Future Directions for Translational Informatics - Translational Informatics: Realizing the Promise of Knowledge-Driven Healthcare - page 159

needed. While many standards currently exist for describing healthcare data, robust
standards and meta-data that describe the how, what, when, and where of data col-
lection for the types of data essential to translational informatics remain under-
developed [ 12 , 17 ].

10.1.2.2 Cultural Norms

Beyond the technological, prevailing cultural norms signifi cantly impact prog-
ress in translational informatics. In many ways cultural issues have a greater
impact on the development adoption and use of translational informatics capa-
bilities then do the technical and are often far more challenging to overcome.
Indeed, as Reed Garnder, an informatics pioneer once stated, “The success of an
(informatics) project is perhaps 80 % dependent upon the development of social
and political interactions of the developer and 20 % or less on the implementation
of the hardware and software technology!” [ 18 ]. Today's cultural norms in
healthcare and biomedicine impact such translational informatics efforts greatly,
largely because they are still very much aligned to support the traditional, non-
translational, healthcare approaches. Only when those change over time will
translational informatics professionals be able to make more rapid progress with
fewer challenges; unfortunately culture change often takes much longer than
technological change. After all, computers do what they are “told” whereas peo-
ple often do not.

10.1.2.3 Organizational Factors

Along the same lines, organizational factors are also of great importance to the suc-
cess or failure of translational efforts. After all, it is at the organizational level that
decisions about relevant policies and funding are often made. Unfortunately, cur-
rent models for organizational structure and alignment in healthcare are largely
designed with only the healthcare delivery and not the translational research agenda
in mind. Even at the level of empowered and resourced IT leadership, today's pre-
vailing leaders such as CIOs and CMIOs concern themselves primarily with the
clinical and operational missions, often with limited expertise in nor attention paid
to the needs of the research mission. Recently, some academic health centers have
seen fi t to established IT leadership roles specifi cally focused on advancing the
research mission, centralizing and empowering the governance of research infor-
matics/IT alongside clinical and operational IT. Such models should help to facili-
tate responsiveness and strategic planning focused on the unique and often complex
needs of the research community. They should also yield economies of scale both
by enabling investments in IT infrastructure that can often serve clinical, opera-
tional and research mission areas, and by advancing translation between knowledge
and practice [ 19 ].