Health IT needs more nurses: 6 questions with nurse informaticist Whende Carroll

Whende Carroll, MSN, RN-BC, got into nurse informatics 15 years ago at CHI Franciscan's Highline Medical Center in Burien, Wash., but it wasn't until recently she realized healthcare needs more nurses — who represent the largest group of the healthcare workforce — involved in technology and innovation.

"About three years ago, it really hit me how nurses at a fundamental level really don't understand their role in using technology, data and innovation strategies to be able to create new workflows, devices, gadgets and new models of caring in their workplaces," she told Becker's in an interview. This spurred her to launch Nurse Evolution, which functions as a community for nurses who want to improve the use of technology and data analytics in nursing, and in turn use this knowledge to enhance community health and the patient experience.

Becker's caught up with Ms. Carroll to discuss how hospital leaders and nurses themselves can get more involved in healthcare technology.

Editor's Note: Responses have been lightly edited for length and clarity.

Question: What do you feel is the biggest opportunity for nurses right now when it comes to improving their use of technology and data?

Whende Carroll: Nurses are inundated with a lot of data, charts and numbers that they are given every day for quality improvement purposes. There is so much of it. Leadership also gives them performance data, but they don't always understand what they can do with it and how it serves the quadruple aim: to manage populations, control healthcare costs, improve patient satisfaction and improve their own wellbeing while in the workplace, no matter what their care setting environment is.

Q: What are some things nurses could do today to improve their use of data?

WC: They can begin to study what data is — there are lot of opportunities through different organizations and continuing education. They can begin to learn about what data is on a foundational level and start to learn about big data and how data feeds larger ecosystems. Educating themselves on what data is, how it comes from technology, and how it can be used in innovation strategies can help nurses create what's next. Nursing leadership needs to understand how to be able to foster environments for nurses to innovate, teach their teams and really create that innovation culture in different healthcare settings.   

Q: How can hospitals and nurse leaders encourage innovation among nurses? Is there any way to create that culture?

WC: One of the opportunities that nurse leaders have is to be able to inspire engaging, playful environments within their teams. They need to spend time working to create a spirit of play in their work environment. That's something you see a lot in startup environments, but not necessarily in healthcare organizations. One thing that was really cool at HIMSS this year was the nurse pitch. That was a cool venue to give nurses the opportunity to stand up and say, 'I've got this great idea,' and have it actually be funded and move forward in that Shark Tank kind of way. There were some great ideas, and it's just a drop in the bucket of what nurses really create and can do. Nurses have such great ideas. There's a lot of opportunity, and they don’t know necessarily how to bring it to leadership.

Q: Is there anything you feel is misunderstood about nurses and technology?

WC: One area I think nurse leaders don’t completely appreciate is the role of the nurse informaticist and why organizations need them. When you think of classic nurse informatics, it's really been a department or group of nurses who are from the front lines but are super users of technology. They come together, usually for an EHR implementation, but then we often see those groups get disbanded. This is because leadership may not feel like they still need those roles, when in fact they do.

Nurse informaticists speak technology and clinicians speak medicine. You must have that liaison who can speak both languages and manage things like reporting and the full life cycle of an implementation. Part of that life cycle is what happens after the implementation. How do you continue to sustain those systems to help with things like downtime, and any issues or suggested improvements that come up? They can also be ongoing, at-the-elbow support for clinicians — nurses and doctors — on how to use specific technologies. It may not be EHRs; it may be devices; it might be telehealth. They can introduce and be champions of newer technologies we're seeing, advanced analytics and AI. Nurse informaticists can really be the ones to adopt, apply and influence others to embrace and apply those technologies. 

Q: The health IT industry is all about AI right now. What areas of healthcare do you feel will benefit most from AI applications? On the flipside of that, is there anywhere where AI is inappropriate?

WC: We are going to benefit from AI in two places: actual care we give and administrative processes.

In the care we give, some examples of applications are being able to predict diagnoses, patient deterioration and chronic disease progression so you can put population health management and precision medicine programs into place. And then you have your administrative side, where AI can help with staffing and bed management within an organization. On the administrative side, you've also got revenue cycle, finance and supply chain. Smart suggestion and recommendation engines can put those [tools] in place.

As for places where it's not appropriate, what comes to mind is more making sure you have the right use cases for AI. It can help if we have clinicians and nurses who are thinking of these great ideas, and we have startups and incubators and those divergent collaborations that are happening. You want to make sure you are starting with those really high-value use cases. I think we have to focus on the most critical and at-risk populations.     

Q: Is there anything else you would like to add?

WC: Beyond AI, there are also so many other types of emerging technologies being used right now, including virtual reality, the Internet of Things, and even blockchain is really emerging. We need to begin to really involve nurses in healthcare organizations and health IT vendor companies to begin to use their experience to put these new technologies in place. We are seeing some of that now, but we are going to see it even more in the future. And when it comes to involving nurses in it — I can't be more of a champion for that.


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