The Uninformaticist

Someday, when dictionaries and spellcheckers routinely include “informaticist” in their lexicon I may be one. But for now, I am probably the HIMSS Physician Committee’s Uninformaticist. However, that’s not to say that I don’t use informatics every day in my physician executive role. 

My interest in technology began early in my clinical career. It’s what drew me to emergency medicine as my clinical specialty. There was no Internet and signals were analog, but creative people were figuring out how to transfer the space program’s remote monitoring technology into clinical use and eventually into paramedic core services. This was the beginning of telemedicine, and the topic for my Masters’ thesis. Much remained the same until wireless networks and the Internet came of age, and enabled the high-speed transfer of images and data. (For you country music fans…and with apologies to Barbara Mandrell… I was telemedicine…when telemedicine wasn’t cool.)

Roll forward to the late 1990’s. We introduced electronic health records, and quickly learned that the “promise” was a long way off, that change-management was the leadership challenge of the decade, and that when properly selected and implemented, information technology was a powerful enabler of change.  Fast forward to the HITECH act in full swing and the Affordable Care Act a glimmer in President Obama’s eye. As physician executive I became responsible for many information technology policy issues and worked closely with IT staff implement change, system implementation, and mustering up the political forces to mandate adoption of provider order entry. 

The HITECH act’s promotion of EHRs, the Affordable Care Act’s stimulation of new care and financing models, and the Triple Aim’s connection of care quality, health care cost, and population management/analytics, made it clear that all leaders all needed an understanding of these evolving models and technologies. While much could be learned on-the-job, I concluded that completing a graduate degree program would help me tie these pieces together. 

My decision is validated daily as I review my calendar and project lists. Almost all involve informatics. Ranging from predictive analytics to managing individuals at high risk for ED visits and/or in-patient (re) admissions and telemedicine to improve engagement while reducing travel times, informatics has become a core health care leadership skill. 

Transformation to value-based care depends upon our ability to link clinical and business functions, so that we can improve quality, experience, and outcomes and reduce cost in a thorough thoughtful manner, rather than by slashing and burning expense budgets. While we need leaders with specialized skills in the clinical, technical, and business aspects of health care, our best our best path to value-based care depends upon us all embracing informatics as the bridge connecting these disciplines.


About the Contributor

Joel J. Reich is the interim Chief Medical Officer for the first “social ACO”, which serves as both the insurer and provider of care management and primary care to a dual eligible population. He previously served as Chief Medical Officer for a community health care system. In addition to traditional CMO responsibilities he led development of the health system’s clinically integrated network, which included a physician-led governance organization and post-acute care services with a home telehealth program. Prior to that he was Chair of Emergency & Ambulatory Care/Medical Director of EMS.

Dr. Reich chairs the Governance & Culture workgroup for the Accountable Care Learning Collaborative (ACLC). He is an Assistant Clinical Professor at the Frank H. Netter School of Medicine. He received his B.A. from Brandeis University, M.D. from SUNY at Buffalo, M.S. (Technology & Human Affairs: Telemedicine) from Sever Institute of Technology (Washington University), M.M.M. from Heinz School of Public Policy and Management (Carnegie Mellon University), and M.S. in Health and Medical Informatics from Brandeis University. Dr. Reich is a member of the HIMSS Physician Committee for FY18.