Elizabeth Anderson, MSN, RN, Director of Clinical Experience and Solutions, Rauland
LinkedIn: Elizabeth Anderson MSN, RN
Trina Geiss, MPH, Senior Product Manager – Interoperability
LinkedIn: Trina Geiss
LinkedIn: Rauland
Nurses are at the center of the rapidly evolving landscape of healthcare technologies. From EHRs and smart beds to IV pumps, real-time location systems, and virtual nursing, nurses are engaging with technology intended to impact the healthcare space. While each tool is designed to support care, poor connectivity between systems creates data silos, compounding the cognitive burden on clinical staff and leading to delays that negatively impact patient care.
Recent evidence underscores this burden: JMIR Medical Informatics’ 2024 report, “Impact of Electronic Health Record Use on Cognitive Load and Burnout Among Clinicians: Narrative Review,” found that EHR interface complexity and disconnected systems significantly contribute to clinician cognitive overload. Furthermore, JMIR Nursing’s 2025 study, “Evaluating Nurses’ Perceptions of Documentation in the Electronic Health Record: Multimethod Analysis,” revealed nurses enter up to 875 documentation points per 12‑hour shift, amplifying the mental strain that occurs when systems don’t talk to each other.
Overcoming these challenges and achieving true interoperability that enhances care begins with giving nurses a seat at the table, not just as users, but as co-creators of medical technology.
The Interoperability Challenge
A critical gap exists between the promise of interoperability and its usability at the frontlines despite significant progress driven by advances such as the 21st Century Cures Act and HL7® FHIR® standard. A major contributor to this disconnect is the misconception that integration equals interoperability. In contrast to integration, which moves data from one system to another; interoperability goes several steps further, ensuring that data is structured to be meaningful, usable, actionable, and in the right place at the right time to support real-time clinical decisions.
From a nurse’s perspective, however, many tools lack interoperability. Nurses view fragmented medical technologies as something they need to manage, rather than a partner in providing care. In addition to adding cognitive burden, poorly designed medical technology drives inefficiencies that lead nurses to develop workarounds. When nurses are distracted, overburdened, and operating outside intended workflows, it not only fuels frustration and burnout, but increases safety risks and undermines patient satisfaction.
From Theory to Action: Strategies to Achieve Nurse-Centered Interoperability
To translate the promise of interoperability into meaningful impact, healthcare organizations must go beyond integration and prioritize the realities of the frontline experience. Achieving this requires the unique insight of nurses, whose perspectives are essential to supporting clinical workflows.
Involving nurses in shaping medical technology design results in experience-driven solutions that align with workflows and support real-time decision-making. Strategies for achieving nurse-centered interoperability include:
- Involve Nurses Early and Continuously: It is crucial for nurses to be co-creators in solution design, not validators after the fact. This requires nurse involvement from ideation through post-implementation monitoring. Healthcare organizations should include nurses in technology committees and innovation councils, workflow mapping and problem scoping, and as key contributors during pilots and simulations.
- Provide Nurses with Protected Time for Participation: Without time and structure, innovation is impossible. Healthcare leadership must prioritize, resource, and protect nurses’ time to ensure their engagement in technology planning and piloting.
- Empower Nurses in Vendor Selection: Nurses should be involved from the beginning of vendor selection. Early participation allows direct engagement in solution demonstrations, with nurses providing valuable insights and questions related to real-world bedside experiences. When evaluating vendor solutions, prioritize platforms that adhere to interoperability standards, demonstrate compatibility with other systems, and avoid vendor lock-in. Clinical validation and real-world testing should also be prerequisites, not afterthoughts.
- Ensure Proper Technical Considerations: With the adoption of innovations such as AI-powered clinical decision support tools and ambient listening interfaces, it’s critical to ensure that technologies support patient care in an ethical manner. Ask vendors detailed questions about how their solutions: minimize bias in data and AI-driven tools, support diverse patient populations, account for real-world workflow testing with clinical staff, etc.
The Business Case for Interoperability
When nurses help shape the technologies they use every day, the results are tangible. Interoperability designed for the bedside experience leads to reductions in documentation burden, alerts, and redundant tasks for improved nurse satisfaction, increased retention, and more time for direct patient care.
HIMSS Interoperability in Healthcare Guide cites many business and administrative improvements made possible through interoperable information exchange, including the elimination of time-consuming tasks such as, “processing of intake information, coordination across care teams, and reporting needs associated with various regulatory requirements.” In turn, nurses have more time for empathy versus task management for better patient experiences and outcomes.
Nurse-centered interoperability unlocks substantial operational value as well. Coordinated care improves operational efficiencies, lowers administrative overhead, and enhances staff productivity. These efficiencies bolster healthcare organizations’ readiness to meet CMS quality measures and value-based care incentives.
Shaping the Future of Interoperability with Nurse-Led Design
Achieving value-based care requires more than just technology adoptions; it demands deliberate design that reflects how care is delivered across a variety of patient care spaces. Now is the time for health IT leaders to elevate nurses’ voices, demand smarter, standards-based systems, and rethink how technologies are implemented with bedside realities in mind.
This is only possible when nurses are included as architects of technology innovation. Nurse-centered interoperability advances the focus of the Quadruple AIM: driving better outcomes, improving the patient experience, lowering costs, and enhancing nurse well-being. It also ensures the delivery of technology that serves as teammate that understands the intricacies of care and adapts to support clinicians and staff, rather than overwhelm or replace them.