Challenges within Nursing Informatics and Health IT

Question:

In your opinion what were the challenges you faced in your role as a nurse in health IT and are there really job opportunities available for those interested in pursuing a career related to Nursing Informatics?

Answers from Dana Alexander:

There has and continues to be many challenges for nursing informaticists, however, the environment is changing and today there is a greater understanding and recognition of the importance of nursing informatics. Historically, defining informatics and nursing informatics was a challenge; the field is relatively young as compared to other roles and industries. An exciting aspect that I (and many others) have had is the opportunity to pioneer roles and define scope and responsibilities of those roles. The challenge has been gaining understanding from individuals in both IT and the profession of nursing. However, today informatics and nursing informaticists are more readily understood. And while the field continues to evolve and define itself, the industry at large is recognizing the importance of nursing informatics as HCIT continues to be a focal point to achieve the goals of the National Quality Strategy and in support of US healthcare transformation.

Challenges have also included defining nursing informatics as an extension of nursing practice, defining the nursing informatics competencies required for every nurse and those specialized competencies required for nursing informaticists. Within nursing informatics, there are many roles which may require specialized competencies as well. Another challenge has been defining the nursing informatics infrastructure within an organization to support nursing and patient care, and subsequently how to integrate nursing informatics as an aspect of the professional practice model. Great strides have been made in these areas and continue to evolve. As the degree of HIT implementation increases the nursing informatics infrastructure and roles need to evolve to optimize the changing care delivery model and strategies of the organization.

Moving forward into the future, I strongly believe that career opportunities in nursing informatics will be very strong and will exceed opportunity levels as compared to other industries and fields. I consider nursing informatics to be a “sweet spot” for growth. While there is much work yet to be done to achieve meaningful use and implementing EHRs there will be significant growth in clinical business intelligence and analytics creating a further demand for nursing informatics. Organizations will need a well-tuned analytics strategy to manage patients to achieve accountable care and goals of the National Quality Strategy.

As we drive toward accountable care, we can expect the financial/reimbursement models of today to change to support new care delivery models that will better leverage the inter-professional care delivery team. There will be a greater demand for nurses in roles outside of the hospital setting into the community and home. New technologies will be needed to reach, connect and engage the patient and caregivers. The U.S. Healthcare IT market spend is expected to grow at 22+ % annually from 2012 -2014. Additionally, as future technologies continue to emerge to support and connect the patient and family through remote health management, nurses will have a key role in managing and monitoring these patients from settings outside of the hospital. That said nursing informaticists are needed to support the development, design, usability and implementation of these emerging technologies.

In addition to the growing demand for nursing informaticists in practice and education settings, nursing informaticists that have a research focus to support evidenced based practice and the evolving care delivery models are needed as well. These are a few areas where I foresee continued opportunities for a career in nursing informatics. It is our responsibility as nurses and nursing informaticists to innovate, create and define the roles that are necessary to support the transformation of U.S. Healthcare. The opportunities are abundant and needs only to be seized.

Answers from Willa Fields adds:

I made my way into informatics from the field of quality/performance improvement. Informatics was a natural progression from my interest in using computerized data to answer clinical questions. I accepted a position with a clinical information system software vendor to help them and their clients maximize the use of data in the system. I found that working for a vendor was quite different from a hospital. First off, I realized the engineers and programmers had an acronym language I was totally unfamiliar with. With the help of the internet, I soon mastered this new language. Then I realized the engineers and programmers did not understand hospital operations, nursing, or patient care; I needed to be specific in my requests and speak their language, not mine. It was also important to establish nursing’s credibility and the clinical voice. We all had the same goal in mind: to establish a safe, user friendly system that would improve care, so it was important to communicate nursing and patient data needs in a way the engineers and programmers could understand.

The challenges faced by nurses in health IT may not be that different today. Every discipline has its own language, and the nurse informaticist needs to know both the clinical and IT language to bridge nursing and software development and design.

Recent research has demonstrated that health IT is demonstrating positive results, although dissatisfaction among some clinicians remains a problem and is a barrier to achieving the potential of health IT (Buntin, Burke, Hoaglin, & Blumenthal, 2011). Nurse informaticists play a key role in improving clinician satisfaction by helping design better systems, educating clinicians on effective and safe use, and bringing forward solutions to maintain and improve existing systems. The demand for nurse informaticists will continue to increase, especially with the number of organizations implementing complex clinical systems as a result of the HITECH Act.

Many organizations are hiring nurse informaticists and Chief Nursing Informatics Officers. Now is an exciting time for health IT - as nurses, we are making contributions by helping to design better systems and ensuring clinicians are well equipped to effectively and safely use health IT to improve care. I completely agree with Dana, “The opportunities are abundant and needs only to be seized.”

Reference: Buntin, M., Burke, M., Hoaglin, M., & Blumenthal, D. (2011). The benefits of health information technology: A review of the recent literature shows predominiately positive results.Health Affairs, 30(3), 464-471.

January 2012