By Beth Friedman, Sr. Partner, FINN Partners
LinkedIn: Beth Friedman
LinkedIn: FINN Partners
The year was 1990. I was a clinical data analyst for a three-hospital health system reviewing cases for medical staff Joint Commission compliance. And I was bored. My supervisor, a senior nursing executive, encouraged me to make a change. Six months later, I started a new career in health IT and never looked back.
Over the decades I’ve worked with (and for) several nurses. Each and every experience reinforces my belief that nurses are the bedrock of our healthcare ecosystem. They are the glue that holds our industry together, simultaneously supporting patients, patient families, healthcare teams, administrators, and more.
In honor of National Nurses Week, this article explores the career trajectory of five unique nursing professionals. Their journeys will inspire, lead, and encourage everyone working in this remarkable profession. Spoiler alert…bedside is just the beginning.
Always a Nurse: Advocating for Nurses in AI Development
I met Sophia Walker Henry, BSN, MS, Clinical Consultant, Beckman Coulter Diagnostics and a 22-year Johns Hopkins nursing veteran, at the HIMSS AI in Healthcare Forum. With a BSN and MS in Nursing Education, Henry has experienced it all. But what inspires her today is the adoption of AI by nursing professionals. Henry reminds her fellow nursing professionals that technology is not designed to replace you. The new tools are designed to help you.
Here are Henry’s five valuable takeaways for healthcare AI companies building systems to support, not hinder, nursing professionals.
- Nurses must focus on patients, not clicks.
- Developers should absolutely first check with nurses to be sure new concepts will actually help them.
- Nursing conversations are most valuable at the very beginning, not several weeks into an implementation.
- Every detail of a nurse’s day-to-day workflow is important to understand.
- Nursing knowledge can help health IT and AI companies build better products and systems.
Health IT Vendor Community Is Open Door for Nurses
Amy Larsson, RN, MBA, Vice President, TruBridge, became interested in the administrative side of healthcare while in nursing school. Her first positions included administrative staffing, scheduling, and pediatric nursing. Soon Larsson was introduced to quality assurance and following a relocation took a position managing pre-approval, medical necessity, and prior authorization coordination for medical transplant patients and their families.
Larsson applauds the transplant team for recognizing the value of nursing expertise in navigating the complex matrix of payer approvals and reimbursements. Together with her team, Larsson built a center of excellence combining clinical and financial outcomes data for medical transplant procedures. By coupling clinical and financial data to support value-based care, Larsson gained experience with databases, analytics, and tracking.
This early transplant experience became the foundation for Larsson’s health IT career. Larsson has now served for three of the largest health IT companies in the US in a variety of roles including implementation, product development, and leadership.
Her advice to nurses is clear. “If you find something you are interested in, consider a volunteer position in that area.” Volunteering for a project introduces you to new experiences, helps you decide if the space is right for you, expands your network, and can lead to the next phase of your career. Let people know you are interested in a change and new doors will open.
Larsson encourages nurses to explore the business and technology sides of healthcare. And for nurses already serving in health IT roles, Larsson reminds you to remember the mission. “Quality patient outcomes are priority #1.”
EHR Teams Need Nursing Expertise
Daniel O’Connor, RN, MBA, serves as the Vice President of Client Experience at HCTec, a managed services and IT consulting company. O’Connor is one of the rare examples of a trained and certified nurse directly joining the ranks of health IT. He is also a staunch believer in having nurses involved in EHR implementation, upgrades, and day-to-day support.
“Nurses understand clinical workflows and at-the-bedside challenges. They possess first-hand knowledge of the importance and criticality of acute care environments”, states O’Connor. From system development to implementation, EHR vendors and health system IT teams only have one shot to get it right during new installations or upgrades. If you don’t succeed the first time, nurses (and physicians) will question the investment and adoption will lag. Nurses know how to fill this gap with empathy, compassion, and expertise.
One example of nurses’ crucial role is in the specific documentation workflows. Their involvement in both the education and supporting peers during the implementation of new systems and support of EHRs over time is vital. To be fully adopted by nurses, documentation applications must have specific nursing workflows developed into the pathways, providing the ability to easily document and access order groups based on patient problems. Correlating information should be pushed to the nurse to expedite work. In addition, integration with telemetry and all the other data-collecting systems expedites nursing documentation, according to O’Connor.
Data, Innovation and Nurses Support Quadruple Aim
Asha Immanuelle, Maternal Health Equity Program Consultant for the Center for Black Women’s Wellness, has been passionate about caring for moms and babies since nursing school. Early nursing positions included labor and delivery, high-risk obstetrics, and OB case management. Immanuelle finds joy in helping women give birth and transition into motherhood.
