Nurses need only look at a few trends to see the promising future for nursing informatics, the specialty that combines nursing information and knowledge with management of data and information technology.
According to the latest data from the Healthcare Information and Management Systems Society, average salaries for nurse informaticists increased 42% in seven years — from $69,500 in 2004 to $98,702 in 2011.
The average education level also is increasing. Those with master’s degrees and PhDs increased from 52% in 2007 to 56% in 2011.
Only 9% of hospitals had adopted electronic health records in 2008. In 2013, more than 80% have demonstrated meaningful use of EHRs, according to the U.S. Department of Health and Human Services.
Joyce Sensmeier, RN-BC, MS, CPHIMS, FHIMSS, FAAN, vice president of informatics for HIMSS, said demand for informatics nurses is outpacing supply, especially as EHRs become the standard and hospitals move to optimize their use.
Increasingly, informaticists have trained specifically for the field. Rather than being drafted into service because they know a little about technology, many nurses are graduating with advanced degrees focused on informatics or they obtain certifications specifically for the field.
Different settings, different titles
An informatics position may be known by another name, such as clinical analyst. Some nurse informaticists write software and maintain systems for their facilities, while others are liaisons between clinicians and information technology experts.
Considerable knowledge and interest in both worlds is critical.
At Winthrop University Hospital in Mineola, N.Y., informatics nurses are key as the hospital prepares for stage two of meaningful use of EHRs and works toward attaining Magnet status, which requires a tremendous amount of documentation.
Lois Basile, RN-BC, MSN, associate director of clinical informatics at Winthrop, said she was the only person in the informatics department 15 years ago. Now the department has grown to a staff of 26, most of them nurses.
Her department is called clinical informatics because its staff works with all providers. Basile said the nurses there don’t build the programs or write the software as some informaticists do. Instead, they are liaisons between IT staff and clinical staff. She describes clinical informatics as 60% clinical and 40% technical.
Kerry O’Brien, RN, MPH, also an associate director for clinical informatics at Winthrop, said their department juggles support for hospital initiatives, patient safety goals, regulatory requirements and efforts to improve functionality and efficiency for users. They also make sure the providers’ prescription-ordering system works well with the pharmacy’s information mamagement system.
Basile shows how nurse informaticists can solve problems through her own experience. Winthrop nurses had been writing instructions and condition summaries by hand when patients were transferred from one unit to another, but much of what they were writing already was entered into the EMR system. Informatics nurses figured out a way to computerize those instructions and summaries and thereafter nurses could just print out the information.
Nurse input drives innovation
Maureen Scanlan, RN, MSN, director of nursing informatics and decision support at Montefiore Medical Center in the Bronx, is the liaison between staff nurses and the IT department. Nurse informaticists in the IT department build screen templates and perform coding and programming.
Informaticists depend on the knowledge, wisdom and information from staff nurses on the front end, she said.
“Staff nurses really are the experts in process and workflow,” Scanlan said.
Since they are on the front lines, staff nurses know how technology can help them and the patients, according to Scanlan. They know when a procedure such as medication reconciliation can be done better or faster with the help of electronics. Their bedside expertise is crucial to helping the informaticist know what solutions to pursue.
Nurses throughout the hospital share ideas in meetings of the clinical informatics council, and informaticists help bring ideas to development in IT, Scanlan said. Nurses are asked to look at performance improvement measures, she said.
“In order to improve any performance, you have to start with collecting credible, actionable data and display it in a simple, meaningful way for the nursing staff or the healthcare team,” Scanlan said. “At the very start of any of these efforts is nursing practice.”
One common misperception, she said, is that if nurses are working in informatics, they have to be able to repair and build computers. While some nurse informaticists do have those skills, clinical training in nursing is the emphasis. Nurse informaticists also are involved in translating clinical practice standards into EMRs so nurses can use them.
As Montefiore transitions to an EHR system, nurse informaticists play an increasingly vital role in the process, Scanlan said.
Informatics in home care
At MJHS in New York City, clinical analyst Maureen Clancy, RN, MSN, also helps coordinate the needs of clinicians with the information systems department.
Because the focus is on home care and clinicians are working out in the field, communicating and coordinating is critical so clinicians don’t have to come back into the offices to discuss informatics needs.
Clancy, who received her master’s in nursing education, has been the technology liaison since the time clinicians were using PalmPilots for documentation. With electronic health records, the system is better able to handle the increasing needs and regulatory demands.
Clancy’s informatics role has included finding a way to standardize patient assessments in palliative care and determine whether they are candidates for hospice.
When MJHS nurse leaders want to change the way tasks are completed, such as documenting assessments and plans of care, they turn to Clancy, who then discusses how to implement the change with the information systems department. She also helps test the changes to the EHR and presents the findings to nurse leadership.
Informatics nurses are involved in all nursing settings, including acute care, ambulatory care, home care and long-term care.
Sensmeier said the field has come very far in a relatively short period and the demand for nursing informatics continues to increase. “It’s really an exciting field to be a part of,” Sensmeier said. “Every day is different. You can be very entrepreneurial and creative. You’re doing problem-solving, but it’s based on your nursing training.”