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Hospitalists are leaders in improving the hospital experience both for physicians and patients. And as hospitals become increasingly digital, improving care means being on the front lines of this digital transformation.

The field of health informatics, which includes electronic health records (EHRs), data dashboards, and health information exchanges is becoming essential to improving hospital care, and as a result, it’s a growing field within healthcare.

Increasingly, hospitals are establishing administrative roles, large and small, for physicians to aid in this digital transformation. Research has shown a 22% increase in these jobs, presenting an opportunity for hospitalists to move into new informatics roles using their breadth of knowledge and motivation to improve care.

New Informatics Roles for Hospitalists

Hospitalists are uniquely positioned to improve hospital care because of their understanding of the inner workings of a hospital. And today, much of that improvement is mediated by technology.

“Hospitalists are particularly interested in quality improvement because of their high volume of patients with distinct and diverse needs,” said Joanna Cavalier, MD, academic hospitalist and associate medical director for the Digital Strategy Office at Duke University School of Medicine, Durham, North Carolina. “Hospitalists are there day-in and day-out, knowing patients from admission all the way through to discharge,” she said.

As health systems seek to improve care in the digital age, a number of informatics roles, large and small, have emerged depending on how much clinical time a physician wants to maintain. The Chief Informatics Officer (CIO), sometimes known as Chief Medical Information Officer (CMIO), oversees information technology for the hospital. CIOs and CMIOs also have associates who report to them.

At the other end of the spectrum, smaller roles may also include “provider champions” who use informatics to improve care within each specialty. These roles provide hospitalists with protected time to serve as the liaison or representative for their department with the information technology department to ensure that each department’s needs are being met, said Anisha Chandiramani, MD, a hospitalist and clinical informaticist at Duke University Hospital, Durham, North Carolina.

Chandiramani said it’s important for physicians to continue to do clinical work and not end up “looking down from an ivy tower,” which happens when they no longer work with patients and don’t know what’s needed on the hospital floor. Healthcare is changing constantly so physicians need to be on the front lines in order to understand how the changes they implement impact both physicians and their patients.

Each of these roles protect certain amounts of physician time, making the job more manageable as you progress along in your career vs working on the clinical side full time, which is often on a 7-days-on and 7-days-off schedule.

“Roles that provide for protected time allow for a break from the really intense clinical work while also allowing physicians to have a greater impact on the system,” said Poonam Hosamani, MD, a hospitalist and clinical associate professor at Stanford Medicine, Stanford, California. She added that hospitalists who work in informatics roles have one foot in clinical care and one foot into improving it using digital technology.

How Hospitalists Use Informatics to Improve Hospital Care?

Hospitalists know what works and what doesn’t, and they also have a good sense for how to use the EHR and other digital tools to improve care. Research suggests that the EHR can improve care by providing treatment goals or alerts to remind providers so that patients are up-to-date and don’t fall behind on their screenings as well as ensuring that tests are not duplicated and reducing any delays in treatment.

The EHR can also streamline care that reduces medical errors, speeds up diagnostics, improves patient information forms, and tracks changes over time. An understanding of informatics can also ensure that hospitalists are using the right codes to properly bill insurance companies for their services so that they end up getting reimbursed, said Cavalier.

Additionally, physicians who feel frustrated with their hospital’s EHR system can use their informatics expertise to be a part of the solution. For example, designing order sets that process in bundles. This way when you’re placing a medical order, all related orders are prompted at the same time so that physicians aren’t overburdened. “Having orders prompted in a bundle makes for less cognitive load for physicians,” said Chandiramani.

She added that hospitalists at Duke are hard at work designing patient engagement technologies in the inpatient rooms that allow patients to see what their daily calendar looks like. This way they don’t feel inundated with information around procedures, medication administration, and surgeries.

“Patient engagement technologies give patients some amount of control and transparency that’s empowering to them at a very vulnerable time,” said Chandiramani.

Hospitalists working in the digital space are also working to do what they can to bridge the transition to care. When high-risk patients get discharged to nursing homes, this may include a telehealth visit with the nursing home staff to make sure all those complicated lose ends relating to medications and wound care are addressed once a patient leaves the hospital. 

“This helps us to bridge any gaps in care,” said Chandiramani.

Additionally, the informatics team at Stanford developed an app that streamlines patient distribution systems. When patients are admitted at night, the system decides which teams are taking over patients in the morning and where there’s room for occupancy.

“This can be an arduous and difficult process to figure out but with the app, the physician can just click a button instead of having to do it all manually,” said Hosamani.

Digital tools like these allow physicians to spend their time caring for patients rather than carrying out menial and repetitive tasks. Hosamani said that if used properly, informatics can reduce a physician’s time burden, allowing them to return to why they entered the field in the first place.

“It’s important to recognize that AI and informatics are here to stay and those who become familiar with it are really able to see the opportunity and leverage it to improve the job,” said Hosamani.

No reported disclosures.