Nursing Informatics Institute Sharp Healthcare, San Diego, CA

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1 Nursing Informatics Institute Sharp Healthcare, San Diego, CA Informatics Nurses: What? Where? And How Many? Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN January 27, 2012

2 Objectives Review the history of nursing informatics as a nursing specialty Explore current demographics of the nursing informatics population Discuss the background, roles and impact of informatics nurses today

3 Florence Nightingale, 1896 In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purpose of comparison. If they could be obtained they would enable us to decide many other questions besides the one alluded to. They would show the subscribers how their money was being spent, what good was really being done with it, or whether the money was not doing mischief rather than good. 3

4 Why Nursing Informatics? If we cannot name it, we cannot control it, finance it, teach it, research it or put it into public policy. Source: Lang, N

5 Nursing Informatics Defined Nursing informatics (NI) is a 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. Nursing Informatics: Scope and Standards of Practice, ANA

6 Nursing Informatics is Nursing! NI is was recognized as a specialty by the American Nurses Association (ANA) 1 st Scope and Standards of Nursing Informatics Practice published rd Scope and Standards Revision 2008 Meets Panniers and Gassert s (1996) attributes of a specialty in nursing A differentiated practice A defined research program Organizational representation Educational programs A credentialing mechanism 6

7 Who are Informatics Nurses? Expert nurse clinicians in utilizing the nursing process Expert analytical & critical thinking skills Understand patient care delivery workflow & integration points for automated documentation Clinicians with extensive clinical practice Experienced in utilizing and implementing the nursing process Have additional education & experience related to technology and information systems Are excellent project managers because of the similarity between the project management process & the nursing process May be board certified in Nursing Informatics through ANCC 7

8 How does Informatics Impact the Nursing Process? Enables the professional nurse to be the Coordinator of each patient s care Communicates & coordinates care with ALL other clinical disciplines Coordinates discharge planning, education & teaching, transitions of care Manages ALL information related to the nursing process and patient care delivery Evaluation 8 Assessment Implementation Planning

9 How does Informatics Impact the Nursing Process? Standardized Documentation The collection tool for information management Information Management Key role for Nursing Informatics Key to research and evidence collection Process Re-engineering Key to successful implementation Research and Evidence Collection Key to repeatable, standardized care and improved outcomes 9

10 What is the Value of Informatics? Informatics Nurses are bi-lingual! They can: Re-engineer clinical workflow and facilitate change management Analyze clinical and financial data Promote and facilitate access to resources and references Provide nursing content to standardized languages Enhance continuity of care Improve relationships between providers and recipients of health care 10 Enable cost savings and productivity goals

11 NI Success in Helping to Achieve Organizational Objectives Making Sure IT Does No Harm 5.83 Administering Correct Medication Improving Clinical Reporting Improving Quality Reporting Preventing Never Events Identifying Conditions Present on Admission 5.04 Eliminating Documentation Redundancies 4.22 HIMSS 2009 Informatics Nurse Impact Survey 432 Respondents

12 What are the Many Roles of an Informatics Nurse? Administration, leadership, & management Analysis Compliance and integrity management Consultation Coordination, facilitation, and integration Development Educational and professional development Policy development and advocacy Research and evaluation 12

13 Role of Informatics Nurses Relative to Emerging Technologies Medical Device Integration Smart Devices 75% 81% Remote Monitoring Personalized Healthcare 59% 63% Predictive Modeling Data Warehouse 51% 50% Voice Recognition 39% HIMSS 2009 Informatics Nurse Impact Survey

14 Formal Nursing Informatics Education Nursing Informatics courses at the BSN level Specialty in Nursing Informatics MSN Distance learning online Traditional Certificate programs Post graduate degree DNP 14

15 Nursing Informatics Certification American Nurses Credentialing Center Board Certification in Nursing Informatics Healthcare Information and Management Systems Society (HIMSS) Certified Professional in Healthcare Information and Management Systems 15

16 About HIMSS Vision Advancing the best use of information and management systems for the betterment of health care. Mission To lead healthcare transformation through the effective use of health information technology.

