An Introduction to Nursing Informatics, Evolution, and Innovation

Nursing informatics (NI) is the specialty that integrates nursing science with information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. Nursing Informatics supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in a wide variety of roles and settings to achieve desired outcomes. This is accomplished through the use of information structures, information processes, and information technology.

An Introduction to Nursing Informatics, Evolution and Innovation, 2nd Edition is the ideal gateway to all the professional possibilities this continuously evolving discipline has to offer. Describing the evolution of nursing informatics from its origins to current practice in today’s complex, diverse healthcare environment, this book offers the next generation of nurse informaticists an understanding of the discipline, best practices, and its scope of influence in healthcare. The book also explores Nursing Informatics as it is evolving into the future, including technology creation and implementation and the development of influential policies and best practices. Special features include descriptions of the ‘a day in the life’ from informatics nurses in multiple roles and fields of influence, including academia, research, clinical settings, the executive suite, consulting, and government, as well as an Appendix featuring case profiles.

This new edition updates the content to better align with the current state of nursing informatics and expand on additional roles. New to this edition is a chapter providing tips and advice for those trying to find their first nursing informatics job or are changing their careers. Another new chapter covers healthcare analytics and how it fits into the nursing informatics role.

An Introduction to Nursing Informatics, Evolution and Innovation, 2nd Edition is the ideal resource for nursing students and as a reference guide and pint of inspiration for nurses currently in the field.

Susan M. Houston, MBA, RN-BC, PMP, CPHIMS, FHIMSS, is a senior consultant in healthcare IT after retiring as the Chief, Portfolio Office within the Department of Clinical Research Informatics at the National Institutes of Health Clinical Center. Her background includes clinical nursing, informatics, and project and portfolio management. Ms. Houston has presented at the local, regional and national levels. She has authored a variety of articles and books on project management and informatics. She is a member of Project Management Institute (PMI), American Nursing Informatics Association (ANIA), and the Healthcare Information and Management Systems Society (HIMSS), while serving on various committees.

Tina Dieckhaus, MSN, RN-BC, NE-BC, CPHIMS, FHIMSS served 14 years as the director for Patient Care Services Informatics at St. Jude Children’s Research Hospital and more than 20 years in informatics nursing. Ms. Dieckhaus received her Bachelor’s Degree in Nursing from Mississippi University for Women and her Masters Degree in Nursing Informatics from Tennessee State University. Ms. Dieckhaus has served on the HIMSS Nursing Informatics Committee, the Nursing Pre-Conference Symposium Planning Committee and the HIMSS Annual Conference Education Committee.

Bob Kirchner, MSN, MBA/HCM, RN, is a Nursing Administrative Specialist at the Mayo Clinic. He obtained his BSN from San Jose State University and his MSN and MBA from University of Phoenix. He has 30 years of experience in general care and ICU nursing. Mr. Kirchner has eight years of Nursing Informatics experience and was the Nursing Informatics Lead working on the Barcode Medication Administration project at Mayo Clinic and other point of care documentation projects. He has also served on the HIMSS Nursing Informatics Committee and was the Chairperson for the Nursing Informatics Awareness Workgroup.

Michelle Chu Lardner, DNP, RN-BC, is the Deputy Chief Information Officer and Chief of Clinical Informatics for the Department of Clinical Research Informatics at the National Institutes of Health Clinical Center. She has been practicing informatics nursing since 2005, holding various roles in the private and public sector. She received her BS in Nursing from the University of Illinois, MS in Nursing Informatics and DNP from the University of Maryland. Dr. Lardner is board certified by the ANA in nursing informatics, a Jonas Nurse Scholar and associate faculty at the University of Maryland. She is also a veteran of the United States Navy Nurse Corps, having completed wartime and humanitarian deployments aboard the USNS Comfort and Mercy.

Lou Barr, MSN/MHA, RN, has been in the medical field for 20 years. He started as a secretary in the emergency department. He graduated from nursing school in 2004 and became an emergency department nurse. Mr. Barr previously trained multidisciplinary medical professionals how to navigate and document in St. Jude’s electronic medical record and currently works at Baptist Hospital in Pensacola, FL.

