An Appreciation for the Evolving Role of Nurses in Health IT

Oct. 5, 2016
National Nurses Week (May 6-12) is a great yearly reminder about how valuable nurses are to healthcare organizations, and how they are continuing to become fantastic clinical informatics leaders.

It’s National Nurses Week (May 6-12), and before I get into the meat and potatoes of this blog, I’d like to take a moment to thank all of healthcare’s nurses for their continuing hard work and effort day in and day out. I’m someone who usually thinks that there are too many days and weeks devoted to people and groups, but I make an exception for this profession. To use a sports term referring to the most indispensible players on the team, even if not flashy, nurses are the “glue guys” in the healthcare industry.

In health IT specifically, nurses’ roles continue to grow in scope and importance. According to a June 2014 post from Kate Goddard, senior analyst at the Washington, D.C.-based The Advisory Board Company, “Engaging nurses is critical to the success of clinical IT-enabled initiatives. Nurses are often the first and last point of contact with a patient and, therefore, the first and last opportunity to prevent an error. This makes them an enormous asset in ensuring that clinical information systems do no unintentional harm to patients.”

In patient care organizations nationwide, informatics nurses continue to bring great value to the use of clinical systems and technologies at their healthcare organizations, according to the 2015 HIMSS Impact of the Informatics Nurse Survey. The results of the survey, released at the Healthcare Information and Management Systems Society annual conference in Chicago last month, indicated that informatics nurses bring greatest value to the implementation phases (85 percent) and optimization phases (83 percent) of clinical systems process.

What’s more, one-fifth of those survey respondents reported working for an organization that employs a chief nursing information officer (CNIO), a role that’s emerging as a major transformational leader in this era of healthcare reform. To this end, HCI Editor-in-Chief Mark Hagland just recently interviewed Judy Murphy, R.N., who last year became chief nursing officer and director, Global Business Services, at IBM Healthcare. Prior to that, Murphy had been chief nursing officer and director of the Office of Clinical Quality and Safety in the Office of the National Coordinator for Health IT (ONC).  Murphy is extremely well connected in the clinical IT world, and is a prime example of how nurses can be fabulous informatics leaders, a trend that is developing across healthcare organizations.

Indeed, the role of nurses in health IT continues to evolve. Last year, I wrote a story about eICU technology from the Andover, Mass.-based Philips, being deployed at the Baptist Health Eye Center building on the Baptist Health Medical Center-Little Rock (BHMC) campus in Arkansas.  There, the eICU control center acts as an air traffic control center, giving the ICU staff an extra set of eyes and ears, Vicki Norman, R.N., director of eICU care at Baptist Health, told me. At Baptist, physicians and nurses are staffed in the eICU control center and act as additional support to monitor critical care patients, and provide faster response times through use of computer technology as well as audio and video components. Norman said there is a staff of 15 critical care physicians and 25 critical care nurses in the control center, of who average 20 to 25 years of experience.

Similarly, at the Arizona-based Banner Health, physicians and nurses with Banner’s eICU operations center, known as Banner Telehealth, located in Mesa, monitor ICU patients in 430 ICU beds in 20 Banner hospitals across five states. The program has seen a reduction in both mortality and length of stay, Banner officials say. In fact, over the past two years, Banner’s ICU mortality rates have been among the lowest on the country. In 2012, ICU actual length of stay was 20,000 fewer days than predicted, based on patient acuity; and total hospital days were reduced by 49,000. Costs avoided: more than $68 million, say Banner officials.

At Banner, Alice Sneed, R.N., a longtime cardiovascular nurse, decided to become a telehealth nurse eight years ago when she realized that she was getting up there in age, making 12-hour days on the floor very tough on her knees. Sneed has been a critical care nurse for more than two decades, and her role has evolved from being a bedside nurse to the manager of an eICU “central command center,” through which she can now monitor patients and provide insights to nurses who are in six different locations. While a bedside nurse can usually monitor five to six patients at a time, Sneed manages nearly 40-45 patients in several locations across the country.

“My knees were giving out, but knew I needed to do something that would enable me to continue to use brain, experience, and education, and not kill myself. I really like technology, I saw the potential, what it can do, and thought since I like change, new technology, and doing cool stuff, I might like this idea. So I jumped ship,” Sneed told me in a recent interview.

For Sneed, the experience is a far different one than physically being on the floor, and she said that it “takes a special type of nurse.” She said the atmosphere is not as rushed, quieter, and certainly not for adrenaline junkies. “My brain has had to become much more muscular,” she said. “You multitask on the floor, but you’re taking care of one or two patients. I might have 45 patients, but some in the medical ICU, or the neurological unit, or in a tiny unit ICU in Brush, Colorado. I need to think differently about everyone of those patients. I have had to learn, neuro, transplant, and sepsis. But statistically, we’re saving more lives because of the eICU.”

The aforementioned HIMSS survey also found that respondents reported a direct positive impact on the quality of care patients receive as a result of the work of informatics nurses. Specifically, 60 percent of respondents indicated that informatics nurses have a high degree of impact on the quality of care. No question, the work Sneed, Norman, Murphy, and all other R.N.s are doing in clinical IT serve as a great reminder to the power and impact that nurses have on all aspects of the healthcare ecosystem. Happy National Nurses Week! 

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