Health Informatics - Where are the opportunities for nurses?
The following is an excerpt of the NurseTogether.com Community members’ online chat (May 10, 2011) with Dr. Catherine Garner, dean of health sciences and nursing at American Sentinel University.
NT.com: This is going to be a great and informative chat session about a tremendous opportunity for nurses. Today, I am proud to welcome two co-hosts: Dr. Catherine Garner, Dean of Health Professions at American Sentinel University, and Ellen Harper, CNO and VP at Cerner Corporation.
Dr. Garner can offer guidance and information about how to get your MSN in Nursing Informatics. She is here to offer information on how, when, what, and why you should elevate your career. Ellen Harper represents Cerner, an industry leader in health informatics that employs nurses for this career path. She can offer insight on what opportunities are available in the field.
Dr. Garner: Informatics is a growing area as hospitals and physician practices move to electronic medical records and computerization of care delivery systems. Many companies who sell and install this software and hardware hire nurses to do the training of healthcare professionals.
NT.com: What is the correct title for nurses who work in this field? Nurse Informaticians?
Ellen Harper: Yes, that is correct. It is recognized by the ANA.
NT.com member comment: What overall education does an associate nurse need to become certified in health informatics?
Dr. Garner: American Sentinel has a “fast track” program where you take 7 courses from the BSN and, if you make B’s in all courses, you can transfer immediately into the MSN program. You do not earn the bachelors degree. But if you are intent on completing the MSN, this program allows you to move ahead and graduate faster. The Masters in Nursing Informatics at American Sentinel is 36 credits.
The degree is generally required for advanced nursing informatics positions. Informatics Nurses must have strong verbal and communication skills, analytical skills, as well as clinical knowledge and technical proficiency. The American Nurses Credentialing Center (ANCC) offers the Informatics Nurse Board Certification Exam for the RN-BC credential. This credential improves a nurse’s employment and salary potential.
Ellen Harper: After nurses have their RN, they may choose to seek further certification in their specialty area. The American Nurses Credentialing Center (ANCC) offers an Informatics Nursing certification exam.
NT.com: Does someone have to take an entrance exam like the SAT?
Dr. Garner: No, we do not require the SAT.
NT.com member comment: I currently have a dual master’s degree - Nursing Management and HR Management. Would I need the 36 credits?
Dr. Garner: No, just the following informatics courses: Clinical and Administrative Systems, Data Mining, Project and Change Management, Information Security and Privacy, Healthcare Informatics, and a Capstone Project.
NT.com member comment: Are all the classes 100% online?
Dr. Garner: Yes, all are online and do not require clinicals. One year of coursework, with a good set of fundamentals in computer science, programming, and multiple applications will provide the groundwork needed to step into a nursing informatics role. After a few years of informatics work, the next logical step was to take the ANCC Board Certification in Informatics. A master’s degree or certificate in Nursing Informatics, Health Informatics, or related fields will improve salary and job potential.
Ellen Harper: In order to meet the goal of the Meaningful Use Mission, namely to “improve health care quality, efficiency, and patient safety,” it is immediately apparent that active collaboration with nursing, and especially nursing informatics, is required.
NT.com member comment: I have a BSN. What would be required?
Dr. Garner: A 12-course MSN program, which takes about two years if you take one class at a time. Each class is eight weeks in length and designed for working adults.
NT.com member comment: I am currently going for my BSN, a second degree. I have a master’s degree in Library Information Science and a BA in Education. With my background, would informatics be good for me?
Dr. Garner: Many electronic health records have decisions support systems, which link evidence-based literature to the medical record. A library background would be incredibly useful.
NT.com member comment: Are jobs in this field available in all areas of the country?
Ellen Harper: The US Department of Labor estimates 49% job growth in health information and health informatics. Healthcare Informatics was recently named one of the top careers in U.S. News & World Report.
Dr. Garner: Nursing informatics provides excellent salary potential. Here are average salary figures for the most common career titles: Informatics nurse: $80.000/year, nurse analyst: $69,000, and nurse informatics specialist: $66,000.
Income for senior managers can go well into the six figures. A Senior Nursing Informatics Specialist job opening in a major city is currently offering $105,000 to $145,000/year and a Director of Nursing Informatics job is currently offering $90,000 to $140,000/year.
Ellen Harper: Informatics nurses can look forward to a variety of career options in numerous settings. Nurses can have informatics careers as managers or executives, administrators, educators, and consultants.
Dr. Garner: Approximately 70,000 health informatics specialists are needed, according to Don Detmer, the CEO of the American Medical Informatics Association (AMIA), the main professional body relating to health informatics in the U.S.
NT.com member comment: I wasn’t originally thinking of the money, but that’s nice to know.
