The American Medical Informatics Association estimates that employers need about 70,000 health informatics specialists to install and maintain new systems and train staff to use them.

While the increased demand for specialists is relatively new, the field is not. Nurses have been helping hospitals adopt technology  to work smarter since before the specialty even had a name.

Nancy Stockslager, who became a nurse in 1983, worked in neonatal intensive care units until she was presented with a unique job opportunity in 1995. A health care corporation was buying  products to create a clinical technology records system. When she was asked to help build the system, she accepted the challenge and never looked back.

Today, as director of clinical information at Gwinnett Medical Center, Stockslager, RN, MSN, is responsible for implementation, process analysis, training and maintaining all the health care network’s clinical technology systems. Gwinnett Medical already has adopted electronic medical records and is working toward computerized provider order entry,  in which physicians enter their own orders.

“Informatics has been a very exciting journey and I love it, but it’s a constant challenge. There is never a dull moment,” she said.
According to Stockslager,  informatics developed in two stages — an evolutionary stage and a revolutionary period.

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Demand is growing for patient engagement, as the health care landscape shifts toward more shared decision-making. As more health care organizations adopt technology such as electronic health records and patient portals, meeting those expectations has become easier.

Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle set out to see whether opening clinical notes to patients would enhance patient engagement. Sometimes the concept is called “open notes” — making notes readily available to patients, generally through an EHR or portal.

The results were encouraging, and researchers said the message to physicians was loud and clear: “There’s little to worry about,” said Jan Walker, RN, MBA, a health services researcher at Beth Israel Deaconess Medical Center, Harvard Medical School in Boston. Walker was a co-author of a study in the Oct. 2 Annals of Internal Medicine.

Physicians and patients in the pilot program at Beth Israel received no training or preparation before going live, Walker said, but that will change.

“When we started, we were thinking we’ll teach the patients about the notes and we’ll teach the doctors about what not to write, and we’ll do all this educating. Then we decided not to do all that, simply because if it worked, we wanted anybody to be able to do it,” she said.

Information from the pilot will help shape educational materials and programs for physicians and patients, but the materials may look different for each organization that adopts this approach.

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Physician adoption of electronic health records and other computerized tools to help improve the care, safety and coordination of healthcare for patients continues to rise, the Office of the National Coordinator for Health Information Technology reported.

The report by the ONC, part of the U.S. Department of Health and Human Services shows that since 2009, the proportion of physicians with the technology to e-prescribe has more than doubled, from 33% to 73%. And 56% of physicians have the technology to engage with patients and their families by providing patients with summaries after visits, an increase of 46% within the past year.

Last week, the Centers for Disease Control and Prevention’s National Center for Health Statistics reported that the proportion of physicians who have adopted electronic health records has increased from 48% in 2009 to 72% in 2012.

According to the ONC data brief, since the Health Information Technology for Economic and Clinical Health Act was enacted in 2009, the proportion of physicians who meet five meaningful use core objectives has increased by at least 66%.

The HITECH Act authorized incentive payments under the Medicare and Medicaid EHR Incentive Program to eligible professionals and hospitals for the adoption and meaningful use of certified EHR technology. To participate in incentive programs, professionals are required to demonstrate computerized capabilities that meet defined meaningful use objectives.

Among other findings in the ONC report:

• In the past year, the proportion of physicians using EHRs that meet nine meaningful use measures increased by at least 21%.

• As of 2012, at least two-thirds of physicians have the technology to improve patient safety through electronic tools such as drug interaction checks and electronic medication lists.

• At least half of physicians reported they have adopted the technology needed to meet 12 of the 13 meaningful use core objectives that were included in the data brief, while at least two-thirds have adopted the technology to meet nine measures.

The 13 measures analyzed in the data brief are computerized provider order entry for medication orders, recording of demographics, e-prescribing, recording of smoking status, recording of vital signs, medication allergy list, active medication list, drug interaction checks, maintenance of problem list, providing clinical summaries to patients, providing electronic copies of health information to patients, implementing clinical decision support rules and reporting clinical quality measures. (For more about the meaningful use measures, see www.healthit.gov/policy-researchers-implementers/meaningful-use.)

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Are physicians satisfied with the use of Electronic Health Records (EHRs) in their offices? In most cases, yes, as a survey conducted by the Centers for Disease Control and Prevention recently determined.

In fact, more than half of physicians surveyed in 2011 said they had already adopted EHR technology in their practices, a majority of whom were very or somewhat satisfied with their systems. Another half of physicians said that their EHR systems were good enough to purchase again.

Physicians are seeing the benefits of EHRs in and out of the office. EHR use leads to reduced cost of care through the elimination of duplicate tests and greater coordination between specialists. EHRs also prevent errors as healthcare providers are more easily able to cross-reference patient history. EHRs also enhance patient care by alerting administrators to the presence of possible drug conflicts or errors, and expediting the alert process for clinical lab results. And because records can be accessed remotely, EHRs make it possible for patients to receive care beyond office hours or when their physicians aren't on site.

Expect expansion of the trend: if the US Department of Health and Human Services has its way, EHRs use will become even more widespread in offices and hospitals. As part of the 2009 Recovery Act, care providers are now encouraged to adopt the technology and meet meaningful use requirements, with eligible practices receiving Medicare and/or Medicaid incentive payments. Over 3k hospitals and 119k professionals had already received incentive for using EHRs as of June 2012.

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How can the healthcare providers of tomorrow meet the needs of an evolving system? By training on simulated (or academic) EHRs before they start practicing in a clinical environment. Education institutions that integrate simulated EHRs into their curricula give their learners a clear advantage in the job market. Students who experience EHR use prior to entering a real-life clinical setting will have reduced on the job EHR training, and make fewer errors when entering data into the real EHR, marketable assets that place them at the top of candidate lists. Read more about simulated EHRs by downloading the whitepaper

What's the best way to improve surgical patient safety nationwide? Collaborate. Or so claim the American College of Surgeons (ACS) and Centers for Disease Control and Prevention (CDC), who recently released a plan for a three-year strategic partnership. According to an ACS news release, the alliance will combine knowledge and streamline resources to track, report, and prevent adverse surgical site outcomes, encourage use of technology, and equip practitioners with the tools they need to ensure excellence in healthcare delivery.

Namely, quality of care measures, electronic health record (EHR) systems for data collection and quality measurement, and cutting-edge solutions for surgical training such as clinical simulation technology.

And to help fill knowledge gaps between local care and public health, the alliance plans to engage field experts. Practitioners and surveillance and prevention thought leaders will help the ACS/CDC group categorize what data will be collected, and in what way, to determine how best to maximize safety. They'll also develop measures aimed at preventing infections and complications, ultimately improving patient safety and surgical outcomes.

Clifford Y. Ko, MD, FACS, director of the ACS Division of Research and Optimal Patient Care said in the release, "It's clear that our national health system is seeking better ways to measure quality care."

The ACS and CDC are on the right track – together.

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