Future of Global Informatics_Episode 3_Michelle Currie: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
TJ Southern:
Hey, y’all! Welcome to the Outcomes Rocket, the Future of Global Informatics podcast. Through conversations with industry leaders and innovators, we discuss global healthcare informatics so that you can understand what it does, what it is, and how it shapes healthcare of our future. I am your host, T.J. Southern. Let’s get started!
TJ Southern:
Alright, good day, good day, good day, everyone, and welcome to the Future of Global Informatics Podcast. Today, we have Michelle Currie, yes! She is so amazing, so amazing. I actually met her at HIMSS, and she just blew me away about all of her years of experience and all of her knowledge as it relates to nursing informatics. So Michelle, give us a little bit of background about yourself, tell people about yourself.
Michelle Currie:
Yeah, thank you, and so great to meet you, right back at you. I was so excited, I felt like I met my sister from another mister at HIMSS. So, yeah, so, nurse, obviously, been in healthcare for 25 years. I got a master’s degree in informatics 20 years ago, before anyone knew what it was. I didn’t really know what it was either, but it had some serendipitous thing happen, and there I ended up in it. So have been applying nursing and just informatics theories in general for that long. Yeah, so I’ve had kind of run the gamut, I guess, if you will, from beginning with the EMR implementations, then I moved into quality, which I think is a great segway, and then I worked in performance improvement, which is a … great segue, and then I’ve been doing independent consulting for the past couple of years, so working a lot program and development, program management, helping people really get up to speed and interpret all these regulations, FHIR is, kind of, one of my little things right now that I’m very, very interested in. So yeah, and you know what? When I became a nurse, never knew I would end up where I am, but you know what? I couldn’t have picked it better for myself. It’s just been such a great fit, and there are so many opportunities in nursing and informatics, which, you know.
TJ Southern:
See? That’s what I’m telling you guys. So Michelle has been in it for 20-plus years, so now you guys, because I keep telling everybody, I’ve been in this for at least 15 years and they’re like, no way. And I’m like, yes way. We are here, we have been here for quite some time.
Michelle Currie:
We were on the bleeding edge, right? Some call it the cutting edge, I call it the bleeding edge.
TJ Southern:
Yes, we are. We are, we are, we are. So you see why I had to have her on the show? Because she is a well of knowledge. She’s very versed in nursing informaticist and where it’s going, where it’s come from, and where it’s going. So what inspires your work in nursing informatics? What inspires that work?
Michelle Currie:
So, I have three different things that I think kind of really just sum it up for me anyway, and everyone’s going to be different, of course. But for me, what really resonates with me about nursing informatics is one, a systems perspective. So really understanding that multifaceted view. So we all know healthcare traditionally is very siloed. Clinicians are siloed into a medical area of expertise. People work in finance, people work in HR, people work in the health plan, and so there aren’t a lot of people who actually understand enough to connect the dots across those silos. And so I’ve always been, informatics really gave you that thinking, that systems perspective. I’ve always been interested in complexity and kind of connecting the dots. So that’s kind of one of the first things that stuck out to me. And the RNs connecting those dots across silos, everyone, I’ve heard this analogy used that physicians are the quarterback of healthcare, and I like to say, you know what, actually, there’s a coach calling the play, and the nurses are actually the ones who are in the quarterback executing, right?
TJ Southern:
We hold that ball. We hold that ball.
Michelle Currie:
We hold that ball. We’re the one who’s like helping the lab when they can’t find a specimen or something goes wrong in the pharmacy, right? We are the executors, that’s the first thing. The second thing that I think is really underappreciated about nurses and nurses informaticists is that being a nurse, you are the make-it-work person. I don’t know if anybody watches Project Runway and Tim Gunn, but he is like, make work, girl. You know what I’m saying? And you know what? You know what that is to me? That is about innovation.
TJ Southern:
Yes.
Michelle Currie:
Nurses constantly don’t have what they need. There’s other departments that they don’t have what they need. Whatever processes sometimes aren’t in place or sometimes they haven’t been redesigned in a long time, and the nurses make all of that work. So nurses are literally, when they’re on the job, they are innovating. Pretty much, there are two to at least three opportunities during a day where they’re innovating, being small or large, and figuring out how to improve something or apply something in a unique way from something else that they know. So I’m a big believer that things can always be improved. And I think nurses are the same way, they’re always looking to identify a solution and approve something, they can do it like that.
