Nursing Informatics and Healthcare Policy


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  • I am delighted that each of you are here today and are attending the 2011 ANIA-Caring Conference- Nursing Informatics Blazing the HIT Trail. I believe the word blazing represents the fire that should be sustained in each of us as we pave and lead the way through one of the most exciting eras in informatics. Thank you Kathleen for that warm welcome , introduction., and inspiring history of nursing informatics related to the shaping of public policy. I am so proud to be a nurse and to be specialized in nursing informatics . As nursing informaticians we are strong, powerful assets to our organizations and policy actions. Thank you to the ANIA CARING conference planning committee for allowing us to be here today and all of your endeavors to promote and sustain nursing informatics. It is certainly an exciting time for nursing and nursing informatics!
  • By attending this workshop you have taking advantage of hearing from some of the most industrious knowledge players in nursing informatics in an extreme format. I am privileged to be here today speaking with these amazing women representing the best in nursing informatics.
  • This morning we are going to discuss nursing informatics and healthcare policy, We are going to build a foundation, connect the dots, and strengths and weaknesses. It is my role today to provide the foundational information as Kathleen, Judy, and Joyce dive into the details of 3 critical areas where nursing informatitions are having a tremendous impact. Your collective critical thinking about will help chart our future direction. My disclaimer-my beliefs are mine. Again, thank you for this opportunity. We hope that you will active participants with us today, and help blaze the trail.
  • As we dive into foundation components let me share with you a statement from the Jim Collins book, good to great. I use this often in my consulting practice. Basically Jim is saying that we are good at what we do, but we can be great. I use it to level the playing field, to say we are good at what we do, but we can do better. We can be great, but it is going to take us retaining absolute faith at we are going to be great. It is going to take us confronting the most brutal facts of the way things really are today. To get there. So let’s BLAZE THE PATH. Our stake in the ground Faith=Action=Results= Greatness
  • So now that I have provided a stake in the ground as to our critical thinking during this workshop. Now let’s get into the details. The Who, What, What Where, How of nursing informatics shaping public policy. Ultimately, the chapter provides a case to be made for the expanding skills required for nursing informatics to educate, advocate and collaborate with those outside of nursing. In 2010 during the IOM’s Forum on the Future of Nursing, Mary C. Selecky noted “public health cannot be separated from politics. If we believe that Selecy has made a valid point and that nurses are at the forefront to improving public health then I believe we “owe it to society” to be “masters’ at politics. Navigating politics is not often a priority for nurses or in our comforrt zone. As nurses do we sometime shy away from the politics of a situation? Is it that we do not feel powerful, Is it that we do not have the power? Is it that we do not enjoy the debate, or that we do not have the abilities to be a key player.. On the more positive note nurses have led several initiatives throughout the United States and beyond that today are recognized as unquestionable policy successes. These initiatives include vaccination campaigns, AIDS prevention and awareness, infection control and disaster response mobilization. The increasing role nurses in the creation and execution of public policy cannot be overlooked.
  • It is especially critical for the NI community to understand public health care policy. This will not happen by chance; carefully crafted strategy and collaboration needs to occur now! The 18 th chapter examined the critical pathways to public health care policy, public health pollicy, and NI policy and an analysis of the skills informaticists must possess in order to effectively communicate with policy makers and those in positions to sway policy makers. use this graphic to show the relationship between, policy, healthcare policy, nursing, and nursing informatics. In the GOAL circle we are going to identify the target nursing informaticians As nursing informaticist our unique skills are required to shape policy. We have an indisputable responsibility to advocate, engage stakeholders, lead and collaborate with others, including those outside the discipline of nursing, to develop and implement policy solutions. Ok our definitions the WHAT
  • In the chapter three domains of policy are described: Public healthcare policy, public health policy, and healthcare/nursing informatics policy. Public policy helps determine standards of care, data metrics, as well as care of documentation processes. An example of public health policy can be described from the perspective of supporting the growth and staffing to conduct epidemiology and prevention in public health. Public healthcare policy also guides equipment features, functionality and systems selection. It is described from the perspective of those national organizations and structures that work on the health care reform bills, Medicare and Medicaid reimbursement, provider shortages, and professional education. Healthcare and nursing informatics policy will be developed from the perspectives of the organizations and missions supporting Healthcare Informatics Policy. Future of Nursing, National Quality Strategy, Accountable Care Organizations, Care Delivery Systems, Public Health, Data Interpretation, Workforce, HIN, Standards, Outcomes, MU, IT Certifications, CMS, Health Reform, Security, Privacy, Measurements, Bioinformatics, Epidemiology, E-Prescribing, Clinical Trials Nursing Models, Care Delivery, Workforce Issues. HIE
  • Vast Footprint
  • The public policy is complex, with diverse agendas, perspectives, and obstracles that require strategic management. Policy changes can occur on the micro or macro levels. On the micro-level, changes transpire within an organization(operational or process) or within the construct of a clinical system. Public healthcare policy occurs on the macro level, where there ‘s greater diversification of stakeholders and where policies have far greater range and impact. This is complex, I draw this to the analogy of a spider web.
