Perspectives on Nursing Informatics in 2011

Dana Alexander RN, MSN, MBAJudy Murphy, RN, BSN, FACMI, FHIMSS

Mark Sugrue, RN, BC HIMSS NI Task Force Call

March 28, 2011

Agenda

• Emerging Nurse Leadership Roles• Today’s Practice Environment• Meaningful Use• TIGER • Future of Nursing

Perspectives on Nursing Informatics in 2011

Dana Alexander RN, MSN, MBAVP & Chief Nursing Officer

GE Healthcare HIMSS Nursing Committee

Email: dana.alexander@ge.com

Why are we having this conversation?ARRA/HITECH 2009

PPACA 2010Future of Nursing

Oct 2010

“There is no aspect of our profession that will be untouched by the informatics revolution in progress.”-Angela McBride, Distinguished Professor and University Dean Emeritus Indiana University School of Nursing

2009 2011 2013 2015HIT-Enabled Health Reform

Mea

ning

ful U

se C

riter

ia

HITECH Policies 2011 Meaningful

Use Criteria (Capture/share

data) 2013 Meaningful Use Criteria

(Advanced care processes with

decision support) 2015 Meaningful Use Criteria (Improved Outcomes)

HIT-Enabled Health ReformAchieving Meaningful Use

Source: HIT Policy Committee 6/16/2009

What’s in a Name?Titles, reporting structures, scope of responsibility

and sphere of influence are dynamic and evolving

Structured for Success:• Alignment with the organization’s vision and

strategy• Key Partnership Relationships to include

Executive, Clinical, IT and Education• Communication channels• Intertwined with the Professional Practice Model• Patient-Centric, interdisciplinary team focused

Partners in Practice: The Chief Nurse Executive and Nursing Informatics Executive

• What is the relationship between the Nursing Professional Practice Model and Nursing Informatics?

• How does the model look today and what are the emerging models?

“Advancing Nursing Practice throughNursing Informatics”

Where Does Nursing Informatics Live?……….”Everywhere”!!

Nursing Informatics Leader Responsibilities and Influence:– Educate organizations about informatics– Defining competencies and provide mentorship– Partnering for workforce readiness & development– Supporting & optimizing evolving care delivery models– Blending business & clinical intelligence and analytics– Incorporating ethnographic research, human factors concepts and

usability for transforming care delivery– Communicating and sustaining the vision– Build and infrastructure for evidence based practice

“In the future it will be necessary for every clinician to have informatics competencies at some level.” -Dr. David Blumenthal, Office of the National Coordinator

Driving toward Improving Outcomes and Population Health….2015 and Beyond

• Building an infrastructure for evidence based practice is essential

• Informatics is key to increasing knowledge and informing practice

• Nursing informatics links practice to care delivery and the professional practice model

• Regulatory & Policy Influence• Supporting and optimizing care delivery models

e.g. ACO’s

NOW is YOUR TimeNursing has a choice:

• “At the table or on the menu?”

Perspectives on Nursing Informatics in 2011

Judy Murphy, RN, BSN, FACMI, FHIMSSVice President, Information Services Aurora Health Care, Milwaukee, WI

HIMSS Board of Directors ANI Co-Chair

Email: judy.murphy@aurora.org

Technology Impact on People• Informatics Workforce

– Proliferation of Workforce Training Programs– Staff “furloughed” away from direct patient care for

big implementation projects– Impact on bedside staffing

• Interdisciplinary Collaboration– Cross functional & cross venue improvements– “Interprofessional”

• Online Education– Ubiquitous

Technology Impact on Process• Workflow

– How the technology is used within the context of patient care delivery

– Use of social networking tools• Standardization

– Terminology / Vocabulary– Interoperability

• Optimization– Application usability– Use of decision support– Quality measure as byproduct of documentation– Evidence-based staffing decisions based on acuity

Technology Use• Explosion of device variety• Device use at point-of-care• Barcoding• Impact on nurse-patient relationship

Adapted from:Murphy, J. “Trends in the Delivery of Nursing Care: What Impact Will Technology Have?,” Nursing Informatics Commentary, Journal of Healthcare Information Management, Vol 25, No. 1, 14-15 (Winter 2011).

A special thank you to Michael Kurliand and the HIMSS Nursing Informatics Community in helping identify many of these ideas. The NI Community has always been selfless in sharing and helping each other; here is just one more example. I truly appreciate being part of this group –Judy

Response Profile &Methodology

– Requested Health System Executives to refer us to their corporate nursing informatics leader

– Response Rate: 77%– Representative of 31

Health Systems– Average Net Patient

Revenue: $2.8 billion

Health Management Academy Survey –CNIO’s

Health Management Academy Survey –CNIO’s

Health Management Academy Survey –CNIO’s

Health Management Academy Survey –CNIO’s

Health Management Academy Survey –CNIO’s

Nursing Informatics responsibilities

Health Management Academy Survey –CNIO’s

Health Management Academy Survey –CNIO’s

Perspectives on Nursing Informatics in 2011

Mark Sugrue, RN, BC Director, Health Industries Advisory

PricewaterhouseCoopers HIMSS NI Task Force Chair

Email: mark.d.sugrue@us.pwc.com

The Future of Nursing: Leading Change, AdvancingHealth

Released October 5, 2010Type Consensus ReportTopics Health Care Workforce,

Quality and Patient Safety, Health Services, Coverage, and Access

Activity Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine

Board Studies under the IOM Executive Office

http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

Highlights - Key Messages1. Nurses should practice to the full extent of their

education and training.2. Nurses should achieve higher levels of education

and training through an improved education system that promotes seamless academic progression.

3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.

4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.

8 Key Recommendations# Recommendation

1 Remove scope-of-practice barriers

2 Expand opportunities for nurses to lead and diffuse collaborative improvement efforts

3 Implement nurse residency programs

4 Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020

5 Double the number of nurses with a doctorate by 2020

6 Ensure that nurses engage in lifelong learning

7 Prepare and enable nurses to lead change to advance health

8 Build an infrastructure for the collection and analysis of interprofessionalhealth care workforce data

Leadership

EducationPractice

Transforming Nursing

Nursing Informatics & Future of NursingFON Recommendation

• Remove scope of practice barriers

• Increase nurse residency programs

• 80% BS by 2020• 100% Doctorate level• RN Lifelong learning• Opportunities to Improve• Lead Change/Advance

Health

Nursing Informatics

• Information technologies to support practice and demonstrate RN value

• Competencies !!!• Curriculum• TIGER !!• Prepare Nursing Leaders• Develop NI Leaders

PRAC

TIC

EED

UC

ATIO

NLE

ADER

SHIP

Scope of Practice Barriers

TIGERTechnology, Informatics, Guiding Educational Reform

www.thetigerinitiative.org

“Our vision is to enable nurses to use informatics tools, principles, theories, and practices to make health care safer, more effective, efficient, patient-centered, timely, and equitable by interweaving enabling technologies transparently into nursing practice and education, making information technology the stethoscope for the 21st century. “

Nursing Informatics in the Eye of the Storm !!

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Nursing

Informatics

ARRA

ICD10

PPACA

RWJF IOM

Questions?