Feature

Nursing Informatics

Exploring career paths in a high-demand specialty

“Nursing informatics (NI) is the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice.”

American Nurses Association, Nursing Informatics: Scope and Standards of Practice

 

SWAT Team to the Rescue

Back when electronic health record (EHR) systems were first rolled out, they were expected to save time charting — except that they didn’t.

In response, Huntington Hospital in Pasadena called in the SWAT Team. No, the Huntington Hospital SWAT Team doesn’t carry guns or wear balaclavas. Formally known as the Safety Workflow Assessment and Technology Team, they’re four informaticists whose job is to relieve nurses’ technological headaches.

Amberle Bond, RN, BSN, CCRN, is a founding member of the group. When Huntington implemented its EHR in 2014, the SWAT Team focused on making the new technology easier to use by streamlining documentation and fixing issues like interoperability.

Over time, Bond and her team developed a partnership with the hospital’s information technology (IT) staff. Now, instead of IT making unilateral decisions, they seek nurses’ input and get approval from the SWAT Team.

“Nursing informatics plays a huge part in the design and implementation of new workflows for bedside staff,” Bond says. “We take the smart IT folks and the knowledge of bedside nursing and bring it all together to find products that work for both.”

 

Left to right: Amberle Bond, RN, BSN, CCRN, SWAT Team, Huntington Hospital; Candice Ney, RN-BC, MSN, Lead Operational Workflow Specialist, Cedars-Sinai; Ellen Pollack, RN-BC, MSN, Chief Information Officer, UCLA Health Services; Karen R. Pope, RN, BSN, M.A., Manager of IT Applications – Epic, Hoag Memorial Hospital

Building a Tech Team

The role of nurses in informatics has only increased as healthcare technology has proliferated. “Getting the technology in was the last 10 years,” says Ellen Pollack, RN-BC, MSN, chief information officer (CIO) of UCLA Health Sciences. “Now, it’s about what we do with the technology to help make patients safer and clinicians more efficient.”

As CIO, Pollack oversees the role of technology in research and academics as well as the clinical side. That’s made nursing informatics a growing specialty.

“Now, we have nurses in every nook and cranny of the organization,” Pollack explains. “They are programmers, educators and data scientists. Even the director of business operations is a nurse. Having nurses onboard makes a stronger tech team.

Robust Job Opportunities

The pandemic has further accelerated the demand for technology and for nurses who understand how to use it.

Candice Ney, RN-BC, MSN, is the lead operational workflow specialist at Cedars-Sinai in Los Angeles. She points to a need for more remote monitoring, less unnecessary documentation, more clinical decision support tools, and ways to connect patients to their providers through online portals and mobile devices.

Hiring Now

“We need streamlined workflows as well as more efficient and smarter tools,” Ney says.

That need translates into more jobs and higher pay for nurses in informatics. According to the Healthcare Information and Management Systems Society (HIMSS) Nursing Informatics Workforce Survey, the nurse informaticist is one of the 15 highest-paying nursing professions in the U.S., and the role of chief nursing informatics officer is on the rise.

Here are five possible roles for nurses in informatics:

1. Testing and Training

As new products and applications are released, they must be tested to ensure that they work as intended. Nurse informaticists who are familiar with the needs of the unit (or partner with key nurses who are) play a vital role.

“We collaborate with different specialties to create something that is unique and specific for an individual unit, but that also is a really great product overall,” Bond explains.

Nurse informaticists also train others in the use of new technology. “We work closely with our dedicated EMR training teams to design training curricula and content as well as providing at-the-elbow support for changes, implementations and general proficiency,” says Ney.

2. Data Scientist

The growing amount of data accumulated in EHR systems brings with it a need for machine learning models that can process and organize information for maximum clinical value.

“There is so much data that clinicians have to deal with,” Pollack explains. “How do we make it easier for them? How do we present the information in ways that make the clinicians smarter and enable them to have what they need at their fingertips?”

This is where the data scientist comes in. “Data scientists help us organize and present the data in meaningful ways, to turn input into knowledge into wisdom,” says Pollack. “Nurse data scientists come with clinical knowledge. They speak the language.”

3. Project Manager

Working on special projects is an important part of nurses’ role in informatics.

One of Bond’s first projects with the SWAT Team was a revamp of infectious disease documentation. “We came up with a new, streamlined form,” she explains. “It asks the needed questions, but gets rid of the fluff. That’s been huge. We get a lot of positive feedback from projects like that.”

