3/9/2011. Marybeth Mitchell, MSN, RN-BC Texas Health Resources

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1 Marybeth Mitchell, MSN, RN-BC Texas Health Resources 1 Describe emerging roles in Nursing Informatics to support key HIT initiatives throughout Texas. Discuss the importance of the Nursing Informatics leadership role in educating and informing nursing and healthcare leaders in use of EHRs and other technologies. Identify ways in which Nursing Informaticists contribute to adoption and optimization of the EHR and other technologies

2 NI has been an emerging discipline since the 1960 s, but has become more and more prominent since the 1990 s. NI Certification through ANCC since the RN s certified in NI in RN s in Nursing Informatics At least 75% of Nursing Informaticists are developing or implementing clinical systems, primarily within IT (Information Technology). However, more expanded and advanced clinical roles NI roles in Nursing are starting to emerge 4 Nationwide, CIOs are in consensus: the success of large IT implementations will depend not only on the willingness of floor nurses to accept new technology, but also on the strength of the IS-nursing executive management connection. CIOs across the country are finding that getting CNOs and other top nursing executives to take ownership of clinical information systems initiatives is no longer a luxury, but a necessity. Virtually every hospital or health system that is succeeding with its clinical IS rollouts has hired or internally promoted a chief clinical informatics officer of some sort The clinical informaticist executive job is becoming one of the hottest positions in the industry, and executive recruiters are having a hard time keeping up with the demand. I'm a translator and interpreter. CNIO role, because it encompasses implementation, optimization, training, change management. Nurse Leader Nursing Informaticists are key in Healthcare Organizations for managing federal initiatives and other emerging technologies EMR Meaningful Use Mobile Health/ Health Home Telemedicine Health Information Exchanges Accountable Care Organizations Clinical Decision Support Clinical Business Intelligence 6 2

3 7 Value Creation & Implementation Adoption Optimization Transformation Source: Promise or Peril? Advisory Board, Implementation Adoption Optimization Value Creation & Transformation 9 3

4 Global Access Through EHR Other Epic providers (Children s, et al) Epic-Centric CareEverywhere CCD Non-Epic providers Urban and Rural Care CBI THR CareConnect Environment Data Analytics Technical HIE (TBD) Process Design (Carol) Imaging Lab IPA/PHO Accountable Care Payer 10 Overview of NI Role Clinical Integration and Quality Focus EMR EMR Related Optimization Projects Support MU Nursing Optimization Clinical Decision Support Core Measures Upgrades Ongoing Requests BMV Device Integration HIE Improve Operating Performance Increase partnership level of workforce Other Training & Nursing Technologies Communication Informatics Smart Pumps Increasing use of Dashboard Clinical Business Intelligence Portals Social Media Technology enable nursing communications Management of Policies and Procedures NI Council Expanded use of SuperUsers Advancing the role through education Professional Development Technology integrated with Clinical Practice 11 Need to commit front line staff with NI skills for implementation and ongoing support. SuperUsers Trainers Subject Matter Experts Advance new roles for Nursing Informatics within the nursing department to provide collaboration between Nursing and IT. Support of education and training for staff to learn and maintain skills and knowledge with technology. Repurposing of staff to accommodate changes in roles: i.e.: US and order processing. 12 4

5 Expanded role now encompasses use of technology in all aspects of Nursing Leadership. Nurse leaders need to understand the integration of the regulatory requirements, the technology, and impact on clinical practice Outcomes driven approach to care, especially through management of reporting and dashboards. Foster interdisciplinary collaboration Ability to see beyond the walls- integrated health care delivery models; accountable care organizations Represent Nursing voice both within the organization and globally, through involvement in local, state and national committees. 13 Benefits Better outcomes and reporting of outcomes ROI expressed in terms of quality and safetynot reduction in FTE s. Improved quality, processes and efficiencies Better collaboration among caregivers, including physicians Opportunities Adoption may be slow. Significant resources needed to implement and maintain (optimize) Requires increased amount of coordination of care. May need to repurpose some roles to account for some loss of responsibilities: i.e.: order entry. 14 Boone, E., (2010, March). EMR usability: Bridging the Gap Between Nurse and Computer. Nursing Management Hagland, Mark (2008, November) Nursing First - Smart CIOs are partnering with nurse executives for IT implementation success. Healthcare Informatics November;25(11):48-53 HIMSS Usability Task Force, (2009, June). Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating. HIMSS Adoption Model- HIMSS Johnson, E.O. and Mitchell, M.B. (2009, July). Growing Clinical Informatics in a Multi- Facility Environment. Nursing Management, 40(7), Jha, A. K., et al. (2009, April 16). Use of Electronic Health Records in U.S. Hospitals. New England Journal of Medicine. 360(16) Moody, L., et al., (2004). Electronic Health Records Documentation in Nursing: Nurses Perceptions, Attitudes, and Preferences. Computers, Informatics, Nursing. 22(6), Ribitzky, R., Sterling, M.A., Bradley, V. (2010, March). EHR Usability Pain Points Survey Q HIMSS EHR Usability Taskforce User Pain Points Workgroup. HIMSS Annual Conference Swindle, C., and Bradley, V. (2010, June 20). The Newest O in the C-Suite- CNIO. Nurse Leader,

6 Creation of educational content and dissemination Campaign to Raise Awareness HIT CNE for practicing nurses Nursing HIT curriculum development Constituent involvement [incl. TIGER] Benchmarking Reports Towards Progress Formation of Advisory Structure Recommendations Potential Strategy 16 Marybeth Mitchell, MSN, RN-BC Texas Health Resources 17 6