Back in the early 80’s, I had the opportunity to work in one of Canada’s first fully computerized hospitals located in New Brunswick. After adjusting to the world of online documentation, care planning, order entry, results review and a variety of other functional components, I came to realize the significant benefits to be derived from such a system. Most notable was to no longer struggle to decipher hand-written orders, clear and consistent documentation, and new safety nets for medication administration. Despite the system not having an intuitive, colourful interface, it did have light pen, point and click device which worked marvellously – of course the notion of a “mouse” had yet to be conceptualized. I always wondered why that particular design disappeared, tethered to the monitor, it required minimal time and training to become comfortable with its use. While the system was one of the earliest to market, it endured for almost 3 decades, ultimately being lapped by new technology, new vendor products and of course, was incompatible with new notions of systems design and architecture, standards, interoperability, and a new generation of computer savvy users.
During those early years, I made a move from NB to Toronto to pursue graduate studies. As a full-time student I found a casual staff nurse position in a large academic health science centre. Initially dumbfounded to learn that computerized systems were not the norm in a majority of healthcare organizations, I quickly learned that my previous employer was among a handful of early adopters of these new tools. Having to revert back to paper processes was disappointing but also the impetus for the pending turn in my career path. Immersing myself into the world of “informatics”, I found organizations like COACH and AMIA and began to meet and network with other like-minded nurses. My informatics career path has taken many interesting turns including different practice and leadership roles, participating in research, setting policy directions, developing health informatics competencies and programs of study, consulting, and the opportunity to work nationally and internationally. At times very challenging and frustrating, it has also been exhilarating to ride an evolving wave for almost 30 years!
Describe what your current role involves?
Today I spend my time in a variety of ways. I love teaching so dedicate a good portion of time to educating our future nurse leaders and health informaticians. Although working primarily with graduate students, I am also working with other faculty to advance the integration of informatics into undergraduate nursing programs across Canada. The current Digital Health Faculty Peer Network is providing an opportunity to extend our capacity to ensure that nursing grads of the future are “informatics ready” to work in the majority of healthcare organizations that are now much more advanced in their use of information and communication technologies as compared to 30 years ago.
I also spend a good portion of my time focused on my health informatics consulting practice that affords me a chance to work with many different organizations. I have truly enjoyed the variety of work in my independent practice in the world of informatics – tackling everything from IT strategic planning systems acquisition, implementation, and evaluation. Overall, developing health informatics leadership capacity for the future is probably the biggest focus of my work activities these days.
Finally, volunteer and Board activities are now a big part of my work life; there’s lots of more work to be done, so no shortage of things to do!
Which areas of nursing informatics do you find most interesting?
While I enjoy all aspects of informatics, the most challenging but also most rewarding is working with clinicians and health leaders to develop their understanding and appreciation of the potential of informatics. I want them to embrace the centrality of informatics science and practice that enables safer, quality care but also garners efficiencies and cost-savings for our health care system.
The implementation of health information systems has presented us with an unprecedented opportunity to standardize approaches to the measurement and capture of health data. However, we have yet to capitalize on this opportunity; instead persisting in designing organizationally unique tools for universally common practices much as we did in the paper world. Time to put this discussion to bed once and for all.
Historically, organizations have not done a good job at evaluating the outcomes of their ICT investments so I have a particular interest in advancing our collective discipline in this area.
What advice do you have for others who are interested in nursing informatics?
In a word, “network”; discover and connect with others doing this work, get to know others and be known. There are a number of forums in which to do this: join CNIA and your jurisdictional chapter if one exists and get involved with COACH. The best thing you can do to develop your career in informatics is to participate in meetings and conferences, volunteer for working groups, and identify opportunities to advance your formal education and training. Lastly, if possible, find yourself a mentor. All of these options were few when I started, but they are there for the taking now.
What was your goal in founding CNIA?
Although there was once a nursing special interest group within COACH, this group was disbanded in 2000. All of sudden our small but important network of nurse informaticians had no home. Thinking about the time, it was post-Y2K, many organizations were beginning to implement EHR’s, nurses were being seconded to IT departments to support these projects, Infoway’s predecessor (Office of Health Information Highway) was inviting clinicians to strategy and planning tables and nurse participants were few and far between. At the time, CNA was being asked to provide input and did not have an identified community of nurse informaticians to draw upon.
In discussing these unfolding events with a group of interested colleagues, it became apparent that we needed to organize. The primary focus: to ensure that the voice of nurses would be part of Canada’s thought leadership for health informatics immediately and for the long-term. Moreover, advancing informatics opportunities and creating a network for communicating with like-minded nurses in Canada was a necessity. Affiliating with CNA served secure a home for our group and has provided them with immediate access to CNIA expertise over the years; the rest is history!
Follow Lynn on Twitter @LMNagle