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Where will innovation come from for Nursing Informatics? Today we discuss that with Beck Fox CNIO for Atrium Health at the HIMSS conference. I hope you enjoy.


All right. Here we are from HIMS 2020. And we're with Becky Fox C and I O for atrium. Is that correct? Yes. Yes, CNIO great. , so we're going to talk innovation in the clinical informatics, specifically nursing informatics area. You gave a talk this week.

What'd you talk about this morning?

This morning, we were talking about the state of clinical and nursing informatics and where we've been in the past, where we are today, and more importantly, how we can continue to influence things in the.

So, where were we? Where are we

going? Well, it started with Florence Nightingale, you know, $200.

Yeah. It's pretty far back. But the thing that, , you know, Laugh and joke, but really Florence kind of set the stage, the data science, pulling it all together, and then bringing with that, some skills around technology, business, strategic and financial acumen. And then you, you, you embed all those skills in your clinical informatics team and look out world.

You can really make a big impact. This is

an interesting group. What do you think about a couple hundred people?

Yeah. Yeah. It's really exciting to get everybody back together and to be in person. I mean, there's just a different dynamic when you get to talk face-to-face and collaborate face-to-face and, and, , I'm really excited to be here.

There's some great, , leaders from organizations that really innovated during the pandemic and we're leveraging those same, , quick, , the things that we did differently during the pandemic. We're gonna keep that and keep it moving forward.

I still want to get back to what's the future look like. I was sitting in one of these conversations over here and somebody was going, Hey, we're doing what you're doing.

Trait. And there's a lot of like, oh, I didn't realize you were doing this. I didn't realize you were doing this kind of thing. Yeah.

So th that's the great thing about being able to get together here at hymns is that, , we all need to move healthcare loan faster, and there's no better way. If there's another organization that's already gone through the steps of evaluating learning, you know, , feeling, figuring out what are the pitfalls and failing quickly and learning from that and pivoting, then we all need to absorb that and then keep the ball rolling.

When I talk to people about healthcare, I'm like we do compete, but we don't compete on our costs. If we can help the hospital across the street, we're going to help the hospital across the street. Cause it's about the community.

Well, and that's exactly right. I mean, that's, to me, that's what clinical informatics is here to do and we're here to help change healthcare in the entire world.

So it's not about being at atrium. Or another healthcare organization it's about how do we all collaborate together and make things better? We know that technology has ramped up really fast. We've had some setbacks during the pandemic. And so now we need to catapult though that forward and really make a difference in the way we do that is empowering our clinical infant.

Using innovation, , making sure that we learn and collaborate from each other and then aim on nothing for the best for our patients and communities.

So that's the future. That's where we're going. I like how you did that without me

bringing it. But I say the future is today. So we don't need to wait for five or 10 years.

We need to start making innovation changes and that we need to implement. Not wait for fight. I mean, we are always looking toward the future, but we have to put to change this in now.

Yeah. I heard some, I heard fail fast and those kinds of things, which you don't hear on the clinical side, all that often it's obviously we fail carefully, but I also saw we're still sitting on a mountain of data.

That's just an absolute mountain. I saw somebody put up a slide with a. Seven or eight dashboards. And if you want the information, here's the eight dashboards you go to, or we we're still struggling with

that a little bit. Well, I think that we've done a really good job of putting in foundations everywhere.

And now we've been in this space of layering upon that. So what niche system can I put on top of something to pull down? And now we need to weave all of these different systems together and remove the noise. So we know where to focus. That's, that's really the key. So as a clinician, when I'm taking care of the patient, there's lots of data about that patient, but where do I need to focus my attention?

If I'm the nursing and administrator or a nurse manager, I need to know. A staff of 50 people. I need to know which of the staff do I need to focus on? How do I help them? How do I make sure that they're where they are in their wellness journey? , so that they're happy clinicians taking front of the patient.

And then of course, as a healthcare administrator from organization, you can look at lots of dashboards, drill down into lots of detail, but you really need to know where do I need to focus immediately so I can quickly fail, learn, pivot, and

change. So we're looking at. Clearly,

we have a significant amount of burnout and those kinds of things are we gathering a lot of metrics on that. And then where do we get that? Where do we get those metrics? Is that surveys or what? That

it comes to us in a variety of different ways. I mean, a lot of it is through surveys, direct, you know, just having conversations with them.

And there are data points out there that, that are in place today and those that are emerging. So for example, how often am I, , interacting with patients can provide some insight as to the patient satisfaction, as well as the nurses satisfaction. , we have a couple, , organizations that I'm working with that we're looking.