TJ Southern:
So now, with that being said, what are the biggest challenges? Because we know that we have to be innovators, right? And fast thinkers on our feet. So what are some of the challenges in having to be that type of nurse informaticist?
Michelle Currie:
Well, one of the biggest challenges that I see, and this is kind of outside of nursing informaticist. My whole career, I haven’t really focused on nursing informatics specifically, but more the interdisciplinary team, which nursing is a part of that. So one of the biggest barriers, I think is that a lot of times we’re not at the table.
TJ Southern:
HA! Can you say it again?
Michelle Currie:
Yes, one of the biggest issues with innovation and actually being able to bring all of the knowledge and to share that and to help the profession in general and just healthcare in general and these multidisciplinary teams is that we need to be at the table and I don’t know what it is, but we are so often overlooked. But thanks to you, doing this podcast, and other women in health IT that we know that are also getting the word out there, I think that the tide is turning, and people are going to really start to learn what it is that nurses do. A lot of people, I think, just really still have this old idea that we are the physicians’, like … I hate to say it that way, but not probably the best way.
TJ Southern:
But it’s true!
Michelle Currie:
Right, so we’re not at the table. So that, I think is the biggest barrier because, you know, when we get in the table, when someone invites me to a meeting, oh, I see things all over the place and I’m asking a bunch of questions. And after they’re like, are we sure we want to invite her? But you know what? What ends up happening is that you identify all the risks upfront, and then your projects are successful.
TJ Southern:
Yes, yes, and that is the number-one key to projects for all my project managers out there, that is the number-one key to a successful project is to make sure that all of your stakeholders are at the table, and those stakeholders will help you identify all of the risks. That’s PMP 101. So, in stating that, how does your organization, or what it is that you do because I know that you’re an entrepreneur, how do you use data analytics? Or do you even use data analytics in your position?
Michelle Currie:
So, personally, for me as an entrepreneur, I use data analytics for business development. Who’s looking at my post if I post on LinkedIn. Who’s visiting my website, what types of keywords are people using, all of that SOA type of stuff. I do use it frequently with clients. I mean, a lot of my clients are in quality, a lot of them are doing performance improvement, a lot of them are working on interoperability, so that’s all about data and analytics. And so that’s kind of a multifaceted question, I think, and there’s different areas in ways that you need to look at it. At the very foundation, we have a problem with data in the industry. We not only have a problem with data in that it is captured and represented in many different ways. I wrote a post on LinkedIn about everybody’s using different Legos. Some are using Lincoln Logs, some are using Tinker toys, right? So that’s kind of my metaphor that I like to use. So the foundation of our data is a mess, and it’s very complex. It’s very complex because in order to bring data together from different places, you have to make sure that an apple over here.
TJ Southern:
Is that apple over here.
Michelle Currie:
Is mapped to an apple over here and not a crab apple.
TJ Southern:
Yes.
Michelle Currie:
That is not going to make any good pie, I’m telling you, alright? So anyway, that is why I mentioned at the beginning of the podcast that I’m very, I’m passionate about FHIR, I’m evangelizing it as much as possible. So that’s, that is one thing that we have to get that right. We have to get that right and that, after that, we’re also now, CMS is a big person who’s pushing the move to electronic clinical quality measures so that we can not only decrease burden on physicians or on documentation but people who put together and run those reports. Then the other, one of the other parts is, you know, it’s an art and a science to design a measure and to understand contextually, intimately what are you trying to measure and what is the best way to measure that, and what is the best data or data proxy to measure that process? So that’s a big part, and then lastly, the visualization is critical because you don’t want to have knocked up A, B, and C out of the park and then fail on D, right? So you really need to be able to figure out what is the best way visually to present this information in a way, you don’t want someone to have to sit there and read a slide or read all of this text, you need to pick out, a picture says a thousand words, right? To me, that is also an art and a skill, is picking the right visualization so that people go, oh.
