Digital transformation in healthcare is more than just a buzzword—it's an imperative. It's shaping the future of nursing and healthcare leadership, bringing both exciting opportunities and complex challenges. We're bringing you insights straight from the frontlines of this transformation by spotlighting two of our nursing leaders, Karlene Kerfoot, PhD, RN, FAAN and Ali Morin, MSN, RN-BC. Their collaboration with the American Organization for Nursing Leadership (AONL) and strategic role in preparing leaders for digital transformation offer invaluable perspectives.
What are some key principles or takeaways you would like people to know about embracing digital transformation?
Karlene: We're in a big cycle of digital transformation, and it's important to be prepared for it. We're partnering with AONL to bring nursing and informatics leaders together. We want to expand our network and connections and help these leaders feel confident they should be part of the conversation and have a voice. Nurse leaders should often be present for technology discussions that ultimately impact clinicians, but unfortunately, they don't always have a seat at the table. We need to change that because this is a critical area that requires clinical expertise.
Ali: Many health systems, especially smaller community hospitals, don't have informatics leaders, but they do have nurse leaders who use technology. They may be a CNO, for example, who also plays the role of CIO or COO, and our focus is on educating and empowering these leaders with the necessary comfort and confidence to be advocates for their staff.
What is the role of the Chief Nursing Informatics Officer (CNIO) in healthcare and how pivotal is this role for digital transformation?
Ali: In my experience, the evolution of the CNIO really took off with the advent of EMRs. Suddenly, we needed nurses to figure out how technology works as we transitioned from paper to electronic. And that was the simplistic version of clinical informatics in the late 90s, early 2000s, which is when I started doing it. Since then, that role has expanded in large healthcare organizations that have the capacity to build critical clinical informatics infrastructures. Having a clinical nurse informatist working side by side with nurses as technology is rolled out, helping developers and IT analysts with updates to flow sheets and EMR upgrades is invaluable. The CNIO role started as a leader from an EMR perspective, but now it has transformed and has become much more broadly engaged in technologies within health systems.
As we consider new care models for nursing, like virtual nursing, telehealth, and home care, the technologies involved have evolved significantly compared to 20 years ago. So, having a role that is forward thinking about technology for nurses and other clinicians is critical. The CNO needs to sit alongside the CIO and the CMIO at the same table, laying out the roadmap for how they can meet nurses' technology needs in a strategic way.
Karlene: The CNIO is such a pivotal role, and there's always issues in terms of where this person should report. Should they be reporting to the CNO or to IT? Honestly, it doesn't matter. The point is that people see this role as someone who bridges both areas - attending administrative and management meetings in IT, just as they would in nursing. If they're not fully integrated into the nursing leadership team and shared governance structure, valuable information gets left behind. The same goes for not being part of the administrative and management team in IT. We lose out on valuable insights.
With the digital transformation, as a CNO, you're not going to know everything, but you can lean on your nursing informatics folks to help make those decisions and guide you into the future. They look at the technology, simplify things, and predict what you're going to need down the line. And trust me, that's invaluable because simply buying technology without input from the end users or letting HR handle it, well, that's never going to work. We need the users, the ones who know the technology inside and out, to express their needs and desires. That's where the magic happens. It's an amazing partnership, and the more we embrace it, the better our healthcare systems will be.
How can technology be simplified for nurses and clinicians on the frontlines?
Karlene: Too much time is spent nursing the computer verse the patient because of all the technology. According to some studies, the technology burden is why many clinicians leave the field. When we conducted our recent Compass Survey with CHIME, we asked how much time could be redirected back to clinicians if they didn't have to deal with numerous systems and phone calls. A whopping 84% of respondents estimated they could redirect a significant amount of their time, potentially up to 20% per week.
As a staff nurse, you're bombarded with various complex platforms, and managers have it just as difficult. They're spending 50 to 60% of their time on staffing-related tasks, which means they're unable to focus on essential tasks like staff development and connecting with patients and their families. Think about all the beautiful moments that people are missing out on because they're tied up on the phone or trying to navigate through all the chaos. Bringing back those beautiful moments that truly matter is possible if we simplify the systems and clean up the chaos.
Ali: We need to think about the purpose of the technologies we're putting out there. In the last 20 years, healthcare tech has progressed so quickly, faster than what we can handle. There are many reasons to look at those 50+ tech solutions within a hospital and think, what are we really getting out of them? What are the outcomes that patients are experiencing from us having this technology and how is it benefiting nurses, physicians, etc.? Instead of adding on, we need to focus on fixing the fundamental problems that already exist in our health system tech stacks.
What are your thoughts on the future of nursing? What excites you? What makes you nervous?
Karlene: Some days, I get discouraged because I could walk into a hospital and make a long list of what hasn't changed since I was a nursing student. For example, the IVs going off at 3am, the gowns that haven’t changed. The communication between the techs and the nurses could be a lot better. Although it's frustrating, I believe that digital transformation presents a huge opportunity if we embrace it. We can simplify so many things. No more filling out forms for example; machine learning can handle all of those tedious tasks. And imagine if we had better predictive systems; our lives would be so much simpler.
If an airplane can fly itself or a Tesla can drive autonomously, why can't we apply the same concept to staffing and scheduling? Why can't we rely on the system to analyze predictive data, match it with available nurses and patients, and present us with the perfect solution? It's exciting to think about the possibilities. It gives us another way of doing things. Without digital transformation, we're still going to be doing things the same way we did when I was in nursing school. So, this is an opportunity to embrace it, not be afraid of it, but to monitor it and never let go of that human element.
Ali: I get to see the future of nursing through the eyes of my nephew who's about to graduate from nursing school in a couple months, and he is so excited about nursing. He always has been. He's like, "I can't wait to get out there and do my job". And for me, in my job and in my role, it's about making that runway smooth and easy so that he can go be the nurse he's supposed to be and not deal with all the noise that we know exists in nursing today. The purity of his excitement is what excites me. There are still people out there who just want to be really good nurses, and we need to help them do just that.
