Please help me job craft my new- and IT-ish role in healthcare

[lilactree]

First, if anyone is reading this, thank you, and second, please accept my apology in advance as I am afraid I might not keep up with quick replies and proper etiquette as much as I would like, as in addition to full time work and parenting a little, I am also dealing with medical/disability issues and truthfully am having trouble keeping on top of things quickly. -- I also don’t have a dishwasher. -- But I will eagerly read everything and respond when I get chances to sit at my (personal) computer.

I work for a healthcare system in an HCOL area in the United States. My background is in public health + social science research methods. I was in a different department at my current employer for several years, and a lot of the work included data analysis. When a new Analytics service was developed I moved departments, with everyone’s blessing, as it seemed like it would be a perfect fit. In fact, early on I was approached by the person (temporarily) in charge of setting up the Analytics service at the time because some people in the organization suggested he evaluate whether I could fill the director position. He and I had agreed it would be a big stretch but it wouldn’t hurt to apply. I applied without specific expectations, and was offered one of several informaticist roles which I accepted enthusiastically.

(I’ve struggled with how much detail to share here in case it is read by anyone I know “in real life”. If you’re reading this and think you may know who I am, may I respectfully ask (a) that you please keep it private, and (b) please understand that I am looking for insights that would really be in everyone’s interests, not only my own but the department, the organization and ultimately the community we serve. My intention is not to criticize anyone but to seek win-win-win outcomes.)

Well, the first year in some ways didn’t work out well, and several people from the team at various levels left under varying circumstances in a short time. There was some reorg, and eventually some new people hired. I am one of few leftovers currently without a normal boss situation, i.e. I informally am attached to a smaller “analytics” team that is “purely technical”. The idea being that when a new Chief Medical Information Officer is hired I will re-apply for my job to report to that person. In the meantime I am doing a variety of things including providing specs to app developers, reviewing their work, etc.; working with our data management people to make sure we are getting access to certain kinds of EHR data we’ll need; I’ve done some work with a customer on feasibility of whether we can produce data on certain quality measures (e.g. read a document from CMS, do we have the right data elements in usable form, do we have the right software/skill to do certain calculations, do the particular physicians they have in mind have significant volumes it would be relevant to and are they identified in a field we can use, etc.); follow-up with other departments to make sure a particular field is being entered into correctly; and more. There are also some performance improvement projects I’m involved in, but that’s another long paragraph I may procrastinate on a bit :)

Sooo…. In some ways I am in a weird situation but at the same time there’s a bit of freedom and perhaps an opportunity to add value in awesome ways. There are some things I’m struggling with that I can’t quite articulate and there may be an opportunity cost there in terms of my brain power. For one thing, I don’t have an IT background, and some things have been an adjustment. Like there’s a lot of emphasis on tickets, but I feel there are things that need to be done that no one is going to specifically put in a ticket for. Or, if an app is developed, I may be instructed to then close a ticket, but I feel like the thing still needs to be worked on because for me the main point is not the app, the app is a useful tool, but the actual thing includes the information being used and understood and some further action or understanding coming from it, or maybe an additional analysis.

Which leads me to… the word “analysis”. Does anyone have insights into the different ways this word is used, in particular inside vs. outside IT? It seems that most of the people I’ve been working with since leaving my old department don’t really have much experience actually analyzing data. They may be very good at moving it around, storing it efficiently and such. Am I misunderstanding something? Does this ring true with what others have found?

I could keep going but wow this is long already! Any thoughts to share so far about the above, or more generally about being in IT without an IT background, e.g. is there a blog you suggest, or certain concepts I should try to learn about (including the words. Part of my issue is knowing the words.). If anyone has read this far, thanks!!

[formerlydivorcedmom]

I am IT and worked in a hospital system in the Analytics department. 

IT is focused on tickets.  We build what we are asked to build, and our goal is usually to get customers about 90% of what they want, because it's almost impossible to satisfy them 100% (especially in healthcare).

