Nursing informatics 2nd semester

Quebral,zayrah angela e.- bsn 2a

Chapter 16 nursing informatics and healthcare policy

Introduction and Background and processes shaping the industry policies for health IT
integration. Topics include:
Patient Protection and Affordable Care Act (ACA)
• Forces of Change in Today’s National Healthcare
• Affordable Care Act aka obamacare System
• signed in March 23, 2010 by Barack Obama and • Mandate for Reform: ARRA and its HITECH Act
111th congress. Is dedicated to replacing a Provision
broken system with one that ensures all • State and Regional Health IT Programs
Americans access to healthcare that is both • Health IT Federal Advisory Committees and
affordable and driven by quality standards. Agencies
• It turned the spotlight on the ever-increasing • Nursing Informatics and Healthcare Reform
recognition that advanced health information
• The Road Ahead
technology (health IT) is and will be essential to
support the massive amounts of electronic
information exchange foundational to industry
reform. FORCES OF CHANGE IN TODAY’S NATIONAL
HEALTHCARE SYSTEM

American Recovery and Reinvestment Act (ARRA) of

The journey to the passage of ACA, ARRA, and HITECH
2009 goes back several decades. In 1991, the Institute of
Medicine (IOM) concluded that computerization could
• Health Information Technology Act (HITECH) help improve patient records and information
• This legislation authorized the Centers for management.
Medicare & Medicaid Services (CMS) to provide Subsequent reports such as To Err Is Human in 1999 and
reimbursement incentives (around $22 Billion) for Crossing the Quality Chasm in 2001, were a call to action
eligible professionals and hospitals that take for a paradigm shift from reliance on paper and verbal
steps to become “meaningful users” of certified communication for managing patient care to a new era
Electronic Health Records (EHRs) technology to where healthcare professionals are supported by
improve care quality and better manage care technology while providing patient care.
costs (ARRA and HITECH Act Resource Center,
2009). • IOM followed up on these reports in 2012 with
Best Care at Lower Cost: The Path to
Continuously Learning Health Care in America,
Adoption of EHR’s
which urged systemic transformation to reduce
inefficiencies in the health system.
• The adoption of EHRs by hospitals and providers • Early report on the Computer-Based Patient
improved care quality, managed costs, and Record emphasized the need for a commitment
enabled better data analysis and information to continuous improvement and highlighted the
access across the healthcare continuum. importance of better data management through
EHRs and mobile technologies.
Growth of Health IT Job • Other significant forces of change, one of the
earliest and most influential was PITAC: The
President’s Information Technology Advisory
• The growing commitment by health systems and
Committee.
physician practices to the implementation and
demonstrated meaningful use of certified EHR The President’s Information Technology Advisory
systems will also continue to create new
Committee (PITAC)
opportunities for health IT professionals.
• The Bureau of Labor Statistics has projected that • In 1997, an Executive Order of the President
employment growth in the health IT area will established the visionary, 24-member President’s
increase overall by 20% through 2020, with some Information Technology Advisory Committee
segments like network and computer systems (PITAC).
administrators expanding by 28% (Bureau of • They are involved in networking and information
Labor Statistics, 2012) technology (IT) research and development with
• All in all, some 50,000 qualified health IT workers expert, independent advice on maintaining
will be needed to meet the demands of hospitals advanced information technologies.
and physicians as they move to adopt EHRs and • PITAC established a panel to provide guidance
connect to statewide health information on how IT could be leveraged to transform
exchanges (HIEs). healthcare and increase access to care for all
Chapter Overview citizens.
• submitted a report entitled “Transforming
This chapter discusses the importance of nurses and healthcare through information technology”.
health IT professionals in healthcare transformation. It
focuses on primary influencers, organizations, programs,
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

“Transforming healthcare through information Other key points of ONC:

technology”.

