Nurses leading in health care transformation
Editor’s note: October 2012 marks the second anniversary of the landmark report from the Institute of Medicine (IOM), The Future of Nursing: Leading Change, Advancing Health. The IOM report calls for nurses to take on a leadership role in all settings to meet the demands of a changing health care system.
Two years later, how are nurses meeting the leadership challenge? To investigate, The American Nurse introduces a feature column that asks nurse leaders directly about their expanding roles and opportunities. As a part of continuing coverage of the IOM Future of Nursing report and its impact, Senior Reporter Susan Trossman, RN, introduces the series, “Take 5 with a Nurse Leader.”
Judy Murphy, RN, FACMI, FHIMSS, FAAN
Judy Murphy is deputy national coordinator for Programs and Policy at the Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services, in Washington, DC. In this leadership role at ONC, she coordinates federal efforts to assist health care providers and organizations in adopting health information technology to improve care. She also works to promote consumers’ greater understanding and use of health information technology for their own health.
How did your career path lead you to your current role?
I was working in continuing education in the early 1980s when the hospital brought in computers to use on the nursing units. I signed up to be the liaison between the computer department and clinical staff to help physicians and nurses learn how to use them. That first application was really rudimentary – mainly used to look up lab results. By the mid-1980s, I was working as an analyst in the computer department, and by the mid-1990s as the nurse informaticist in the department – which grew with the health care system as it went from one hospital to 15 hospitals and more than 100 clinics. Since then, I have led efforts to select and implement electronic health records (EHRs) and comprehensive health information technology throughout the system. I have built my career on bringing clinical and quality-related information and needs to computer applications.
How do you use your nursing skills and knowledge in this position?
In my current role at ONC, I’m responsible for the federal programs supporting EHR adoption, including those around meaningful use (capturing the right data that can improve patient outcomes), the implementation of electronic information exchange, consumer ehealth and workforce training. I use my nursing skills and knowledge every single day in interpreting requirements and evaluating how EHRs are used. My knowledge of how health care works, how care is reimbursed, and how patients move from one venue or setting to the next helps me in this work.
How did you develop your leadership skills?
I believe you can lead from any chair. And just to be in our profession, you need to be a leader. As a staff nurse, I organized care of individual patients. My first foray beyond that was working as an assistant head nurse where I supervised other nurses. Once I was in the computer area, I went from being an individual contributor to leading over 150 people on the EHR implementation project. My leadership skills evolved during this time based on learning from my day-to-day experiences working with other people.
What can other nurses do to lead efforts, such as implementing health information technology, in their work environment?
I have to go back to my belief that you can lead from any chair. You can start by changing your own practice. In the case of health information technology, nurses can lead by being role models and using their own electronic personal health records. Then they can talk to every patient they touch and their colleagues about the importance of having an up-to-date health record and what it has meant to them. In addition, hospitals and other health care employers often have committees around documentation and other health information technology, so nurses can raise their hand and get involved in that way. Some employers will furlough employees who are interested in helping select and implement these systems onto a dedicated team. And, nurses can take an even greater leadership role by getting additional education to become a nurse informaticist.
What’s on the horizon for professional nursing, and what advice can you give to nurses to prepare for potentially new or different roles?
I used to think we provide health care first, and that the need for health information was secondary. But, as nurses, we can’t provide good care without having the right information to make the right decisions when we care for our individual patients. So in some ways you can say we are an information-based profession that provides health care. Technology helps us bring all that information to the point of care. It can also remind us of best practices.
So we need to sit up, look around and see how much our world is shrinking because of the access and portability of information. Nurses need to be at the front of the pack in adopting and having a voice in how new technologies are put to use to provide quality health care.
If you have comments or want to recommend an ANA member to be profiled in this column, please send them to the TAN editor at 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492 or via e-mail at email@example.com.