17 22 nd Annual HIMSS Leadership Survey Primary Clinical IT Focus Ensure Operational EHR 24% Installing CPOE 20% Focus on Physician Systems Linking Clinical Systems 11% 11% Certification of EHR System Focus on Business 8% 7% 326 Respondents Establish Clinical Protocols Focus on Nursing Systems 3% 2% Sponsored by Citrix Systems

18 22 nd Annual HIMSS Leadership Survey Most Significant Barriers to Implementing IT Lack of Financial Support Lack of Staffing Resources Vendor Inability to Deliver Product Difficulty in End User Acceptance Lack of Clinician Time Commit. Lack of Interoperable Systems 11% 10% 10% 7% 7% 7% 5% 4% 18% 17% 16% 24% Sponsored by Citrix Systems

19 22 nd Annual HIMSS Leadership Survey Role of Clinicians Participate in System Evaluations Project Champions for Other Clinicians Participate in Development of Policies Involved in Clinician Training Employ Hospitalists for Clinical Employed by IS Department Project Leaders for Implementation Explore Innovative Ways to Use IT We have a CMIO Clinical Department Managers Pick IT We have a CNIO 15% 16% 8% 8% 30% 26% 60% 57% 54% 57% 44% 48% 43% 41% 42% 45% 42% 43% 79% 80% 77% 76% Sponsored by Citrix Systems

20 Emerging Role of the CNIO Chief Nursing Informatics Officer #1 recruitment target Senior informatics nurse Strategic/operational leadership Guides implementation & optimization of HIT systems Reports to CNO/CNE or CIO Partners with CMIO (Chief Medical Information Officer) 20

21 22 nd Annual HIMSS Leadership Survey 2011 IT Staffing Needs (Top Ten) Clinical Application Support 39% Clinical Informaticist Network and Architecture Support Process/Workflow Design Clinical Transformation Systems Integration User Training Clinical Champions System Design IT Security 24% 21% 17% 15% 14% 14% 12% 12% 12% Sponsored by Citrix Systems

22 2011 NI Workforce Survey Primary Workplace Hospital Health System Academic Setting 5% 5% 5% Vendor Organization Consulting Firm 5% 5% 6% Government/Military 4% 2% 3% Ambulatory Care 2% 1% 1% Other 7% 5% 5% 48% 55% 51% 20% 16% 13% 9% 10% 16% 660 Respondents 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

23 Level of Nursing Education 2% 6% 4% PhD in Nursing Other PhD Other Masters 21% Masters Degree In Nursing 33% Bachelors in Nursing Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS Only highest degree is shown.

24 Years of Clinical Experience More than Twenty Sixteen to Twenty Eleven to Fifteen Six to Ten One to Five 15% 17% 19% 20% 19% 21% 22% 19% 19% 12% 13% 11% 31% 31% 31% 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

25 Nursing Specialty Background ICU/CCU 24% Med-Surg 22% 32% Administration 34% ED 24% 21% 7% 15% Pediatric 17% 3% 13% 12% 6% 12% Home Health/Community 13% 3% 12% 13% 5% 12% Quality Improvement 11% 1% 10% 10% 1% 9% Oncology 10% 44% 43% 43% 48% 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

26 Time Devoted to Clinical Activities More than 75% 51% to 75% 26% to 50% 3% 2% 1% 3% 3% 3% Less than 25% None 22% 18% 2011 Results 2007 Results 2004 Results 77% 71% 74% Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

27 Years of Informatics Experience 2004 Results 2007 Results 2011 Results 33% 39% 23% 23% 14% 13% 19% 16% 14% 18% 18% 15% 14% 13% 10% One or Two Three or Four Five or Six Seven to Nine Ten or More Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

28 Years in Current Position 23% More Than Five 26% 30% 26% 26% 32% Three to Five One or Two 18% 19% Less Than One 2011 Results 2007 Results 2007 Results 2011 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

29 Training as a Nurse Informaticist Degree Earned in Results 15% 15% 23% 2% Bachelors Certificate On the Job Training Masters/PhD Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

30 Nursing Informatics Certification ANCC 19% 23% 21% CPHIMS 4% 3% 2% Other 9% 16% 20% None 58% 55% 55% 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

31 Nursing Informatics Certification Anticipate Obtaining 42% 4% 17% 35% None 2011 Results Other CPHIMS ANCC Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

32 Salary Impact of Certification Non-CPHIMS CPHIMS Non-NI Certified NI Certification $0 $50,000 $100,000 $150,000 Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

33 Reporting Department Information Systems Nursing Administration Education Quality Improvement Implementation Physician Practice Software Design Sales/Marketing Ancillary Case Management 6% 6% 3% 5% 6% 5% 5% 6% 3% 2% 3% 5% 2% 3% 3% 1% 2% 1% 2% 37% 32% 26% 38% 17% 22% 50% 52% 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