Use of health information technology in healthcare: • Participates actively in the execution of ARRA
and the HITECH Act to advance health IT
• computer-aided surgery
initiatives.
• use of tele sensing methods to examine patients
• ARRA led to the establishment of two important
from their homes.
committees - the Health IT Policy Committee and
• patient/doctor interaction via the Internet the Health IT Standards Committee, both of
• Digital medical libraries which provide recommendations to ONC.
US Lacks a broad disseminated and accepted vision for
Appointed National Director of ONC
information technology in healthcare.
Suggests defining a clear vision of how IT could improve
the US healthcare system; and
To appoint a senior IT to provide strategic leadership.
Dr. David Brailer
1st national coordinator

President’s Council of Advisors for Science and

Technology (PCAST)

• PCAST focused on a wide range of issues,

including energy, nanotechnology, and
personalized medicine.
• In 2010, they released a report entitled: Dr. Farzad Mostashari
“Realizing the full potential of health information
technology to improve healthcare for Americans: May 2011
the path Forward. ” emphasizing the need for
increased access to patient information,
streamlined diagnoses and care, improved public
health monitoring, and enhanced clinical trial
capabilities.
• The report also highlighted the importance of a
universal exchange language for healthcare
information and patient record privacy.
• PCAST urged the ONC and CMS to develop Dr. David Blumenthal
guidelines for transitioning from traditional EHRs
to health information exchanges.

President Bush’s Executive Order and the Birth of

Office of the National Coordinator for Health
Information Technology (ONC)
Dr. Karen De silca
George Bush issued an executive order: Incentives for
the Use of Health Information Technology and January 2014
Establishing the Position of the National Health
Information Technology Coordinator, ” which has had an
impact on every healthcare entity, provider, and
informatics professional in the United States .
Components of the order:
1) establish a national health information Health IT Training Programs: An Essential Element of
technology coordinator position; Reform
2) develop a nationwide interoperable health IT
infrastructure; and Addressing Shortage of health IT experts.
3) develop, maintain, and direct implementation of a
strategic plan to guide implementation of 1) Collaboration of HHS with different leading
interoperable health IT in both public and private universities, college centers and research
sector. centers to advanced the widespread of
meaningful use of health IT.
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

2) Training programs - can be on-campus or online

programs. Available at certificate, bachelors
degree and masters degree. HIPAA Security Rules
3) The American Medical Informatics Association
(AMIA) 10x10 Program (2015) - 10, 000 healthcare
professionals by the end of a decade. • took effect in April 21 2003
4) American Recovery and Reinvestment Act (ARRA • Deals specifically with Electronic Protected
)Funding - granted $118 Million to 16 universities Health Information (ePHI)
and 82 community colleges to suppoer the • a major goal is to protect the privacy of
training of more than 20,000 health IT individuals’ PHI while allowing covered
professionals. entities to adopt new technologies to improve
the quality and the efficiency of patient care.
The Health Insurance Portability and Accountability • it is designed to be flexible and scalable so
Act: Privacy and Security that a covered entity can implement policies,
procedures, and technologies that are
Signed in: 1996 appropriate for the entity’s particular size,
organizational structure, and risks to
Goal: To allow the flow of health information needed to consumers’ electronic ePHI.
provide and promote high-quality healthcare while
protecting the public’s health and well-being.
HIPAA Security Rules
2 rules published by HHS: HIPAA Privacy Rule and the
HIPAA Security Rule Significant impact on health informatics.

The HIPAA Privacy Rule • Patients must be permitted to review and

amend their medical records
• Enhanced doctor–patient communications.
• Effective date: April 14, 2003. • Minimal risks in increasing patients’ access to
• covers all PHI, including paper and electronic their records.
records • Patients who choose to access their records
Overview of the HIPAA Privacy Rule could experience increased anxiety.

- established national standards for protecting Greatest changes to HIPAA

individually identifiable health information -
referred to as Protected health information (PHI) -
Regulation of the use and disclosure of PHI - Set • The ARRA extended HIPAA mandate,
standards for individuals' privacy rights regarding introducing new privacy and security
their health information. requirements.
• Key Changes in HIPAA Electronic Transaction
Application of the Rule: Standards occurs.
The rule applies to those organizations identified • The old version of the American National
as “covered entities, ” which include: Standards Institute (ANSI) X12 Standards for
HIPAA transactions was replaced by Version
1) .healthcare clearinghouses 5010.
2) sponsored health plans • National Council for Prescription Drug
3) Health insurers, Program (NCPDP) standard for pharmacy and
4) other medical service providers that supplier transactions was replaced by
engage in the transfer of PHI. Version D.0.
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

