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Nursing Informatics InstituteSharp Healthcare, San Diego, CA

Informatics Nurses: What? Where? And How Many?Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN

January 27, 2012

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.

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. 1993

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 2008

6

Nursing Informatics is Nursing!

• NI is was recognized as a specialty by the American Nurses Association (ANA)– 1st Scope and Standards of Nursing Informatics Practice

published 1992

– 3rd 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

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

8

How does Informatics Impact the Nursing Process?

– 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

Assessment

Planning

Implementation

Evaluation

Enables the professional nurse to be the

“Coordinator” of each patient’s care

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

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

• Enable cost savings and productivity goals

NI Success in Helping to AchieveOrganizational Objectives

4.22

5.04

5.22

5.51

5.55

5.58

5.83

Eliminating Documentation Redundancies

Identifying Conditions Present on Admission

Preventing Never Events

Improving Quality Reporting

Improving Clinical Reporting

Administering Correct Medication

Making Sure IT Does No Harm

HIMSS 2009 Informatics Nurse Impact Survey432 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

Role of Informatics Nurses Relativeto Emerging Technologies

39%

50%

51%

59%

63%

75%

81%

Voice Recognition

Data Warehouse

Predictive Modeling

Personalized Healthcare

Remote Monitoring

Smart Devices

Medical Device Integration

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

15

Nursing Informatics Certification

American Nurses Credentialing Center

• Board Certification in Nursing Informatics

http://nursingworld.org/ancc/

Healthcare Information and Management Systems

Society (HIMSS)

• Certified Professional in Healthcare Information and

Management Systems

http://himss.org/ASP/certificationHome.asp

http://nursingworld.org/ancc/



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.

22nd Annual HIMSS Leadership Survey

Primary Clinical IT Focus

2%

3%

7%

8%

11%

11%

20%

24%

Focus on Nursing Systems

Establish Clinical Protocols

Focus on Business …

Certification of EHR System

Linking Clinical Systems …

Focus on Physician Systems

Installing CPOE

Ensure Operational EHR

Sponsored by Citrix Systems

326 Respondents


Most Significant Barriers to Implementing IT

4%

7%

7%

10%

16%

24%

5%

7%

10%

11%

17%

18%

Lack of Interoperable Systems

Lack of Clinician Time Commit.

Difficulty in End User Acceptance

Vendor Inability to Deliver Product

Lack of Staffing Resources

Lack of Financial Support

2011

2010



Role of Clinicians

8%

16%

26%

43%

45%

41%

48%

57%

57%

76%

80%

8%

15%

30%

42%

42%

43%

44%

54%

60%

77%

79%

We have a CNIO

Clinical Department Managers Pick IT …

We have a CMIO

Explore Innovative Ways to Use IT

Project Leaders for Implementation

Employed by IS Department

Employ Hospitalists for Clinical

Involved in Clinician Training

Participate in Development of Policies

Project Champions for Other Clinicians

Participate in System Evaluations

2011

2010


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)


2011 IT Staffing Needs (Top Ten)

12%

12%

12%

14%

14%

15%

17%

21%

24%

39%

IT Security

System Design

Clinical Champions

User Training

Systems Integration

Clinical Transformation

Process/Workflow Design

Network and Architecture Support

Clinical Informaticist

Clinical Application Support


2011 NI Workforce SurveyPrimary Workplace

5%

1%

3%

6%

16%

5%

13%

51%

5%

1%

2%

5%

10%

5%

16%

55%

7%

2%

4%

5%

5%

9%

20%

48%

Other

Ambulatory Care

Government/Military

Consulting Firm

Vendor Organization

Academic Setting

Health System

Hospital

2011 Results 2007 Results 2004 Results

660 Respondents

Data from the 2011 HIMSS Nursing Informatics Workforce Survey ©HIMSS

Level of Nursing Education

4%2%

21%

33%

6%

PhD in Nursing

Other PhD

Other Masters

Masters Degree In Nursing

Bachelors in Nursing

Only highest degree is shown.


