Q How has nursing informatics advanced, especially during the COVID-19 pandemic?
Nursing informatics has continuously evolved since it was formally recognized as a nursing specialty in 1992 by the American Nurses Association. The Healthcare Information and Management Systems Society's (HIMSS) 2020 Nursing Informatics Workforce Survey showed an increase in respondents who have a master's degree or PhD in nursing informatics, and the role of nurse informaticists has expanded into many forms and functions in the past decades, including system educators, project architects, and analysts.1
In retrospect, the nursing informatics role at the height of the COVID-19 pandemic was essential to keep the lights on while managing and leading critical operations in response to emergent situations. Nurse analysts provided technologic support by constantly managing the critical change requests necessary to keep the electronic health record (EHR) aligned with evolving public health recommendations and government regulations, including updating order sets, infection prevention and control measures, clinical documentation, and care plans for patients with COVID-19. New beds were continuously added in the system to match repurposed and new care spaces, and these real-time changes required additional integration between upstream and downstream systems. Nursing informatics teams performed quality assurance testing to facilitate a quick turnaround time from development to implementation of system changes in coordination with information technology (IT) and infection prevention and control staff.
Nurse informaticists led the management of 24-hour command centers, with nurse analysts working with the command center to oversee scheduling, training, and deployment of regular and volunteer staff members to ensure that staffing levels were adequate to provide safe, quality patient care. Some were involved in data analytics, providing real-time reports on bed capacity, supply inventory, and COVID-19 case tracking. Operational dashboards were configured within the EHR to track patient movement, identify confirmed and suspected COVID-19 cases, and monitor acuity with the number of patients on ventilators. As the need for frontline staff continued, nurse informaticists volunteered for redeployment based on their skill sets and competency; others made telephone calls to follow up on discharged patients in addition to their daily IT roles and responsibilities.
Before the COVID-19 pandemic, nurse informaticists in charge of training provided hands-on, face-to-face sessions; however, they pivoted quickly to a hybrid state due to social distancing guidelines. Classes were redesigned to accommodate prework in addition to scheduled distance learning sessions via online meeting platforms. To minimize prolonged exposure and keep staff safe, electronic tablets were deployed to facilitate communication between nurses and patients, and nurses used video chat apps to connect patients with their families. For patients on isolation precautions, the use of information and communication technology helped maintain a sense of presence and caring despite the reduced amount of human touch.
The use of telehealth has rapidly expanded due to the pandemic and as the context of virtual care delivery took on new meaning, health inequities in the community were highlighted. Nursing informaticists engaged in professional organizations such as HIMSS shared the experiences of underrepresented communities accessing COVID-19 testing. The pandemic shed a light on challenges related to access, computer literacy, language barriers, and other social determinants of health. Through social media chats, nursing informatics specialists disseminated these issues and increased awareness about health equity by promoting HR 7663, intended to protect access to telehealth for seniors.
The unprecedented impact of COVID-19 on the healthcare system has required nurse informaticists to be nimble, flexible, and resilient. As we continue to celebrate the International Year of the Nurse and Midwife through 2021, let's shine the spotlight on nursing informatics, a specialty that will continue to evolve in moments of need, as well as in times of scientific and technologic discoveries.
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