Most hospitals are well into the complicated and costly process of implementing an electronic health record system. Now begins the journey of actually using that patient information to transform care, work largely carried out by nurses. But with so much already on chief nursing officers’ plates, who should be in charge of shepherding nurses into this connected era?
Increasingly, health systems are adding the role of chief nursing information officer — a counterpart to a chief medical information officer — to help bridge the gap between nursing and the information technology department.
Surveys by the Healthcare Information and Management Systems Society indicate there's growth in employment of CNIOs, however, from a low base. Employment of CNIOs was about 20 percent in the "2015 HIMSS Impact of the Informatics Nurse Survey," while in HIMSS' Leadership Survey the previous year the number was 15 percent, and the year before that was about half of that, according to HIMSS.
The CNIO role has been around for a number of years, but experts say it’s evolving to take on added importance as hospitals analyze EHR data and determine how to manage the health of patient populations.
“I think you’ll end up with a better product, better devices, better rollouts and better training when you have a chief nursing information officer who understands education and the clinical outcome needs, and who is a seasoned leader and can navigate these conversations at the executive table,” says Patricia Mook, R.N., the CNIO at five-hospital Inova Health System, Falls Church, Va.
The polling of 600 executives found that three-quarters of leaders think nurse informatics specialists play a critical role in ensuring that nurses accept and appropriately use emerging technologies.
“Once these systems have been implemented, it’s a matter of, OK, now how can our clinical departments pull out the right information to make decisions on caregiving, cost and analytics?” says Chris Wierz, R.N., principal with executive search firm Witt/Kieffer. “You need somebody who is able to see the whole picture from a clinical side.”
Whether a system should bring aboard such a role in the C-suite likely depends on its size — typically large, integrated hospital networks — and where it is along the journey of implementing an EHR system, Wierz says.
At Inova, Mook transitioned into the role about two years ago after serving as chief nursing executive, helping to lead the switchover to a new IT platform. With implementation largely complete, Mook, among other things, helps to oversee recruitment and training of nurse information specialists, contributes as a leader of the health system’s strategic planning process for the future of clinical informatics, and coordinates technology requests. She reports to the health system’s chief nursing officer and works in tandem with both its chief medical information officer and chief financial officer.
Hiring a CNIO may not be for all types of health care organizations, but Mook thinks every leader should consider its needs for nurse informatics leadership, especially when spending tens of millions of dollars on new technology that is designed to improve clinical performance.
“You need to have a leader who isn’t just an IT person, but someone who understands and who’s really an advocate for nursing,” Mook says.