Years of Clinical Experience

11%

19%

21%

19%

31%

13%

19%

19%

17%

31%

12%

22%

20%

15%

31%

One to Five

Six to Ten

Eleven to Fifteen

Sixteen to Twenty

More than Twenty



Nursing Specialty Background

1%

1%

5%

3%

6%

3%

7%

22%

24%

10%

10%

11%

13%

13%

12%

17%

21%

34%

48%

43%

9%

10%

12%

12%

12%

13%

15%

24%

32%

43%

44%

Oncology

Quality Improvement

Home Health/Community

Pediatric

Administration

ICU/CCU


Med-Surg

ED


Time Devoted to Clinical Activities

74%

18%

3%

3%

2%

71%

22%

3%

1%

3%

77%None

Less than 25%

26% to 50%

51% to 75%

More than 75%



Years of Informatics Experience

23%

19%18% 18%

23%

14%16%

14% 13%

33%

13%14%

15%

10%

39%

One or Two Three or Four Five or Six Seven to Nine Ten or More



Years in Current Position

2007 Results

2011 Results

More Than Five Three to Five

One or TwoLess Than One

23%26% 32%

19%

26% 30%26%

18%

2007 Results 2011 Results


Training as a Nurse InformaticistDegree Earned in 2011

2%

15% 15%

23%

Bachelors Certificate On the Job Training

Masters/PhD

2011 Results


Nursing Informatics Certification

55%

20%

2%

21%

55%

9%

3%

23%

58%

16%

4%

19%

None

Other

CPHIMS

ANCC



Nursing Informatics Certification Anticipate Obtaining

NoneOther

CPHIMSANCC

42%

4%17%

35%

2011 Results


Salary Impact of Certification

$0$50,000

$100,000$150,000

NI Certification

Non-NI Certified

CPHIMS

Non-CPHIMS


Reporting Department

3%

3%

6%

3%

6%

26%

37%

1%

1%

3%

5%

5%

5%

17%

38%

50%

2%

2%

2%

2%

3%

5%

6%

6%

22%

32%

52%

Case Management

Ancillary

Sales/Marketing

Software Design

Physician Practice

Implementation

Quality Improvement

Education

Administration

Nursing

Information Systems



Number of Staff Reports

6% 7% 3% 2% 4% 4% 5% 6% 6%

58%

7% 8%4% 2% 2% 3% 4% 4% 5%

61%

More than 20

Ten to Twenty

Seven to Nine

Six Five Four Three Two One None



Top Three Job Responsibilities

13%

23%

15%

32%

25%

52%

67%

N/A

13%

15%

16%

32%

21%

41%

45%

53%

57%

Nursing Education

Vendor Communication

Informatics Education

Strategic Planning

Liaison

Quality Initiative

Systems Development

Systems Implementation



3

Systems Developing/Implementing

N/A

34%

22%

43%

74%

71%

52%

48%

68%

N/A

36%

34%

47%

52%

77%

46%

57%

77%

30%

33%

41%

48%

56%

58%

60%

62%

77%

Quality Improvement/Risk …

Point-of-Care Decision Support

Bar Coded Medication Management

eMAR

Non-nursing Clinical Documentation

Clinical Information Systems

CPOE

EMR/EHR

Nursing Clinical Documentation



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 201037

Applications with Experience

39%

53%

57%

55%

85%

63%

83%

40%

41%

43%

48%

65%

68%

72%

72%

76%

91%

Quality Improvement

Point-of-Care Clinical Decision …

Ancillary

Bar Code

eMAR

Non-nursing Clinical …

CPOE

Clinical Information Systems

EMR/EHR

Nursing Clinical Documentation


N/A

N/A

N/A


Largest Barrier to Success

7%

16%

18%

24%

29%

65%

33%

26%

23%

Lack of Integration

User Acceptance

Availability of Financial Resources



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

HIMSS Nursing InformaticsMilestones

*HIMSS is proud

cosponsor/collaborator

Community

Population:

3,400+

NI Community Framework

• Committee (Strategy)

• Task Force (Education & Networking)

• Workgroups (Participation)

• Multidisciplinary activities

• External collaborations

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

The TIGER Initiative Foundation

– NEW TIGER Website @ www.thetigerinitiative.org

– Formed as a 501.c.3 independent entity

– Partnerships and Collaborations growing in Nursing, Interdisciplinary and Allied Health to over 100 groups interested

– 2011 - Nursing Informatics: Where Technology and Caring Meet Book Published (Thanks to Marion Ball and TIGER Contributors)

44

http://www.thetigerinitiative.org/

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

Alliance for Nursing Informatics

45

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

The Final Word . . .

• Invaluable!

• Priceless!

•Necessary!

Questions?????

Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN

Vice President, Informatics, HIMSS

33 West Monroe Street, Suite 1700

Chicago, IL 60603

[email protected]

www.himss.org

48

mailto:[email protected]

Resources and References Alliance for Nursing Informatics

http://www.allianceni.org

American Nurses Association

http://www.nursingworld.org

American Nurses Credentialing Center

http://www.nursecredentialing.org/

CPHIMS http://himss.org/ASP/certificationHome.asp

HIMSS Nursing Informatics Community

http://www.himss.org/ni

HIMSS Nursing Informatics Research

http://www.himss.org/ASP/researchHome.asp 49

http://www.allianceni.org/

http://www.allianceni.org/

http://www.nursingworld.org/

http://www.nursingworld.org/

http://www.nursecredentialing.org/




http://www.himss.org/ASP/researchHome.asp

NI Community Tools

• NI Toolbox & NI Knowledge Repository (website) www.himss.org/ni

• NI Community (website) www.himss.org/nursing

• NEW! Discussion Forumhttp://www.himss.org/niforums

• List serv [email protected]• Webex (conference calls)

• NI Facebookhttp://www.facebook.com/profile.php?ref=name&id=100000434371377

• Twitter: #Christel_Anders

• Clinical Informatics RSS feed http://www.himss.org/ASP/himssNewsRSS.asp

• Clinical Informatics Insights http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=305

• HIMSStv NI Channel http://www.himss.org/ASP/topics_nursinginformatics_videos.asp?faid=398&tid=30

• HIMSS Blog http://blog.himss.org/

• Wiki (online workstation) http://himssni.pbworks.com/


http://www.himss.org/nursing

http://www.himss.org/niforums

mailto:[email protected]

http://www.facebook.com/profile.php?ref=name&id=100000434371377



http://www.himss.org/ASP/himssNewsRSS.asp

http://www.himss.org/ASP/himssNewsRSS.asp

http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=305

http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=305

http://www.himss.org/ASP/topics_nursinginformatics_videos.asp?faid=398&tid=30



http://blog.himss.org/

http://himssni.pbworks.com/

www.himss.org/ni

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