The healthcare community is ‘abuzz’ with new efforts to accelerate implementation and adoption of EHR systems. In my role as Vice President of Informatics, nearly every day I learn of new EHR projects that are underway, many that involve disengaging from one vendor system and moving forward with another. Interestingly, the general press is nearly silent about the role of nurses in this systems upheaval. Perhaps that is our own doing because we – as nurses – are so ‘heads down’ busy making sure the project plans are in place, the workflow is analyzed and the new systems are optimized.
But, let me take a moment to highlight the nurse’s role in driving technology decisions and ensuring EHR implementations are successful.
Too frequently, nurses are not effectively engaged as leaders of IT projects, and as a result, nursing workflow and even productivity are negatively impacted when systems are poorly designed, or the usability needs of nurses are not addressed. As an informatics nurse who has been active in this space for decades, I know the value of informatics nurses first-hand. Believe me, none of my colleagues are confused about the important role they play in IT system implementations.
Nurses are central to the ARRA principles for ensuring that meaningful use of certified EHRs improves the quality of healthcare by:
• Promoting care coordination
• Improving continuity of care
• Reducing medical errors
• Improving population health
• Reducing health disparities
• Reducing chronic disease
How could we begin to accomplish these clinical outcomes without involving nurses?
The specialty of nursing informatics was first recognized in 1992 by the American Nurses Association with the publication of the Scope of Nursing Informatics Practice. I served as a contributor to a subsequent revision that describes how the specialty is evolving.
Results from a HIMSS survey of healthcare IT leaders identified that informatics nurses involved in system analysis, design, selection, implementation and optimization of IT have the greatest impact on patient safety, workflow and user/clinician acceptance.
According to the 2008 HRSA National Sample Survey of Registered Nurses, there are more than 9,000 informatics nurses in practice today. These informatics nurses work in partnership with chief nursing officers and chief medical informatics officers to ensure that informatics competencies are successfully applied to the complex IT systems being rapidly implemented in healthcare organizations.
Clinical informaticists are in demand to guide these efforts, and recruiters note that salaries are exploding for those with a nursing background. Together, we must work as a team to lead the clinical transformation that is necessary to improve the quality of healthcare through meaningful use of technology.
In future contributions to this blog, I’ll explore how we can raise the visibility and value of nurses to improving patient safety and quality outcomes in the current scramble to take advantage of incentives.
Thank-you Joyce for bringing forward the signficant role nurses and our allied health colleagues play in meeting ARRA and Meaningful Use criteria – and ultimately achieving meaningful work and outcomes. Your experience, advocacy and global perspectives will serve many. I look forward to following your blog….
I enjoyed your post and could not agree with you more. In my relatively new role as a Informatics Nurse Specialist I intend to use IT to help improve patient outcomes and advance nursing practice. I am hopeful that meeting the goals of ARRA meaningful use will highlight the valuable role nurses play in patient care. I believe we need to take this opportunity to help advance the nursing profession. I look forward to reading your future posts.
Joyce,
If there’s anything I’ve learned from you and the nurses that I’ve worked with over the years is that nothing gets done without them. We wouldn’t be where we were today with respect to ARRA and HITECH if it hadn’t been for the efforts of nurses who have been involved in all of the Healthcare IT activities that have led us to this point. Your post reminded me that there’s something I need to do for one nurse in particular.
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Thank you Joyce,
Great comments about the role and importance of nursing and informatics. I agree that nursing is head-down and at work to accomplish all of these associated tasks with “Meaningful Use”. The importance of involving us from the begining is critical to any facilities success but falls to us to get involved. I remain hopeful that our expertise will be valued and recognized as we move forward in improving the quality and safety our patients’ experience.
As you say nurses have and are contributing much to all the changes that are occurring. I am teaching a graduate informatics course and often hear the great successes that are going on in my students’ facilities. As a consequence, I have encouraged several of them to publish their successes, so all can share and learn.
Great post, Joyce!
I believe the most important role I have as a nurse informaticist is to be an advocate for the bedside nurse! Before ‘meaningful use’ was common terminology, nurse informaticists have had a vision for leveraging the data in our EMR systems to provide feedback to clinicians in real-time on the patient’s progress toward going home. HealthIT will have meaning for nurses when the time and effort spent documenting is transformed into time saved through evidence-based clinical decision support.
I completely agree! Informatics Nurses should not have their “heads down.” If these nurses were not involved in the process of EHR it would not be nurse friendly which in turn would take nurses longer to use the programs and would take valuable time away from the patient. It is very important to have nurses involved because they use the system the most. Many medication errors have been corrected by a nurse before they even made it into the patient’s room. The EHR is wonderful because the patient’s information is readily available to each person providing care to the patient and everyone is clear of what the patient needs. This makes the nurses and physicians work as a TEAM to provide the best care for the patient. By involving nurses in the making of the EHR it will be nurse friendly. The nurses that help design this technology will be able to go into the health care setting and explain the process of the EHR in a way that nurses will understand and will be able to relate to the “nurse-lingo.” Physicians and nurses relate to a patient in different ways much like they relate to the EHR in different ways. I am so excited that nurses have been involved in this project because many times nurses do not receive the credit they deserve!
Your post is very interesting and true. without nurses, patient care will be greatly affected in a negative way. However, with the new AHA and the use EHR and all the clause in it, do you think nurses are currently adequately equipped with the knowledge base to carry out this new policy. I am of the opinion that not all nurse are knowledgeable with the new policy. I might be wrong, so I am looking for articles on nurses knowledge of the use of EHR for my capstone work. Do you have any references to offer? I will be most greatful.
Thank you