EHR Certification and Testing Interoperability

• the passage of ARRA and HITECH, ONC has -the ability of health information systems to work together
become the driving force behind the within and across organizational to advance the effective
definition of meaningful use of EHRs and the delivery of healthcare for individuals and communities by
certification of EHR systems. sharing data between EHRs.
• Certification Commission for Healthcare
Information Technology (CCHIT) was founded • It is not simply the exchange of data between
in 2004 with support from three industry two organizations, but rather the ability of the
associations: two organizations to exchange and consume
a. American Health Information data to and from each other’s EHRs.
Management Association (AHIMA) HIE Governance.
b. Healthcare Information and • refers to the framework of rules, policies, and
Management Systems Society processes put in place to manage the exchange
(HIMSS) of electronic health information in a trusted and
c. National Alliance for Health interoperable manner. purpose is to facilitate
Information Technology (NAHIT). secure and seamless electronic health
information exchange nationwide. ONC believed
• (CCHIT) played a significant role in the that implementing a common set of guidelines
certification of Electronic Health Record covering privacy, security, business, and
(EHR) systems in the healthcare industry. technical requirements would create a solid
• Two certification programs: foundation for the expansion of electronic health
information exchange capabilities across the
Temporary Permanent nation.
ONC authorized approved Permanent program
organizations, called includes the certification of INTEGRATING THE HEALTHCARE ENTERPRISE. (IHE)
ONC-Authorized Testing other types of health IT,
and Certification Bodies such as personal health
(ONC-ATCBs), to both test records (PHRs) and health • PURPOSE: to create the framework for passing
and certify EHRs and EHR information exchange (HIE) vital health information seamlessly from
Modules networks application to applicatioan, system to system,
and setting to setting across multiple healthcare
enterprises
• It brings together health IT stakeholders to
Standards and the Nationwide Health Information demonstrate the implementation of standards for
Network communicating patient information efficiently
throughout and among healthcare enterprises by
developing a framework of interoperability.
• In late 2005, the U.S. Department of Health • IHE is in a unique position to significantly
and Human Services commissioned the accelerate the process for defining, testing, and
Healthcare Information Technology implementing standards-based interoperability
Standards Panel (HITSP) to assist in among EHR systems.
developing a Nationwide Health Information
Network (NwHIN), which would create a
nation-wide, interoperable, private, and
secure exchange of health information
between EHR .
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

• $22 billion was used to drive reform through the

NON-PROFIT ORGANIZATIONS DRIVING REFORM
use of advanced health IT and the adoption of
EHR
• the incentives were intended to help healthcare
• many non-profit organizations today advancing providers purchase and implement health IT and
health IT and nursing informatics, few have had EHR systems.
such positive impact on the industry than the
American Medical Informatics Association Incentives for Meaningful Use of EHRs
(AMIA) and the Healthcare Information and
Management Systems Society (HIMSS). • funding will be used to reward hospitals and
American Medical Informatics Association (AMIA) eligible providers for “meaningful use” of
certified EHRs by “meaningful users” with
• promotes the effective organization, analysis, increased Medicare and Medicaid payments.
management, and use of information in • The law specifies that eligible healthcare
healthcare to support patient care, public health, professionals and hospitals can qualify for both
teaching, research, administration, and related programs when they adopt certified EHR
policy. technology and use it in a meaningful way.
• For 30 years, the 4000 some members of AMIA
and its honorific college, the American College of ”Meaningful use ” is a dynamic, evolutionary process
Medical Informatics (ACMI), have sponsored that will involve three stages:
meetings, education, policy, and research Stage 1:
programs.
• AMIA became a source of informed, unbiased • begins in 2011 as the starting point for all
opinions on policy issues relating to the national providers
health information infrastructure, uses and • it is consists of transferring data to EHRs and
protection of personal health information, and beginning to share information, including
public health considerations, among others. electronic copies and visit summaries for
patients.

