One informatics leader told Parker that, prior to COVID-19, her organization had an average of 150 weekly telehealth visits — and now handles 10,000 visits each week.
“Too many patients and providers are in love with telehealth,” Parker says. “There’s no going back.” The CNIO, then, will have to help an organization standardize this shift — for instance, by implementing drive-through lab tests.
Chief Nursing Informatics Officers Grow in Number and Influence
Response to a global health emergency has shined a spotlight on the CNIO, but the informaticist role has been steadily gaining in importance for more than 25 years.
The nursing informatics discipline was first recognized by the American Nurses Association in 1992. Back then, informaticists focused mostly on implementing electronic health records and making the technology work for clinicians.
“Clinicians were needed who understood both the technological and clinical components and could serve as interpreters, because there was a big communication gap between the clinicians and the technologists and engineers,” Parker says.
As EHR systems became standard — more than 95 percent of hospitals now have EHRs — technology and data became more integral to care delivery. The need grew for executive informaticists who could communicate with other executives about technology implementation and the organizational changes it required.
“It became apparent we needed a senior informatics nurse specialist at the executive table for their depth of understanding and experience,” Parker says. “Because if that person wasn’t at the planning and strategizing stages, comprehensive decisions were more difficult.”
Following a 2009 legislative push for meaningful adoption of EHRs, the first CNIO positions began to emerge, becoming more common in the 2010s. By 2016, 14 percent of hospitals had CNIOs — a big jump from 4 percent five years earlier.
“You need that person to support you with the strategic planning,” Mook says of operational leaders’ dependence on CNIOs’ informatics expertise. At the same time, the CNIO relies on operational leaders to ensure that any tech initiative serves to benefit patients and providers.
Data-Driven Leadership Culture Supports Nurses and New Technology
After Sherri Hess began working as an informaticist in 2007, she oversaw teams that implemented or supported more than 200 EHRs. Today, she and other CNIOs are less involved in straightforward EHR implementation.
“We’re more driven by data and outcomes to ensure that what we’re implementing makes a difference,” says Hess, CNIO at Banner Health in Phoenix. That goal, she notes, entails measuring everything from sepsis rates to patient satisfaction.
Yet respect for the CNIO role hasn’t always matched its importance. A 2016 report co-authored by Mook, of Atrium Health, found that most healthcare executives surveyed said the CNIO role was not understood or respected in their organizations.
That has changed, Mook says. “We’re in a different time today. The value of the knowledge that CNIOs bring to the table has risen because of the need and value for innovation and technology to do our work.”