Many Informatics Hats


My transcendence into clinical informatics was unexpected. I was a director for multiple clinical and support services for Kaiser Permanente and utilized our ambulatory clinical documentation system to review emergency department summaries for neurosurgery patient transfers or repatriations. In 2007, our medical centers began the two-year journey toward system wide adoption of an inpatient electronic health record recognized by HIMSS Analytics as Stage 7.  The tall order was for a project lead with a strong clinical background.  I would like to think that my sparkling personality and ability to work in a labor management partnership played a role in the selection process but I never thought to ask.

I was eased into the role in 2007 by stepping into the manager position for our application support specialists as a temporary fix to cover a maternity leave but the job morphed into a permanent director role a year prior to migration. You really need to be a people person to be a successful informatics leader.  Managing information and communicating technologies requires going to the source, which is patients, clinicians, or members if you work for Kaiser Permanente.  

Kaiser Permanente provides care to over 4 million members with My Health Manager on kp.org providing 24/7 online access to personal health information, online appointment scheduling, prescription refills, and secure e-mailing with doctors. Investing in telemedicine, mobile apps, and other emerging technologies, supports population management, preventive care screening, and a reduction in mortality rates.  Large databases allows us to assess the impact of evidence-based practice and we have versatility in updating physician order sets and electronic documentation in our overall care delivery system.

In 2010, Nursing Informatics and Clinical Education merged into a single department throughout the Northern California region.  I am currently the Director of Clinical Education, Practice and Informatics in California’s East Bay, our largest service area, including the Oakland and Richmond medical centers but have been in this role since the reorganization. This role provides an incredible opportunity to experience clinical transformation across all service lines including perinatal, surgery, emergency care, adult services, and intensive care, to name a few. Creating and delivering education that incorporates clinical documentation and supporting evidence is an efficient process.  It enables the informatician to hear supporting arguments about new and upcoming features from end users that utilize our system every day.  

In 2014, I graduated from the California State University, Northern California Consortium Doctor of Nursing Practice program.  In 2015, I published original research on hemorrhagic stroke mobility utilizing our electronic health record and stroke patient registry.  Meeting the research preparation requirements of Kaiser’s institutional review board and the publication demands of an international journal will thicken the skin of any clinician.  My alma mater brought be back after graduation to teach “Technology, Informatics, and Data Management in the Transformation of Healthcare,” to DNP students.  Indulging in seemingly impossible demands leads to a personal sense of accomplishment and system wide rewards.

Promoting the success of your teams at every opportunity, practicing loving kindness in a tumultuous healthcare environment, participating in HIMSS, and remaining open to criticism when it comes to eliciting change are my most valuable lessons learned as an informaticist and educator.  

About the Contributor

Dr. Maxine Rand, DNP, MPA, BSN, RN-BC, CPHIMS is the Director of Clinical Education, Practice and Informatics at Kaiser Permanente. She is a HIMSS scholar, founding member of the HIMSS Clinical & Business Intelligence Committee and has a passion for melding evidence based practice with clinical analytics to improve patient outcomes. She teaches Technology, Informatics, and Data Management in the Transformation of Healthcare to doctoral nursing students and includes a module devoted to telehealth and its impact on patients and consumers.