Projects like this are also an excellent opportunity for a bedside nurse to gain informatics experience.

“Offer to take on a project if you see a need,” suggests Bond. “Staff nurses can be really instrumental in helping to lead an initiative alongside a nursing informaticist.”

4. Workflow Design

Nurses in informatics have a unique ability to understand the ways technology can impact the flow of information and cause patient care delays. No one is better positioned to identify opportunities for greater workflow efficiency than those closest to the care.

“Our application analysts help guide us on the functionality and features, so we make the most informed decisions around workflow design,” Ney says.

Bond adds that workflow designers must consider the overall picture. “There needs to be an understanding of what something will look like after it’s been documented,” she explains. “We need to know how it will appear to a regulator, a physician or somebody from Risk or Quality.”

Nursing Education

This means that when designing workflows, nurse informaticists must consult with others on their healthcare team about considerations that bedside nurses may not be aware of, such as regulatory requirements.

“Information technology is truly a team sport. There are opportunities for nurses to be deeply involved in roles like clinical educator or clinical nurse specialist, subject matter expert or superuser,” Ney says. “My team works side-by-side with all of these individuals.”

5. Leader or Entrepreneur

Nurses skilled in informatics can also pursue leadership roles in emerging technologies and promote new and better ways of doing things, either inside or outside of an existing organization.

“The explosion of telemedicine due to the pandemic has created a new space for nurse entrepreneurs,” says Karen R. Pope, RN, BSN, M.A., manager of IT applications – Epic at Hoag Memorial Hospital Presbyterian in Newport Beach. “They can create novel avenues for patients to access healthcare services on mobile platforms, whether with telehealth, patient wearables or self-care applications.”

She adds: “One of my favorite buttons has a large red strike across the words ‘Because We Have Always Done It This Way.’ Being a nursing informaticist means being a trailblazer in the use of technology.”

How to Get Started

So, how can you get your foot in the informatics door? A good starting point is providing ideas, input and support for technology deployments and improvements.

“Volunteer to be a part of a council where changes are happening,” suggests Bond. “Be a unit representative so that your voice is heard. Volunteer to be a superuser or to work on different projects so that you have some foundational and background knowledge.”

“Submit great ideas of how to make things better on your unit using technology and offer to partner with someone to make it happen,” adds Pollack.

Some of her other recommendations: “Shadow a nurse informaticist for a day to see the role firsthand. Join professional organizations, such as the American Nursing Informatics Association (ANIA), and attend their annual meetings. Get to know staff who work in IT and build connections so that when a position does open, you already have a relationship.”

Pope, who currently serves as vice president and education committee chair of the ANIA SoCal Chapter, couldn’t agree more.

“Joining ANIA is an outstanding decision for individuals interested in entering the specialty of informatics,” she says. “Participation in events allows individuals to meet industry leaders and experts who are more than happy to help mentor and provide opportunities. Volunteering at the chapter level also offers experience, education and great networking.”

While informaticists need some specialized training, a nursing informatics degree may not necessarily be the best place to start.

“A lot of nurses pursue advanced degrees in informatics, which of course can be helpful and demonstrates a strong interest or passion,” explains Ney. “But, what is most important is that the individual spend time getting to really understand what opportunities their organization offers, to be sure it’s a good fit.”

Do You Have the Right Stuff?

In informatics, having the right mindset can be just as important as technological proficiency. While technical skills and an understanding of bedside care are both useful, you also need to be able to look beyond nursing.

“Siloed thinking, without seeing the big picture, does not lend itself to this nursing specialty,” warns Pope. “It is important to understand the interconnectivity of systems and processes.”

Pollack adds that if you like predictability and doing the same things all the time, informatics is not for you. She says the nurses who excel in the field are curious and are early adopters. “They are the ones that their coworkers on the unit come to with technology questions,” she explains.

Finally, you should embrace the idea that nurses in informatics are still taking care of people and having a profound impact on patient care, even if it’s not at the bedside.

“The nurse informaticists who find the greatest satisfaction with their career choice still view themselves as caregivers and clinicians — just for a much larger patient population,” Pope says. “They feel rewarded knowing that their work touches innumerable lives.


DARIA WASZAK, RN, DNP, CNE, COHN-S, CEN, is a Long Beach native and an SDSU and UCLA alumna. She has more than 25 years of clinical and leadership experience, and is currently an academic nurse educator and associate dean.


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