How can I even judge based on the, how many steps that the nurse takes in a day? So for example, if the nurse takes 12,000 steps in a day, which is still a lot of steps to take in a day 12,000, , but perhaps I

wouldn't take 3,500 years

to get on it, but, but if they take 12,000 steps in a day, how does that correlate with how happy they are in their.

Or if we look at their physical space and say, well, gee, the nurse had to put these extra 3000 steps on because the supplies aren't where they need to be. And it's reflected in the turnover rate the satisfaction of the nurse, as well as the experience of their patients. Versus if I look at nurses that perhaps were averaging eight to 10,000 steps, perhaps that's an impact.

And it would just be interesting to look at that wellness outcome of how well they're doing. Are we putting stuff where they need to be? Are they able to do. In an expedited and easy way. And then how is it reflected in their wellness scores? And that can come through surveys.

And there's an awful lot of digital exhaust too.

I mean, we just, we could look at how they're using the EHR and go, these people may need a little more training or more customization of the EHR to, to find to

that. Yeah. I think the challenge though, is it's not just about the EHR anymore. It's about, I mean, there's almost nothing that you talk touch when you talk with a patient or take care of.

That doesn't have a technology component. So whether it's the bed, that's, electronified whether I walk in the room and it's the, I am beyond of the room, , patient portals, communication tools, all of those things surround the EHR and interact with the EHR. But it's so much more, I mean, so the nursing staff from, from badging into the parking deck, there's electronic, , things that touch them, , all along the way.

So it's the internet of things within healthcare that are impacting our nurses as well. How does it, how

does. From the nurse at the bedside get into policy or, or are we not making that connection? Meaning like, you know, we have a lot of advocacy that happens, health it through chime onto the hill. So they they're hearing the voice of, Hey cybersecurity and patient identifier and all those things.

Is there, are we advocating for. , clinician burnout, those kinds of

things. Absolutely. So we have strong leadership and our American nurses association, our AOL, which is our leadership organization. And of course, even through the hymns community, we have a long and strong, , strong, , you know, history of advocating for nursing.

Now it doesn't mean that there's not opportunity to still continue to do that advocacy and talking about the burden and technology can put on a clinician and yet at the same time that the technology and how it can enhance. Workload and the work experience of our clinicians. And I think that's the message that you're going to hear.

This is the space that we need to innovate in and how can we better take care of the staff that are caring for the patients? You know, when you help a clinician be their best than they are the best for their patient. And that's what we really want for all of our patients, families in our communities. So

put you on the spot, where are you looking at innovation right now?

So innovation to me is really, I think the big explosion that is happening in is going to happen. It's about how do we help the bedside nurse innovate? So when they have an idea, do we give them a space to be creative, to fail, to be supported, , to start a company, to lead, , , an initiative to develop something.

, those are the spaces that I think that we need to create, and we need to realize that nurses are our most valuable resource in the health. , industry, , in not to take away from anybody else's contribution, right? But they see so much, it's the number one most trusted profession and who better to know what to help with and do for a patient than a nurse.

A good, a good colleague of mine once said that, you know, more, the chances are that when you come into this world, the first person that will touch your hand is going to be a nurse. And the last person to see you before you leave is more than likely a nurse. So let's empower them with ways that they can.

Contribute and make a difference.

Yeah, it was, as my father-in-law was dying, my wife came in all the time and said, I love our nurse and I barely see our doctors. And you understand that because they're special. I mean, he was at heart condition and a couple other things. So just go from seeing people for 10 minutes and then they were going somewhere else.

But the nurses.

Yeah. And that's everyone's role. So it's it's how does it, how do you help support the team? You know, I think, I don't know any physician that wouldn't say yes, we want our nurses to be the best that they can be, because that makes the entire care team a better experience. And that's, that's our goal as a nursing informaticist is how do I bring technology?

How do you put it in the hands of the clinicians? How do you help them innovate? How do you innovate with them?

One of the things I love about these conferences is that I get to know people a little bit better. And I got to see pictures of you on skis with people like pyramid, which I hadn't seen since Cypress gardens.

When I was a little kid, I can see

that's right. I do like to water ski a little bit on the side. My, my nursing career has helped support my water-skiing habits.

I like to water. It's one thing to like to water-ski it's another thing to have, like people on your shoulders and stuff like that, you

know what I'll I'll tell you, it teaches you great life skills.

You have to learn how to depend on your fellow colleagues. You need to learn how to trust, , your boat drivers and your spotters. , and then you, you find out that if you all work together, you can make cool things happen.

I want to close out this interview, but I'm thinking about. The drivers really have to know what they're doing about that.

Absolutely. That's that's like a train thing. Yeah. Well,

water skiers are unique birds and they will, they're not, they're not shy with their opinions, so they're happy to tell the boat driver, you need to do a little bit 📍 different. So

thank you for your time.

Thanks so much. Appreciate it.

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