Nursing Information Officers: Newest Health IT Leaders

Does your organization have a chief nursing informatics officer (CNIO)? If not, chances are you'll need one.

The prevalence and role of CNIOs have been on an uptick, especially as hospitals, healthcare systems, and other providers are rolling out health technology for participation in Health Information Technology for Economic and Clinical Health (HITECH) Act Meaningful Use programs and other initiatives.

A 2011 Health Information and Management Systems Society (HIMSS) leadership survey found that just 8% of organizations had CNIOs. However, with 80% of healthcare organizations having some form of electronic health record (EHR) by 2013, the need for these new leaders will rise, said Mary Beth Mitchell, CNIO at Texas Health Resources, a nonprofit healthcare organization which operates 14 hospitals.

Nursing informatics is a specialty in nursing that integrates nursing science, computer science, and information science, said Mitchell, who was a practicing RN for 25 years before moving into nursing informatics full time several years ago.

But even before taking on the job as Texas Health Resource's CNIO, she was director of clinical informatics at one of the organization's facilities. Prior to that role, her work as a nurse involved informatics for many years, Mitchell said during a HIMSS12 session on Tuesday aptly called "Role of the CNIO."

[ Read more from the most important live event in health IT on our HIMSS Special Report page. ]

Now Mitchell, like many other CNIOs at other healthcare providers, works closely with her organization's CIO, chief nursing officer, and chief medical information officer. At Texas Health Resources, Mitchell also works with the organization's nursing informatics council, which is made up of nurse champions whose purpose is to optimize the EHR to meet the needs of nursing throughout the health system.

As a field, nursing informatics has been around since the 1960s, becoming more prominent in the 1990s, with the American Nursing Association recognizing it as a discipline in 1992. There are about 3,000 informatics nurses in the United States currently participating in HIMSS and other organizations, she said.

About 75% of nursing informatics is involved in the development or implementation of clinical IT, and more roles defined for the discipline are emerging--including the top leadership role of CNIO, said Mitchell.

"It's a leadership position that bridges nursing and IT," she said. And it's also "the newest member of the C suite," she said.

Under the CNIO's purview are strategic and operational oversight of clinical application implementation, and relationship building between key leaders and departments including nursing, IT, medicine, and quality compliance.

Professional development opportunities are growing for these individuals, but slowly, she said. "As more organizations implement EMRs it's important for more nurses to go into this field and for us to support them," she said. At Texas Health Resources, there are four nurses certified in informatics, but there are others involved with the work, she said.

CNIOs' responsibilities often include EHR implementation and adoption; regulatory requirements compliance; infrastructure and Integration; managing the corporate vision; emerging technologies; analytics; and the professional development of other staff in nursing informatics, said Mitchell.

A key part of the CNIO's job is to be a "translator" of technologies' risks and benefits to clinical staff and for patients, she said.

Other helpful traits for the job of CNIO include "being a good negotiator and being willing to be the person that says 'the buck stops here,'' she said.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)