Pretend For a Moment That Nursing Informatics Doesn’t Exist. In Its Place, We Have … Well, Nothing

Yes, we still have nurses, and yes, we still have computers. And Electronic Health Record (EHR) systems and Meaningful Use incentives and cloud computing.

And of course, we have a lot of unhappy clinicians, driven to flammable frustration by inefficient computer systems that force them away from the patient’s bedside to the keyboard, mouse, and screen.

Well, as fate would have it, one day you’re driving home and recalling that study about ICU patients and the amount of time a clinician is in their room. A physician is there 13 percent of the time. Critical support staff is there eight percent of the time.

But nurses! Whenever there’s at least one health care worker in the room, a nurse is there 86 percent of the time!

Inspiration hits you. Nurses are the answer.

Nurses spend a LOT of time with patients. Nurses know patient care. Nurses work with the EHR. They possess deep experience with EHR workflows and forms and documentation processes … and they suffer just like everyone else with the clumsy interface and workflows. Goodness, it’s as if all the computer systems were designed entirely by computer geeks. Smart programmers, but they don’t understand healthcare workflows.

But the nursing profession. THAT’S the answer, you realize. Nurses can bridge the gap between health delivery and powerful technology systems.

So you invent nursing informatics, become a national hero, and are the featured star at the next Super Bowl halftime show.

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What is Nursing Informatics?

The American Nurses Association describes nursing informatics as “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.”

And in reality, nurses were the heroes. They recognized the potential of computerized systems and formed the Capital Area Roundtable on Informatics in Nursing (CARING) in 1982 “to provide a forum for the advancement of automated healthcare information systems.”

In those early days, you couldn’t find a college of nursing with a program in informatics. Instead, nurses who had clinical experience, along with interest and skills in computer science, simply looked for ways to improve clinical care through information and automatic processes.

Information + Automatic Processes = Informatics

Today, it’s easy for RNs to find nursing programs that offer masters and doctoral degrees in nursing informatics. However, it’s still common for RNs to becoming informaticists without formal education in the specialty. With or without the degree, the last decade’s surge in EHR implementations increased the need for tech-savvy nurses who can help research, evaluate, design, develop, and test clinical information systems. Their work provides valuable decision-making support to patients, their families, and their healthcare providers.

The key to success in nursing informatics is the background in nursing. A recent HIMSS report shows that nearly 60 percent of nurses had over ten years of bedside clinical experience before becoming an informaticist.

What does a Nurse Informaticist do?

The HIMSS Nursing Informatics Workforce Survey gives us a sense for the general duties of a nurse informaticist:

HIMSS NI Job Responsibilities

But there’s much more value to nursing informatics than a dry bar chart can portray.

In short, nurse informaticists are a remarkable gift to society.

Because in nursing informatics, we start with a group of people who want to take care of us when we are our most physically vulnerable – even when it gets messy.

In addition to their active compassion, we add the knack for analyzing patient records and workflows, then finding ways to achieve desired health outcomes more efficiently and effectively.

Next, we add technical skills for using, evaluating, designing, and building computer systems.

Finally, we top it off with an ability to apply their integrated clinical and technical wisdom to training, educating, and guiding a wide range of people:

  • Patients and their families
  • Other clinicians at all levels
  • Computer programmers
  • Administrators and organizational leadership
  • Compliance professionals
  • Policy professionals

Now, consider the last three ingredients we discussed:

  • Data analysis for the purpose of improving efficiency
  • Technical skills for developing computer systems
  • Communication skills

Someone with these abilities can still improve our healthcare system by working in the more generalized field of health informatics.

But the person whose first passion is nursing, and who then acquires and develops the other three skills? That person bridges the gap between the technical and clinical worlds and is indispensable for helping the healthcare industry create superior computer systems that support the best workflows and decision-making around patient care, communication, and documentation.

So to repeat: Nurse informaticists are a remarkable gift to society.

Let’s look at seven benefits of nursing informatics.

Benefit #1: Nursing Informatics informs and influences IT systems

As seen in the “Job Responsibilities” chart above, nursing informatics specialists spend much of their time helping to develop, implement, and optimize computerized patient information systems. It’s their blend of clinical and technical knowledge and experience that makes them perfect liaisons between the clinical and technical communities.

One of the early contributions of nursing informatics was to help move healthcare away from paper forms and into electronic documentation. Today, a nurse’s standardized notes are immediately available to physicians and other caregivers through EHR systems. Workflows and decisions are more informed and efficient.

Many EHR vendors recognized the value of hiring nurse informaticists to help design and build their system. In short, these EHR vendors acquired a double-barreled secret weapon because nurse informaticists:

  • Recommend the most practical layout for forms and reports, and the best processes for electronic medication administration.
  • Prevent EHR mutiny because they can predict clinician reactions to technically efficient – but clinically clumsy – workflows, and shape EHRs that avoid these poor workflows.

Here’s another way to look at it: Nursing informatics specialists are trilingual.

  1. They understand the clinical language of efficient patient care.
  2. They translate knowledge and clinician feedback into the technical language of business analysts and programmers.
  3. They communicate clinical and technical matters with administrative leadership.