  • A Web of Problems or a web of solutions. It is critical for nursing informatics to understand public healthcare policy drivers and how to deliver a unified message to those who create pubilc healthcare policy. This will not happen by chance; carefully crafted strategy and collaboration that is occurring Needs to be moved from good to great.
  • ARRA HITECH Meaningful Use Quality Interoperability Judy Warren on NCVHS Joyce Sensmeier leading HIMSS NI and ANI, Judy Murphy on ONC committee Connie Delaney on ONC commttee and Nursing Minimum Data Set Charlotte Weaver leading home care policy Kathleen McCormick leading AMIA NI Guideposts, Establishing AHRQ Evidence/Guideline Policy Virginia Saba leading Terminology and Public Health Policies Carol Gassert shaping educational policies at HRSA Diane Skiba shaping education policies at NLN (not a nurse) Sue Newbold establishing regional networks of policy and Caring Dana Alexander leading the charge for AMIA policy Angela McBride working form the IOM to advance nursing informatics policy Patricia Grady incorporating Nursing Informatics into NINR/NIH policy Carol Bickford shaping policies and standards for Nursing Informatics Practice at ANA Rita Zielstorff for consumer empowerment Judy Walker - first nurse on NCVS standards committee Many more pioneers - see below     You also might want to look at the Pioneers and read the biographies to see their impact on policies.
  • And how about the nurses that have served in Congress- Lois Capps (D-CA_, Eddie Bernice Johnson( D-TX), and Carolyn McCarthy (D-NY). Or Ellen Marie Whelan RN PhD, who was assigned ot the office of Senator Tom Daschle(D-SD). After a year on capitol hill, Wheelan joined the staff of Senator Barbara A. Mikulski (D-MD) as staff director on retirement and aging.. She contributed to the passage of a bill reauthorizing funds for breast and cervical cancer screening and helped shaped legislation reauthorizing the Food and Drug administration. And others…. Lillian Rivera RN, MSN and Ann Neasman, RN, MS that led the way for the formation of the Miami Dade County Health Department on a quality improvement journey that is widely admired. And Susan Cooper, MSN, RN in 2007 was the first nurse to serve as commissioner of the Tennessee Health Department. And Jeanette Wrona Klemcsak, RN, BSN, MSN, one of the first state CNEs. In this role she had direct access to the governor, her own health policy advisors, and others in business that can support nursing’s agenda. These are just a few of the reasons why we should be involved. Healthcare Informatics Policy Will Fail Healthcare Policy Will Fail
  • These organizations work to impact policy. By accepting recommendations from informatics nurse leadership, professional organizations like AMIS actually legitimize the leadership’s claim. These organizations like of their professional organizations as well as professional lobbyists' to promote the causes of nursing informatics and effective care delivery. Some are, by charter, lobbyists themselves, like AMIA which states: AMIA is committed to building to building better and greater awareness and federal government investment in biomedical and health informatics education, practice, and research. HIMSS has a national advocacy office and is very active with planned events and well orchestrated policy impact plan.
  • So far we have discussed our rich history, the foundational descriptions of public, healthcare policy, We have outlined a very complex polcy development process and outlined why and how nursing informaticians need to be engaged. We have looked a numerous organizations and associations that lobby for determined policy decisions. We have looked at mapping the public policy process to how and where nurses need to be involved. but we have not really discuss engagement, influence, versus being a decision maker. I believe that our ultimate goal are seats at the decision making table.
