By Susan Kreimer, MS, contributor
Feb. 5, 2010 - As federal funds begin to revolutionize health information technology (HIT), nurses will play a pivotal role in developing and implementing electronic medical records. Many are already on the cusp of making computerized reform a reality, and some are even finding new career opportunities along the way.
"HIT has the potential to greatly change how we communicate with our patients, how we track and trend illness, what nursing interventions we know are the most effective," said Ellen Makar, MSN, RN-BC, CCM, finance clinical coordinator in decision support at Yale New Haven Health System.
"Integrated records do offer the promise of a safer health system as well," she added. "Being able to pull out the most salient data to assist nurses in providing care - that will be key."
Incentives for the adoption of electronic medical records stem from the American Recovery and Reinvestment Act of 2009. Of the $819 billion stimulus, $20 billion has been earmarked for HIT innovation.
"It's great to see resources flowing to this area. This will help the industry make significant strides in getting electronic health records implemented," said Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, vice president of informatics at the Healthcare Information and Management Systems Society (HIMSS).
President Obama has said he intends for every patient to have an electronic medical record by 2014. Organizations and providers, including nurse practitioners seeking Medicaid reimbursement, will be compensated at higher rates if they can demonstrate meaningful HIT use, Sensmeier said.
Easy access to well-organized information enables clinicians, patients and families to make sound decisions. "Nursing has led the passion to reduce clutter in the medical record and to have clinical teams agree on common forms," said Marna K. Flaherty-Robb, RN, MSN, CNS, chief nursing information officer at the University of Michigan Medical Center.
"Nurses are also at the forefront of designing medical records and health information in a manner that serves communication with the patient as well as assists with self and family care," she said.
Some schools and colleges of nursing offer undergraduate courses, certificate programs and/or master's degrees in health informatics. Others partner with educational institutions in medicine, rehabilitation, public health and pharmacy to share knowledge about the emerging transformation. Nurses can also build on their technology skills with on-the-job training. This additional education and training can help nurses in their caregiver roles, and may open up more career opportunities as the HIT field continues to grow.
Employers are tasking nurses with integrating new technology into the workflow and identifying gaps before implementation. "This structure - having the end users present from the ground up - allows them to really own their own process," said Sandy Ng, MSN, RN-BC, informatics nurse specialist and manager at the University of California, San Francisco Medical Center.
Becoming involved is the most crucial step. "Projects rarely only affect one discipline, so nurses often have to ‘play in the sandbox' with others," Ng said, citing pharmacists, physicians, regulators and performance improvement experts. "Nurses are the patient's primary advocate and liaison with everyone, making them like an air traffic controller. It is only natural that nurses who reach out to so many other departments become a key partner in the development of HIT."
At the bedside or in other roles, nurses should reflect on how HIT can benefit their practice. "We want solutions that will ease the documentation and data collection burden on nurses," said Yale's Makar. Automation should be useful to nurses at all levels and in all settings. "In nursing, oftentimes the very systems meant to ease the workload of care actually end up increasing the workload in not-so-easily-identifiable ways," she said.
Makar and UCSF's Ng have been selected by the Alliance for Nursing Informatics to participate in the Nursing Informatics Emerging Leaders Program in 2010. The initiative is jointly supported by the American Medical Informatics Association and the Healthcare Information and Management Systems Society.
While nurses with informatics expertise will be needed to lead these efforts, those at the bedside should be trained in using the new technology, said Sensmeier of HIMSS. The nursing profession stands to benefit from their hands-on feedback on what works and what doesn't, with the goal of ironing out glitches and enhancing usability.
For a detailed look at nursing informatics, visit these sites:
The Alliance for Nursing Informatics
American Medical Informatics Association
The Healthcare Information and Management Systems Society
Agency for Healthcare Research and Quality/HIT
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