It’s so important to take time to acknowledge the many contributions of nurses and to recognize our current and future leaders. After reading this week’s blogs and the different perspectives on nursing, I have a BIG smile on my face.

What really grabbed my attention was the passion and excitement each nurse expressed about her work. It seems clear that each of these individuals is demonstrating leadership in her current role, from graduate student to HIMSS Board Chair-Elect, from vendor to provider.

As I look back on this week, I am reflecting on what it takes to be a leader.

Who comes to mind when you think of someone who is a great leader? Some of the bloggers this week mentioned people who inspired them to begin their nursing careers. Others reflected on events that occurred or mentors that encouraged them to advance down a certain career path.

What leadership traits do you admire most in those that have inspired you?  One trait that comes to mind is being willing and able to stand up for what you believe in. Leaders do this well. It is not an afterthought, or something they have to be reminded of. It simply comes from having the courage of their convictions.

• Do you speak up for what’s important in your organization?
• Do you do the same in your profession, your specialty, or your community?
• Are you able to express yourself in a way that makes others listen?
• Are you willing to push yourself outside of your comfort zone?

Speaking up for what is right requires being confident that you are focused on the right principles and that your mission and vision are sound. Nurses are, first and foremost, patient advocates. That advocacy role lays a wonderful foundation for speaking up on others’ behalf. True leaders challenge themselves and others to make a difference. Speaking up takes courage, but when you look back at your career, I bet those are the moments that you will remember, and be most proud of.

I will never forget one of the nursing instructors in my ADN program, Mrs. Ackert. She had a reputation for being tough and giving students a hard time. But she taught me one of the best lessons that I learned in school. She reminded us daily that we weren’t becoming nurses to simply give good patient care. She stressed that the most important thing that we were learning was how to think. And I still take that advice to heart each day.

• Do you think about how you influence those around you?
• Do you take the time to mentor others as future leaders?
• Do you empower your staff members to think for themselves and take the necessary actions to advance their work both within and outside of your organization?

If so, this is a great week to commend yourself as a leader and for others to offer thanks for what you do. 

And, before we leave Nurses Week, be sure to check out the many tools and resources the members of the HIMSS Nursing Informatics Community have developed to help you advance as a leader.

In closing, I will quote another great leader who said, “As we look ahead into the next century, leaders will be those who empower others.” Bill Gates.

Sounds like good advice to me.

My older sister was my inspiration to go into nursing.  She was my inspiration for most things growing up, as the younger sibling who wanted to be just like her, from the clothes she wore to the activities she joined.

I was a total copy cat mostly because she was so passionate about her approach to life in everything she did that it created an energy and enthusiasm for others in a way that just made you want to be part of whatever she was in to.  My choice to go into nursing was no different. 

While I have always admired my sister, there is still that sibling rivalry that middle children seem to be blessed with, so I knew I wanted to go into nursing but that my career path, once in the profession, was going to be very distinctive and completely opposite from hers, so that I could stand out. 

So, before ever entering school or laying hands on a patient, I knew that I was not going to be a Pediatric Nurse Practitioner or a Legal Nurse Consultant, like my sister. And that’s when I set my goals on forensic nursing.  I wanted to study crimes and care for my patients by helping to put their offenders behind bars.  I guess you could say being the middle child also gave me a flare for the dramatics!

Then I started nursing school. 

During my first week of my first year of a BSN program, I took an Introduction to Nursing Informatics class at Case Western Reserve University in Cleveland, Ohio, and I was hooked!  From the moment my instructor (and my first nursing informatics mentor, Chris Hudak) began her opening remarks to the class, I caught the informatics bug! 

At the time, in the mid 1990s, this was only School of Nursing in the country to offer this curriculum to its undergraduate nursing students all four years of the program.  Case Western Reserve University was also awarded as the “Most Wired” University in the country when I attend, so technology was becoming a part of the main stay in dorm rooms and across campus life. 

That said, I was still a very rare case with my instant interest in this field.  All of my classmates, like most nurses today, could not understand or see the significance as to why nurses need to engage in the adoption of technology at the point of care and how this specialty area of nursing practice had any practical application to caring for patients. For my analytical mind though, it just clicked. 

I was inspired from moment-one of my nursing journey to give high quality, efficient care to my patients and to other nurses by helping to manage data and information in a safe and effective way that promotes patient care.  I couldn’t help but sit in class as a young college freshman and think of the endless possibilities for the future with this field. 

