‘Welcome to Healthcare’
The idea for this post — which will be published in two segments — came after I recently had someone actually thank me (!) for quickly explaining the fundamentals of healthcare to them.
After that conversation, it dawned on me that I’ve never really found a good welcome introduction to healthcare, the industry that I’ve worked in for years. It’s been open for business, 24/7, for roughly 250+ years, but has never had a good opportunity to pause and ask itself: What we are doing, and how we are doing it?
If you’re a newcomer to healthcare, the welcome can sometimes seem a little cold and informal, like the graphic to the right.
While there are some reasons why seasoned healthcare professionals might greet newcomers this way, it doesn’t actually help newcomers understand healthcare. Sure, it’s an industry that saves lives and treats diseases, but it can also make technology companies throw in the towel, and cause frustration for politicians, providers, and patients alike. We could probably all benefit from newcomers having a good understanding of its inner workings, before they get started.
So, as a Clinical Informaticist, clinical translator, and general ‘tour guide’, I thought I’d write a friendlier, more explanatory piece, to help newcomers succeed by better understanding the fundamentals of this industry.
First, let’s start with a sample diagram showing the overall structure of a typical healthcare organization:
If I actually did a walking tour of this ‘House of Healthcare’ (not an org chart!), it might actually sound like this:
The Administrative Room
Walking into the administrative room, you can see a lot of departments, collectively tasked with running the organization and providing services to the areas below them. From here, some of the departments include: Finance, Human Resources, Legal/Regulatory/Compliance, Privacy and Information Security, Contracting/Procurement, Employee Health, Public Safety/Security, Staff Education, the Switchboard/Operator, Staff Directory, Public and Internal Communications, Enterprise IT/Informatics, Enterprise Project Management, Enterprise Analytics and Data Governance, and even the Library!
These departments are all busy managing the day-to-day support needed for the Academic/Education, Research, and Clinical domains below them — and that means understanding both the common and unique needs of these three areas. (This is no small task!)
The Academic/Educational Room
Walking down the path from the Administrative area, the Academic/Educational room often has a lot of schools/departments, including Medical, Nursing, Dental, Pharmacy, and other Ancillary types of schooling. While these students and staff may also do research, and may provide clinical support (work) to the clinical enterprise, the main focus of this area is academics and education. So, for example, a Medical school might have several divisions:
- Undergraduate Medical Education (UME)
- Graduate Medical Education (GME)
- Continuing Medical Education (CME)
Before you think that these academic areas have it easy, keep in mind that clinical care and technology are constantly changing at an increasingly rapid pace. What was once considered desirable in the past — memorizing textbooks full of science and clinical information — is now considered passé, since a student who rotely memorizes facts is only memorizing clinical information that is rapidly outdated. Modern clinical educational thinking depends on not only learning a great deal of foundational knowledge, but also incorporating electronic databases and real-time decision-support tools into daily practices, with the goal of producing clinicians (doctors, nurses, and pharmacists) who continuously improve their knowledge while making decisions.
Finally, since the Research and Clinical Enterprises often depend on the students and staff from these Academic areas, they are a cornerstone of many healthcare institutions. (Except non-academic institutions, which do not have an academic/educational mission.)
The Research Room
From the Academic/Educational room, you can walk down the hallway to the Research room, where you’ll find a lot of very important departments, including: The Independent Review Board (IRB), Grant Management, Research Centers, Research Laboratories, Research Compliance, Research IT, Research Analytics, and Translational science. And of course, a lot of highly-educated Researchers and Research Assistants!
This research is very important to us as a society, since it drives the foundations of medicine by creating the therapies and understanding that we all depend on.
In the next installment, we’ll tour the clinical enterprise, which is broken down in three areas, while also touching on a few other key segments.