Nurses Should Shape More Health IT Decisions: HIMSS

Nurse informaticists play key role selecting health IT that's interoperable, user-friendly, and focused on quality outcomes.
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The development of policies and programs that will improve a nurse's ability to better integrate informatics solutions into clinical care encounters should be endorsed by government agencies, academic organizations, health IT vendors, and other healthcare stakeholders, according to a position statement recently published by the Healthcare Information and Management System Society (HIMSS).

The document went on to say that as health IT adoption accelerates, and the drive toward population health management through accountable care organizations (ACOs) gets underway, it is essential that nurse informaticists lead change-management efforts that shape behaviors and shift the current physician-centric healthcare approach to one that includes all appropriate care team members.

The statement heralds the role of nurses--the care providers that spend the most amount of time with patients--and particularly nurse informatics specialists who apply technology to clinical workflows and to patient care processes, saying they need to be able to respond effectively to rapidly changing healthcare settings and an evolving healthcare system.

Further, as ACOs focus not only on improving quality, patient safety, and outcomes, but also on managing costs, nurses will have the critical role of meeting expected quality and financial metrics and integrating clinical and business solutions to monitor and inform outcomes. However, a number of barriers exist that will prevent them from responding effectively to rapidly changing healthcare models, said HIMSS.

"These barriers need to be overcome to ensure that nurses are well positioned to lead change and advance healthcare," the document stated.

The statement went on to say: "As Meaningful Use criteria evolve, it is essential that nurses be involved as key stakeholders in the implementation of electronic health records (EHRs), especially in leading the planning, design, evaluation, and optimization of health IT."

In alignment with the America Nurses Association (ANA) and the Alliance for Nursing Informatics (ANI), the HIMSS position statement identifies specific recommendations for eliminating barriers and addressing nursing's role in transforming healthcare through the use of IT, particularly in regard to the role of nursing informatics. These recommendations include:

-- Prepare and enable nurses to lead change to advance health. Partner with nurse executives to lead technology changes that advance health and the delivery of healthcare.

-- Support the development of informatics departments. Increase the proportion of nurses with a baccalaureate degree to 80% by 2020 and double the number of nurses with a doctorate by 2020.

-- Transform nursing education to include informatics competencies and demonstrable behaviors at all levels of academic preparation. Additionally, promote the continuing education of all levels of nursing, particularly in the areas of EHRs and health IT.

-- Foster the evolution of the chief nursing informatics officer role.

-- Remove scope of practice barriers. To do this, ensure that data, information, knowledge, and wisdom form the basis of the 21st century nursing practice by incorporating informatics competencies into practice standards in all healthcare settings. Additionally, facilitate the collection and analysis of inter-professional healthcare workforce data by ensuring information can be collected from existing heath IT systems.

-- Implement nurse residency programs.

-- Build an infrastructure for the collection and analysis of inter-professional healthcare workforce data.

"Nursing informatics leaders are essential stakeholders who orchestrate what information must be provided, how it is captured and documented to support patient care, as well as monitoring the associated financial and business indicators to track and report on outcomes management," the document stated. "Technology will continue to be a fundamental enabler to the future care delivery models and nursing informatics leaders are essential to transforming nursing practice through technology."

The position statement also urges health IT vendors that develop electronic systems for clinicians to incorporate nurse informaticists in analyst, leadership, and officer roles as a way to design systems that are interoperable, patient-centric, and user friendly.

HIMSS warns government agencies to recognize that regulations and reimbursement policies that remain exclusively physician-focused will not achieve the goals of healthcare transformation and recommends that public policies and regulation language should reflect all provider roles, allowing all clinicians, particularly nurses, to practice to the full extent of their education and licensure.

The position paper also suggests that provider organizations should employ nurse informaticists in leadership roles such as a nursing informatics executive, chief nursing informatics officer (CNIO), chief clinical information officer, or VP of nursing informatics in order to help lead the healthcare transformation in embracing technology that is interoperable, patient-centric, user friendly, and focused on quality outcomes.

The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.