Recently a Twitter follower — you all do follow @InfoTechRN, don’t you? — asked me a question there is no way I can answer in 140 characters. (True, there are few questions I can bring myself to answer tweet-size, but that’s another story.) She works in a hospital with at least some electronic clinical documentation (what we call ClinDoc in the business) and barcoded medication administration (eMAR). Seems like the implementation has resulted in a workflow that does not make life easy for nurses, or at least for her. She wants to fix it, and would love some advice on getting her hospital to create an informatics job for her.
Well, I wish I had the magic pill to create jobs in nursing informatics or anywhere else, but I don’t. Instead, some thoughts on how to get there. They are tailored to my follower’s particular case, but others in similar situations may pick up a pearl as well.
First, know your organization as it pertains to clinical information systems. Are there informatics nurses already in place? If so, who are they and what are their roles and functions, and how do they report up the organizational ladder? If there aren’t any, sounds like your organization is treating this CIS as just another IT project. That is wrong-headed; it needs to support and facilitate clinical workflows — after all, hospitals are there to provide clinical services to patients — so it needs to be a clinical project not an IT one. Yes, you need strong IT and project management support, but they need to be the supporters, not the drivers. Most of the major vendors in the CIS space today have solutions that can be configured to properly support clinical workflows; the vendor at my follower’s facility is not one with which I have personal experience, and the KLAS rating service puts it fairly far down the list in terms of client satisfaction, but it clearly CAN be successful.
Get some face time with a key player in your CIS shop. Find out how they came to set up the screens and workflows the way they did. Let them know, from an “end user” perspective, how it’s broken. Give specific real-life examples, even having them shadow you for an hour or two if necessary to see exactly where the model breaks down. In general, be passionate about your vision to provide better and safer patient care using information technology, and emphasize the unique insight you possess in helping to achieve that vision.
As we all know, job markets are tight. But even in hard-hit locations, there should be some hiring in healthcare IT. Last year’s stimulus bill included over 19 billion dollars to be distributed to healthcare entities who can demonstrate meaningful use of electronic health records systems. So there will, eventually, be money available to pay more clinical informaticists. The catch is that hospitals and others need to prove their systems are working and achieving specific objectives with their EHR. Therefore, they need to bring the resources on now and hope for reimbursement later. According to a recent online article, “The Office of the National Coordinator of Health IT projects that healthcare providers will need 50,000 additional IT workers to meet the meaningful use criteria to get government incentives for EMRs.”
The question is, will you be one of those 50,000? As noted above, it’s important to demonstrate an overriding interest in improving patient outcomes by improving the EHR. But the hiring manager’s ideal candidate will have excellent clinical knowledge PLUS strong skills in computing and informatics. While there are now degree programs with majors in nursing informatics, it’s not generally necessary to have one to get into the field, though many employers will require at least a bachelor’s degree of some sort. There are lots of online references that will provide subject matter pertaining to NI. If there happens to be one at a time and location that suits you, look into attending a WINI — Weekend Immersion in Nursing Informatics. It lays out the theoretical and practical bodies of knowledge essential for NI professionals. It also happens to closely mirror the content tested in the ANCC’s certification exam for nursing informatics. Certification does also require employment experience in the field, so you can’t use it as an entry-level qualification, but it is something to consider once you have been in it for a while. I attended a WINI a couple years back as preparation for my certification exam, and it was definitely helpful.
I’ll stop here. I’d definitely like to hear from readers, certainly including my correspondent who posed the question in the first place. If you are already in NI, how did you get there? What advice would you give, or what would you add to or subtract from what I have posted here? Let us know. Thanks!