TJ Southern:
I get it.
Michelle Currie:
I get it.
TJ Southern:
Yeah.
Michelle Currie:
I see it, I see it, right?
TJ Southern:
Yeah, yeah. Let me tell you this. Out of all of those things that you mentioned, every time that I heard you mention one of them, you talked about it being an art, being a skill set. So does this mean that there are additional opportunities for nurses in this arena?
Michelle Currie:
So can you say a little bit more about that?
TJ Southern:
Sure.
Michelle Currie:
Or just give me a little short example.
TJ Southern:
No, you’re absolutely fine. So what I’m wanting to know is, because we have all of these items, right? You talked about visualization, you talked about making sure that the apple over here matches the apple over there, right? So these are all new opportunities that are presenting themselves that are being found by individuals such as yourself, that are actually being considered or brought on as consultants, right, for these projects. So would this mean that there were opportunities for other nurses that are coming behind you to do these particular things, because that’s one thing that I hear in the Nurse Informaticist community for the students, right? Because I’m very well connected in that community. And a lot of times, the students are like, well, you know, I want to get a job, but am I going to get, do I, I want to go get a degree, but am I really going to get a job afterwards? And I’m always in there pounding and saying, guys, there are more opportunities than you realize.
Michelle Currie:
So what are, so I would say kind of as a new grad out of informatics, kind of the glide path is really to take a role as a super user. A lot of us have been there, that’s why it was one of my first jobs as an informaticist. That, to the community at large is the most, is what they see, as kind of an easy glide path. All of these other things that I mentioned, though, are there. So think about it, in order to do this data mapping and data harmonization, it kind of falls under harmonization, that’s in the industry what we call it. In order to map an apple over here to an apple over here and not a crab apple, you’re not just going to look at one data point. You need to look at a few data points associated over here to understand the context, because different, the same data can mean different things in different contexts.
TJ Southern:
Yeah, yeah, yeah.
Michelle Currie:
Medication is a perfect example. We have data related to medication orders, we have data related to medication administration, we have data related to medication refills, we have data medication records related to pharmacy inventory. So you have to really have an intimate, deep understanding of healthcare and healthcare operations because, in order to do the mapping, you have to be able to identify, okay, what is the larger context around this one piece of data and let me go find the equivalent somewhere else. And you know what? They’re never named the same, never. And so the reason why it’s so important to understand the context is because they’re not made the same. So that is one of the things. And I also, this is another thing, I see people, when I’m looking out for what’s available out there, I consistently see people posting jobs for people with a technical background. No, they do not understand the context of the information that we’re using enough to do the mapping. In claims, okay, stay with me, in claims, we have 40 roughly concepts that we’ve been using for decades, right? We’re familiar with that. Well, guess how many FHIR has, over 150. Going from 40 to 150, and so the FHIR data is much more granular, it’s smaller pieces. So you have to be able to create that context out of different things. In claims, that’s a bigger concept, it includes more of that context just in the data point itself. So that is one of the things that whenever I talk to anybody about data and data mapping, this is my soapbox that I get on, but I’ll get off. That’s one of the things. Another thing, in quality. Quality is a perfect place if you want to work in informatics, even if you may not, I’ll tell you what, you might not think you’re going to be using informatics, but you know what? You are. You are going to be mapping workflows, and when you’re mapping workflows, you are going to identify who, what and where. What kind of data are they getting? Who is collecting it? Where in the process is it being collected? And all of that is contextual knowledge, and you need to understand the contextual knowledge to identify the right data point to plug in and measure. So it’s kind of soup to nuts, you know what I’m saying? And all of these places are great places to start, right? Because you have the nursing context and understanding in operations. Maybe if you’ve been in administration or whatever, but you need to be able to integrate that with your informatics and your technical knowledge. And so those, I would say, the visualization, that will come, that kind of takes a little bit longer, I would say, to gain, because you have to be able to understand all the data and what you have available, right? But you also have to be able to put yourself in the shoes of the other person. So when I’m, as a nurse informaticist, when I’m doing a visualization, I’m looking at who’s in this room and I’m saying, okay, you know what, most of these people are in finance, I’m going to be talking numbers, okay? I better be talking per member, per month. I better be talking how much are we losing, because we’re not getting reimbursed for readmissions, etc., or pressure ulcers, hospital-acquired infections, all that stuff. So now that one takes a little bit more time and skill to develop because you have to be able to understand, you have to be able to speak to your audience because they want to know what’s in it for me.
