successfully apply clinical decision support (CDS). He is lead author of the HIMSS CDS Guidebook Series, which includes the 2005 health IT book of the year, “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide.” The 2009 installment on improving medication use and outcomes—another award-winning bestseller—was developed by nearly 100 individuals from a variety of organizations in the US and abroad, was co-published by leading informatics and medication societies, and co-sponsored by AHRQ, leading CIS vendors and others. The second edition of the 2005 book was also developed through another large, broad-based effort, including ONC.
He is lead author of the 2006 white paper commissioned by the US Health and Human Services Department (HHS) entitled, “A Roadmap for National Action on Clinical Decision Support.” Osheroff has been working to support meaningful use, through consulting with other federal agencies on healthcare quality improvement - including leading the ONC CDS4MU project - and through other related collaborative activities.
Osheroff is board certified in internal medicine, and is an adjunct associate professor of medicine and courtesy clinical staff at the University of Pennsylvania Health System.
HIMSS: How did you become involved with HIMSS?
Osheroff: My first exposure to HIMSS was the annual conference in 2003, when I participated as the chief clinical informatics officer for a major healthcare decision support vendor that I had recently joined. I was impressed with the large, multi-stakeholder gathering and organization. Not too long after, a group I was working with on healthcare quality improvement and clinical decision support from different angles (academic, vendor, care delivery organization) came together to provide practical guidance on improving outcomes with CDS. HIMSS provided wonderful support for this work, forming the CDS Task Force under the Safety/Quality Committee, and publishing over the past decade four widely used, award-winning guidebooks on CDS and quality improvement.
HIMSS: What has been the most rewarding aspect of your involvement with HIMSS?
Osheroff: It has been very rewarding working with the large, vibrant group of individuals crossing key healthcare improvement stakeholder groups. Likewise for the HIMSS staff that supports these productive collaborations. For example, between the four guidebooks - and related tutorials, workgroups/task forces, symposia, roundtables, and other educational sessions - we've interacted with hundreds of individuals across the gamut of healthcare improvement stakeholders. This dialog, collaboration and content have informed recently delivered tools and resources from ONC for improving care with CDS.
HIMSS: Please provide a brief description of the session you will be hosting at HIMSS14: Improving Outcomes with CDS #2 (Improving Outcomes with CDS #2 (A Focus on CDS to Improve Targeted Outcomes), on Sunday, Feb.23 from 2:15-2:45 p.m. EST, at the Orange County Convention Center in room 224.
Osheroff: This session is part of the daylong pre-conference educational offering, "Physicians IT Symposium: The road to quality-enabled Health IT." One hour is devoted to CDS-enabled quality improvement (QI), which my colleague Dr. Jonathan Teich and I are covering. My part will cover the 'CDS Five Rights' framework from the HIMSS CDS guidebooks, which asserts that improving care processes and outcomes requires getting the right information to the right people in the right formats through the right channels at the right times. I'll describe the CDS/QI worksheets, and related tools and collaborations, which are based on this framework and available in the ONC QI resources, to support stakeholders in measurably improving key performance measures. I'm also sharing related material as part of the panel "Providers: Capturing EHR Enabled Quality Improvement- Decision Support, Measurement, and Reporting" in the symposium "Keeping the Delicate Quality Measurement Ecosystem in Balance."
HIMSS: What are some of the challenges you encounter with improving CDS, targeted outcomes, with consideration of the use of health IT? What solutions have you found to be successful?
Osheroff: Health IT-enabled QI requires addressing people, process and technology dimensions of care delivery and improvement. Successful efforts invest heavily attending to people issues - culture, engagement, communication, etc., whereas sub-optimal results can often be traced to inadequate attention to people and process. Part of our guidance regarding people issues is encapsulated in the directive "Do CDS with stakeholders, not to them!" A set of CDS/QI worksheets in the ONC CDS/QI resources (which are refined versions of worksheets in the latest HIMSS CDS guide) have been helpful to providers, quality organizations and vendors in documenting, analyzing, improving and sharing target-focused CDS information flows and workflows (i.e., the 'process' dimension).
HIMSS: What advice would you give professionals just entering the healthcare or IT field?
Osheroff: The intensifying pressures to improve care delivery and outcomes creates tremendous opportunities for anyone interested in the field, new entrants and others, to find a match between their talents and interests, and urgent organizational needs. I encourage those seeking health information management-related positions to consider activities they find most rewarding (such as working with people, processes and/or technologies), and think broadly about where these activities will be valuable and valued within the broad healthcare landscape in addressing pressing business needs.