At that point, I worked steadily to improve my clinical knowledge and experience as well as my technical knowledge and system experience.  For me, the two will forever go hand-in-hand throughout my nursing career.

Note:  In conjunction with HIMSS Professional Development and Informatics sections,  Cleveland Clinic is hosting the Nursing Informatics Institute on May 31. Find out more..and register…here.

Marianela ”Nelita” Zytkowski, DNP, MS, RN-BC is Senior Director of Nursing Informatics at Cleveland Clinic Health System in Cleveland, Ohio.

How did you decide to become a nurse? I always had an interest in science and the study of health. When I was in high school, I became a nurse’s aide, and I found the work extremely interesting. From there on, I never questioned what I wanted to do. I was one of those few students who go to college and never change their major!

How did you transition into nursing informatics? For the first few years after graduation from nursing school, I worked as a staff nurse in various acute care settings, but I knew I wanted to pursue further education. Since the university I attended did not offer a MSN/MBA degree, I pursued the MBA to leverage nursing better within business and management communities.

After graduation, my first management role was as a Director of Nursing for a 770-bed hospital in Florida. I was pleased to contribute my expertise and be the voice at the administrative table for other nurses for 12 years. Then, pursuing a different direction with an eye on ways to improve the quality of care, I began to participate in quality improvement work and attended a nursing informatics meeting.

The meeting was fascinating, and I recognized immediately that informatics held great power for nursing and patient care. However, everyone spoke in acronyms, and it was difficult to understand the content of the meetings.  I decided it was time again to pursue more knowledge, and the path for the future became more clear.

I took four graduate online nursing informatics classes at Indiana University. One of my projects was with TIGER, where a small group of students and I looked at the extent to which nursing graduate programs had included informatics content in their Doctorate of Nursing Programs (DNPs) programs. From there, I rapidly became involved in a series of TIGER projects.

During that time, I also pursued my own goals for more education and attended the ONC’s Community College Consortia Program for HIT in the Implementation Manager Role Program. Before becoming the Senior Director of the TIGER Initiative Foundation, I worked as a clinical analyst implementing EHRs. In this first role as the Senior Director for The TIGER Initiative Foundation, I am on the front-end of establishing a foundation,  working with national collaborators and helping develop the structure and infrastructure of The TIGER Initiative Foundation.

What advice would you give nurses looking to get into the Informatics field?

1. Ask questions. Become involved in informatics related projects or committees.                 

2. Learn the terminology. There are plenty of online opportunities to learn about nursing informatics either through formal graduate classes or CEU classes. Education in this field is vital, and the learning curve is steep, but so rewarding! As soon as you are involved in informatics, you can see the value to the nursing profession.

3. Avail yourself of information in informatics-related organizations, such as HIMSS and the TIGER Initiative Foundation.                                                              

4. Try to find an informatics mentor. I have been grateful for the mentors I have had over the years, they really make a difference in your career. 

What do you see your role as within Nursing Informatics today?

• Educating nurses regarding informatics and technology and their important role in the success of informatics to change healthcare; and 
• Continuing the work that I have done in the past related to implementation of nursing informatics in interdisciplinary environments and across the continuum of care.

Sally Schlack, RN, MBA, is Senior Director, The TIGER Initiative Foundation.

Why did you become a nurse? My immediate response when anyone asks me this question is “divine intervention.”  I was in high school when I was called out of class one afternoon by a high school guidance counselor.  He informed me that I fit the profile perfectly for a new nurse co-op aide program with a local hospital, and before he could say any more I exclaimed, “I don’t want to be a nurse!”  He encouraged me to consider this unique opportunity and after discussing it over with my parents I decided to enroll in the program.

Michelle Troseth, RN, MSN, DPNAP

My initial reaction about nursing was primarily due to having no nursing role models in my life, and the stereotypical television characters of nurses back in the ’70’s did little to entice me into the career.  But here is the good news…..when I started working in the hospital and side-by-side with nurses….I was AMAZED by who nurses were and what they did. 

I saw quickly how they played a key role in patient care.  I also was in awe of how much nurses knew (and how much they needed to know) to deliver the best care possible.  I am forever grateful for the knock on the door from my high school counselor, Mr. Rice.

