Nursing Knowledge: Big Data Research for Transforming Healthcare HIMSS NI Nurse Executive Workgroup January 9, 2014 Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics, HIMSS President, IHE USA
Nurses Call to Action In spite of our best collective efforts and after decades of implementing electronic records nurses still can t consistently use EHR data for research, or for reporting quality and patient safety outcomes.
Nursing Knowledge: Big Data Research for Transforming Healthcare National leaders in nursing, healthcare, and informatics came together to develop an action plan for shaping health policy and informatics initiatives that use a national nursing knowledge model.
Primary Goal is.. To guide consistent documentation and data collection to support big data research for transforming healthcare
Created an Action Plan for: integrating nursing information into health and healthcare knowledge systems; optimizing nursing language and healthcare information; influencing policy; and modifying and standardizing the informatics educational framework.
Advancing the vision of a transformed health system Informatics and health IT have the potential to reshape the healthcare delivery system, transitioning to: A more coordinated structure where information can be easily and safely shared among patients, consumers and providers to enable improved outcomes, quality of care and lower costs.
Steps in the process Eliminating paper-based systems, manual processes Enhancing workflow Identifying best practices through clinical decision support and analytic algorithms.
To reach this vision All providers, health systems, hospitals, patients and consumers must have access to real-time, accurate and actionable health information
Current progress towards this vision HITECH Act Federal government investment to encourage EHR adoption and demonstrate meaningful use of these systems to improve healthcare delivery and outcomes Value of Health IT is being challenged Need comprehensive evidence that health IT and informatics are producing value in the delivery of the transformation of our health system http://www.himss.org/valuesuite
HIMSS Value Suite
Key drivers for informatics role in enabling a transformed health system Adaptation to the Affordable Care Act Business and clinical intelligence elicit outcomes, using advanced analytics Value driven implementation/optimization of systems Meaningful use of systems to improve healthcare delivery and outcomes Advances in mobility, cloud-based solutions Clinical decision support, usability and evidencebased care
A Health IT Framework for Accountable Care Information sharing among clinicians, patients and authorized entities; Data collection and integration from multiple clinical, financial, operational and patientderived sources; HIT functions supporting patient safety; and Strong privacy protections. CCHIT (2013). A Health IT Framework for Accountable Care. https://www.cchit.org/hitframework
Interoperability is essential Infrastructure is still fragmented which contributes to inefficient, uncoordinated care Need to bridge gaps between entities, organizations, settings Need to understand impact on patients, end-users Need comparable, shareable, consistent data Advances in EHR > Patient Care Device > EHR integration Moving to ICD10, Meaningful Use Stage 3
Consumer engagement is critical Portable, accessible personal health information will provide an essential foundation Mobile advances are an accelerator Growing focus on preventive care Learning health system # of home-based devices is increasing Access to genomics information, family history requires guidance, education Transparency of cost and quality will inform choice
What is the role of the health record? It is not simply data, or even a repository into which data are poured. It is.. information that has been transformed by the knowledge, skill, and experience of clinicians, motivated by the healing impulse, into an understanding of human experience that makes the care of the patient possible. Foote, R.S. 2013. The Challenge to the Medical Record. JAMA Internal Medicine, 173 (13), 1171-2.
What is the purpose of a health record? Recording/aid to memory Each patient presents many pieces of information Guiding thought By the nature of it s form it forces clinicians to edit information, organize it in a specific way and present it in a specific order Communicating It communicates information to others caring for the patient Teaching It is a tool for teaching as it reveals not only the nature of the patient s illness but also the thought process of the clinician that created it Foote, R.S. 2013. The Challenge to the Medical Record. JAMA Internal Medicine, 173 (13), 1171-2.
Action plan to achieve the vision Develop a strategy/campaign for educating front line nurses, students, and faculty on informatics competencies and the value of standardized nursing data; Advocate for the adoption of SNOMED-CT and LOINC as national standards for clinical data, and link them with nursing terminologies through mappings;
Action plan to achieve the vision Convene a consensus conference with leaders of the major nursing organizations and interprofessional stakeholders to educate them, hear their views, and ultimately speak with one voice; Refresh and activate the ANA s NIDSEC (Nursing Information & Data Set Evaluation Center) criteria to advance systems that represent and value nursing data; and Participate in standards and profile development to ensure a nursing voice.
Nursing s role in the transformation Leverage the EHR to optimize workflow and support clinical decision making Tell the patient s story Gather information from throughout the EHR Present and update it in an interactive, interprofessional summary Collaborate to foster knowledge translation Leverage analytics to extract actionable knowledge Build evidence out of practice
In a transformed healthcare system Our focus is on patient satisfaction, patient safety, health promotion, and quality of care The healthcare experience is personalized Consumers are engaged in their health and healthcare, with their care team Evidence-based care is improving outcomes and promoting health
And informatics will help lead the way! This is an opportunity to step outside of our comfort zone to make a difference Your participation is not only welcome, it is necessary We seek your help in further developing and executing the action plan We are perfectly poised to be the enablers There are exciting times ahead!
Thank you! Questions???? Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics, HIMSS Email: jsensmeier@himss.org