Nurses Call to Action to Realize Sharable, Comparable Data

In spite of our best collective efforts, and after decades of implementing electronic health records, nurses still can’t consistently use EHR data for research, or for reporting quality and patient safety outcomes.

This concern was the focus of an invitational conference that I participated in this week at the University of Minnesota School of Nursing, attended by a diverse coalition of stakeholders.

National leaders in nursing, healthcare, and informatics came together to develop an action plan for shaping health policy and informatics initiatives that use a national nursing knowledge model. Our primary goal is to guide consistent documentation and data collection to support big data research for transforming healthcare. So, after hearing presentations on a vision of the future, enablers, gaps and challenges, and participating in multiple, iterative, facilitated discussions, where did we land?

We created an action plan for:

1)      integrating nursing information into health and healthcare knowledge systems;

2)      optimizing nursing language and healthcare information;

3)      influencing policy; and

4)      modifying and standardizing the informatics educational framework.

This action plan will organize and present knowledge for clinicians and consumers, so that together, they can make the best decisions about their health and healthcare. How cool is that?!

To advance the vision of a transformed health system, we need a more-coordinated structure where information can be easily and safely shared among patients, consumers, clinicians and providers to enable improved outcomes, quality of care and lower costs. This vision requires access to real-time, accurate, and actionable health information. Attendees focused on determining what we can do to achieve the vision.

Specific components of the action plan are to:

  • Develop a strategy/campaign for educating front line nurses, students, and faculty on informatics competencies and the value of standardized nursing data;
  • Advocate for the adoption of SNOMED-CT and LOINC as national standards for clinical data, and link them with nursing terminologies through mappings;
  • Convene a consensus conference with leaders of the major nursing organizations and interprofessional stakeholders to educate them, hear their views, and ultimately, speak with one voice;
  • Refresh and activate the ANA’s NIDSEC (Nursing Information & Data Set Evaluation Center) criteria to advance systems that represent and value nursing data; and
  • Participate in standards and profile development to ensure a nursing voice.

Why is this action plan important? As knowledge workers, nurses must leverage clinical data from the EHR to:

  • Optimize workflow and support clinical decision-making;
  • Tell the patient’s story;
  • Collaborate to foster knowledge translation;
  • Leverage analytics to extract actionable knowledge;
  • Use sharable, comparable data; and
  • Build evidence out of nursing practice.

 And ultimately, when we realize this transformed healthcare system…

  • Our focus is on patient satisfaction, patient safety, health promotion, and quality of care.
  • The healthcare experience is personalized.
  • Consumers are engaged in their health and healthcare, with their care team.
  • Evidence-based care is improving outcomes and promoting health

As we tackle this action plan, nursing informatics is leading the way. This is an opportunity to step outside of our comfort zone to make a difference. Your participation is not only welcome, it is needed. We seek your help in further developing and executing the action plan.

Let me know if you are interested in participating, and please watch for specific opportunities in future blog posts. There are exciting times ahead!

About Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN

Joyce Sensmeier, RN-BC, MS, CPHIMS, FHIMSS, FAAN, is HIMSS Vice President, Informatics.
This entry was posted in Health IT, Health IT News and Developments, Nursing Informatics and tagged , , , , . Bookmark the permalink.

7 Responses to Nurses Call to Action to Realize Sharable, Comparable Data

  1. btritle says:

    Joyce, I’m so glad to hear of this effort, meeting and action plan! I think all of the items considered are important, and would also like to suggest nurses (the most trusted professionals, according to consumer surveys) look at taking a lead on suggesting community-based patient longitudinal infrastructure “where information can be easily and safely shared among patients, consumers, clinicians and providers to enable improved outcomes, quality of care and lower costs” as you described. There is a growing recognition that we need an HIE-like infrastructure that also involves patients and caregivers (and nurses are often considered patient advocates), as well as professionals, and researchers, but that is architected in a way that facilitates all of the attributes of a desirable Health Information Infrastructure (such as ability to be used for research with patient consent, and is an auditable source of truth for the patient’s record, including med rec). Health Record Banks should be a consideration. A new advisory board has been established for the Health Record Banking Alliance (HRBA; http://www.healthbanking.org/board.html) that includes myself, but also Fran Roberts, PhD, RN, FAAN, Ted Shortliffe, MD, PhD (Chair), and others. I would love to see how the HRBA might interact with this initiative.

    • Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN says:

      Thanks for your excellent comments and for the outreach. Sounds like these efforts have much in common. We will be sure to add the Health Record Banking Alliance to our list of collaborators and we look forward to working with you!

      Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN
      Vice President, Informatics , HIMSS

  2. btritle says:

    Thank you, Joyce. I’ll make some introductions. Thank you for your leadership!

  3. Nurse Sensmeier, this doessound exciting. Is there a web site with more information ? Perhaps a list of who participaated? Plugging a “nNational Nursing knowlege model” into the national healthcare diologue is a vital step forward. I’m interested to read what others took from the UMSN discussion. Is there a Google+ or LinkedIn forum yet? Excited informatics nurses, myself include, want to know more. Please & Thank You!
    Cleveland in Atlanta

  4. Ann Farrell says:

    HI Joyce,
    I have long lobbied HIMSS and EMR vendors and nursing leaders re the value (benefits and cost effectiveness) of aligning with a common nursing nomenclature to analyze nursing processes and performance and better quantify our contribution to outcomes, including the bottom line.

    VBP and Obamacare is a “game changer” with RNs-driven outcomes for first time driving significant revenue. If nursing fails to better quantify its contribution to financial, clinical and service performance, RNs will continue to be laid off, marginalized and replaced inappropriately with less educated personnel.

    VBP ties payments to new metrics (Patient Experience, Readmissions, HAIs) all clearly nurses’ domain. Yet CFOs with one foot in FFS and the other in VBP will use blunt cuts in nursing budgets as a profitability strategy. Nursing remains the largest labor expense base is in the crosshairs with revenue shortfalls and profit focus (FP & NFP CDOs). We need to look beyond ratios and acuity to better analyze what we DO that drives positive outcomes that justify ROI in nursing. We would validate resource allocation and establish RNs appropriate roles, and uncover “sacred cows”, i.e. tasks we could safely delegate.

    I am painfully well aware of the politics with nursing nomenclature vendors/ providers. As former RN/Nursing exec and vendor R&D VP however, I don’t understand HIMSS (NI or IT) or CDOs vision of how 9 AHA approved diverse nomenclatures (some not designed for computers) can be mapped AND normalized. Why is this the proposed solution versus a common inclusive language that maps to SNOMED and LOINC and ties interventions to outcomes? Has a presentation comparing these two approaches been published? Would MDs or lab and pharmacy professions proposing 9 disparate nomenclatures be considered seriously? Has an analysis been performed considering cost, results and practicality of implementing this approach?

    In our experience, Nursing is often invisible and undervalued as critical thinking profession. MU is MD-centric, while advocating a team based care approach. RNs are order takers (eMARs are “completion of an MD order”) and documenters of data for MDs (BMI data for med orders, not complete data sets). Concepts of care plans now being coopted in government committees. Roles RNs have long mastered, although not been reimbursed for (care coordination, patient education and case management), are being reassigned with payments now attached. Nursing has not well articulated our value in business terms, in part because we lack a common language designed for computers, but mostly because we have never billed for service.

    VBP and Obamacare is new and unfolding. Thus it’s an ideal time for these efforts in order to create optimal care teams, clinical processes and financial models. I look forward to following this initiative.

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