Q How will nursing informatics continue to reimagine and innovate its role based on The Future of Nursing 2020-2030 report?

The core component of The Future of Nursing 2020-2030 report focuses on eliminating health disparities and addressing social determinants of health (SDOH) to ensure health equity. The CDC defines SDOH as "conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes."1 Substantial research shows that SDOH impact health status and contribute to health inequity. How can nursing informatics specialists leverage their expertise and work collaboratively with key stakeholders in advancing health equity? And what are the existing challenges that our clinicians face?

The COVID-19 pandemic accelerated the use and adoption of telehealth; however, according to Pew Research Center, minority populations, older adults, and persons with lower levels of education and income are less likely to have broadband Internet service at home.2 Healthcare organizations, providers, and community centers must be creative in supporting patients who may not have easy access to the Internet or those who don't have an email address or understand how to use virtual health applications. Despite advanced practice nurses' (APN) educational background and training to facilitate telehealth consultations, state regulations limit APNs' autonomy to practice at their full potential. There are still barriers that nurses face with restrictions on providing telehealth services, payment reimbursements for telenursing, and organizational adoption of remote patient monitoring.

Nursing informatics specialists can offer their expertise in redesigning data collection tools that capture SDOH in the electronic medical record. Data elements that create barriers include language and literacy. Although assessment of language and patient education is included as standard documentation, monitoring the utilization of interpreter services is helpful to assist segments of patients who may need further follow-up when they go back to the community. Nursing informaticists can also work with clinicians to understand hindrances in using patient education tools. Having a baseline understanding of patients' computer literacy opens opportunities to work with instructional designers and software education vendors to customize health information needs, preferences, and access to educational materials for patients and caregivers.

With the goal to expand information sharing and increase data portability as patients transition through different phases of care, opportunities exist to use predictive modelling to increase patients' self-efficacy in taking control and managing health concerns or illnesses. For example, based on family history, behavioral patterns, disease process, medication adherence, risk factors, and physical activity, data analytics can project what the overall health status would look like in 3 to 5 years for a 35-year-old patient with newly diagnosed type 2 diabetes. Thus, an early intervention care plan and targeted outcomes can be designed to proactively engage the patient.

Nursing informatics specialists and APNs can create partnerships through a health coach model to support patients' clinical and information management needs. This can be facilitated through a hybrid interaction that's flexible enough to accommodate in-person or virtual visits. As communities continue to deal with COVID-19 spread, the use of telecommunication tools will need to be considered depending on the patient's familiarity with the tools, geographic location, and broadband connection. Other types of patient- and clinician-facing tools can be promoted through remote patient monitoring for patients with chronic conditions, such as hypertension, diabetes, and asthma, particularly in rural areas where healthcare access may be limited.

Regardless of technology use and adoption, the human element of caring is an integral part of nursing practice and patient engagement. The value and contribution of nursing informatics professionals will continue to spread beyond geographic lines, expanding globally and virtually.

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