Dr. Garner: The RN to MSN faculty have all worked as nurses and many continue in active practice, so they can relate to the daily demands and pressures you face in the work environment. All have either master’s degrees or doctoral degrees, and many have additional specialty certifications. Our faculty have published and done research in nursing, so they are quite accomplished. You will find that they come from all over the U.S., and many have worked internationally. They are all committed to teaching.
NT.com member comment: How does one find positions in informatics and how do you get experience?
Dr. Garner: Go to CareerBuilders.com and search “Informatics, Information Systems.” You will find lots of companies like Cerner that have employment listings on their websites. Check out the home page of any big EHR company. Join the ANA CARING organization. There may be federal grant dollars to help with education.
Ellen Harper: While the opportunities are plentiful, nursing informatics is not an entry-level career. RNs who find work in this specialty typically have several years of experience and professional education in both information systems and nursing.
NT.com member comment: After taking the 7 courses do you move into the master’s program and then into the informatics program?
Dr. Garner: Yes, if you make B’s or better in the BSN courses.
NT.com member comment: If there are no clinicals, how do you get experience?
Dr. Garner: You will complete projects at your own or another institution.
Dr. Garner: If you have an EHR where you work, check to see if they need any solution matter experts and offer to volunteer. The informatics division will often take short-term assignments to complete a project. Dip you toe in the water and see if you like it.
NT.com member comment: How easy is it to get into informatics after completing the program?
Ellen Harper: Your foundation in nursing is the launching point to any specialty such as nursing informatics.
NT.com member comment: How long does it take to complete the Associate-to-MSN to the informatics programs, and can you get funding to help with school?
Dr. Garner: About 2.5 to 3 years for the RN to MSN program in informatics. American Sentinel has access to federal financial aid and the American Nurses Informatics Association (ANIA) has a Caring Group that is dedicated to advancing nursing informatics.
NT.com member comment: What DNP areas does your program have?
Dr. Garner: American Sentinel has a two-year DNP in Executive Leadership. Ellen, can you speak to what nurses do at Cerner?
Ellen Harper: We provide our associates with world-class training for their roles, as demonstrated by our high ranking in Training Magazine’s Top 125 for the past five years. You will have the options of learning and professional development opportunities, ranging from healthcare basics for consultants to health informatics training for healthcare professionals and students.
Our focus on core learning principles - relevant, learn by doing, performance-based, just-in-time and real-time – ensures a consistent and high quality of learning.
NT.com member comment: I am currently a clinical informatics nurse and would like to become certified. Do you have certification programs?
Dr. Garner: The American Nurses Credentialing Center (ANCC) offers the Informatics Nurse Board Certification Exam for the RN-BC credential. This credential improves a nurse’s employment and salary potential.
NT.com member comment: Does it require classroom time?
Dr. Garner: The American Sentinel Masters in Nursing Informatics is 2 years, one course at a time, totally online. Check it out on our website: AmericanSentinel.edu.
NT.com member comment: What do nurse informaticians do? What are their roles and responsibilities?
Ellen Harper: We have over 600 nurses that do vastly different jobs depending on the area where they work. Some work in the research and development areas as solution matter experts to design the look and feel of the computer system. Others play a lead role in installing the computer systems or helping the client understand the evidence-based workflows. We look for nurses with strong nursing skills, good communication skills, and an appetite for travel, as they may be traveling a very large percentage of the time.
NT.com member comment: Do you have nurses that work remotely as well as those who travel to the site?
Ellen Harper: Not really. Depending on the position, you will be at corporate headquarters or working at a site.
Dr. Garner: You can look at companies that provide IT support services and can do this remotely at CareerBuilders.com.
Another good educational opportunity is WINI (Weekend Immersion in Nursing Informatics), a nursing informatics continuing education course that travels around the country to provide affordable, in-depth nursing informatics education. Approved by the Maryland Nurses Association, an approved provider of nursing continuing education, WINI focuses on basic competencies in nursing informatics.
Ellen Harper: We push boundaries every day, working to provide solutions that eliminate medical errors, improve outcomes, and increase efficiency in hospitals, clinics, physician offices, and for employers.
Another huge piece of work is the integration of medical devices – solutions like smart medical devices that can talk to each other or clinical and research processes that provide data for new discoveries.
Dr. Garner: Let’s welcome Chris Kowal. Chris, as a working nurse, can you elaborate on why informatics is critical core knowledge and how you used this in your own quality improvement?
Chris Kowal: Everything we do in the ICU, and I imagine in most places in a hospital setting, requires some form of electronic documentation. All that information is stored and retrievable to be able to show how differences in care practices improve patient outcomes or need to be worked on to improve or innovate care.
