Creating systems that work

Abstract

Sengstack PP, Boicey C (2015) Mastering Informatics: A Healthcare Handbook for Success. Sigma Theta Tau, Indianapolis IN. INFORMATION TECHNOLOGY is becoming so pervasive in health care it is almost impossible to find a care setting void of some type of electronic clinical system. Evaluating and managing these electronic tools require an understanding of patient care delivery and technology. They also require the knowledge to design systems with which nurses interact on a daily basis and the skills to evaluate care delivery effectiveness. Nurse informaticists are perfectly positioned to meet these requirements. The American Nursing Association recognised nursing informatics as a specialty in 1992. Some say, though, that the first nurse informaticist was Florence Nightingale back in the 1850s, when she compiled and processed data to advocate for appropriate nursing and medical protocols and to improve sanitation in military hospitals during the Crimean War. Fast forward to the 1960s, when the electronic medical record made its debut and continued to evolve as adoption increased over several decades. The Health Information Technology for Economic and Clinical Health Act, signed in 2009 as part of the American Recovery and Reinvestment Act, drove even higher levels of adoption. As of June 2014, three quarters of the nation’s eligible professionals, equivalent to more than 403,000 people, and more than nine out of ten eligible hospitals, equivalent to more than 4,500 organisations, had received incentive payments (Office of the National Coordinator for Health Information Technology 2014). Add to this the increasing use of mobile technologies, the expansion of telehealth, the proliferation of health-related apps, the demand for patient-engagement tools and the drive toward interoperability of patient data, and the need for nursing informatics expertise becomes imperative. Devices developed without the expertise of someone with clinical informatics skills typically result in end-user frustration and systems that do not support clinical workflows. Workforce survey results from the Healthcare Information and Management Systems Society (HIMSS) confirm that nurse informaticists play a crucial role in the development, implementation and optimisation of clinical applications including nursing clinical documentation, computerised practitioner-order entries and electronic health records (HIMSS 2014a). Other survey results show that four out of five healthcare organisations had plans to hire additional IT staff this year, with almost all vendors indicating similar plans. They also show, however, that more than one in three respondents working for a healthcare provider are scaling back or putting IT projects on hold because they cannot be fully staffed (HIMMS 2014b). Delaying IT projects to improve the support of clinician workflow and reduce system inefficiencies ultimately affect patient care. The bottom line is that nurse informaticists are needed more than ever. It is also important to engage nurses in the design, development, purchase, implementation and evaluation of medical and health devices and IT products (Institute of Medicine 2010). The education and training required to serve in the role of a nurse informaticist is not taught at the baccalaureate, or bachelor’s degree, level, nor is it learned on the job alone. Expertise requires graduate education in the field of informatics. There are universities around the world that offer nursing informatics education at master’s level and above and it is here that nurse informaticists and nursing informatics leaders are prepared. While nurses at baccalaureate level with no formal informatics training can assume informatics positions in some organisations, they will not have studied the science formally and developed the focused competencies that graduate informatics education provides. Additionally, nurses serving in informatics roles should obtain their board certification in nursing informatics offered by the American Nurses Credentialing Center. A career in nursing informatics will drive clinical transformation and care delivery. Clinicians and patients count on technology that works for them, not the other way around, so nurses must be there when decisions are made. If you’ve been thinking about a career focus, consider informatics. Our patients and fellow nurses need you.