Cognizant of their critical influence in healthcare, nurses are taking a more active role in health IT leadership and implementations around the world.
It’s been said that nurses are the backbone of the healthcare system. Nurses care for patients at the bedside, in schools and communities, and at homes. With technology rapidly changing healthcare, it is critical for nurses to have a resonant voice and a big role in health IT implementations across practice settings to ensure every project’s success.
Taking the Lead
Many hospitals and facilities have created specific nursing informatics roles for nurse leaders within their organizations to help steer health IT projects to success. Many of these nurses first became involved with health IT by helping their facilities implement electronic medical records for clinical care—with specific applications like computerized physician order entry (CPOE). Over the years, many have transitioned to leadership roles as nursing informaticists.
"I think nurses have a unique ability to transition into IT fairly easily," Theresa Meadows, MS, RN, CHCIO, FHIMSS, and CIO (Chief Information Officer) at Cook Children's Health Care System in Fort Worth, Texas, said in a FierceHealthIT report. "We have a lot of complex situations [to handle]. I think workflow and process and understanding how hospitals work is very important--and nurses bring that skill set."
Meadows is currently helping the organization create a business intelligence and health populations analytics initiative.
Patricia Sengstack, DNP, RN-BC, CPHIMS, and CNIO (Chief Nursing Informatics Officer) at Bon Secours Health System in Marriottsville, Maryland, said nurses can serve as a bridge between clinicians and the technical team—two sides which have different approaches to solving problems.
"Nurses can play a pivotal role not just at the IT table, but also as peers to other IT colleagues," Sengstack said in the article. "It's really getting everyone to think in terms of the benefits that IT brings to the clinical setting rather than looking at it from a true IT perspective. [Nurses] are really seen as specialists in understanding that translation between IT and clinical."
Nurses as Partners
In a post about Cerner’s Nursing Informatics Boot Camp, Katie Chaffee, Cerner’s senior vice president, Worldwide Consulting, highlights The Institute of Medicine’s (IOM) Future of Nursing (2011) report:
”Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States” and recognize that “effective workforce planning and policy making require better data collection and an improved information infrastructure.”
Nurses are stepping up to the challenge as IT changes swoop into healthcare. According to the American Medical Informatics Association (AMIA), nurse informaticians could advance today’s healthcare by taking on new roles such as:
- Chief Nursing Officers
- Chief Information Officers
- Developers of communication and information technologies
- Educators and trainers
- Researchers
- Software engineers
- Implementation consultants
- Policy developers
- Business owners and consultants
Nurses are also getting graduate education in IT and informatics provided by several colleges and universities. Many take the Informatics Nursing (RN-BC) accreditation offered by the American Nurses Credentialing Center (ANCC).
Outside The United States
The Canadian Nurses Association (CNA) believes that
“Registered nurses should advocate for and lead efforts toward the collection, storage, retrieval and use of nursing care data to generate information on nursing outcomes.”
The CNA has been successful in pushing for Canadian nurses’ greater role in the country’s health initiatives—such as EHR, telehealth, decision support systems, workload measurement, and virtual learning environments.
“Registered nurses have been leaders in telehealth and nurse-led patient advice lines that are now improving access to primary care in many provinces and territories,” the CNA said in a statement.
Across the pond, in the United Kingdom, nurses are also beginning to learn new skills as digitized, information systems slowly replace paper-based workflows.
“New training modules for nurses in data collection and analysis are developing the day-to-day understanding needed for nurses to reach long-term consensus on standardised content, so the future is bright,” Anne Cooper, Clinical Informatics Advisor (Nursing) at NHS England Mirfield, West Yorkshire, wrote in a HIMSS article.
She added that nurses are ably acting as “navigators to support patients taking more care of their own health and well-being” by perusing a growing, and often confusing, array of information resources.
Meanwhile, nurses in the Middle East, where digital health is taking off, have been involved in numerous IT implementations in their facilities.
For instance, nurses at King Faisal Specialist Hospital and Research Center (KFSHRC) worked with the hospital’s IT department in developing an EMR solution for home health care patients.
“The Nursing Informatics Department at KFSHRC played a major role in developing the solution,” Samir Sawli, CPHIMS, RN, PhD, Senior Business Analyst at the Sidra Medical and Research Center, and Ali Awada, RN, a Nurse Unit Manager at KFSHRC told HIMSS. Both worked on the project.
In Hong Kong—which is described as having one of the world’s most advanced healthcare systems—community nurses in the early 2000s actively participated in the development of a Community-based Nursing Information System (CBNS) which made use of palm mobile devices. It helped them retrieve and use patient data while performing some 800,000 home visits annually. Today, older mobile devices have given way to tablets and smartphones, but nurses in Hong Kong have continually updated this system—which now features a 5-ounce EHR device—according to a HIMSS article by Eric Chan, who was the Principal Nursing Officer at Hospital Authority, Hong Kong at the time of publication.
Other countries in the Asia Pacific region—such as China, Japan, Korea, Taiwan, Malaysia and Singapore—have had active health IT and mHealth programs in the past ten years wherein nurses helped develop EHRs in hospitals and communities, as well as nursing informatics curricula for student nurses.
In Brazil, nurses held a key role in developing and implementing computer technologies in the medical sector. This movement started in the 1980s when nursing faculty from Federal University of Rio Grande do Sul used computers to teach home care. Today, the Brazilian Health Informatics Society’s (SBIS) Nursing Informatics Working Group (SBIS-NI) is active in various telemedicine and telehealth programs to reach Brazil’s underserved minorities in the interior Amazon basin.
During the past decade, more nurses have become actively involved in many different types of health IT programs in many organizations in the United States and other countries—leveraging their clinical expertise to mitigate risks, while maximizing the potential of IT to improve patient care.
Jof Enriquez is a registered nurse, medical writer and healthcare journalist. You can follow him on Twitter @jofenriq.