Q&A: HCA Healthcare CNIO shares how nursing informatics improves patient care

As vice president and chief nursing informatics officer (CNIO) for HCA Healthcare, Sherri Hess uses her experience as both a nurse and technologist to improve patient care. Her career spans almost 40 years in healthcare, working to reengineer how care is delivered so technology supports better outcomes for patients — and transforms the care delivery experience for nurses and clinicians.

Beginning her career as a registered nurse in the neonatal intensive care unit (NICU), Sherri learned early how technology can improve healthcare. Her inspiration to marry nursing with technology led her to build several nursing informatics programs within the healthcare industry, and her focus on sharing best practices makes her a sought-after thought leader as well as a policy advisor to Congressional leaders.

At HCA Healthcare, she is paving the way for the future of nursing informatics at one of the nation’s leading healthcare providers. Below she shares her perspective on why nurses and nurse informaticists must be at the heart of healthcare in order for the industry to evolve.

Can you briefly describe the field of nursing informatics?

The American Nurses Association (ANA) defines nursing informatics as “the integration of nursing science, computer science and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.”

In simpler terms, nurse informaticists are translators between care and technology. Nursing informatics (NI) is a field often pursued by registered nurses with nursing degrees as well as technical training/degrees, who bring together the two fields into one. NI is recognized as a specialty practice by the American Nurses Credentialing Center (ANCC), which offers the opportunity for certification.

Nurse informaticists create systems that support clinical workflows and decision making around documentation, communication and patient care. For many years, the focus for NI was electronic health record (EHR) implementation and over the years, the focus has shifted to innovating with technology and utilizing data to improve workflow efficiency.

Nursing informatics specialists are trilingual.

1. They understand the clinical language of efficient patient care.
2. They translate knowledge and clinician feedback into the technical language of business analysts and programmers.
3. They communicate clinical and technical matters with administrative leadership.

It’s challenging to speak effectively with clinical, technical and administrative leaders at the same time. Nurse informaticists are uniquely qualified to do this, and have proven to be indispensable to the development of superior healthcare IT systems.

Q: How is nursing informatics integral to care delivery across the healthcare industry today?

Nursing requires clinical knowledge, compassion, stress tolerance and time management while also being physically and emotionally demanding. These factors, combined with the nursing shortage and the fact that healthcare is behind other industries in technology adoption, create an optimal environment to support nurse workflow with technology.

The field of nursing informatics does just that. It aligns people, processes and technology to build evidence-based IT systems that support efficient, effective nursing care. This directly correlates with improved patient satisfaction.

Nurse informaticists are healthcare leaders for the 21st century. We merge education, nursing practice, IT and leadership skills to create partnerships among leadership, clinicians, data scientists, information technologists and more. We move health information technology from arduous implementation to ubiquitous practice; from data management to decision support.

Q: What are a few key initiatives you are leading that exemplify how HCA Healthcare is leveraging nursing informatics to improve care delivery and experience for nurses, care teams and patients?

At HCA Healthcare, we have an ideal setting to leverage nursing informatics. As one of the nation’s leading healthcare providers, we have more than 99,000 nurses providing care to patients across the country every day. We learn and evolve from every one of those patient encounters, using data from care to inform and improve future care. The privilege of our scale allows us to respond, measure, learn and evolve at speed…and our nurses, care teams and patients benefit.

A few key initiatives at HCA Healthcare include:

• We’ve made a large investment in mobility, with more than a hundred thousand iPhones in the hands of our clinicians. It’s changed the way we communicate and collaborate in support of patient care and the colleague experience. When you think about generative AI and other new technologies, that mobility platform is critical for delivering them.
  • We provide each RN and care team member with a smart phone to support quick communication and find other care team members. We send critical alerts directly to phones to bypass overhead paging. This allows patient calls to go directly to clinicians, saving time and bypassing the nursing station. We offer the ability to review patient charts and documents on the phone
  • This also provides the ability to take pictures of patient wounds that populate in the medical record, saving time in documentation.
• With ambient voice technology on the horizon, we now can imagine a time where a nurse can speak about what they need to document while they are completing it. Currently, the nurse has to go to the computer and enter the information, which takes approximately 30% of their time.
• With virtual nursing, we’re employing highly tenured virtual nurses to help reduce the administrative burden of bedside nurses. They’re helping with admission assessments, medication history, discharge planning and much more. This is only the beginning of the ability to use telehealth technology, and early results show that our nurses and patients are extremely pleased with it.

Related article: How virtual nursing is increasing nurse satisfaction and transforming patient care

Q: How does our nursing informatics agenda tie into our larger HCA Healthcare technology strategy?

We have a senior leadership team that is technologically savvy and understands the importance of developing technologies to address challenges nurses tell us they are experiencing. It’s a continual conversation. We discuss what we want to do from an operational perspective and the related technology needs in the same context.

Nursing informatics works as partners with many departments, which includes our Information Technology Group (ITG) and Care Transformation and Innovation (CT&I) teams. Nurse informaticists are a part of the interdisciplinary team for all technology projects that affect our clinicians and patients.

Together, we are all focused on delivering technology solutions that support optimal outcomes, efficient care delivery and increased time at the bedside. We do more than deliver a solution to meet a need. We are grounded in the reality of nursing challenges and developing solutions to meet them. Always in collaboration with nurses.

Q: What is on the horizon for the field of nursing informatics in the next five years that will help drive care innovation?

This is an exciting time in healthcare technology. I foresee the ability for nurses to voice their documentation as opposed to logging onto the computer. And not just nurses, but the entire care team. That will be a significant workflow improvement that enhances patient care and caregiver experience.

Other initiatives we are exploring include:

• Advancements in the integration of real-time patient information from medical equipment into EHRs
• Expansion of virtual care solutions to support other healthcare disciplines
• Enhancements to patient monitoring not only in hospitals but also at home
• Use of data analytics to provide meaningful insights that help nurses make data-driven decisions and identify trends in healthcare delivery
• Growth in mobile apps for clinical staff to support better patient engagement and monitoring

Technology will not replace the care of a nurse or the expertise of a physician, but providing real-time decision-making support and reducing administrative burden can strengthen the critical work that humans do. We are drowning in data — and we need data and technology that is helpful to a nurse’s workflow.

Nursing informatics brings high-level creativity to applying technology in a way that improves care and experiences for patients and clinicians. We work with stakeholders at all levels to create solutions together that not only solve existing industry challenges, but create a better healthcare system for the future.