IN MY TENURE WRITING THIS COLUMN, I have tried to provide briefs about emerging technologies that will affect teaching and learning in higher education. I have also, on occasion, called attention to issues related to informatics competencies and information literacy. At this time, I want to focus on a pressing curriculum issue that we will all face in the near future - the movement toward an informatics-intensive health care delivery system. * As informatics-intensive care delivery develops in the clinical arena, we in education will need to grapple with how best to prepare nurses to practice in a transformed health care environment. Schools of nursing will begin to experience a type of digital divide. Faculty who do not have access to the various clinical information systems that nurses will use as integral components of practice will have difficulty understanding how the nursing curriculum needs to change. BUT HAVE NO FEAR. HELP is COMING. A GRASSROOTS EFFORT HAS SET OUT TO TACKLE THIS CHALLENGE. The TIGER Team During the spring of 2004, President Bush called for national implementation of interoperable electronic health records by the year 2014. He also established, by executive order, the position of national coordinator for health information technology and named Dr. David Brailer to fill that post. In July 2004, Dr. Brailer announced the Strategic Plan for Health Information Technology, which set forth the goal of creating a health care delivery system that is consumer-centric and has an informatics infrastructure to provide safe, quality care. The strategic plan has four major goals: * Inform clinicians by encouraging the widespread adoption of electronic health records * Interconnect clinicians so that data and information can be more easily shared * Personalize care through the use of personal health records and telehealth * Improve public health through accessible information. As these goals were presented, the focus appeared to be on physicians, with little mention of nursing. Thus, the Technology Informatics Guiding Education Reform (TIGER) Team was formed. The first meeting of interested parties took place in January 2005. The TIGER website outlines the following statement of purpose: "The TIGER Initiative aims to enable practicing nurses and nursing students to fully engage in the unfolding digital electronic era in healthcare. The purpose of the initiative is to identify information/knowledge management best practices and effective technology capabilities for nurses. TIGER's goal is to create and disseminate local and global action plans that can be duplicated within nursing and other multidisciplinary healthcare training and workplace settings." To seize the opportunity to take quick action, the decision was made to hold an invitational summit. This summit, titled "Evidence and Informatics Transforming Nursing," took place October 30-November 1, 2006. In planning for the summit, it was understood that this is a critical juncture for nurses, as the nation is working full speed to realize the 10-year goal of electronic health records for its citizens. Nurses constitute 55 percent of the health care work force and must become involved at every level or the Informatics Revolution will pass the nursing profession by - to the detriment of health care consumers. Summit Participants This invitational summit brought together 120 leaders and key stakeholders for the purpose of creating an actionable plan to prepare nurses to practice in an increasingly automated health care environment. Participants included representatives of nursing organizations, government agencies, and other institutions as follows: * Nursing Organizations Leaders from more than 30 specialty nursing organizations, along with Alliance for Nursing Informatics representatives from almost 20 informatics specialty groups, including the American Medical Informatics Association, the Health Care Information and Management Systems Society, CARING, the American Nursing Informatics Association, the American Nurses Association, and Sigma Theta Tau International * Government Agencies The Division of Nursing, the National Library of Medicine, the Agency for Healthcare Research and Quality, the Veterans Administration, and the Department of Defense * Other Key Stakeholders Academic institutions, including the University of Maryland at Baltimore, practice settings, the Robert Wood Johnson Foundation, the American Health Information Management Association, the Independence Foundation, and representatives of the business community (Apptis, Audience Response Systems, Cerner, CITPO, Clini-Comp International, CPM Resource Center, Ecilpsys, Elsevier, GE HealthCare, IBM, McKesson, The Mitre Corporation, Seimens, Thomson/Micromedex, Tenet Health Care). …