NURSING INFORMATICS. Nikole L. Farmer, MSN, RN, PMP September 6, 2014

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1 NURSING INFORMATICS Nikole L. Farmer, MSN, RN, PMP September 6, 2014

2 WHAT IS NI? Nursing Informatics (NI): Specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. NI supports consumers, patients, nurses, and other providers in their decision- making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology. ANA, Nursing Informatics: Scopes and Standards of Practice, 2008 The science and practice that integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide. AMIA, Special Interest Group on Nursing Informatics, 2009

3 NURSE INFORMATICIST: A.K.A. THE TECHIE NURSE Computer Geek! Nerd! Just a Nurse... Computer Help Desk Subject Matter Expert (SME) Technical Liaison Functional Tester Analyst Developer Project Manager

4 Analyze Current Clinical & Business Processes Design Systems (Create Requirements) Develop/Configure Systems Act as Liaison between Providers & IT Personnel Test System Changes Deploy New Systems Train & Educate End Users Manage IT Programs Create Policy Perform Research NURSE INFORMATICISTS

5 EDUCATION On the Job Training Degree Programs Bachelors Degree Courses Masters Degree: MS Nursing Informatics Doctorate Degree: DNP Informatics Certifications HIMSS: CPHIMS ANCC: RN-BC Organizations HIMSS AMIA ANIA HIMSS 2011 NI Training Survey Masters Degree/ PhD Bachelors Degree Certificate Highest Degre On the Job Training

6 ON THE JOB TRAINING Subject Matter Experts (SME) Nurses Know the Clinical Use Case Best! Technical development follows a process similar to the nursing process: SDLC: Software Development Lifecycle Nursing Process Analyze/Write Requirements Develop Solution Test Solution Implement Solution Analyze the Solution for Improvements

7 HEALTH IT IMPACTS Clinical Finance/Mgmt Networks Electronic Health Records (EHRs) Admission (ADT) Systems Med System Barcode Scanning Medication Pumps FHR Monitoring Ventilation Systems Documentation Scanning X-rays and Imaging Dictation Safety and Risk Monitoring Systems Registration Claims Systems/ Direct Billing to Insurance Companies Billing to Patients Charge Captures Payroll Systems HR Systems Staff Scheduling Procedure Scheduling Wi-Fi Internet (Network Bandwidth) Intranet Back-up Power Source Location/ Planning Intercom Systems Mobile/Telecom Networks Smart Phones Tablets

8 XML X12 INTEROPERABILITY HL7 </SOAP-ENV:Header> <SOAP-ENV:Body> <AppBody> <OHIQuery> <PTNT_ID> </PTNT_ID> <OHI_INQ_PERD_BGN_DT> </OHI_INQ_PERD_ BGN_DT> <OHI_INQ_PERD_END_DT></OHI_INQ_PERD_END_DT> <HIC_ID>ABCDE012345</HIC_ID> <OHI_PLCY_ID></OHI_PLCY_ID> <OHI_CVG_TYP_CD></OHI_CVG_TYP_CD> <OHI_CVG_PYR_TYP_CD></OHI_CVG_PYR_TYP_CD> </OHIQuery> </AppBody> </SOAP-ENV:Body> </SOAP-ENV:Envelope> Claims/Benefits/Financial Data Sample Message: ISA*00* *00* *ZZ* MHSEWRAS- CENTRAL*ZZ*DMDCDEERS1600NB* *1051*U*00401* *0*T*+!G S*HS*AGA *DMDCDEERS 1600NB* *184800*1*X* X092!ST*270*0002!BHT*0022*13*0005* *1051!HL*1**20*1!NM1*P5*2*D MDCDEERS*****46*DMDCDEERS1600N B!HL*2*1*21*1!NM1*1P*2*EWRAS*****S V*385!HL*3*2*22*1!NM1*IL*1******MI* !HL*4*3*23*0!NM1*03*1*Smith *John!DMG*D8* !EQ*30**IND *C1!SE*13*0002!GE*1*1!IEA*1* ! Healthcare Data Sample Message: MSH ^~\& ADT1 MCM LABADT MCM SECURITY ADT^A01^AD T_A01 MSG P 2.5 <cr> EVN A <cr> PID 1 PATID1234^5^M11^ADT1^MR^ MCM~ ^^^USSSA^SS JONES ^WILLIAM^A^III M C N ELM STREET^^GREENSBORO^NC ^ GL (91-9) (919) S PATID ^2^M10^ADT1^AN^A ^NC <cr> NK1 1 JONES^BARBARA^K WI^WIFE NK^NEXT OF KIN<cr> PV1 1 I 2000^2012^ ^LE BAUER^SIDNEY^J. SUR ADM A0 <cr>