But she has also witnessed decades of health disparities with Black mothers consistently experiencing worse clinical outcomes than white patients regardless of income or education levels. Immanuelle saw enough and decided to embody the saying, “not on my watch”. She knew there was more that could be done and set out to do it.
Determined to make a change, Immanuelle moved from labor and delivery nursing to population health management where she learned the power of data to drive improvement. “Clean, accurate and timely data identifies gaps in care so nurses can improve health outcomes for each population they serve”, she states. Time spent working in population health also confirmed the influence of social and environmental factors on health outcomes. Immanuelle observed that psychsocial factors were being assessed but not making it into the patient’s care plan or closing social gaps.
With experience at the bedside, for a payer, and within a health system behind her, Immanuelle obtained a Master’s Degree in Population Health Management and immersed herself into the community health sector. “Community health is where nurses can really impact health outcomes,” she states. Here are five ways Immanuelle believes collaboration between community and clinical settings enhances healthcare.
- Maximize Data Utilization: Collaborate with community partners to securely capture, exchange, and use comprehensive data on medical, behavioral health, and social needs.
- Facilitate Smooth Patient Transitions: Establish seamless handoffs between clinical and community resources to bridge existing gaps.
- Prioritize Patient Goals: Collaborate based on the patient’s priorities and goals, as defined by the patient themself.
- Accessible Patient Care: Reach patients in their communities, meeting them where they are.
- Enhanced Organizational Connections: Strengthen connections between healthcare organizations (HCO) and community organizations to support every at-risk population.
“If we really want to close gaps in health disparities (and they are obscene), we need good data, innovation, and a community-oriented approach,” states Immanuelle. Data enables us to collaborate around the patient’s goals and achieve the best possible care outcomes.
In 2021 Immanuelle embarked on a consulting role with The Gravity Project, serving as a Clinical Informaticist and Community Liaison. This initiative aims to establish consensus-based data standards for the capture and exchange of SDOH data. For example, the group developed a comprehensive value set that includes the terminology for assessment, diagnosis, goal setting, and interventions related to transportation insecurity, and many other social risk domains.
“About 80% of pregnancy-related deaths in the state of Georgia alone are preventable and most occur during the postpartum period”, mentions Immanuelle. After birth the health system doesn’t follow up with mothers very well. Faster access to Georgia’s All-Payer Claims Database will help guide quality improvement initiatives by empowering data-driven decision making, monitoring trends, and continuously improving quality and efficiency, making the system more responsive to unmet needs.
Immanuelle’s advice to nurses includes:
- Be curious
- Lean into it
- Use the Quadruple Aim as a guiding principle (improving patient and caregiver experience, bending the cost curve, and equitably improving the health of populations)
- Data, innovation, and data-driven strategies help achieve the Quadruple Aim
- Don’t be afraid of the technology, you’ll learn it
- Explore new ways to positively impact the population you love
Nurses Empower the Next Generation
Risa Ramji, RN, BSN, MSN Ed, began her nursing career later in life. Starting nursing school in her early 40s, Risa spent several years on the floor in med-surg and labor and delivery to gather real-world experience. But she always had a life-long love of teaching. She pursued a Master’s in Science and Nursing Education and now teaches young nurses to give them a good foundation to proceed in their education and careers.
“I love having a positive impact on young lives,” she says. “Nursing school isn’t easy. It is stressful. It was harder than I ever imagined. So I want to alleviate this stress for my students.” Risa stives to remain empathetic and understanding of the student’s commitments and requirements, especially during clinic days. She suggests nursing educators consider the following six best practices for younger generations.
- Go through the concepts with students, ask questions, talk about things, and be sure they are prepared for their next exam.
- Educate students in a nontraditional route—more like a study group than a classroom.
- Be part of their nursing career journey.
- Identify each student’s optimal learning style and accommodate where possible.
- Encourage students to take mental breaks. Even a few minutes can increase receptivity for learning.
- Teach students simple tips and techniques that help in the real world such as smarter ways to give shots and infusions. Don’t just teach to the exam.
Risa also encourages nurses to become entrepreneurs. She’s always had an entrepreneurial spirit and recently learned about neuroplastic chronic pain. Research shows that the brain can be retrained to alleviate the pain or decrease it. Dots connected for her. It made complete sense. “Fifty million people in the US have chronic pain. We are building a virtual network of Pain Reprocessing Therapy (PRT) therapists to address this problem via a new company called Spark.”
Time to Open New Windows
As Risa mentioned during our conversation, “Nurses should never stay at the bedside if they aren’t fulfilled.” Unhappy nurses bring little benefit to patients, families, peers, or themselves.
During this year’s National Nurses Week, I thank every nursing professional for their hard work, dedication, and service. Thank you for all you do! I also encourage nursing professionals to reflect on your career and consider opening new windows to tomorrow. An entire healthcare industry is waiting.