Last December, I had the honor of being recognized as Alumni of the Year at Grand Valley State University (BSN ’83 and MSN ’97) and one of the highlights of the evening was being able to have Mr. Rice there, who I had not seen in over 30 years, to thank him for being the angel in my life that introduced me to nursing!

How did you transition into informatics?  After working three years in critical care, at the same hospital where the nurse co-op aide program was, I decided to go to another hospital where a new professional practice model of care was starting.  Bonnie Wesorick, MSN, RN, DPNAP, FAAN, was an assistant professor my senior year in college, and a mentor of mine. 

She left academia to start the Clinical Practice Model (CPM) and to create the type of environment and tools nurses needed to support their professional practice.  It was through the evolution of CPM, and my transition to a leadership role at the hospital, working in partnership with allied health and the hospital information system department, that I co-led a very committed group of clinicians in creating the first evidence-based, interdisciplinary clinical documentation system based on the CPM Framework. 

In 2001, I left the hospital and joined the CPM Resource Center to help lead the integration of professional practice and technology, and to help guide a growing CPM Consortium through the transition from paper to computerized documentation.  My first title was VP of Point-of-Care Automation, which I loved, because it represented the need to automate at the point of care – where care happens!  In the ’80’s and ’90’s so much of the focus in healthcare automation was in billing and non-direct care areas – it has been a long road looking back.

Part of my informatics journey involved becoming part of a software company (Eclipsys) from 2004-2007, which has led to my current home at Elsevier Clinical Decision Support, (2007-current) where Elsevier CPM has continued to grow and thrive.  Today, we have close to 400 hospitals using multiple health information technology systems that are using the same CPM tagged data-base for intentionally designed automated evidence-based interdisciplinary care planning and documentation. 

This year, we have accomplished another milestone by working directly with hospitals, even if a business-to-business partnership does not exist with their health IT vendor –and it has been strong nurse leaders advocating for the clinical team to ensure they have the practice support they need as they automate their care processes.

Another major part of my informatics journey has involved my engagement with key groups to advance the evidence and informatics agenda to prepare educators and practitioners for the 21^st century of practice.

I am proud to say:

• I have been part of TIGER (Technology Informatics Guiding Education Reform) since its first meeting at Johns Hopkins School of Nursing in January of 2005. 
• I have since served as the TIGER Summit Program Chair (2006) and co-chaired the TIGER Collaborative “Usability and Clinical Application Design” (2007-2008).
• I am now the Co-Chair of the newly formed TIGER Initiative Foundation, now a 501(c) (3) organization operating for charitable, educational, and scientific purposes.
• I also have been engaged with HIMSS Nursing Informatics and Usability Task Forces and have presented at national and local HIMSS conferences.

What advice would you give nurses looking to get into the informatics field?

• Make the connection between professional practice and technology.
• Volunteer to get engaged with efforts at your school/primary practice/hospital/health system to automate their clinical systems.
• Partner with all disciplines. Just as nurses are the coordinators of care at the point of care, informatics brings coordination for nursing informatics at the system level.  Patient care includes all disciplines and it must be well-integrated.
• Partner with nurse leaders (CNOs, Directors of Nursing, etc) to hear their vision of what informatics can do to improve patient care.
• Join HIMSS at the local and national levels – and get engaged with various work groups.
• Become engaged with the TIGER Initiative Foundation and use the TIGER Reports in your efforts to understand and implement information systems.
• Become a Polarity Thinker – healthcare is complex, and it requires the ability to manage polarities vs. solving problems. The CPM Resource Center has presented Polarity Management™ for healthcare at HIMSS, ANIA, AONE and other national conferences as an important competency for leaders in informatics.

What do you see your role as within nursing informatics today? I see my role to expand the current thinking and understanding of what nursing informatics can be today.  Nursing informatics can be at the helm of healthcare transformation as long as we ask the right questions and engage the right people.  Healthcare transformation requires a deep understanding of not only the role of informatics, but the roles of culture and professional practice to create true sustainable and interoperable health information systems. 

Ultimately, I see my role as being an advocate for nurses, physicians, allied health practitioners and patients to influence health policy so we achieve the type of interoperability we desire that represents our professionalism and the best patient-centered care across the continuum of care.

Michelle Troseth, RN, MSN, DPNAP, is Executive Vice President and Chief Professional Practice Officer for the CPM Resource Center. 