9 HL7 ADMIT MESSAGE MSH ^~\& ADT1 MCM LABADT MCM SECURITY ADT^A01^ADT_A01 MS G P 2.5 <cr> EVN A <cr> PID 1 PATID1234^5^M11^ADT1^MR^MCM~ ^^^USSSA^SS JONES^WILLIAM^ A^III M C 1200 N ELM STREET^^GREENSBORO^NC^ GL (91-9) (919) S PATID ^2^M10^ADT1^AN^A ^NC <cr> NK1 1 JONES^BARBARA^K WI^WIFE NK^NEXT OF KIN<cr> PV1 1 I 2000^2012^ ^LEBAUER^SIDNEY^J. SUR ADM A0 <cr> *Sample message from HL7 v2.x Certification Practice Guide

10 HL7 RADIOLOGY MESSAGE MSH ^~\& XRAY CDB ORU^R01 K172 P...<cr> PID...<cr> OBR 1 X ^OE 78912^RD 71020^CHEST XRAY AP \T\LATERAL ^MASTERS^JOHN^B...<cr> OBX 1 CE 71020&IMP^RADIOLOGIST'S IMPRESSION 4 ^MASS LEFT LOWER LOBE A F...<cr> OBX 2 CE 71020&IMP 2 ^INFILTRATE RIGHT LOWER LOBE A F...<cr> OBX 3 CE 71020&IMP 3 ^HEART SIZE NORMAL N F...<cr> OBX 4 FT 71020&GDT 1 circular density (2 x 2 cm) is seen in the posterior segment of the LLL. A second, less well-defined infiltrated circulation density is seen in the R mid lung field and appears to cross the minor fissure# F...<cr> OBX 5 CE 71020&REC ^Follow up CXR 1 month F...<cr> *Sample message from HL7 v2.x Certification Practice Guide

11 MEANINGFUL USE The Health Information Technology for Economic and Clinical Health (HITECH) Act was part of the American Recovery & Reinvestment Act (ARRA) of 2009 Stimulus to promote adoption and meaningful use of health IT Improve quality, safety, efficiency, and reduce health disparities Interoperability $550 Million in Grants for State Health IT Exchanges in 2011 NHIN: Nationwide Health Information Network Adoption of Certified EHR s by 70% of Primary Care Providers by 2014 $27 Billion in Phased Incentives As much as $44,000 (through Medicare) or $63,750 (through Medicaid) per eligible health care professional Eligible Hospitals can receive up to $2 Million (July 2014)

12 WHAT DOES THIS MEAN TO ME?! Increased presence and use of multiple Health IT systems Connected commercial and personal Health systems Improved ability to care for patients More comprehensive health data available from various providers Increased patient safety Better patient monitoring and reporting tools available More comprehensive health data for diagnosis Time savings Data shared across systems and providers Patient involvement Apps available for patient s home use increase compliance and engagement

13 WHAT CAN I DO? Support Health IT initiatives in the workplace Participate in surveys and studies for improving your systems Engage in NI working groups at your organization Provide feedback on enhancements or changes to make your systems better Volunteer to be a tester Help train new users Support Health IT initiatives in your personal life Utilize personal health apps Utilize health apps and tools from your provider or insurance company Be patient with system upgrades and conversions (especially at small providers)

14 QUESTIONS?