EHR Integration and Meaningful Use: A Nursing Perspective

This is Part Two of a two-part series. Part One covered the basics of the HITECH Act, explained the goals of Meaningful Use, and gave an overview of the timeline for phasing in Meaningful Use requirements.


As we saw in Part One of this series, a lot has to happen before all providers and hospitals have fully implemented their EHRs and are making meaningful use of them. At the very least, nurses should recognize that big changes are just ahead. It’s likely they’ll experience some frustration at the bedside as imperfect implementations are rolled out.

For example, according to a study published in the September 2012 issue of the Journal of American Medical Informatics Association (JAMIA), CPOE requirement is more challenging than any of the other criteria. As e-prescribing is adopted in stages, what will the affect be on nurses? Will they have to keep track of both paper orders and digital orders, on two different systems, until the entire transition is made to the electronic system? Will orders be more likely to get lost in the system, or duplicated in two forms, during the transitional phase? What safeguards will nurses have to put in place to detect these transitional errors?

When questions like this arise, it becomes clear that nurses, as frontline caregivers, must collaborate with IT departments to keep patients safe and meet the goals of meaningful use. Fortunately, hospital administrators are beginning to realize this.

Due to the influential roles that nurses play in patient outcomes and patient satisfaction scores, hospitals are creating key positions for nurses who will contribute to the IT decision-making process as electronic records are implemented. These nurse informaticians will act as liaisons between clinicians and the IT department, helping to optimize workflows, train bedside nurses in EMR use, and help the IT staff understand technology’s impact on patients. In addition, many hospitals are creating a brand new position known as chief nursing information officer (CNIO). So this is another important way in which meaningful use is affecting nurses – it is creating expanded career opportunities for tech-savvy nurses, including the opportunity to move into executive leadership.

The EHR Translates into Career Opportunities

One of the main objectives of the HITECH act was to create jobs, even as it fostered the development of a first-class health information infrastructure. And the frenzy to hire qualified informatics specialists has already begun.

A recent survey by the Hay Group found that 96 percent of respondents had started to create new IT positions and structure new departments, in response to HITECH requirements. Yet interestingly enough, the same survey found that newly formed, full-time, clinical informatics positions are surprisingly difficult to fill. In fact, 47 percent of health care organizations that participated in the survey said they had challenges with recruitment, retention, or both. This indicates that the field is wide open to qualified individuals and that job security will remain strong.

For nurses looking to specialize, informatics is a career choice that can put them ahead of the curve in terms of this astounding growth, because their clinical background brings crucial strengths to the field. The Agency for Healthcare Quality and Research reports that the industry is in need of nurses who can analyze technologies from both the bedside and IT perspectives.

As hospitals face the daunting task of implementing electronic records, nurse informaticians will be called upon to use nursing-based knowledge to:

  • Manage the transition from paper to digital records in ways that keep patients safe from error.
  • Design information systems that are optimized to reflect current, evidence-based standards of nursing care.
  • Contribute to initiatives that shape local and federal policy regarding health care IT.
  • Develop and implement technological tools outside the realm of the EHR, including disease registries, home care management systems, remote patient monitoring, quality tracking and reporting systems, etc.


Take the first step: become a super-user

The people with a lot of experience in implementing new technologies place a lot of emphasis on identifying what they call a “super-user” – oftentimes a nurse who is naturally tech-savvy, enthusiastic about new tech roll-outs, and well regarded by other staff members. Super-users help to translate technology into good clinical practice by participating in testing, designing, and training. Are you interested in standing out as a leader by becoming a super-user? Some specific activities you might volunteer for include performing trial runs with  potential hardware solutions (laptops, tablets, mobile carts) and giving input; becoming trained on the new system early in the process; and helping to redesign nursing workflow processes to accommodate the new technologies. If you show a lot of aptitude and enjoy the work, you may be asked to help roll-out the new system in other areas of the hospital, or even to help customize order sets within the system.

You may find that becoming a super-user opens the door to a new career specialty in informatics. At some point, online MSN degree in nursing informatics might even become right for you. American Sentinel University is an innovative, accredited provider of online nursing degrees that can help you improve your knowledge, skills, and value to your organization.