Based on these recommendations, members of the Board-appointed HIMSS Annual Conference Education Committee (ACEC) review all the proposals submitted,  comments and scores, and then, recommend the most-compelling sessions for the annual slate of education across over 20 topic categories. 

If you are considering submitting a proposal for HIMSS13, I have five guidelines that may help you in your submission process. I am not promising your proposal will be selected, but rather, I offer guidelines, if followed, to ensure that your submission is one of high quality.

1. The Topic.  With over 20 topic categories available for consideration at HIMSS13, the opportunities abound for potential presenters to share their experiences.  Ensure that your topic is timely, that it’s appropriate for health IT professionals, that it provides applicable (and actionable, if possible) information for attendees to use once they return to their work site, and that it avoids any hint of commercialism. 

2. The Structure.  The structure of your proposal is very important.  The title of the session must accurately reflect the summary description, which in turn, must accurately reflect the learning objectives.  The three items, in tandem, set the tone for supporting details to follow.  If you have a great title but poorly written learning objectives that do not support the summary of the proposal intent, your proposal will not score favorably.

3. The Content.  Ensuring that you have the details to support your proposal is very important.  In the past, we have received compelling submissions that either had not yet been implemented by the time of the Annual Conference (when in fact the entire submission was based on the implementation), the research was not concluded, or some other missing detail(s) that raised a question(s) in the reviewer’s critique.  So be sure that what you submit can be validated.  Also, keep in mind, not only do our attendees learn from successes, but also, from projects that did not result in what was intended, or, perhaps just failed.

4. The Details.  Be sure to include enough detail in your submission to support the title, session description, and the learning objectives.  While we receive many submissions, some are more detailed than others: and those proposals that are compelling offer enough supporting detail to accurately reflect session’s intent.  This is really important as our reviewers and the ACEC compare and contrast one proposal to another.

5. The Benefits. It’s exciting to learn that your proposal has been selected for placement at a HIMSS Annual Conference & Exhibition.  You’ll have the opportunity to share your knowledge and experiences on a national stage so that all can learn and benefit.  But you also will need to adhere to very strict timelines.  And for your effort, you will receive the opportunity for a complimentary conference registration (non-transferrable), advancement points towards Senior Member or HIMSS Fellow, as well as potential points toward the renewal of a professional certification, i.e. CPHIMS, PMP, or other.

So good luck, be detailed and be compelling. 

And what suggestions may you have to those considering responding to the HIMS13 Annual Conference & Exhibition Call for Proposal?

I am a student nurse who is just about to graduate; my pinning ceremony is May 10, 2012. Nursing is a second career for me; I have a BS in computer science and worked in that profession before realizing it wasn’t right for me (don’t worry, NI community: my CS background is serving me very well as I enter the healthcare field).

I chose nursing after thinking long and hard about what made me feel fulfilled as a person.

At the time I decided to become a nurse, I was working as a Service Desk Analyst for our very own HIMSS. My favorite part of the job was that I got to help people every day, so I decided I needed a career where helping people was the main goal. I was very fortunate to be surrounded by supportive nurses at HIMSS, who encouraged me every step of the way.

Nursing beckoned.

Nursing school has been a truly transformative experience. It’s taught me more than rationales and medications, than procedures and diseases.

• I’ve learned I can take the risk of quitting a stable job and start something new.
• I’ve learned that I can excel at something completely different and unknown.
• I learned to embrace the leadership potential inside of me, and this fall I was elected President of my school’s chapter of the Student Nurses’ Association.

“Helping people” doesn’t end with patients, and as SNA President, I’ve spent a bit of this year helping my fellow students navigate the intensive process of nursing school.

After graduation, I look forward to celebrating with my family and friends, then taking the NCLEX and finding my future career. While in school, I realized my passion for women’s health can be combined with my nursing career, and I’m hoping to find a position in labor & delivery. After I get more experience, I hope to return to school to become a Certified Nurse Midwife. It will be a long journey, but a fulfilling one.

Kairsten Thies is a graduate nurse at Truman College in Chicago, Ill.

I came from a blue-collar community in the early ’70s where many women ended up in lower paying jobs expecting that their husbands would take care of them.  Being a rather independent person, I  wanted to wanted to find a career that would allow me to always put a roof over my head and food in my mouth without having to depend on anyone to provide for me. I chose nursing since I am lousy at math and I figured that there would always be sick people. 