Charles Boicey MS, RN-BC, CPHIMS is the Chief Innovation officer for Clearsense, an outcomes-driven healthcare technology company based in Jacksonville, FL. Previously, Charles was the enterprise analytics architect for Stony Brook Medicine, where he developed the analytics infrastructure to serve the clinical, operational, quality, and research needs of the organization. In his current role of Assistant Clinical Professor, Stony Brook University Charles developed and teaches the analytics elective concentration. He was a founding member of the team that developed the Health and Human Services award-winning application NowTrending to assist in the early detection of disease outbreaks by utilizing social media feeds. Charles is a former president of the American Nursing Informatics Association.

Lisa Anne Bove, DNP, RN-BC, is a Nursing Informatics Specialist focused on improving health through the use of electronic information. Dr. Bove has worked in healthcare informatics for over 20 years and received her DNP from Duke University. Dr. Bove has been certified by the American Nurses Credentialing Center in Nursing Informatics since 1996 and has published and spoken on numerous topics, including informatics and project management.

Susan Brown, MSN, FNP-BC, CPHIMS, has been a Family Nurse Practitioner for more than 20 years. In addition to her certification as an FNP, Ms. Brown is also certified in Nursing Professional Development, and is a Certified Professional in Healthcare Information and Management Systems. Her professional practice experience includes academic faculty, rural primary care, student health, urgent care, nursing professional development, and for the past 10 years, retail health.

Patricia Foley Daly, DNP, RN-BC, was a Senior Director at Cerner Corp. in Kansas City, MO. Ms. Daly joined Cerner in May 1989. She has served in many nursing roles throughout the organization. She has presented various topics on nursing informatics in academic, national and international settings. Ms. Daly received her BSN degree in nursing in 1978 from the University of San Francisco; her MN from the University of Kansas in 1984; her post Masters Certificate Program in Heath Care Informatics at the University of Kansas in 2011; and her DNP at the University of Kansas in 2014. She is accredited in Nursing Informatics by the American Nursing Association. Ms. Daly is a member of HIMSS, ANA, AMIA, Sigma Theta Tau and Phi Kappa Phi. She has served as a member of the HIMSS Nursing Informatics Committee.

Beth L. Elias, PhD, MS, is an Associate Professor at the Virginia Commonwealth University School of Nursing in Richmond. A previous senior computer systems engineer with experience in health IT, Dr. Elias has been involved in efforts to integrate radiologic imaging services and IT, manage clinical trials patient data, and evaluate next-generation point-of-care testing devices. Dr. Elias has focused on supporting the use of health IT as part of nursing practice. With nurses making up the largest group of health IT users, Dr. Elias feels that these tools should be more effectively integrated into nursing workflow.

Linda Fischetti, MS, RN, is the Director of the Health Technical Center at the MITRE Corporation. She has dedicated her career to informatics, policy, health information technology, value based care and federal health programs and currently leads a team that leverages their diverse domains of medicine, technology, law, engineering and the life sciences to solve large, complex health problems.

Sharon Kirby, MSN, RN-BC, BC is the Chief Nursing Informatics Officer for the Mayo Clinic enterprise that spans throughout the Midwest as well as Arizona and Florida. She has over three decades of nursing experience in a variety of clinical specialty areas, clinical informatics and executive leadership. Her experience includes many EHR implementations and conversions, population health, care coordination, ACOs, value-based care and data analytics. She serves on the HIMSS Executive Institute committee and is a board member of the Minnesota Epic Users Group. She has presented several webinars and presentations on the topic of nursing informatics. She holds a Bachelor of Science in Nursing and a Master of Science in Nursing with informatics specialization and is ANCC board certified in nursing informatics.

Sarah Knapfel, BSN, RN, CCRN, MSN, served as the project coordinator for the i-TEAM Grant Program in the College of Nursing at the University of Colorado, Denver. She has several years of clinical intensive care experience, most specifically in the neurosurgical setting. At the time of this writing, Ms. Knapfel had recently completed a Master of Science in Nursing degree with a Healthcare Informatics focus at the University of Colorado.