It’s not simple to speak effectively with clinical, technical, and administrative people. Still, nursing informatics specialists are qualified and have proven to be indispensable to the development of superior healthcare IT systems.

“Informatics professionals with a nursing background combine the best of both worlds: deep expertise in clinical care helps nurse informaticists understand the needs and stresses of the clinical workflow, while their education and background with information technology systems and data analytics helps them sculpt health IT infrastructure into a meaningful and helpful tool.” – Health IT Analytics

Benefit #2: Nursing Informatics leverages evidence-based clinical best practices

Most clinicians want to apply their knowledge and experience to improve patient care. The nurse informaticist takes it a few steps further by:

  1. Researching clinical nursing practices outside of their own experiences.
  2. Finding evidence to prove which clinical practices are best.
  3. Influencing the design of clinical systems to support and promote the best evidence-based practices and workflows (see Benefit #1).
  4. Training other nurses to use clinical IT systems (see Benefit #3).

Benefit #3: Nursing Informatics generates stronger nurse training in clinical IT systems

Clinical IT systems are complicated, and their interfaces and workflows are not always intuitive.

But nursing informatics specialists are well-suited to teach other nurses how to get the full benefits of these systems.

Because in some cases, nurse informaticists helped design and create those very systems. But at the very least, they understand the reasons, from a nursing care perspective, for the structure of each digital form and each sequence of clicks. They can explain built-in interoperability and behind-the-scenes interfaces to other clinical systems in language that’s easily understood by nurses.

Benefit #4: Nursing Informatics leverages IT investments

Every health facility – from the single-physician practice to the large academic medical center – invests a significant amount of their budget on essential health information technology products and services. These include patient care systems like the PACS and electronic medical records system, communication technologies like pagers and secure messaging systems, and analytics tools.

Nurse informaticists help get maximum value from these investments in at least three ways:

  1. They ensure that systems are designed to support effective patient care workflows (see Benefit #1).
  2. They help train other nurses to use IT efficiently (see Benefit #3).
  3. They apply advanced analytics strategies to develop predictive models.

As an example of predictive models, consider Texas Health Resources in Dallas-Fort Worth. Their informatics nurses use analytics tools to identify the risk of sepsis, risk of readmission, and potential benefit from palliative care.

Benefit #5: Nursing informatics contributes unique wisdom to clinical care that is acquired only through a deep understanding of both clinical practice and data analysis

Let’s hear from Gina Wade, an informatics nurse specialist, to see how their distinct blend of clinical and data knowledge equips them to offer valuable insight and guidance to the healthcare system.

“Informatics nurse specialists work with leadership regarding regulatory and quality initiatives – and governance for technology implementation and change. For example, we work with the delivery-of-care team – the chief nursing officer, chief medical officer, and quality leadership – who might give us a directive based on improving patient safety by decreasing readmissions.

“We’ll identify the key areas where studies tell us problems arise: inadequate discharge education, a patient doesn’t have support at home, poor hearing or sight, or being on multiple medications. We’ll take those variables and identify how and wherein the system we should alert a nurse that this is a possible red flag and give her the elements of a plan to decrease the risk for a readmit. We explain to the technical and application team what we need the system to do. They build it, and we validate the build. Then we go back to clinical leadership and demonstrate what was designed and built.”

Because nurse informaticists understand data analysis and nursing practice, they immediately know which trends are worth analyzing and which anomalies are significant enough to escalate.

Benefit #6: Nursing Informatics enriches the evolving healthcare delivery system

Advances in healthcare technology launch new options for healthcare delivery, and nurse informatics specialists are helping ensure these new options are beneficial to both patients and clinicians.

Two examples are developments in communication technology and remote healthcare, known as telehealth.

Regarding communication technology, vendors are using Smartphones to transform the way communication in nursing happens. Advanced applications – from secure messaging to EHR integrations that push critical results to a physician’s phone just seconds after the results hit the EHR – are dramatically improving the efficiency of healthcare delivery.

Regarding the growing field of telehealth, patients are receiving education and self-management training, automatically storing and forwarding medical data, and seeing their providers – from the other side of town, or the other side of the world. And nurse informatics specialists are helping design and implement telehealth systems, as well as training their fellow nurses in how best to use the systems.

Benefit #7: Nursing Informatics Improves Patient Care, Patient Safety, and Outcomes

The more generalized field of healthcare informatics focuses mainly on administrative issues, whereas nursing informatics focuses on patient care.

In fact, the substance of the first six benefits of nursing informatics is all about improving care, safety, and outcomes for patients. The nurse informaticists resume is like an endowment to patients and their families:

  • More efficient electronic health records
  • Better IT systems
  • Research and application of clinical best practices
  • Training of other nurses
  • Analytics-based predictive models
  • New avenues for patient education
  • Support for telehealth technology

And how do patients benefit from nursing informatics?

  • Fewer medical errors
  • More informed clinical decision-making
  • Shorter hospital length of stay
  • Lower admission and readmission rates
  • Better self-management


We’ve looked at seven benefits of nursing informatics. Along the way, we tried to hint at a healthcare system without nursing informatics. We’d manage, surely. But our healthcare system is much better off with nurse informaticists doing their thing, being a remarkable gift to society.

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