These experts support nurses’ patient care delivery.
Nursing care requires the science of informatics, but I hear far too many nurses say, “I just don’t understand technology.” Those who feel this way tend to avoid trying to use the technology that’s posing an issue, or they believe understanding how to use it isn’t necessary for them. I understand the frustration that comes with learning a new technology, especially over the past 3 years. No one can fully comprehend how to use a technology without appropriate and effective education. So, the statement isn’t necessarily only a user issue. However, it does indicate a need for more attention and associated education.
Quality patient care requires healthcare technologies as well as nurses and other healthcare professionals who know how to use data and information effectively to make safe, timely, patient-centered, equitable, efficient, and effective decisions. Fortunately, the nursing profession has a practice discipline that specializes in meeting these needs—nursing informatics.
Nursing informatics as a specialty practice
Since 1992, the American Nurses Association (ANA) has recognized nursing informatics as a specialty practice that “transforms data into needed information and leverages technologies to improve health and health care equity, safety, quality, and outcomes.” Nursing informatics integrates multiple sciences, including nursing science, computer science, information science, cognitive science, library science, and terminologies and taxonomies. Note that the ANA leads with data and information. Technology serves as a supportive tool to aid using data and information to achieve optimal health outcomes (equity, safety, quality).
Nurses and other healthcare professionals can’t deliver care without data, information, knowledge, and, if possible, wisdom, which serve as the foundational concepts of informatics within a hierarchy. Data (numbers, letters, and symbols) form the building blocks of the hierarchy, but they have no meaning without information in the form of organization and structure (flowsheets, forms, orders). That information provides knowledge (alerts, reference ranges, algorithms) for care delivery. Wisdom (insight and advanced clinical judgment), the pinnacle of the hierarchy, isn’t always achievable. Information sources can be digital, paper, or temporary tools, but nursing and healthcare delivery rely primarily on digital tools and will continue to do so into the future.
Although nursing informatics has been recognized for over 30 years, digitization of patient health records has largely occurred over the past decade. Digitizing patient information into electronic health records (EHRs) requires nursing and informatics expertise to communicate clinical needs to the information technology (IT) teams. Nursing informatics expertise also aids in translating technical capabilities back to the clinical teams. The specialty helps bridge the significant gap that exists between the two disciplines to create synergistic solutions.
Informatics roles
The ANA defines two specific nursing informatics roles: informatics nurse and informatics nurse specialist. As described in the second edition of ANA’s Nursing Informatics: Scope and Standards of Practice, informatics nurses are “registered nurses with an interest or experience in an informatics field, most often nursing informatics.” Informatics nurse specialists share the same interest and role but possess a graduate degree in nursing or health informatics. However, titles may differ within healthcare settings.
Informatics nurses and informatics nurse specialists frequently begin and initially develop their careers in hospital and health center settings. According to a 2020 Healthcare Information and Management Systems Society (HIMSS) survey, nearly 70% of informatics nurses reported working in a hospital or health center. The remaining 30% reported working for a vendor or payer (<10%), in a government agency (<10%), in an academic setting (~5%), or in other unspecified settings.
Within hospitals and health centers, informatics nurses and informatics nurse specialists act as internal consultants to clinical care areas regarding data, information, knowledge, and wisdom needs. They help clinical users (nurses, doctors, and others) understand design options and provide training and education as technology develops. These informatics experts also act as internal consultants to health IT developers, analysts, and the executive team. They advise on best practices to leverage technology functionality and provide input on areas where enhancements might benefit workflow design. Typically, nurses and IT professionals receive training in distinct disciplines, so informatics nurses work to create synergistic workflows that meet clinicians’ needs through the support of health IT.
Take advantage of expertise
Whether or not you’re interested in pursuing a career in nursing informatics, you’ll likely need the expertise of an informatics nurse or informatics nurse specialist. Although informatics nurses can work in several types of settings, let’s consider their role within a hospital or health center. Perhaps you’ve identified that you can’t chart specific data on a patient flowsheet. As a result, you use the “other” or “comment” field. Or perhaps you’re a nurse leader and the reports you receive don’t reflect the data shown in the charts. In both instances, an informatics nurse or an informatics nurse specialist should be your go-to professional; bring these issues to their attention to determine how best to address them.
