The Three Essential Responsibilities of a Nurse Informaticist

The Three Essential
Responsibilities of a
Nurse Informaticist

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Responsibilities of a Nurse Informaticist
As data becomes more widely used to
drive healthcare improvement, so does
the term “informatics,” referring to
processing, storing, and retrieving data
to optimize healthcare delivery and
improve patient outcomes.
But who are the people behind the
scenes—the informaticists—who make
these data processes happen?

There are many types of informaticists in
healthcare (e.g., nursing, lab, medical),
but the nurse informaticist plays a
pivotal role in identifying, defining, and
sharing data, information, and
knowledge in the science of nursing.

With massive amounts of data at health
systems’ fingertips—and exacerbated by the
urgency for even more data in response to
COVID-19—a nurse informaticist’s role is vital
for health systems to maximize data-driven
nursing practice in pandemic management
and the everyday clinical setting.

Nurse informaticists’ familiarity with nursing’s
frontline role in a clinical setting combined
with an understanding of clinical processes
and workflows enables them to maximize
data and technology in daily nursing practice.
More than a translator who works in silos
with the IT department, a nurse informaticist
bridges the gap between data and clinical
nursing practice.
Nurse informaticists understand the flow
of data at a deep level and make
modifications to support new methods
that lead to safe care delivery.

The American Nurses Association defines
nursing informatics as the specialty that:
“…integrates nursing science with multiple
information and analytical sciences to identify,
define, manage, and communicate data,
information, knowledge and wisdom in
nursing practice.”

Nurse informaticists support nurses,
consumers, patients, the interprofessional
healthcare team, and other stakeholders in
their decision-making in all roles and
settings to achieve desired outcomes.
This support is accomplished through
the use of information structures,
processes, and technology.

The Evolution of a Nurse Informaticist
The role of a nurse informaticist has evolved
since its initial function as a “clinical analyst.”
As healthcare focuses more on data science-
centric processes to improve patient care,
such as machine learning and artificial
intelligence, technology adoption and
communication between clinical teams
and IT resources are paramount.

Because nurse informaticists practice at
the intersection of technology and clinical
practice, nursing informatics is now a well-
established specialty that has grown
beyond designing the EHR.

Technology is not just part of healthcare; it
is healthcare.
Examples include point-of-care solutions
(e.g., electronic physiologic monitors,
electrocardiogram, glucometers, and more),
patient portals, external health information
exchanges, and public health reporting.

As such, the nurse informaticists’ role is an
integral part of healthcare delivery, encom-
passing system selection and implementation
and training of technologies to provide safe,
high-quality, patient-centric care across the
continuum, no matter the delivery method.

Though perhaps not as well-known as other
nursing fields, the American Nurses Credentialing
Center (ANCC) recognizes nursing informatics as
a specialty with board certification.
Additionally, nursing informatics provides a career
path in leadership, as demonstrated by the
increase in Chief Nursing Informatics Officer
(CNIO) positions across health systems.

The CNIO serves as a bridge between nursing
and information technology and partners with
the Chief Medical Information Officer, who
serves as a bridge between the medical
community and information technology—
together, the CNIO and CMIO focus on
information, data, and communication.

With the shift to value-based care, nursing informaticists focus
on a variety of technical areas to better support patients,
nursing staff, and other healthcare providers:
 Departmental systems improvement
 EHR implementation
 Documentation optimization
 Accurate data capture and process
changes that support regulatory
measures and other strategic initiatives.
 Care coordination
 Population health initiatives

Nurse Informaticists Play Pivotal Role in
the Fight Against COVID-19
The nursing informatics role is expanding
beyond process, implementation, and data
capture in the face of COVID-19.
The pandemic has resulted in new IT challenges
for hospital workforce including data capture,
system updates, implementation and integration
of new technologies, and process changes.

For example, hospital leadership faces staffing
and supply chain shortages, capacity challenges,
field hospital management, temporary relaxation
of documentation and regulatory reporting
requirements, and a focus on patient throughput.
And do this while maintaining compassionate,
quality care.
With minimal resources and waning energy,
health systems engage nurse informaticists
to operate safely amid shifting technology,
protocols, and regulations.

Another way a nurse informaticist’s role
is especially valuable during a crisis is
by helping to quickly adjust workflows
and scale care delivery.
With the dramatic increase in telehealth
visits since the onset of COVID-19,
nurse informaticists have worked with
physicians and other disciplines to
modify existing workflows and systems
to properly capture consent and then
document telehealth visits.

With the time-sensitive shift from in-
person to telehealth visits, health
systems have had to leverage a nurse
informaticist’s expertise to rapidly
design and test technology and
workflows while simultaneously
training end users before deployment.

Three Essential Responsibilities of a
Nurse Informaticist
With COVID-19 driving more data sharing, health
systems have access to have even more data.
However, many organizations still struggle to leverage
that data to drive long-term improvements.
Nurse informaticists have three essential responsibilities
that help the nursing workforce document and submit
accurate data and leverage it to develop evidence-based
procedures for optimal care delivery.
 Understand and Communicate the “Why” Behind New
Processes
 Implement New Technology and Processes
 Validating Data with the Three Vs

Nurse Informaticist
#1: Understand and Communicate the “Why” Behind New Processes
Knowing the why behind any process and
communicating it to the nursing workforce
and key stakeholders is critical for accuracy
and adoption.
When a nurse informaticist explains the
importance of documenting specific
observations and measures (e.g., height,
weight, and allergies), nurses understand the
long-term ramifications of incorrect or missing
data on a person’s health and feel more
accountable for capturing the correct data.

