But some observers question whether adding a CNIO to the executive roster with a separate chief medical informatics officer adds costs and maintains the separation of nurses and physicians in different silos.
Ann Shepard, CNIO for Catholic Health Initiatives, said consolidating all informatics functions under a single chief clinical informatics officer is something CHI has considered. But “if you wanted one person to do everything, it'd be a tough job,” she said.
Nursing informatics advocates say the difficulty with having one informatics chief is the required level of knowledge for physician and nursing workflows. Instead, systems should strive to have their CNIO and CMIO “connected at the hip,” Sengstack said. For example, if nurses want to create a new electronic protocol for removing a patient's urinary catheter, the CNIO and CMIO should team up to find out how the proposed change will affect physicians' order sets.
Experts say nurses will play a critical role in solving the gaps in communication between humans and technology and in translating troves of patient data into meaningful, improved patient-care protocols. “The focus had really been on how systems work and getting data in,” Sengstack said. But that's shifted “toward getting data out.”
The nation's 3,000-plus nurse informaticists, whose numbers are growing fast, historically have been very involved in hospitals' IT projects. Some are tech-savvy enough to help with the coding of computer software. Many play key positions in implementing EHR systems and computerized physician-order entry. In addition, nurse informaticists, who earn about $100,000 on average, train peers and manage those projects from the perspective of the patient.