TJ Southern:
Right. So the, so with that being said, what do you think we as the older generation of nurse informaticists, right? We are the ones that have been on the nursing informatics side, as you say it, you started as a super user, I did too. I started in the same way, and then I went along that path of building and working with leaders.
Michelle Currie:
Building is another great way, like super user. Build and configure those EMRs, girls and men.
TJ Southern:
So that, I took that same path. But how do we, being the older generation, help bring in the newer generation? Like how do we support them in that transition? Another person that I was interviewing stated, you know, administration, if they’re in the firefight, they just like to pluck nurses off of the floor and say, do this job. And then what happens is that nurse gets in that job and she’s just waffling, right? She’s just like a fish out of water. And then what ends up happening is she ends up hating informatics, right? And she ends up hating her job and then she just totally walks away. We don’t want that because we know that right now, cybersecurity, data analytics, data science, like you said, quality, all of these things are getting ready to explode. And so we need our sisters and brothers in that informatics world to come over. So how do we help them do that?
Michelle Currie:
So you know what? You actually brought something up that I hadn’t thought about and maybe an idea for a future podcast, is we need to help educate the people coming up behind us. What questions do you need to be asking in your interview of the people who you are potentially wanted to work for? You know what? They’re just not interviewing you, you are interviewing them.
TJ Southern:
Yes, ma’am.
Michelle Currie:
And so that, I think, is one way that we could help. You know, something that just popped into my mind is, you know what, when you’re in the beginning and if you’re even afraid of that happening or if it’s happened to you, maybe take a position that actually reports up through the IT infrastructure and not nursing or operations just to kind of protect yourself, right? So that’s just something that popped off the top of my head, but that I think would, might be a great idea for another podcast that you could do, seriously. Another thing I think is, and I’m so happy that you started this, we’ve got a group that I talked about that we’re kind of, you know, we’re kind of like making a little group of us here, right? And so one of the things that I think that we could do and we could do this, we could kind of get together and start this group and just share opportunities like, hey, you know what, I see this position, we could have a job where I say, you know what? As an experienced clinical nurse informaticist, I see this position posted in you know what, this would be a good one for someone who’s right out of school, and just have somewhere where people could go. We could, if we, in our work with our clients, right, and our contracts are engagements if we potentially see the opportunity that there’s flexibility with our client to bring on someone in an internship just to shadow us if nothing else.
TJ Southern:
Yeah, yeah. So let me tell you, we actually have informatics preceptors specifically for nursing informaticists, healthcare informaticists, we’re getting ready to launch that program full-time, August 28th of 2022. Yes.
Michelle Currie:
So put me on that list.
TJ Southern:
I will. I am, that’s been my baby. A lot of you don’t know, of my listeners, that I’ve been a preceptor since 2014. So I’ve been doing this for quite some time of helping transition those new nurse informaticists into, you know, a career path, into the career world. So Michelle is spot on. We have to have that. My other soapbox that I’m going to stand on is that we have to make sure that our nurse informaticists coming from the education, going into a preceptor program, that their preceptor program is strong, right? That they have that support, that they have that mentorship. That’s what happens a lot of times. The mentorship is kind of weak, and then what it does is the student then gets out into the career path and they’re like, well, I don’t know what I’m doing, I wasn’t prepared for an interview. That’s one thing that we pride ourselves on Informatics preceptors is, the students will have to rewrite their resume, and we prep them. We prep them in an interview process to get them ready for their interview. So we give them those questions that Michelle is speaking about, of what questions you want to ask your employer, like what type of work hours will I be working? Is it on call? Do I have to work weekends and holidays? What about your organization’s work-life balance, right?
Michelle Currie:
What is your mission, vision, and values?
