'Meaningful Use' Could Boost Role of CNIO in Health Care

The chief nursing informatics officer (CNIO) is poised to play a key role in bridging clinical care with health care IT systems.

As the health care industry looks to adopt electronic health records (EHRs) and take advantage of 'meaningful-use' incentives, one position often overlooked but growing in importance is the chief nursing informatics officer (CNIO).

The CNIO helps to bridge the role of clinicians and the implementation of health care IT systems, Toni Hebda, a professor in the nursing informatics master's program at the Chamberlain College of Nursing, in Downers Grove, Ill., told eWEEK.

With the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act providing incentives for meaningful use of EHRs, the CNIO is charged with making sure hospitals are prepared to satisfy the federal government's mandate, said Hebda.

Clinical informatics involves a combination of clinical tasks with health care IT systems as well as financial reporting and collaborative data sharing. A March 2 report by PwC's U.S. Health Research Institute found that health care organizations consider clinical informatics key to boosting patient care.

While doctors' needs are often considered in health care IT, a primary role for CNIOs is to manage the workflow requirements of nurses, Mary Beth Mitchell, CNIO at Texas Health Resources, told Healthcare IT News.

In Hebda's view, "the CNIO helps to ensure that systems are better designed for how clinicians work."

Like clinical informatics, nursing informatics combines the work of clinicians with technology. Clinical informatics might not involve analysis of radiology or lab reports, however, said Hebda.

"In the past, nursing informatics was somewhat overlooked," she said. "We still have people that don't know what it is, but we are gaining in terms of visibility."

A foundation called the Technology Informatics Guiding Education Reform (TIGER) Initiative exists to encourage use of informatics to make health care safer and more effective.

Hospitals and academic medical centers are adopting the CNIO position according to a recent presentation by Linda Hodges, senior vice president and leader of executive search firm Witt/Kieffer's Information Technology Practice, and Chris Wierz, service line executive, Encore Health Resources, at the Health Information and Management Systems Society's conference (HIMSS12) in February.

Still, growth of the CNIO role is slow, a recent study called "Emerging Role of the CNIO" by Witt/Kieffer revealed. The study found that only 17 percent of health care organizations plan to hire a CNIO in the next 12-24 months.

"Originally if you had a health care professional designated as informatics officer, it was usually a physician, which is no surprise because of the political clout, but in terms of numbers, nurses are the predominant health care group most closely aligned with what's going on with the patient and the use of the clinical information systems," said Hebda.

According to the PwC report, 58 percent of health care organizations surveyed had a chief medical informatics officer (typically a doctor) while 58 percent had nurse informaticists and 13 percent had CNIOs.

Though growth in the position is slow, the CNIO is increasingly taking on a critical role in health care now because physicians were in the past hesitant to spend the time to learn the information systems, said Hebda.

In addition, 57 percent of health care organizations said that outlining a nursing strategy for IT is the main role of the CNIO, according to the Witt/Kieffer study.

CNIOs also use health care IT software for order entry and documenting patient medical narratives.

"If we don't document well, it can make the difference in terms of whether reimbursement occurs," said Hebda.

The position sometimes overlaps with that of the CIO and could be synonymous with a nursing informatics executive leader, according to Hebda.

As both clinicians and consumers adopt high-speed data networks, wireless connectivity, mobile devices and exchange health information, nurses will play a role in implementing this technology and interacting with patients, according to a report by the American Organization of Nurse Executives (AONE).

"Nursing informatics professionals are key liaisons to successful interactions between practice, technology and patients," AONE stated.