I have been involved with informatics (informally) in helping to develop a better pain score for ICU patients as well as a falls-prevention program for my hospital. Actually, informatics is a great way to get into nursing research, for those of you interested.
NT.com member comment: I have experience with both Epic and Cerner. Do you know of any government opportunities?
Dr. Garner: Check the VA website.
Ellen Harper: Magnet hospitals are very interested in nursing informatics as well.
NT.com member comment: Is there a designation as far as ED Informatics?
Dr. Garner: Actually, a lot of innovation is happening in the ED in informatics. There is no separate certification.
Chris Kowal: Healthcare relies upon information systems to not only help organize information, but to help guide the outcomes of the future of “caring” through the use of information for quality improvement and real-life reporting of how our care system is working.
NT.com: Is there a variation of “informatics” based on the unit, or is it a universal program that is used by the facility?
Dr. Garner: Good question. We use the term loosely, but it covers everything from electronic medical records to pharmacy systems, labs, critical care monitoring, fetal heart monitoring, and more. Everything we do is now electronic.
Ellen Harper: Change is never easy, but sharing the data with the clinicians where they can see quantifiable proof that their patient outcomes are improving is the help that supports the change.
Chris Kowal: At some point in everyone’s educational career, you will need to have some foundational knowledge of healthcare informatics and how it applies to your particular area of work.
Dr. Garner: It’s a great career choice. It will continue to expand and support the practice of nursing.
NT.com member comment: Is certification needed for director and/or managerial positions in informatics?
Dr. Garner: It is highly suggested for higher pay!
It is clear to me that no aspect of nursing and patient care can remain untouched by the information revolution in process. Still, most nurses remain dubious about the changes or feel unprepared. Many struggle with whether IT is just another thing to learn or something much more profound. It will take nurses well versed in the power of technology to help our frontline nurses view computers and new ways of doing things not as troublesome, but as activities that add value to their already heavy workloads.
Chris Kowal: It is actually more than that. Through Ellen’s eyes, there is a bigger picture: how to run a hospital, organize a healthcare system, regulate the quality of care across a nation, create better public access, etc.
Dr. Garner: In order to sit for the ANCC exam, one must have his or her BSN, RN, have worked as a nurse for two years, and have practiced at least 2,000 hours over the past three years in nursing informatics.
The ANCC Informatics Nursing certification exam is computer-based and contains 150 multiple-choice questions. There is a four-hour time limit given on this exam, and it is offered at training centers across the U.S. Those who pass this exam are able to put RN-BC (board certified) after their name since they specialize in an area (nursing informatics).
In addition to the ANCC certification, the Healthcare Information and Management Systems Society (HIMSS) also offers a Certified Professional in Healthcare Information and Management Systems (CPHIMS) certification. This certification has more of a project management/IT emphasis whereas the ANCC test focuses specifically on nursing informatics and how that relates to nursing in general. Most people choose the certification that best matches the area they work under. If they are in an IT department, they tend to prefer the CPHIMS certification. If they work under Clinical Informatics directorship, they may prefer the ANCC certification. Also, the CPHIMS exam is open to all healthcare IT professionals, including the CIO, programmers, informatics specialists, and consultants.
Chris Kowal: My perspective comes from the bedside level. You have to remember that up until a few years ago, I knew nothing more about informatics except it was a fancy word that meant “charting.” Now I know better.
NT.com: As this field grows, are employers like Cerner clustered in one area of the country due to the talent pool/resources in the area?
NT.com member comment: Doesn’t Cerner have an office in Atlanta?
Ellen Harper: Cerner has hospitals in Atlanta, corporate offices in Kansas City, MO, and international offices in London, Dubai, Australia, etc.
Dr. Garner: Travel anyone?
Chris Kowal: The world is your oyster within the realm of informatics and healthcare. You can use it to survey the land as well as level the terrain!
NT.com: What an exciting opportunity to marry your clinical skills with technology!
Chris Kowal: It think these are the keys to this discussion: continuous education and support. Resources are important when working in informatics as with any other area of healthcare.
NT.com member comment: After completing American Sentinel’s MSN in Informatics program, will it be difficult to find a position?
Dr. Garner: You have to be creative and research the market. Create your own job description and sell yourself. Nursing informatics career opportunities are available in hospitals and other healthcare providers, public health organizations, research labs, medical software companies, insurance agencies, pharmaceutical companies, and educational institutions.
Ellen Harper: Education is so important as we can no longer automate poor workflows. You need the fundamentals of data and structure, decision support, and data abstraction.
NT.com member comment: Would you say people in informatics get the experience and then the degree?
Dr. Garner: Most get exposed in the workplace first, but to really specialize, you need more IT education. A BSN is certainly a great foundation, but you will need additional education either from great academic institutions like American Sentinel University or on-the-job training.