Kimberly Ellis Krakowski, MSN, RN, CENP, CAHIMS, is the Chief Nursing Information Officer for CipherHealth. An expert in performance improvement and informatics, Ms. Krakowski partners with hospitals and health care systems to implement technology solutions that improve quality, safety, workflow efficiencies, staff and patient satisfaction while demonstrating a return on investment. Currently she serves on the HIMSS Certification Committee, Microsoft Nursing Advisory Council, Center for Medical Interoperability Clinical Advisory Council and AONE Corporate Advisory Council. Ms. Krakowski was also recently featured in Building an A Team authored by Whitney Johnson.

Kathy Lesh, PhD, EdM, MS, RN-BC, CPHQ, is a Healthcare Quality Research Leader at the Battelle Memorial Institute in Arlington VA. She has spent the last two decades practicing in the domain of health informatics with a primary focus on health and human services interoperability, policy, quality and performance measurement.

Susan McBride, PhD, RN-BC, CPHIMS, FAAN is Professor and Director for the Masters Nursing Informatics Program within the Texas Tech University Health Sciences Center. Dr McBride’s research focus is on methods development for implementing, evaluating and utilizing EHRs and large healthcare datasets. Teaching responsibilities include graduate courses in informatics, statistics and epidemiology. Dr McBride sits on multiple technical advisory committees at state and national levels as well as consults on various aspects of health information technology and use of data for healthcare improvement.

Rhelinda McFadden, RN, CPHIT, CPEHR, is the manager of the Patient-Centered Medical Home (PCMH) practice transformation team for the Arkansas Foundation for Medical Care. She has more than 20 years of healthcare experience, with more than 10 years in healthcare quality and informatics, focused specifically on improving outcomes in primary care physician practices through practice transformation.

Grischa Metlay, PhD, is a Lead Health Policy Analyst at the MITRE Corporation, where he has work on projects related to health care payment reform and value-based purchasing. Before coming to MITRE, Dr. Metlay completed a postdoctoral fellowship in the NIH Office of History and received his doctorate from Harvard's History of Science Department.

Mary Beth Mitchell, MSN, RN-BC, CPHIMS, has worked in nursing informatics for more than 18 years, both at the hospital level and corporate level. In the role of CNIO Mary Beth oversees the nursing adoption, utilization and optimization of the electronic health record (EHR) for all hospitals within Texas Health Resources. She also serves as the liaison for all information technology-related nursing projects. In this role, Mary Beth chairs the THR Nursing Informatics Council and participates in the Nursing Executive Team, as well as other Information Technology Leadership Committees and multidisciplinary teams. Mary Beth is the past chair of the HIMSS Nursing Informatics Committee, and is currently the co-chair of the Alliance for Nursing Informatics. She is also the 2016 recipient of the HIMSS Nursing Leadership Award.

Patricia Mook, MSN, RN, NEA-BC, is the CNIO for Inova Health System. She is a seasoned executive, working with the CMIO/CIO/CNO, assisting in planning/execution of clinical IT strategies. Ms. Mook provides clinical IT leadership to the operations and IT teams, assisting clinicians in the delivery of efficient and effective patient care leveraging health information technology. She is presently a two year appointed American Organization of Nurse Executive board member represented Nursing Informatics leadership and is on the Board of Governors for the Alliance for Nursing Informatics representing AONE. Concurrently she is the President Elect for the Virginia Organization of Nurse Executives.

Judy Murphy, RN, FACMI, FHIMSS, FAAN, is CNO for IBM Global Healthcare. Prior to this she was CNO and Director-Clinical Quality and Safety, and Deputy National Coordinator for Programs and Policy at the Office of the National Coordinator in Washington, DC. Ms. Murphy’s previous 25 years of health informatics experience were at Aurora Health Care in Wisconsin, including the last 10 years as VP-EHR Applications in IT.