Healthcare Information and Management Systems Stage 2:

Society(HIMSS) • to be implemented in 2014 “meaningful use”
includes significant new exchange functionality
such as online patient access to their health
• founded in 1961 information and electronic health information
• focused on providing leadership for the exchange during transitions between providers.
optimal use of IT and management systems for
the betterment of healthcare Stage 3:
• composed of 23,000 members. 73% of which To begin in 2017, “meaningful use” in this stage is
works in patient care delivery setting. projected to include measures that demonstrate
• it is founded on the premise that an organized improvement in the quality of healthcare.
exchange of experience among members
could promote a better understanding of the Milestones in Meaningful use Program
principles underlying healthcare systems and
improve the skills of those who direct health IT
programs and the practitioners who analyze, December 31, 2009 :
design, or evaluate health IT systems.
• HIMSS frames and leads healthcare public • published a Stage 1 Proposed Rule on
policy and industry practices through its Meaningful Use of EHRs and began a 60-day
educational, professional development, and public comment period.
advocacy initiatives designed to promote July 28, 2010:
information and management systems’
contributions to ensuring quality patient care. • After reviewing more than 2000 comments, HHS
• Provides input on Health IT issues and issued the Stage 1 Final Rule, with final criteria
government programs. for meeting “Meaningful Use” divided into five
initiatives:
MANDATE FOR REFORM: ARRA AND ITS HITECH ACT
1. Improve quality, safety, efficiency, and reduce health
PROVISION
disparities.
• passed in February 17, 2009 2. Engage patients and families.
• referred to as “The stimulus bill” or “The
3. Improve care coordination.
recovery act”
• the lesgilation allocated $787 Billion to rescue 4. Improve population and public health.
and reform the nation’s seriously ailing
healthcare industry.
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

5. Ensure adequate privacy and security protections for The addition of these objectives have played an
personal health information. important role in the improvement of in health IT,
with respect to:
November 30, 2011
• Imaging results and information accessible
• In the launch of an initiative called, “We Can’t through certified EHR technology
Wait,” HHS and the Obama Administration • Capability to identify and report cancer cases to
acknowledged the challenges of meeting Stage 2 a State cancer registry
timeline requirements. • Capability to identify and report specific cases to
• To encourage faster adoption, the HHS’ a specialized registry (other than a cancer
announcement cleared the way for doctors and registry).
hospitals to adopt health IT in 201 1 without
formally meeting the new standards until 2014.
These policy changes were also accompanied by PROPOSED STAGE 3
greater outreach efforts to provide more
information to doctors and hospitals about best • As the goal for Stage 1 was data capture and
practices. patient access and information exchange and
• They also sought to help vendors whose products care coordination for Stage 2, the goal for Stage
were straining to keep up with the changing 3 Meaningful use is improved outcomes.
requirements for their technologies, which allow • The hope is that Stage 3 criteria will simplify and
healthcare providers to meaningfully use EHRs. reduce reporting requirements and that
adherence will rely more on market incentives to
February 23–24, 2012
promote innovation and reward good behavior.
• CMS and HHS announced Stage 2 meaningful-
use steps for providers using EHR technology
and receiving Stage 1 incentives payments from Quality Measures
Medicare and Medicaid.
• Intended to define more than the Stage 2 • The criteria for both hospitals and physicians is
criteria that eligible providers must meet to the requirement to report clinical quality
qualify for incentives payments measures (CQMs) to either CMS (for Medicare)
• the finalized Stage 2 rules define the “payment or the States (for Medicaid)
adjustments” or penalties that, beginning in • Quality measurement is considered one of the
2015, providers will face if they fail to most important components of the incentive
demonstrate the meaningful use of certified EHR program , the purpose of the health IT incentives
technology and fail to meet other program is to promote reform in the delivery, cost, and
participation requirements. quality of healthcare in the United States.
• Each required quality measures in stage 1, stage
August 23, 2012
2, and stage 3 demonstrate a continued focus on
• the government released the final rules for Stage enhancing quality measurement through
2 of meaningful use with assurance that the electronic submission to the CMS.
public’s voice was heard.
• The final rules outline the certification criteria for
ONC and Establishment of the HIT Policy and
the certification of EHR technology, so eligible
Standards Committees
professionals and hospitals may be assured that
the systems they use will work.
HIT Policy Committee and the HIT Standards Committee:
What Is New in Stage 2?
• Members of the two committees are public and
private stakeholders who are tasked to provide
The Department of Health and Human Services (HHS) recommendations on the HIT policy framework,
introduced several new aspects and requirements. Here standards, implementation specifications, and
are the key updates in Stage 2: certification criteria for the electronic exchange
and use of health information.
1. Changes to Computerized Provider Order Entry
(CPOE) - In Stage 1, CPOE was optional, but in Challenges to Achieving Widespread Health Information
Stage 2, it became a required measure. Exchange
2. Elimination of “exchange of key clinical
information" from Stage 1 was replaced with a • the slow progress of EHR interoperability
new core objective focused on "transitions of • Gaps in HIE occur when providers are unable to
care." exchange information with pharmacists,
3. Replacing “provide patients with an electronic commercial labs, and other care settings
copy of their health information” objective with a because of lack compatible exchange systems.
“view online, download and transmit” core • lack of cohesive program requirements across
objective. state-level programs, which inhibits seamless
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Chapter 16 nursing informatics and healthcare policy