34 Number of Staff Reports 61% 2007 Results 2011 Results 7% 8% 4% 2% 2% 3% 4% 4% 5% 6% 7% 3% 2% 4% 4% 5% 6% 6% More Ten to Seven to Six Five Four Three Two One None than 20 Twenty Nine 58% Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

35 Top Three Job Responsibilities Systems Implementation 45% 57% 67% Systems Development 41% 53% 52% Quality Initiative 21% 25% Liaison 32% 32% Strategic Planning 16% 15% Informatics Education 15% 23% Vendor Communication 13% 13% 3 Nursing Education N/A 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

36 Systems Developing/Implementing 77% Nursing Clinical Documentation 77% 68% 62% EMR/EHR 57% 48% 60% CPOE 46% 52% 58% Clinical Information Systems 77% 71% 56% Non-nursing Clinical Documentation 52% 74% 48% emar 47% 43% 41% Bar Coded Medication Management 34% 22% 33% Point-of-Care Decision Support 36% 34% 30% Quality Improvement/Risk N/A N/A 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

37 Growth in the Nursing Market Nursing Applications w/ Highest Expected Purchase Rates for Hospitals over Next 24 Mo. emar Closed Loop Medication Administration Impact on patient safety Nursing Documentation Supports quality outcomes reporting Makes CPOE more effective Vital signs, flow sheet data Nurse staffing/scheduling Nurse acuity Source: HIMSS Analytics Database

38 Applications with Experience Nursing Clinical Documentation EMR/EHR Clinical Information Systems CPOE Non-nursing Clinical emar Bar Code Ancillary Point-of-Care Clinical Decision Quality Improvement N/A N/A N/A 91% 83% 76% 63% 72% 85% 72% 55% 68% 57% 65% 53% 48% 43% 41% 39% 40% 2011 Results 2007 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

39 Largest Barrier to Success Availability of Financial Resources 18% 23% 65% User Acceptance 16% 26% 29% Lack of Integration 7% 24% 33% 2011 Results 2007 Results 2004 Results Data from the 2011 HIMSS Nursing Informatics Workforce Survey HIMSS

40 HIMSS Nursing Informatics Community 3423 nurse members 2282 list serv subscribers 450+ attendees at 2011 NI Symposium 60+ NI Task Force call monthly participants 25 Deliverables

41 HIMSS Nursing Informatics Milestones Community Population: 3,400+ *HIMSS is proud cosponsor/collaborator

42 NI Community Framework Committee (Strategy) Task Force (Education & Networking) Workgroups (Participation) Multidisciplinary activities External collaborations

43 NI Deliverable Framework HIT Landscape, Board & Strategic Guidance, Community ideas Deliverables: Committee Champions Roadmap: Clinical Informatics, National Initiatives, NI Leadership, NI Practice Mapping: ANI, HIMSS, TIGER

44 The TIGER Initiative Foundation NEW TIGER Formed as a 501.c.3 independent entity Partnerships and Collaborations growing in Nursing, Interdisciplinary and Allied Health to over 100 groups interested Nursing Informatics: Where Technology and Caring Meet Book Published (Thanks to Marion Ball and TIGER Contributors) 44

45 Alliance for Nursing Informatics ANI is a collaboration of organizations that represents a unified voice for Nursing Informatics, sponsored by AMIA and HIMSS ANI represents more than 5,000 nurses, bringing together 28 separate nursing informatics groups that function separately at local, regional, national and international levels Each of these organizations has its own established programs, publications and organizational structures for its members 45

46 Closing Observations Informatics nurses are critical to the success of IT in health care Key characteristics - include these C s Clinical-technical bilingual fluency & translation Clinical process & workflow expertise Change management & Communication skills Creativity & Cultural awareness Credible leadership

47 The Final Word... Invaluable! Priceless! Necessary!

48 Questions????? Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics, HIMSS 33 West Monroe Street, Suite 1700 Chicago, IL

49 Resources and References Alliance for Nursing Informatics American Nurses Association American Nurses Credentialing Center CPHIMS HIMSS Nursing Informatics Community HIMSS Nursing Informatics Research 49

50 NI Community Tools NI Toolbox & NI Knowledge Repository (website) NI Community (website) NEW! Discussion Forum List serv Webex (conference calls) NI Facebook Twitter: #Christel_Anders Clinical Informatics RSS feed NewsRSS.asp Clinical Informatics Insights _FocusDynamic.asp?faid=305 HIMSStv NI Channel _nursinginformatics_videos.asp?f aid=398&tid=30 HIMSS Blog Wiki (online workstation)

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