Cheryl D. Parker, RN-BC, MSN, PhD, FHIMSS

Back in the 1970s, nursing schools were begging for students, so off I went for my associate’s degree.  For about the first 18 years of my  career, I was primarily an emergency nurse but also did some medical-surgical, critical care, occupational, nursing home and home health nursing.  But ED nursing was my love at that time…and I still miss it occasionally.

In my late ’30s, I started looking ahead and realized that I probably wouldn’t want ED nursing as my only option as I got older. I decided to finish my MSN with focus on academic education.  Unfortunately, by the time I graduated, I learned I didn’t want to be a full-time academic educator…I like to make money too much and I was too radical in my thinking to fit comfortably into academic world.  So all I could think was “now what?”

Then, while I was working a night shift in ED, the charge nurse asked me to do a literature search and bring back articles from the hospital library.  While there, I ran across a magazine I had never seen before, “Computers in Nursing.”

A light bulb went off, since I was known as the computer nurse in my ED.  There was an ad in the back of the magazine for a post-master’s certificate in nursing informatics at the University of Maryland–BINGO.  Two months later, I left my husband in Seattle and moved off to Baltimore for the next 10 months (no online programs back then), and my NI career began.

My advice to nurses looking to get into the informatics field would be two-fold:

• Find an employer who will hire you into an entry-level informatics; and
• Plan on getting at least a master’s degree. 

Consider that initial implementations will be done in 5-10 years from now, and the focus will be on data analysis for improved outcomes and fiscal management.  You might want to read the Q&A Section of the HIMSS’s eNurse Mentor page for other ideas.

My current role is to bring the power of nursing informatics to my role as Chief Nursing Informatics Officer at Rubbermaid Medical, educating the next generation of master’s prepared nurses as contributing faculty at Walden University, as well as sharing my knowledge and experience through speaking, publishing and mentoring. 

As I look over the past 35 years, I could not have picked a better career…although if anyone back in 1977 could have told me where nursing would take me, I would have suggested they needed their medications adjusted!  In retrospect, the only thing I might done differently would have been to get my advanced degrees earlier…I was almost 50 when I finished my doctorate.  But all-in-all, I’ve been one very lucky nurse.

Cheryl D. Parker, RN-BC, MSN, PhD, FHIMSS is Chief Nursing Informatics Officer at Rubbermaid Medical Solutions.

Willa Fields, DNSc, RN, FHIMSS

It’s National Nurses Week, and HIMSS joins with the American Nurses Association to honor nurses for their contributions to patient care…and more. Nurses from our nursing community will post on the blog this week and tell you why they joined this profession. 

Our first post comes from HIMSS Board Chair-Elect, Willa Fields, DNSc, RN, FHIMSS. Read Willa’s post and check the blog every day to see what other nurses in informatics say about their careers in – and passion for – nursing. Visit the HIMSS website for more information on what we are doing during this important week honoring nurses. Christel Anderson, Director, Clinical Informatics, HIMSS 

by Willa Fields, DNSc, RN, FHIMSS

Why did you become a nurse?  I’m one of those people who always wanted to be a nurse, sort of. Sometime during high school, I thought about becoming a physician, but like many girls of my generation (1950s-1960s), my parents explicitly told me since I was a girl, my choice in healthcare was to be a nurse.

They could not understand why a girl would spend so much time (and money) in school, when ultimately, I would get married and have children. They didn’t understand that a family and career could be mixed. So off to nursing school I went. In my late 20s, I reconsidered becoming a physician in critical care, but decided nursing was where my heart was, so I went back to school to get my master’s and doctorate in nursing. I’ve been thrilled with my career choice!

How did you transition to informatics? After I completed my doctorate in 1990, I went to work in an acute care hospital as the quality coordinator in critical care. My interest was in helping the organization use data to answer clinical questions. I helped the organization transform from a quality assurance perspective (who did what wrong?) to a continuous quality improvement one (how can we improve care and outcomes?). The hospital was computerized, and I became interested in querying the data bases to asses clinical care.

I then worked for a small clinical information software company to help them and their customers use the data in the clinical data base. We developed ORYX indicators; it was an exciting time in quality/performance improvement. I was able to combine my research, nursing, and clinical background. At this point, I considered myself an informatics nurse and became active in HIMSS.

From the software company, I returned to the acute care hospital as the VP of patient care systems in information systems, where I oversaw the acquisition, design, implementation and maintenance of clinical systems.