  • I use this graphic to show the relationship between, policy, healthcare policy, nursing, and nursing informatics. In the GOAL circle we are going to identify the target nursing informaticians As nursing informaticist our unnique skills are required We have an indisputable responsibility to advocate, engage stakeholders, lead and collaborate with others, including those outside the discipline of nursing, to develop and implement policy solutions.
  • In development of the chapter content, I reached out to several individuals with the purpose of interviewing them to have a front line take on what is needed to for nurses to be involved in policy and our obstacles. Susan Begeny at the American Association of the Colleges of Nursing was so helpful, and an intelligent, educated, articulate wealth of information. One take away from her interview was no surprise to me. Suzanne stated that …….……………… This is to the core to our place at the decision making table. Financial means Act as the impetus for the message Orchestrate support Prepare our leaders for the political stage ======nursing informatics will gain the recognition necessary to be taken seriously.
  • So I am going to summaries my foundational remarks by saying …….Judy, Kathleen, Joyce are going to dive deep into I will follow by……..
  • Nurses have always been patient advocates; it’s our duty to care for the patient. We are attentive. Loving, skilled, and patient-masters of the healthcare consumer domain. The formation of good public health policy relies on quality, unbiased, substantial data as well as those who provide care within the healthcare environment. We need to lead the charge and engage leadership on every necessary level to ensure that public policy supports nursing informatic’s initiatives. In chapter 18, I explain how nursing informatitions at all levels impact public policy. And provide an oveview of how education for nurses is changing to focus on technology, and a case for expanding this focus to the skills required for NI community to educate, advocate, and collaborate with those outside of nursing.
  • We need to be strategic, enthusiastic decision making players in the policy activities. We need to enthusiastic embrace the spiders web and connecting the dots. We need to have face time with our reprsentatives!
  • So in conclusion, the need for nursing to step up to the plate and lead in the area of policy will not go away. Inevitably, we will continue to foray into policy. Nursing informatics will often be required to navigate hospital and pubilc policy, as well as, informaticists will be be responsbile for ensuring that data is available for public reporting metrics, and will be expected to be communicate policy requirements to vendors and nursing colleagues. To get us where we need to be nursing informatics education must include communication, relationship-building, an understanding of shared values, judgement, collaboration, leadership, and strategic thinking, IOM 2010. I believe that the generated debate and critical thinking outcomes are essential to effective public policy development and execution. I believe our education and work experiences as care providers working within the technological limits available have well positioned us to lead the way.
  • Nursing Informatics and Healthcare Policy

    1. 1. Nursing Informatics and Healthcare Policy Pre-Conference Workshop 25 Years of Nursing Informatics Policy:A Pathway to Public Healthcare, Public, and Informatics Policy Amy Walker MS, RN, CPHQ, FACHE, NEA-BC CEO Optimize IT Consulting Member HIMSS Public Policy Committee
    2. 2. Thought Leaders That You Will Hear From Today• Kathleen McCormick, Vice President SAIC-F• Judy Murphy, Vice President, Information Technology, Aurora Health Care• Joyce Sensmeier, HIMSS Vice President, Informatics• Amy Walker, CEO and Healthcare IT Strategist, Optimize IT Consulting
    3. 3. Amy’s Poll-Does Policy Have a…• Direct correlation to how you practice nursing?• Direct correlation to your salary?• Direct correlation to the type of individual that selects nursing as a career? or stays in nursing?• Direct correlation to the education level of the nurse working with you?• Direct correlation to the behavior of your organizational leadership?• Direct correlation to clinical decision making ability?• Direct correlation to your safety on the job?• Direct correlation if your patient lives or dies?• Direct correlation to your power as a nursing informaticists? 3
    4. 4. Amy Walker MS, RN, CPHQ, FACHE, NEA-BC.  Healthcare System  Critical Care RN, Certified  Nurse Manager/Nursing Supervisor  Nursing Management Leadership Award  Director of Informatics, CIO Boot Camp-CHIME  Chief Clinical Information Officer (CCIO)  MS in Nursing Informatics and Administration University of MD at Baltimore  Technology Provider-Large Scale  Development, Implementation  Strategic Account Management  Consulting  DoD Health Affairs  Entrepreneur  Fellow in the American College of Healthcare Executives  Certified as a Healthcare Quality Professional  Certified as an Advanced Nurse Executive  2010 President of the National Capital of Healthcare Executives  Nominated Member of the Women’s Business Leader’s of the U.S. Healthcare Industry Foundation 4
    5. 5. Retain absolute faith that you can and will prevail in the end, regardless of the difficulties, and at the same time confront the most brutal facts of your current reality, whatever they might be. (Jim Collins Good to Great)
    6. 6. What We Will Cover
    7. 7. • …health policy is a course of action that influences health care decisions (• Public policy refers to policy that is generated by governmental agencies and enacted through legislation. Public policy is made on behalf of the public and is influenced by factors such as economics, social issues, research, and technology.• Health policy influences decisions about the health of a society.• Similar to public policy, health policy is also influenced by factors such as health status of the citizenry, research, and economics. (New Jersey Collaborating Center for Nursing)
    8. 8. • Policy occurs at the Organizational, State, and Federal levels – On average 7 to 8 years for legislation to pass if it is not on the national agenda. – Some bills based on the national agenda are never reported out of committee – Nurses must understand the politics and policy!