Sejal Patel, PhD, is a Lead Healthcare and Health Policy Analyst at the MITRE Corporation, where she works on Medicaid Enterprise System transformation. Before coming to MITRE, Dr. Patel served as Chief Research Historian at the NIH Office of History and received her doctorate from the University of Pennsylvania’s History and Sociology of Science department.

Minnie Raju, MS, RN, is a Clinical Nurse Informaticist Supervisor with the Department of Clinical Research Informatics at the National Institutes of Health Clinical Center. She holds a Master’s Degree in Nursing Informatics from the University of Maryland Baltimore School of Nursing. Ms. Raju’s experience includes 21 years in nursing as a Registered Nurse in critical care, management and education. As an informaticist she leads a team that develops and implements numerous electronic documents for varied roles and departments for the EHR system, improving interdisciplinary clinical workflow supporting clinical care and research.

Darryl W. Roberts, PhD, MS, RN, FHIMSS, is a healthcare leader and collaborator interested in an array of individual and ecological research and evaluation topics. He has practical experience in informatics and in policy evaluation research. His body of work includes quality measure development and implementation, clinical and real-world evidence studies, and development of research methods, all with a focus on reducing the burdens of care. Dr. Roberts has been a Registered Nurse for 28 years providing physical and psychological care, teaching, and conducting research. He is currently the Policy Analytics and Social Science Lead at LMI in Tysons, VA and Principal Consultant at DWResearch & Education Consulting in Washington, DC.

Carol A. Romano, PhD, RN, FACMI, FAAN (Rear Admiral-Retired, USPHS) is Dean & Professor, Graduate School of Nursing, Uniformed Services University of the Health Sciences. She is a pioneer in nursing informatics with more than 35-years experience in the field as nursing informatics consultant, senior adviser for clinical research informatics, and Deputy CIO at the National Institutes of Health Clinical Center. She contributed to development of the first nursing informatics certification exam, and was the co-architect of the first nursing informatics graduate curriculum and program at the University of Maryland.

Sylvia Rowe, MSN, RN-BC, LNHA, has served as Vice President of Clinical Informatics, Ethica Health and Retirement Communities. She obtained her BSN from Georgia College and State University, and her MSN in Informatics from Walden University. She has more than 20 years of experience in long-term care.

Patricia P. Sengstack DNP, RN-BC, FAAN, is an Associate Professor for the Vanderbilt University School of Nursing and a Nursing Informatics Executive for the Vanderbilt University Medical Center. She is the former Chief Nursing Informatics Officer for the Bon Secours Health System and served for nine years as the Chief of Clinical Informatics at the National Institutes of Health, Clinical Center in Bethesda, MD. She has her DNP from Vanderbilt University and a Master’s in Nursing Informatics from the University of Maryland. She is the Past President of the American Nursing Informatics Association, from 2013 – 2015. She is the author of a Sigma Theta Tau book titled, "Mastering Informatics: A Healthcare Handbook for Success" (2015). She teaches informatics at the masters and doctoral levels at Vanderbilt University and in her role at Vanderbilt’s Medical Center as a nursing informatics executive she provides strategic informatics leadership. Her focus over the last several years has been health information technology’s impact on patient safety as well as building a program to improve the evaluation process of IT systems.

Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN, is Vice President of Informatics at HIMSS, where she is responsible for clinical informatics, standards and interoperability programs and initiatives. An internationally recognized speaker and author, Ms. Sensmeier was inducted in 2010 as a Fellow in the American Academy of Nursing.

Mark D. Sugrue, MSN, RN-BC, FHIMSS, CPHIMS, is the Chief Nursing Informatics Officer and Associate Chief Nurse, Professional Practice at the UMass Memorial Medical Center in Worcester MA, where he is responsible for all current and future state technology to support the delivery of exceptional nursing care. He is recognized nationally for his expertise in patient safety, clinical systems, HIPAA, ARRA/HITECH and the revenue cycle. Mr. Sugrue is an author and a frequent speaker at trade shows and professional conventions and is currently a Board Member - HIMSS North America.