Becoming an informatics nurse has been a natural progression. I’ve had a long career with varied experiences, that ultimately brought me to nursing informatics.

What advice would you give nurses looking to get into the informatics field? 

• Be active in HIMSS at the local and national levels.
• Avail yourself of their committee and educational opportunities.
• Enroll in a graduate informatics program.
• Become certified in informatics.
• Become a super user of your organization’s EHR.
• Find ways to improve the EHR in your organization.
• Find an informatics nurse to mentor you.

What do you see your role as within nursing informatics today? I am in Erikson’s generativity stage of life.  I want to excite other nurses about nursing informatics and promote their careers. I do that through my work as a university professor, where I teach undergraduate and graduate courses in informatics, and my involvement in HIMSS.

Willa Fields, DNSc, RN, FHIMSS
HIMSS Board Chair-Elect                                                                                                           Professor, School of Nursing
San Diego State University

John was a tireless advocate for the importance of health IT toward reducing healthcare disparities, reminding the audience at a Capitol Hill Health Disparities Education Session that there are more than 45 million Americans with no health insurance and a large proportion of the uninsured are in rural and underserved communities. “Healthcare IT must reach every sector of the population if we are to succeed in transforming healthcare.”

Former HIMSS Board Chair John Wade presenting
Chapter Advocate Roundtable training certificate to
Distie Profit in 2006.

I am grateful that I had the opportunity to know John for over a decade. I remember him speaking with his Boston accent, always with a smile on his face.

John’s legacy to HIMSS will be his work to help build the government relations program to provide all members with opportunities to share their expertise with decision-makers. John was at every Advocacy Day on Capitol Hill and a frequent speaker around the nation.

John is probably advocating to St. Peter right now at the Pearlie Gate about his latest passions to help others. We will miss you, John Wade!

by Dennis M. Seymour, Chief Security Architect, Ellumen, Inc.

The HIMSS Privacy and Security Committee chose the topic of medical device security and risk management as the “PSST” for this month.  A hot topic for sure, our committee is fortunate to have a dedicated task force including members of NEMA-MITA, ACCE, vendors and healthcare organizations that have addressed the complexities of the issue over the past eight years. 

Let’s begin by describing the issue. 

Before initiation by HIMSS, a number of organizations, including the Department of Veterans Affairs (VA), identified medical devices as an issue that might not specifically be addressed in many organizations, even with the implementation of HIPAA requirements.  Many organizations did not name these devices as information technology devices. 

In 2003, the VA was charged by Congressional oversight committees to address security issues specific to medical devices and medical research activities.  At that time the Veterans Health Administration (VHA) opened its Center for Healthcare Information Security (CHIS) with these specific goals in mind.  CHIS was a division of the VHA Health Information Security Service that oversaw information assurance requirements for the VHA’s 163 medical centers and enterprise systems, including the Veterans Health Information System and Terminal Architecture (VistA), later changed to Veterans Health Information Systems and Technology Architecture (VistA) with changes in networks and infrastructure. 

Recent articles lead the community to believe that medical device vulnerabilities are a new topic; however, HIMSS has been working with the American College of Clinical Engineering (ACCE), National Electronics Manufacturers Association (NEMA) – Medical Imaging and Technology Alliance (MITA), medical device vendors, healthcare organizations, Federal agencies including VA and DoD and National Institutes for Standards and Technology (NIST), and HIMSS members for more than eight years on issues related to medical device security and risk management.

In 2003, the HIMSS Privacy and Security Steering Committee created the Medical Device Security Task Force to develop a risk assessment process for medical device security so that medical device vendors could work collaboratively with healthcare organizations to develop a common document or process for risk management.  The result, in early 2004, was the release of the Manufacturers Disclosure Statement for Medical Device Security, known as the MDS2. 

The first version of the MDS2 was specifically designed to give medical device vendors  a single form they could provide to healthcare organizations, both those already using devices as well as those considering purchase of devices. This document detailed how their devices support the requirements of the Health Insurance Portability & Accountability Act (HIPAA). 

The original form was specifically mapped to HIPAA Security and Privacy requirements and included instructions on the completion and use of the form.  The HIMSS task force developed the form, but upon its release, a number of organizations, including NEMA-MITA, ACCE, ECRI and others, endorsed the form and provided access through their websites to members.  Over the past eight years, medical device vendors have completed thousands of forms for the devices they sell, and the document is now required for many organizations during the purchase process, including the Department of Veterans Affairs, Department of Defense, and others.  A quick search of the Internet from any search engine will result in thousands of MDS2 posted on vendor portals.