exchanges for multi-state providers and • Patients who use electronic health tools tend to
technology vendors, be more engaged in managing their care. Such
patients also tend to be better at finding the best
Patient-Centered Outcomes Research quality and most cost-effective care, but often
they lack access, despite the increase in mobile
technologies.
ARRA and HITECH increased funding by more than $1 • To address this issue, ONC is working to expand
billion for Comparative Effectiveness Research (CER) and access to personal health technologies; promote
established the Federal Coordinating Council for a more collaborative partnership between
Comparative Effectiveness Research (FCC-CER) patients and their healthcare providers.
• Additional funding was made available to the
Patient-Centered Outcome Research Institute
(PCORI), a non-profit, public–private partnership NIH AND NLM GRANTS TO SUPPORT HEALTH IT
organization , to conduct research that would RESEARCH
provide information about the best available
evidence to help patients and their healthcare • The National Institutes of Health (NIH) received
providers make more informed decisions. over $200 million in 2009 and 2010 as part of
• PCORI’s research is intended to give patients a ARRA for The NIH Challenge Grants in Health and
better understanding of the prevention, Science Research program.
treatment, and care options available as well as • This initiative funded research on specific
the science that supports those options. scientific and health challenges in biomedical
• Currently, PCORI has approved 197 awards and behavioral research.
totaling more than 27 million to fund patient
centered CER project. • National Library of Medicine (NLM) offers
Applied Informatics grants to optimize the use of
clinical and research information through health
Workforce Training IT. In April 2012, NLM awarded 14 five-year
grants totaling more than $67 million for research
the growing demand for health IT professionals—highly training in biomedical informatics.
skilled health IT experts who can support the provider
community in the adoption and meaningful use of SHARP Research Grants
electronic health record.
• To meet this demand, ONC funded the Health IT
• The Office of the National Coordinator for Health
Workforce Development Program.
Information Technology (ONC) allocated $60
• The program’s goal was to train a new workforce
million to fund the Strategic Health IT Advanced
of health IT professionals who will be ready to
Research Projects (SHARP) Program.
help providers implement EHRs to improve
• Four cooperative agreements of $15 million each
healthcare quality, safety, and cost-
were awarded to implement research programs
effectiveness.
focusing on areas such as Health IT Security,
• Integrated training of the incumbent workforce,
Patient-Centered Cognitive Support, Healthcare
aimed at helping them understand how to use
Application and Network Architectures, and
health IT as a tool to enable care delivery and
Secondary Use of Health IT Data.
payment reform.
• In 2012, the SHARP program shifted its focus to
• Patricia Dombrowski, Bellevue College, reported
target barriers to Meaningful Use in EHRs, HIE,
on the adaptation of the curriculum for rural
and Telemedicine, with Personal Health Records
physician practices in rural and migrant clinics
(PHRs) as a key subtopic.
and for the VA. A five-hour online class was
designed that VA employees could take, but on
their own time. STATE AND REGIONAL HEALTH IT PROGRAMS

CONSUMER/PATIENT ENGAGEMENT AND EHEALTH • State Health

all this initiatives
Information Exchange
aim to advance the
• Patient-centered care is considered one pillar of Cooperative Agreement
adoption and
a high-performing, high-quality health care Program
implementation of
system. • Beacon Communities
health information
• Expansion of health information technology and • Health IT Regional
technology (IT) to
consumer e-health tools—electronic tools and Extension Program
improve healthcare
services such as secure e-mail messaging
between patients and providers, or mobile health delivery and
apps—have created new opportunities for coordination.
individuals to participate actively in monitoring
and directing their health and health care.
Nursing informatics 2nd semester
Quebral,zayrah angela e.- bsn 2a
Chapter 16 nursing informatics and healthcare policy