TJ Southern:
Huh! Come on, yes. So, you know, you need to interview your employer, just like your employer interviews you, because a lot of people think being a nurse informaticist, oh, I don’t have to work any weekends, I don’t have to work any holidays, things like that. But as the person that I interviewed yesterday, she said, you might have an 18-hour day on the floor being a nurse and it is true! If the EMR goes down, you’re getting on a bridge line and you’re not going home until they have an ETA of when that EMR is coming back up.
Michelle Currie:
Right, yup, exactly!
TJ Southern:
So there are little things that, you know, being in school, that you’re not taught or you’re not shown, but Informatics Preceptors, along with Michelle and other nurse informaticists who are seasoned vets, we are going to be there to help sustain you guys, bridging education with applications, so.
Michelle Currie:
You know what? One additional point that I just thought of and you and I both talked about at the very beginning, you know what, a very good segue is taking a project management role. And you know what, girl, when I first got out of school and graduated, that was the biggest hurdle. I didn’t, I was not proficient in any, in all the Microsoft Word suite products.
TJ Southern:
Oh my god.
Michelle Currie:
Excel. I had to learn Access, like within the first year, and I was like, what? I’ve never built a database before. So that, I really, my informatics program did not, I mean and this was a long time ago, they’re probably much different now, but I was not really prepared from the business of healthcare perspective. And I think even if you don’t have it, don’t have any experience yet, take the project management certification classes. That you don’t, you can do that without anybody hiring you and that will give, you just open your eyes to a whole world, and you know that.
TJ Southern:
Project management was like icing on the cake for me. Now, I will say that exam was harder than the NCLEX, I will say that.
Michelle Currie:
Really?
TJ Southern:
Oh, yes, oh, yes. It was way harder than the NCLEX because it makes us, as Nurse Informaticists, come from a totally different background, right? Like you said, you had to learn Microsoft Access, you had to learn suite, you had to learn all those processes which we’re not taught in nursing school, so it’s like.
Michelle Currie:
Also the language, right? The language, just like they speak a different language kind of.
TJ Southern:
Correct, it’s a totally different language. But I will tell you, once I became PMP certified and I started running projects, you couldn’t stop me after that. I was going in.
Michelle Currie:
Well, and you know what? I actually just finished all my, continuing education that I had to take before taking the exam. And I was like, Oh my God, I need like some cheat sheet. There’s so many formulas, where do I focus, when I saw that you have one that I could buy and I want to buy it. I was like, Oh my God, if I trust anybody to lead me down this path, it is TJ.
TJ Southern:
Yes! Project management, love it, love it, love it. So I know that you and I could talk forever. Like, I said, I absolutely love you, Michelle.
Michelle Currie:
Right back at you, girl.
TJ Southern:
Do you have any parting words for our listeners? Do you have any parting words or any wisdom that you want to give our listeners?
Michelle Currie:
Yeah, you know what I would say, really? Like I said at the beginning, I had no idea where this journey was going to take me when I started. But the world is your oyster, as a nurse informaticist, I’m telling you.
TJ Southern:
Love it, love, love it, love it, love it, see?
Michelle Currie:
And one other thing, stay open-minded. People have, things have come across my path, job opportunities I was like, that doesn’t have anything to do with what I do, and then I sat back and I thought about it and I was like, you know, it actually kind of does. And those have been the best assignments. And that, just being open to something that doesn’t fit into this box is what has allowed me to gain this breadth and depth of experience that I now have over time. And you know how people are kind of talking about the T, the T individual who is deep in knowledge but also can go crosswise. People now are either one or the other, but nurse informaticists are that, can become a T.
TJ Southern:
Always, always, always. Michelle, it was such a pleasure to have you!
Michelle Currie:
Oh, my gosh. Thank you so much for inviting me, yes, it was.
TJ Southern:
Oh, my God.
Michelle Currie:
We have to figure out when we’re going to get together again soon.
TJ Southern:
We definitely will. So, alright, guys, we will talk to you later on another episode of The Future of Global Informatics. And if you are looking for informatics talent, nursing informaticists, please visit www.Beryllus.net. That is www. B E R Y L L U S .net. Until next time, guys. Thank you, Have a great day,
Michelle Currie:
Thanks everyone! Bye-bye.
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