A modest proposal

Medical informatics needs a rock star. Not a David Brailer-esque figure who could excite people in the technology sphere, but perhaps a Don Berwick type who can reach every level and constituency of healthcare, and even capture the imagination of the general public.

I had this thought yesterday during a highly engaging session at the American Medical Informatics Association‘s annual symposium in Washington, a session with the mouthful of a title, “Harnessing Mass Collaboration to Synthesize and Disseminate Successful CDS Implementation Practices.” In English, that means panelists were discussing the forthcoming “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide” and related feedback mechanisms, including a wiki.

During the session, panelists discussed the difficulties they’ve had in getting clinical decision support integrated into EMR and quality-improvement projects, as well as into medical practice itself. One commenter from the audience, a Veterans Affairs doctor, noted that to too many people in healthcare, CDS sounds like an IT issue, not something related to quality.

To this, Dr. Bill Bria, chairman of the Association of Medical Directors of Information Systems, said, “Our profession has really stumbled on this one.”

Then, AMIA CEO Dr. Don Detmer asked if the informatics community could identify perhaps the top five serious preventable outcomes and create “poster children” for quality improvement via CDS. He said much of the problem with low adoption of clinical IT is related to communications, though there are some scientific and technology issues as well.

I immediately thought of Berwick and his 5 Million Lives Campaign, a nationwide initiative to help prevent 5 million harmful incidents in healthcare from December 2006 to December 2008 by encouraging hospitals to commit to a series of proven interventions. This, of course, grew out of the 100,000 Lives Campaign, which Berwick’s Institute for Healthcare Improvement says successfully prevented more than 100,000 deaths in U.S. hospitals over a year and a half.

I was at Washington Hospital Center in D.C. just a week ago because my dad had surgery there. Everywhere I looked were signs reminding staff to take action to prevent errors and complications, particularly methicillin-resistant staphylococcus aureus infections. At just about every turn in the hospital corridors, wards, waiting rooms and cafeteria were hand sanitizers.

I’m fairly certain this high level of awareness is directly related to the IHI campaign. In fact, my dad picked Washington Hospital Center over another hospital much closer to his suburban Maryland home because the other place had been in the news of late for its high rate of MRSA. Yes, the public is very aware of the danger of hospital-acquired infections, and Berwick has had a lot to do with raising the issue.

Healthcare needs someone similar to take the lead in communicating the benefits of clinical decision support to the masses. Does informatics have a rock star out there? It’s time to come forward.