HEALTH IT FEDERAL ADVISORY COMMITTEES AND NURSING INFORMATICS AND HEALTHCARE REFORM
AGENCIES

• In 2009, as mandated by ARRA and HITECH, ONC • survey sponsored by HIMSS entitled
created two new federal Advisory Committees, “Informatics Nurse Impact Survey” concluded
the HIT Policy Committee and the HIT Standards that the passage of the ARRA and its provision of
Committee in order to gain broad input on the incentives to promote the meaningful use of
use of health IT to support healthcare reform. EHRs created new opportunities for informatics
nurses.
The Health IT Policy Committee • HIMSS empahasized that “Nurses are key
leaders in developing the infrastructure for
effective and efficient health information
• In charged with making recommendations to technology that transforms the delivery of care.
ONC on a policy framework for the development Nursing informatics professionals are the
and adoption of a nationwide health information liaisons to successful interactions with
infrastructure. technology in healthcare” Informatics nurses
• Originally, there were seven workgroups focusing have contributed to the work of healthcare
on key reform issues like EHRs, certification, reform implementation teams, creating
information exchange, and privacy policies. constantly stronger positions from which to help
• Over time the workgroups increased to 14. put the new national healthcare infrastructure in
place.
• This section highlights some of the involvement
The Health IT Standards Committee
that nurses have had in the work of HIT and
healthcare reform.
• charged with making recommendations to ONC
on standards, implementation specifications, and
certification criteria for the electronic exchange Nursing Informatics Competencies
and use of health information.
• from 4 workgroups it becomes 8 work groups
• informatics nurse combines clinical knowledge
focusing on various aspects like patient
with IT to improve the ways nurses diagnose,
engagement and emerging technologies.
treat, care for, and manage patients.
• The Committee collaborates with the Policy
• informatics nurses support, change, expand,
Committee due to the evolving healthcare
and transform nursing practice through the
landscape, emphasizing accountable care, new
design and implementation of information
coding systems, and EHR requirements.
technology.
• Informatics nurses help design the automated
The National Committee on Vital and Health Statistics tools that help clinicians, nurse educators,
nursing students, nurse research, policy-makers,
• established over 60 years ago by Congress to and consumers as they increasingly seek to
advise the HHS on health data, statistics, and manage their own health.
national health information policy.
• In 1996, NCVHS was restructured to meet The Intersection of HIT Policy and Nursing
expanded responsibilities under HIPAA. Informatics
• The Committee also recommends education,
outreach, and practical guidance for those who
must adopt the new standards. • The need for health IT competencies, awareness
of how health IT is changing the way we
diagnose, treat, care for, and manage patients,
The National Quality Forum
as well as healthcare policies that affect
healthcare practices and the global healthcare
• a non-profit organization focused on enhancing landscape.
healthcare quality in the United States. • Informatics professionals need to stay informed
• It has Three-part mission: to set national about both current and proposed healthcare
priorities and goals for performance policies. Policy, as defined, serves as a roadmap
improvement; to endorse national consensus for decision-making in the present and future
standards for measuring and publicly reporting based on specific conditions and selected
on performance; and to promote the attainment alternatives.
of national goals through education and • Important to note that both current
outreach programs circumstances and emerging trends in the
• NQF has taken the lead in defining the quality healthcare industry play a role in shaping policy
measures to qualify for the meaningful use decisions.
incentives under HITECH/
Nursing informatics 2nd semester
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Chapter 16 nursing informatics and healthcare policy

THE ROAD AHEAD

• Leaders in healthcare agree: the future depends

on a system that will continue to innovate using
health IT and to rely on informatics to play
instrumental roles in patient safety, change
management, and quality improvement, as
evidenced by quality outcomes, enhanced
workflow, and user acceptance.
• In an environment where the roles of all
healthcare providers are diversifying, informatics
nurses must prepare to guide the profession
appropriately from their positions as project
managers, consultants, educators, researchers,
product developers, decision support and
outcomes managers, chief clinical information
officers, chief information officers, advocates,
policy developers, entrepreneurs, and business
owners.
The future of nursing will rely on the transformation, as
well as on the important role of nurses in enabling this
digital revolution.