Nursing Knowledge: Big Data Research for

Transforming Healthcare

Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics, HIMSS President, IHE USA

HIMSS NI Nurse Executive Workgroup January 9, 2014

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 evidence-

based 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 patient-derived 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, inter-

professional 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