From Bedside to Boardroom: Reflections from HIMSS19 Nursing Informatics Symposium

By Beth Friedman, RHIT, BSHA, CEO, Agency Ten22
Twitter: @AgencyTen22

As an eighteen-year HIMSS convention veteran, I rarely come across a new meeting, reception or symposium. However, HIMSS19 was an exception. In conjunction with PerfectServe, one of Ten22’s long-term clients and a leading clinical communications vendor, I was invited to attend and participate in the HIMSS Nursing Informatics Symposium for the first time.

Nurses are my most revered healthcare professionals. One of my most influential mentors was a nurse. I worked alongside nurses for 12 years in the hospital setting, and nurses were my lifeline during a friend’s four-month hospitalization in 2015. Nurses are the heart of our healthcare provider organizations.

During the symposium, nursing’s role in advancing critical health IT initiatives became crystal clear. Here are four essential health IT takeaways from the HIMSS19 Nursing Informatics Symposium.

Nurses Drive Care Coordination
The symposium began with a description of nursing’s contribution to effective care coordination. Robin Newhouse, PhD, RN, NEA-BA, FAAN, Dean of Indiana University School of Nursing, defined the six action issues nurses must address to properly coordinate care.

Starting with patient engagement and ending with reimbursement for care coordination activities, the need for teamwork and technology was reiterated across every one of the six issues.

• Engage patients, families and caregivers. Ask what they want to achieve from the care episode.
• Demonstrate competence and readiness
• Optimize teams and teamwork
• Use documentation and health IT in care coordination.
• Measure care coordination using dashboards and data analytics. Provide data and data science training for clinicians to make the most of IT.
• Understand payments for care coordination activities. Do we and should we get reimbursed?

Finally, the speaker recommended nursing teams extend care coordination beyond acute care with defined roles, education and oversight for community care coordinators. Caring for the entire spectrum of a patient’s journey was a key theme of the day—including social determinants of health (SDOH).

Social Determinants of Health Benefit from Nursing Expertise
Caring about a patient’s social and behavioral determinants of health is the essence of nursing. It is part of nursing ethics. The second speaker was Marisa L. Wilson, DNSc, MHSc, RN-BC, CPHIMS, FAMIA, FAAN, Associate Professor, University of Alabama at Birmingham School of Nursing. With much of HIMSS19 abuzz with SDOH jargon, Wilson shared pragmatic steps and real-world use cases to improve wellness by addressing social and environmental factors.

Key questions to ask your SDOH program leaders include:

• Are we making the most of community-level and individual-level SDOH data?
• Can we use predictive analytics to identify high-risk patients?
• What are the most important SDOH that impact health, and can they be integrated in the EHR?

Using the University of California at San Francisco’s SIREN Network as an example, Wilson defined a logical approach to building a solid SDOH initiative.

• Who is the population?
• Will this population want to participate in SDOH initiatives?
• Do I need a targeted survey tool to address this population?
• Are survey tools available, validated and tested?
• Can non-nursing personnel be used to collect and screen information to relieve the nursing burden?
• Are responses to the survey standardized and coded?
• How can we close the loop after an intervention and adequately measure effectiveness with the patient and community resources?

Practical and highly effective examples of creatively addressing SDOH included the use of Lyft and other ride-share services to help patients get to appointments, hospital-funded housing for the homeless and food-bank partnerships in clinics to fill food prescriptions.

In a later session, Ruben Amarasingham, MD, MBA, President and CEO, Pieces Technology, also expounded the benefits of nursing’s involvement with SDOH. He encouraged attendees to build SDOH networks around repeat emergency department patients as an effective way to reduce hospital admissions and improve community healthcare as a whole.

Virtual Nursing Becomes Reality
One of the day’s final sessions focused on the uses of telemedicine to support nursing care. A panel of nurse executives from Geisinger, Ochsner and Memorial Sloan-Kettering shared their experiences with virtual nursing.

Virtual nursing brings together clinical expertise with telemedicine technology through the use of video monitors, iPads and other systems. The panel shared innovative uses for the technology, including patient follow-ups from Sloan’s outpatient oncology departments, Geisinger’s home medicine program and Ochsner’s community care model.

Nurse Mobility Using Smartphones Is a Winner
In addition to six educational sessions, the symposium included a number of informative posters. Paul Coyne, DNP, MBA, MS, RN, AGPCNP-BC, Senior Director, Clinical Informatics and Advanced Practice Nursing, Hospital for Special Surgery, presented a case study poster regarding the use of smartphones to support clinical communications at his facility—the world’s leading academic medical center focused on musculoskeletal health.

Nurse-physician communication is one of the most difficult challenges on patient care units today. This is especially true for orthopedic surgical patients with complex, multi-stakeholder, post-operative care plans. Using PerfectServe’s clinical communication platform, Coyne’s team achieved:

• 19 percent increase in nurse satisfaction with using mobile devices to document and communicate
• 23 percent increase in nurses’ ability to communicate with prescribers (mostly physicians)

The organization currently has a total of 360 iPhones in use across their nursing staff. Phones are passed from nurse to nurse at shift change and include apps for secure messaging, EHR access, call-bell responses, telephone communications and clinical alarms. The program continues to expand in scope and coverage. According to Coyne, “Even our non-patient care teams, like patient access, are asking to go mobile.”

Sitting among hundreds of nursing professionals at this year’s symposium was informative and inspiring. I look forward to attending HIMSS20 to hear more stories of clinical IT excellence and advancement.

This article was originally published on the Agency Ten22 blog and is republished here with permission.