    9. 9. Creating The (simplified) Sent to highest ranking official (President or Governor)
    10. 10. TheGoals
    11. 11. Should We Be Involved• Expertise in our field, we have the vision• Insight into where advancements can be made• Identify the areas that are not improving• Maximize the return on information management and information technology• Wisdom and foresight to see looming threats and react proactively• Critical players in the strategic planning process within our organizations 13
    12. 12. 25 Years of Nursing Informatics Policy Walker, A, Essentials of Nursing Informatics 5e 14
    13. 13. Federal Level Briefs.aspx 15
    14. 14. Federal Level 16
    15. 15. State Level 17
    16. 16. Organizational Level 18
    17. 17. Organizational Level 19
    18. 18. What are the Goals? Respected, Visible Presence the Decision Making Table Retain absolute faith that you can and will prevail in the end, regardless of the difficulties, AND at the same time
    19. 19. According to Suzanne Begeny, Director of Government Affairs at the American Association of the Colleges of Nursing “In order to effectively shape public policy, nurses need to realize that it takes a significant financial investment to compete on the national level. In addition to money, nurses must act as the impetus for the message, orchestrate support and prepare our leaders for the political stage.” In this way, nursing informatics issues will gain the recognition necessary to be taken seriously as healthcare reform progresses.
    20. 20. The American Association of Colleges of Nursing (AACN)Is the national voice for Americas baccalaureate- and higher-degree nursing education programs. AACNs educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelors- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate education, research, and practice in nursing— the nations largest health care profession• 23
    21. 21. SWOT-Analysis
    22. 22. Nursing Informatics and Healthcare Policy Pre-Conference Workshop Strategies to Exercise Our Power, Communicate, Educate, and Support Policy Decision Making The Power of Nursing Informatics
    23. 23. Strategies That Promote Our Place at the Table• Define Assumptions to Promote Our Leadership• Put a Stake in the Ground • 8 Rights of NI to Shape Public Policy• Arm Our Leaders and Evaluate Their Performance• Take Stock: How are We Doing• Path Forward
    24. 24. Assumptions That Promote Our Place at the Table• We will advocate for ourselves within policy groups to ensure they are advocating for nursing• We will be clear and transparent on the progress we are making, and where our efforts fall short of the intended goal• We will sure that the policy groups we support are strategic and that nursing has and takes advantage of a seat at the decision making table• We will be sure that our leadership executes on the defined strategy
    25. 25. 8 Rights of NI to Shape Policy• Right to Lead• Right to Question• Right to a Place at the Decision-Making Table• Right to be Recognized as an Expert Strategist• Right to Have the Financial Means to Offer Support• Right to Share our Knowledge• Right to Argue our Case• Right to be Part of the Solution
    26. 26. Policy Activities• Participation in Taskforces and Workgroups• Attendance at Conferences and Summits• Creation of Whitepapers• Lobbying and Support of Lobbying Efforts• Membership in Relevant Organizations• Acting as an Expert Witness• Leading Selection Committees• Fund Raising
    27. 27. Alliance for Nursing Informatics 30
    28. 28. Women In Government view=&srchtype=discussedNews&gid=128644&i tem=48583701&type=member&trk=eml- anet_dig-b_pd-ttl-cn 31
    29. 29. In Summary Take Our Place at the Table as Strategists Serve as Leaders Be Excellent Communicators Engage Stakeholders Be Bold Exert Our Powerful Influence Move from the “Invisible to the Visible”
    30. 30. Thank you!For more information, please