by Tess Settergren, MHA, MA, RN-BC
*This article conveys opinions of the author, and does not reflect perspectives of the author’s employer or other affiliates.

“Informatics Nurse?  What do you DO?”  Most, if not all, nurses who are working in a nursing informatics (NI) role are asked questions in this vein at some point in their career. They may also be asked questions like; “Don’t you like to take care of patients?” or “Were you injured or something?”  Sometimes informatics nurses find it difficult to articulate what they do, and how they bring value to patient care.  And they DO bring value.  Informatics has evolved in generally similar directions across many disciplines. Health informatics is probably the broadest term used, and comprises many disciplines and several distinct foci. HIMSS defined health and clinical informatics as interchangeable: “Clinical Informatics (aka Health Informatics) promotes the understanding, integration, and application of information technology in healthcare settings. This helps to ensure adequate and qualified support of clinician objectives and industry best practices¹”.

The American Medical Informatics Association (AMIA) defines clinical informatics as “the application of informatics and information technology to deliver healthcare services. It is also referred to as applied clinical informatics and operational informatics².”  In this definition, a clinical informatics expert is concerned with application of informatics skills, by any professional discipline, with overall goals of improving use of information and information systems by clinicians.  “Translational bioinformatics is the development of storage, analytic, and interpretive methods to optimize the transformation of increasingly voluminous biomedical data, and genomic data, into proactive, predictive, preventive, and participatory health³.”  AMIA also recognizes the domains of clinical research informatics, consumer health informatics, and public health informatics.  AMIA has developed a clinical informatics board certification preparatory program, intended for physicians already board-certified in any of the 24 clinical specialties. Physicians become certified through examination, and the first group of physicians were board-certified in Clinical Informatics in 2013.  

The American Nursing Informatics Association (ANIA) uses the definition of nursing informatics that was published when the American Nurses’ Association recognized NI as a specialty, in 1992.  The definition has been regularly updated, and will soon be updated again: “Nursing informatics (NI) is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom to nursing practice.  NI supports consumers, patients, nurses, and other providers in their decision-making in all roles and settings.  This support is accomplished through the use of information structures, information processes, and information technology⁴.”  The American Nurses’ Credentialing Center has provided a board-certification examination for informatics nursing for about twenty years.  ANCC also certifies many other nursing clinical and administrative specialties and advanced practices nurses. Nurse informaticists fulfill various roles in administration, education, research, and practice.  They are hired into well over 1000 distinct job titles by healthcare organizations of all types, payers, HIT vendors, consulting firms, universities and colleges, research groups, and other entities. 

So what?  What differentiates the NI from other informatics disciplines: medical/clinical, pharmacy, health information management, nutrition, dental, and so on?  What is the value proposition?  First, the cornerstone is professional nursing practice—NI’s overall goal, in any setting, is to transform practice, influencing safe, effective, efficient, equitable, timely, patient-centered care and thus health outcomes.  Nursing has a long played a key role in coordinating care, in conjunction with many disciplines and providers and across care settings.  Leveraging technology to support nurses in achieving current and future practice goals, including coordination of care, was a key recommendation in the recent Institute of Medicine report⁵.  Nurses are well-positioned to add value to HIT-related work because they understand clinical care team workflows and information needs, and can translate those concepts to best configure HIT, influence clinician adoption, and enhance information management.  Some specific areas where nursing practice, informatics, and human change management knowledge add value include the following activities and more:

In summary, informatics nurses bring value in a myriad of roles and areas of focus.  They share broad goals with other informatics professionals around improving health care delivery and population health, and very specific goals that focus on phenomena within the nursing practice domain.  Informatics nurses achieve these objectives through application of the potent combination of clinical acumen, informatics and information technology competencies, process improvement and change management skills, and interdisciplinary collaboration, with a large dollop of translational skills (clinical to technical and back again).
References: