ANIA: ARRA means golden days ahead for nursing informaticists
BOSTON–There are mountains of problems to overcome when it comes to automating systems and getting patient health records off of paper. And the HITECH Act has added urgency to the tasks at hand, said John Delaney, RN, BSN, director of IT outreach at University Medical Center in Lubbock, Texas. “It’s a huge job and we’ve got big problems,” said Delaney during a session at the ANIA/CARING conference last week.
Delaney’s presentation on nursing informatics’ role in the light of the HITECH Act focused on the opportunities that come with these problems. “This is the time for all of us in nursing and informatics to really look at the culture and look at the environment and figure out what [we] want to do. Because there is a lot going on and a lot of new opportunity, thanks to HITECH,” said Delaney, a med/surg nurse with 23 years’ experience at University Medical Center and more than 10 years in health IT.
“ARRA is funding a lot of the things you and I are going to be working on for the next several years,” including grants to fund state health information exchange (HIE) development, 60 health IT regional extension centers (HITRECs) and workforce training, he said.
“Now that everybody is trying to get to meaningful use, think of the resource shortage we’re going to have out there. And that’s why all of us are golden…Will there be an increased demand for nursing informaticists? Man, you better believe it,” Delaney proclaimed.
The policy priorities for healthcare IT include improving quality, safety and efficiency; reducing healthcare disparities; engaging patients and families; improving care coordination, improving population and public health; and ensuring adequate privacy and security protections for all personal health information. “Really what we’re talking about, globally, is your [health] information going everywhere you go,” he said.
The HIE initiative includes “big questions,” including what an HIE actually is. University Medical Center, the primary teaching hospital of Texas Tech University, is a Cerner shop, as is the university’s ambulatory facility. “We all share the same database. We thought we’d get away with calling ourselves an HIE,” but the ability to exchange health information within a business group is not sufficient, according to federal guidelines, said Delaney.
Sustainability also is a big question in HIEs: “If you charge most doctors to use it, they won’t use it,” said Delaney, adding that UMC’s EMR includes ambulatory patient data, but “physicians haven’t used it as much as we had hoped they would."
“We have to define what the value of the HIE is down to those individual parties, developing a sustainable business model, technical aspects and governance…There are lots of decisions out there.” In addition, nurse informaticists will be sought for quality reporting, data mining and research necessary for effective HIE implementation and use, he said.
What does ARRA mean for nurse informaticists? Good news, Delaney said, “But you’ve got to watch what you ask for because when you get it, then you’ve got to deal with it.”
That’s what happened with UMC and HITREC—which calls for each regional center to recruit 1,000 primary care providers to get an EMR, get it implemented, go live and achieve meaningful use, he said. “We’ve got four HITRECs in Texas, and Texas Tech got one of them. We’re their partner. We have literally half the land mass in Texas to find 1,000 PCPs and get them to meaningful use. Anyone want to help?”
The advanced degree and certificate workforce training programs will require nursing informaticists to teach, he said. “Most of us trained on the job, [but] these guys will be focused on the training alone [including] implementing systems, workflow analysis and process redesign.”
In addition, “vendors are going to need a lot of help because there will be a lot of installs, and we’ll need those nurse heads to make sure vendors get it right the first time and not disrupt workflow, like we know it needs to be.”
“This is the decade of the informatics nurse because this is an explosion of opportunity for what we do,” he said.
Delaney’s presentation on nursing informatics’ role in the light of the HITECH Act focused on the opportunities that come with these problems. “This is the time for all of us in nursing and informatics to really look at the culture and look at the environment and figure out what [we] want to do. Because there is a lot going on and a lot of new opportunity, thanks to HITECH,” said Delaney, a med/surg nurse with 23 years’ experience at University Medical Center and more than 10 years in health IT.
“ARRA is funding a lot of the things you and I are going to be working on for the next several years,” including grants to fund state health information exchange (HIE) development, 60 health IT regional extension centers (HITRECs) and workforce training, he said.
“Now that everybody is trying to get to meaningful use, think of the resource shortage we’re going to have out there. And that’s why all of us are golden…Will there be an increased demand for nursing informaticists? Man, you better believe it,” Delaney proclaimed.
The policy priorities for healthcare IT include improving quality, safety and efficiency; reducing healthcare disparities; engaging patients and families; improving care coordination, improving population and public health; and ensuring adequate privacy and security protections for all personal health information. “Really what we’re talking about, globally, is your [health] information going everywhere you go,” he said.
The HIE initiative includes “big questions,” including what an HIE actually is. University Medical Center, the primary teaching hospital of Texas Tech University, is a Cerner shop, as is the university’s ambulatory facility. “We all share the same database. We thought we’d get away with calling ourselves an HIE,” but the ability to exchange health information within a business group is not sufficient, according to federal guidelines, said Delaney.
Sustainability also is a big question in HIEs: “If you charge most doctors to use it, they won’t use it,” said Delaney, adding that UMC’s EMR includes ambulatory patient data, but “physicians haven’t used it as much as we had hoped they would."
“We have to define what the value of the HIE is down to those individual parties, developing a sustainable business model, technical aspects and governance…There are lots of decisions out there.” In addition, nurse informaticists will be sought for quality reporting, data mining and research necessary for effective HIE implementation and use, he said.
What does ARRA mean for nurse informaticists? Good news, Delaney said, “But you’ve got to watch what you ask for because when you get it, then you’ve got to deal with it.”
That’s what happened with UMC and HITREC—which calls for each regional center to recruit 1,000 primary care providers to get an EMR, get it implemented, go live and achieve meaningful use, he said. “We’ve got four HITRECs in Texas, and Texas Tech got one of them. We’re their partner. We have literally half the land mass in Texas to find 1,000 PCPs and get them to meaningful use. Anyone want to help?”
The advanced degree and certificate workforce training programs will require nursing informaticists to teach, he said. “Most of us trained on the job, [but] these guys will be focused on the training alone [including] implementing systems, workflow analysis and process redesign.”
In addition, “vendors are going to need a lot of help because there will be a lot of installs, and we’ll need those nurse heads to make sure vendors get it right the first time and not disrupt workflow, like we know it needs to be.”
“This is the decade of the informatics nurse because this is an explosion of opportunity for what we do,” he said.