In March 2007, HIMSS invited its members to join an industry task force to rework the MDS2 to document those changes necessary to meet the requirements of Health Information Technology for Economic and Clinical Health Act or HITECH Act.  The goal of the work group was to conduct a review and writing session for the HIMSS Manufacturer Disclosure Statement for Medical Device Security (MDS2) to convert the document into a standard that can be “referenced” in regulations promulgated by agencies of the U.S. government or other national bodies. 

HIMSS was seeking representatives from the following example stakeholder groups:

• Covered entity organizations – ePHI risk management per HIPAA. (e.g., Providers, Plans, etc.);
• Medical Device Vendors (e.g., Imaging, Monitoring, Pumps, Ventilators, Analyzers/automation, etc.);
• Federal Government (e.g., DoD, VA, VistA, Biomedical Engineering, Indian Health, FDA , CDC , NIST, HHS, OCR, Homeland Security, etc.);
• IT Security Community (e.g., Center for Internet Security, etc.);
• Industrial Consortia / Interest Groups (e.g., NEMA, ECRI, COCIR, JIRA, ACCE, CLSI, etc.);
• Purchasing and buying organizations (e.g., Group Purchasing Organizations); and
• Third party suppliers to medical devices – COTS.

Last year, HIMSS began working with NEMA-MITA, ACCE, device vendors, and healthcare organization representatives to rework the MDS2 to map to the draft requirements of the IEC 80001-1: Application of risk management for IT-networks incorporating medical devices — Part 1: Roles, responsibilities and activities, including the following attribute areas:

• Automatic Logoff (ALOF)
• Audit Controls (AUDT)
• Authorization (AUTH)
• Configuration of Security Features (CNFS)
• Cyber Security Product Updates (CSUP)
• Data Backup and Disaster Recovery (DTBK)
• Emergency Access (EMRG)
• Health Data De-Identification (DIDT)
• Health Data Integrity and Authenticity (IGAU)
• Health Data Storage Confidentiality (STCF)
• Malware Detection/Protection (MLDP)
• Node Identification (NAUT)
• Person Authentication (PAUT)
• Physical Locks (PLOK)
• Security Guides (SGUD)
• System and Application Hardening (SAHD)
• Roadmap for 3rd Party Components in Device Lifecycle (RDMP)
• Transmission Confidentiality (TXCF)
• Transmission Integrity (TXIG)
• Unique UserID (UUID)
• Other Security Considerations

HIMSS, NEMA-MITA, ACCE, and other organizations anticipate the release of the new MDS2 in late June with the publication of the document and instructions to follow shortly thereafter. 

HIMSS, partner organizations and their members are glad to see Congressional attention is being granted  to the issue of medical device security, along with the Office of Management and Budget (OMB), the Food and Drug Administration (FDA), and National Institutes of Standards and Technology (NIST). 

Recent hearings and requests by House of Representatives members Anna Eshoo (D-CA) and Edward Markey (D-MA) to the Government Accountability Office (GAO) to prepare a report on this situation can only help healthcare organizations to better estimate their risks; however, organizations and medical device vendors should be aware that efforts, such as the MDS2 development, are already in place to help mitigate and reduce risks to healthcare networks that have medical devices connecting to them.

So, when you read articles that the “sky” of medical devices is falling, consider that fellow HIMSS members and other related organizations are doing what they can to be our world’s “Atlas.”  The HIMSS Privacy and Security Steering Committee, and our Risk Assessment Work Group, the Mobile Device Security Work Group, and Medical Device Security Task Force continue to develop processes, procedures and best practices in support of reducing your organization’s risks in every way possible.

We continue to evolve the complete suite of HIMSS P&S Toolkits to provide your organization with information and tools.

 We hope you found this month’s topic for PSST! worthwhile and will review and use the MDS2 when it is published in the coming months.  Whether you are in biomedical engineering, clinical engineering, information technology or other professional supporting healthcare operations, you must agree that having a method for assessing and mitigating risks in our healthcare environments at every point of care should be a central focus. 

Have an idea for a future “PSST!?”  Contact Sean Murphy; Chair, HIMSS Privacy and Security Committee, sean.murphy092009@gmail.com