We had a separate Clinical Informaticist group that reported outside the IT chain of command.  (Their director was an MD who had taken on a data role.)  Our informaticists worked very similarly to you - they looked for processes that might be improved with more data, they helped to define requirements, they translated those requirements to the IT developers, they looked for data (because we IT people didn't know where it was), they cleaned up data and derived training programs for ensuring that the data is entered properly, they tested our reports, and then they translated the reports into some actionable conclusion. 

It's this last part that is confusing you, and with good reason.  IT people don't analyze data, unless there's a data scientist in the group.  Our job is to aggregate and filter data.  It can look like analyzing and sound like analyzing, but at its core it is not.  IT people understand the data in a superficial way.  Informaticists should be going much further.

Your job is critical, but if you are reporting up through IT you may need to explain why it is critical, because your random IT director may not understand that.

[lilactree]

Thanks, this is really helpful, formerlydivorcedmom, and has sparked some more thoughts.

Earlier in my career I've worked as part of research studies and did data management and some statistical programming. I had thought that Analytics would involve more advanced methods like regression analyses, statistical tests, and other kinds of methods. I think I'm going to get overly bored if I can't engage with more advanced analysis methods sooner or later. I think I can try to work some of that in, but I need to make sure I carve out enough time and not get too caught up helping the Analytics team with their work (which I don't even know how much is noticed). I do want to help them because I think it's valuable and I also do individually really like them, but maybe I need to be more conscious of how much and how it's viewed. A couple of them did recently speak up in a positive way about working with me at a recent meeting, which was very nice.   

Also, I've noticed that some people in other departments as well as some external consultants hired by other departments seem to mean something different with the word "Analytics" than does IT. It looks like there's already been some confusion over this. I don't know if anyone else sees it! I feel like we need more precise words...

As for the customers, they vary in their ability to know what to specifically ask for. Some are not that used to using data much. Having somewhat of a research background and some knowledge of epidemiology, and my previous experience with the same org, I have some opinions. But in IT it seems like maybe we're not supposed to... but we're going to have input and affect what's produced whether we're conscious of it or not. So anyway I want to have my opinions about how we should build things, or on occasion what we should be looking at. In other words, I'm partly the customer. There is some room for this. Maybe this has to do with why Clinical Informaticists could be in a non-IT reporting stream. I certainly feel I am straddling a gray area. We have been using the term "Data Interpreter" for me a bit at work, which is interesting and I think captures part of what I'm about.

I also don't know if I should consciously try/plan in the longer term to stay in IT or not. Maybe I was lucky to transition in this way. Should I strive to be a "data scientist"? And is that usually in IT or not necessarily? Or is there something else I should aim for?

[formerlydivorcedmom]

The Gartner Model of Data Analytics gives 4 main stages through which a company can climb as they build an Analytics program.  (Easy overview here -> https://www.linkedin.com/pulse/4-stages-data-analytics-maturity-challenging-gartners-taras-kaduk/).  In my experience in healthcare, most companies are still at stage 1, describing what happened.  From your description, your IT staff is at this stage.  It is an important stage, because it's a way to get the company used to the idea that we can actually do something with data and therefore it's important to capture good data  (not only "clean" data, but also making sure we are actually capturing all of the data points that we might need later).

You are itching to get into the higher stages to explain what happened or predict what will happen. This is where the statistical programming usually comes in.  Usually this a role for a data scientist.  At my old hospital system, we were moving towards having data scientists, but none of them reported through IT.  Our IT leadership didn't value those roles enough - there were so many requests to look at what happened, that management ignored the possibility of growing the skillsets because we looked good completing so many tickets for basic reports.

IT may also be limited by the robustness of the reporting platforms that they are using. We used Cerner's Enterprise data warehouse.  I sincerely hope your company uses Epic.   Even so, if the IT skillset doesn't include statistical programming or other advanced data science abilities, then the organization will most likely just settle for staying at stage 1.  It's easier.

You'll have to define your own goals of what you want to do.  There are healthcare informatics degrees available at a lot of universities now, if you want additional training.    You also might consider suggesting to upper management that they consider creating a separate informaticst group....and maybe you'd be a good person to run it.