Eun-Shim Nahm, PhD, RN, FAAN, Associate Professor
Arpad Kelemen, PhD, Associate Professor
Mary Regan, PhD, RN, MS, Assistant Professor
Charlotte Seckman, PhD, RN-BC, Assistant Professor
Nancy Staggers, PhD, RN, FAAN, Professor
Marisa Wilson, DNSc, MHSc, RN, Assistant Professor
The American Nurses Association (ANA) says that nursing informatics “integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice."1 Registered nurses who enter this field via on-the-job training or continuing education are called informatics nurses. Nurses who earn a master's or doctoral degree or pursue a post-master's (non-degree) option in nursing informatics or a related field such as biomedical or health informatics or information management are called informatics nurse specialists.1 All are helping to usher in a transformation of health care by providing essential information to students, educators, clinicians, consumers, administrators, scientists, and policy makers when over and where ever they need it. Here are some examples:
Most informatics nurses and informatics nurse specialists take jobs that draw directly on their clinical backgrounds, as well as their organizational skills and informatics knowledge. Although there is overlap between the types of roles, nurses in applied/professional positions focus more on technical aspects of development and evaluation of systems. Nurses in expert/liaison roles focus more on needs assessment, system selection or marketing, education, and implementation.2 In either type of position, informatics nurses and specialists are uniquely qualified to bridge the gap between the clinical world and the of Information Technology (IT) world.
In a health care organization, nurses will typically fill applied/professional positions in the IT department or expert/liaison positions in the nursing department. Nurses hold similar roles in corporations that develop and sell health care information technology and in consulting firms that assist health care organizations in selecting, implementing, and evaluating health care information technology.
A number of websites list job descriptions for clinical informatics nurses and specialists. The examples are: American Nursing Informatics Association and the American Medical Informatics Nursing Informatics Working Group are just two. In general, the opportunities described on these sites fall within the two categories:
Each of these jobs require stat nursing experience, relevant training, and increasing levels of informatics experience.
Whatever role nurses take in clinical informatics, they stand to make significant contributions to patient outcomes and staff satisfaction. Informatics nurses and specialists have the potential to improve patient care, make the value of nursing visible, reduce the burden of paperwork, and improve communications within an interdisciplinary team.3
In the 20th century, the focus of health care informatics shifted from supporting business processes like billing and registration to supporting health care professionals in decision making, education, and other professional activities4. In the 21st century, informatics is expanding rapidly to deliver information resources to consumers via the Internet and other electronic media.5, 6 With the current emphasis on health promotion, disease prevention, self-management, and patient-centered care, the role of patients and their family members as collaborators has become vital.7, 8
Because one of nursing's central missions is to help patients and families live as well as they can with the health issues they face, consumer health informatics is a natural fit for nurses.
Just as consumers are increasingly learning from the Internet and other electronic media, students in nursing and other health care professions are benefiting from online and Web-enhanced courses, as well as from the integration of health care information technologies into their clinical courses. Informatics nurses and specialists who focus on education may develop, select, implement, and evaluate learning resources for consumers or for health care professionals.13
For example, to make Web-based courses more “real” and interactive, faculty members at the University of South Florida provided synchronous, online lectures and virtual break-out rooms for student work on group projects. Students reported that these innovations facilitated their learning and made their online courses more satisfying 14. At Texas Tech University, Web-based RN-to-BSN students benefited from collaboration and mutual assistance through the establishment of online student learning communities.15 The University of Massachusetts College of Nursing and Health Sciences let students and faculty members borrow personal digital assistants from the library to gain access to up-to-date reference materials in clinical settings.16 At the University of Maryland School of Nursing, informatics faculty members and clinical faculty members are collaborating in revising clinical courses to integrate the use of the electronic health record with simulated patients at every stage the nursing process. Partnership within an academic consortium that includes the Cerner Corporation, University of Kansas, University of Missouri-Kansas City, and University of Utah and with a major vendor of health care information technology, makes it possible to share simulated patient scenarios and other resources and to leverage one each other 's progress.
Nurse clinicians and scientists practicing in public health and epidemiology focus on obtaining, synthesizing, and providing access to information and knowledge related to community and population health for consumers, for other health care workers, and for policymakers. The fledgling field of Public Health Informatics (PHI) addresses the information needs of policymakers and public health professionals by applying informatics principles at the community and population levels.17
The Centers for Disease Control and Prevention (STET) as well as state and local health departments, have identified several areas of PHI focus:
In addition, PHI specialists work on such projects as immunization registries, public health surveillance systems, and domestic violence research and intervention.17
Informatics nurses and specialists in PHI are most likely to work for a government agency such as the CDC or a health department, possibly having to write their own job descriptions for pioneering roles. Many prospective employers will require a master's degree in informatics (or a related field) and related work experience. Professional organizations supporting PHI include the American Medical Informatics Association and the Public Health Informatics Institute.
The ANA sees research as an important function of the informatics nurse specialist.1 Using systematic, scientific methods to collect and analyze data, the INS can gradually build knowledge that applies across settings and applications. In the course of a system life cycle, the INS will assess:
In consumer health informatics, where most programs focus on health promotion and disease prevention and management, the INS can study the impact of the informatics intervention on health practices and outcomes.19-21 Nurses with the Doctor of Nursing Practice degree will develop and use informatics tools to obtain and apply evidence to improve patient care. Nurses with academic doctoral degrees (PhD, DNSc) are developing standards for representing data, information, and knowledge in information systems, developing methods of decision support for nurses, developing and investigating new technologies to support nursing processes, and advancing knowledge about how nurses use and communicate data, information, and knowledge. In the face of the nursing shortage, this research enables “a rebalancing of the human and technological resources deployed to support patient care”.22
Career opportunities in nursing informatics are as varied as nursing itself. Although many nurses have come into informatics through on-the-job training or continuing education, the increasing complexity of the field and the demanding performance standards of today's workplace make formal education increasingly necessary. There is broad and growing consensus that all nurses need to be educated about the basics of informatics to support their clinical, educational, or administrative practice. To practice nursing informatics at an expert level, nurses need to study informatics at the master's or doctoral level. Master's education is increasingly available through online programs at respected universities. Doctoral education usually requires on-campus study.
As expert practitioners, informatics nurses and specialists provide new tools that help clinicians to practice, educators to teach, students to learn, researchers to investigate, policymakers to deliberate, and consumers to manage their own health. In all these ways, Informatics Nurses and Specialists pursue a fundamental nursing goal,“to improve the health of populations, communities, families, and individuals by optimizing information management and communication.”1