The informatics expert will meet with you to understand the current state (what’s occurring now as part of your documentation or reporting workflow). They might ask questions about why you can’t document in an already established field choice or how you know that the report isn’t providing accurate data representation. These questions help the informatics nurse gather information and insights to determine how to design the future state (what you’ll see when the unmet need is addressed in the documentation flowsheet or the report). Finding a solution will require that the informatics nurse spend time working with you or a designated subject matter expert to identify and learn about the opportunity for improvement and then to implement the approved change.
If a solution isn’t already available or in development as part of a different change request, the informatics nurse may submit a new change request (a formal submission for change to a live digital system). Any change requested to a live information system must be reviewed for appropriateness, potential risk, impact on end users, feasibility, and level of effort. If the change receives approval, you’ll work with the informatics nurse to validate the future design and perform the initial test to determine whether the change meets the desired outcome.
Many informatics nurses and informatics nurse specialists work in more than one clinical care area. They may have standing meetings with clinical care representatives to hear about potential needs and to share information and timing of upcoming software or technical upgrades. Nursing informatics professionals also meet with their individual and cross-functional teams, which frequently include executive leadership.
Solving problems
Informatics nurses and informatics nurse specialists work as liaisons between their clinical and IT colleagues to understand unmet needs and to design, develop, and test solutions to implement new digital health technologies effectively in support of nursing’s role in delivering quality patient care. Turn to these experts whenever the need arises—and perhaps consider taking on this role yourself. (See Learn more.)
Learn more
To learn more about nursing informatics as a specialty practice of nursing, tap into the following resources.
- The American Nurses Association’s 3rd edition of Nursing Informatics: Scope and Standards of Practice provides details about this specialty practice role (nursingworld.org/nurses-books/nursing-informatics-scope-and-standards-of-practi).
- Take advantage of regional, national, and international nursing and health informatics organizations, which offer networking, continuing education, and leadership opportunities.
- The Alliance for Nursing Informatics helps advance nursing informatics through practice, research, policy, education, and leadership. (allianceni.org)
- The American Medical Informatics Association has a broad scope that includes biomedical, clinical, and translational informatics. (amia.org)
- The American Nursing Informatics Association has several regional chapters. (anai.org)
- The annual HIMSS conference, the largest health IT conference in the United States, attracts tens of thousands of attendees each year. (himss.org)
- The Summer Institute for Nursing Informatics, which occurs every July, provides an opportunity for informatics nurses to learn, collaborate, disseminate, and present their scholarly work. (nursing.umaryland.edu/academics/pe/events/sini)
Beyond these organizations, many other groups and events provide opportunities to engage with and learn more about nursing informatics. If you’re interested in pursuing graduate education in this specialty field, consider the many nursing informatics master’s degree options.
Tiffany Kelley, an American Nurse Journal editorial board member, is the Frederick A. DeLuca Foundation Visiting Professor for Innovation and New Knowledge at the University of Connecticut School of Nursing in Storrs. She’s also founder and chief executive officer at Nightingale Apps and iCare Nursing Solutions in Boston, Massachusetts.
American Nurse Journal. 2023; 18(6). Doi: 10.51256/ANJ0623139
References
American Nurses Association. Nursing Informatics: Scope and Standards of Practice. 3rd ed. Silver Spring, MD: Nursing Books; 2022.
American Nurses Association. Nursing Informatics: Scope and Standards of Practice. 2nd ed. Silver Spring, MD: Nursing Books; 2014.
HIMSS nursing informatics workforce survey. HIMSS. 2023. bit.ly/42jwZn0
Kelley T. Electronic Health Records for Quality Nursing & Health Care. Lancaster, PA: DesTech Publications; 2016.
Kelley T. Information Use with Paper and Electronic Nursing Documentation by Nurses Caring for Pediatric Patients [dissertation]. Durham, NC: Duke University; 2012.
Kelley T. Opportunities for nurses in the era of electronic health records. Open J Nurs. 2014;4(1):15-17. doi:10.4236/ojn.2014.41003