Nurse Informaticist
Increased understanding also builds the
nurses’ confidence in the system’s data,
making them more likely to rely on that data
to make decisions.
For example, an EHR could require
documenting a patient’s height and weight
and allergies during the admission
assessment before a team member can
enter new orders into the system.

Nurse Informaticist
An estimated height and weight or missing docu-
mentation of allergies has downstream impacts
for determining correct medications and dosages
as well as avoiding a potential adverse event.
A crucial part of a nurse informaticist’s job is
to educate the workforce about the reasons
behind these EHR requirements.
This insight helps the care team understand
how specific data play an important role
throughout the care process and decision
making.

Nurse Informaticist
#2: Implement New Technology and Processes
Any type of new electronic implementation
(e.g., an EHR or patient portal) means a
change in the clinical process.
The clinical team will evaluate and adapt
current processes in the context of the new
technology and then implement it.
With greater data access, health systems
can identify additional care gaps and
improvement opportunities, making a nurse
informaticist’s role in new process education
and implementation even more critical.

Nurse Informaticist
New processes bring improvement opportunities,
but they also bring pain points and learning
curves that can discourage team members.
Without proper training and implementation,
new technologies can flounder, fail to gain
adoption, or even lead to unsafe workarounds,
resulting in compromised patient safety and
team member frustration.
An effective nurse informaticist guides a
new process implementation from beginning
to end, setting team members up for success.

Nurse Informaticist
For example, an ICU nurse needs to use a new
module in the EHR to capture the physiological
(e.g., hemodynamic) monitoring of a patient.
The new module requires capturing the data
directly from the monitoring device and
verifying it versus manually entering it in
an electronic format or historically docu-
menting it in a paper-based flow sheet.
Logging the hemodynamic monitoring
electronically focuses on real-time
data capture.

Nurse Informaticist
With a manual entry process, the nurse may
delay data entry until a break or at the end of
his/her shift, meaning that notes (or data)
wouldn’t be available until later.
The problem is that waiting to capture the data
(the hemodynamic monitoring information)
informs how other care team members will
execute their care delivery and planning.
If the latest data isn’t available, providers
make care decisions based on incomplete
information.

Nurse Informaticist
This change in the process means the nurse
has to electronically submit information
throughout a shift instead of during a break.
A nurse informaticist, understanding the
complex nature of nursing and the challenges
of disrupting a routine, would provide education
about the new process before implementation,
ensure testing completion and provide hands-
on training within the EHR, and a thorough
explanation of the new approach’s benefits
compared to the old method.

Nurse Informaticist
#3: Validating Data with the Three Vs
The nursing informaticist role is
expanding to encompass greater
responsibility with data and analytics.
To promote a data-driven decision
making in clinical practice through
effective data utilization and adoption.
Volume
Variety
Velocity

Nurse Informaticist
Volume: Health systems have access to
(what seems like) unlimited data.
A nurse informaticist realizes the actual
volume of data (e.g., clinical notes,
admission assessments, vital signs
medications, and lab results) and various
data sources the organization can leverage
to support data-driven decision making.
The informaticist role is emerging to include
data stewardship and data validation in
support of an organization enterprise-wide
data strategy.

Nurse Informaticist
Velocity: Data sharing is critical for health
systems to deliver comprehensive care
based on complete patient information.
This means the velocity, or the speed at
which data travels, is also critical.
Delayed access to data can lead to
postponed decision making or decisions
based on incomplete data.
Part of understanding data velocity is
also communicating what data will be
available and when to enable decisions.

Nurse Informaticist
Velocity:
For example, real-time clinical data
supporting analysis of possible and/or
actual Hospital Acquired Conditions (HAC)
enables the care team to take timely
actions that impact patient safety versus
using that same data retrospectively to
identify trends over time.

Nurse Informaticist
Velocity:
For population health, both clinical data and
claims data are included in care coordination
and closing care gaps; however, the velocity of
claims data is currently less frequent than
clinical systems and EHR data.

Nurse Informaticist
Variety: Validating data requires the
informaticist to understand the different
data sources and how they do—or do
not—come together.
Today’s electronic environment is
comprised of discrete data, unstructured
data, images, and connected device data
(to name a few) that need to be validated.
Nurse informaticists understand the variety
of data sources and how to evaluate the
data to tell a cohesive story about the
patient and the population.

Nurse Informaticist
Variety:
For example, a nurse informaticist might
discover that missing data sets could be a
result of data not integrated into the EHR.
The ability to dig deeper into data variety
and then adjust processes to harmonize
the data is critical to delivering care
based on complete data sets.

A Nurse Informaticist: Critical to Healthcare
Success Now and in the Future
With a multifaceted focus to transform
data into information, nurse informaticists
communicate that information to team
members so they can help patients reach
peak health and help health systems
reach optimal performance.
At a crossroads where nursing,
computer, and information science
meet, a nurse informaticist evaluates
aggregated data to drive change,
improve efficiency, cut costs, and
improve the quality of patient care.

As the healthcare industry relies more on
data to understand patient populations,
deliver value-based care, and combat
COVID-19, a health system must adopt
increasingly data-friendly processes and
workflows across the organization.
Data can improve accuracy and guide
clinical best practice but changes also
bring new challenges for team members.

A nurse informaticist provides information
about new workflows, guides new technology
and process implementation, and assesses
data quality, giving care teams the best
chance of optimal care delivery.
With extensive clinical background, growing
analytics acumen, process and workflow
intelligence, and technology savvy, a nurse
informaticist is critical for health systems to
leverage data to better meet every team
member and patient need.

For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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history of working in the information technology and services industry. Strong consulting
professional skilled in Health Informatics, Analytics, Quality Improvement, Professional
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Click to read additional information at www.healthcatalyst.com
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Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement
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The Three Essential Responsibilities of a Nurse Informaticist

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