Devices & Technology

Health IT in the Age of Reform


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By Christina Orlovsky Page, contributor 

February 18, 2011 - When the Patient Protection and Affordable Care Act was signed into law in March 2010, it signified the beginning of a new era in health care.  Now, nearly a year later, the winds of change have already begun to blow, as hospitals across the nation work to embrace the future by implementing new health information technology (IT). For nurses, these changes mean even greater adaptability is needed for the evolving landscape of their chosen profession.

As health reform takes shape over the next four years, nurses will need to be closely involved in all the health IT provisions that result from the new law, said Joyce Sensmeier, RN-BC, MS, vice president of informatics for Healthcare Information and Management Systems (HIMSS), a not-for-profit organization dedicated to transforming health care through the effective use of health information technology.

“The Patient Protection and Affordable Care Act has a number of provisions around health IT, mostly focusing around electronic health information exchange,” Sensmeier said.

HIMSS highlights three distinct groups that the law’s provisions fall into: (1) improving quality of health care through increased data collection through health IT; (2) focusing on operating rules and standards at an administrative level; and (3) increasing the health IT workforce. According to Sensmeier, nurses factor heavily into the first and third groups.

“A big driver is the issue of quality, and nurses are very involved in documenting clinical data,” she said. “At the end of the day, we need to get all the data. Today, someone has to manually go through the data and pull out reports.” 

With health care reform, the goal is to move entirely to the electronic health record (EHR) for data collection, with the government providing financial incentives to organizations that demonstrate the adoption and meaningful use of certified EHRs. This demonstrates a significant shift from current, paper-heavy hospital systems.

“Now, we’re looking at implementing EHRs and making sure there is a flow of the data all the way through,” Sensmeier continued. “Some organizations are calling it a clinical transformation.” 

Sensmeier suggests that the best way for nurses to prepare for the transformation that results from EHR implementation is to get involved.

“The challenges that have happened in a lot of systems implementations in the past are that nurses have been given a system and told to just use it, which sets up a barrier if it doesn’t support the nurses’ workflow,” she says.

“What nurses can do is to try to keep an open mind that technology can improve their work, get involved in the projects and influence them,” she continued. “If IT is leading the project, it’s critical for nurses to be there to say, ‘This is the reality of my workflow; let’s make sure this doesn’t make it more difficult for me or that my work isn’t compromised.’ In order to get that openness to provide input, nurses need to get educated as trainers or super users and partner with the informatics nurses, which gives them the opportunity to give feedback and become the local expert. It has to be a community that makes the projects successful.”

While a lot of informatics training occurs on the job, nurses interested in even more education in nursing informatics can seek out a certificate program or master’s degree in health care informatics. With the Patient Protection and Affordable Care Act’s focus on increasing the health IT workforce, nurses with an informatics background will be in high demand in the coming years.

Finally, in order for an EHR project to be successful, it’s critical for nurses to understand the benefits of the electronic health record in a hospital setting, Sensmeier concluded.

“One of the key benefits is that you’re going to be able to access information about your patient anywhere, anytime. This will really eliminate the duplication of the clipboard,” she explained.

“When it comes to medication reconciliation, the nurse will have that more readily available, and in the transfer of care, the nurse will be able to turn care over electronically, making the continuity of care much better,” she continues. “Finally, the nirvana is that quality will be greatly improved. There are incentives to get this done in a meaningful way so that you really can make a difference and patient care really will be better.”

For more information, visit the HIMSS or Health and Human Services websites

© 2011. AMN Healthcare, Inc. All Rights Reserved. 

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