Roles in Nursing Informatics

TITLE 

REPORTING

COMMENTS

Nursing Informatics Specialist

Nursing and IS

One of two informatics nurses for five hospitals. We report to Nursing. However there are MANY nurses working in Information Services also. The two of us that report to nursing serve more as liaison between the clinical and the technical, whereas those in IS are more technically engaged. My take is that it’s a relatively new area and the job description is open for discussion as projects unfold.

Clinical Applications Coordinator 

IT

I test the new software from the perspective of the clinician and work directly with the vendor with my findings.

Chief of Nursing Informatics 

Nursing

Military –no role details.

Director of Nursing Informatics 

Nursing

If the position is more then just Nursing...cross specialties, you might want to consider a title like Director of Clinical Informatics.

Manager of Clinical Services 

IS

Supervises three Clinical Informatics Analysts.

Position Summary

Responsible for the support of clinical information systems in the hospital network. Works closely with the CIO and the Director of IS. Member of the IS management team. Serves as a resource for the daily operational issues of the hospital’s clinical system applications.

Education and Training Required

Masters or equivalent in Nursing or a Health Care Related field. Bachelor of Science in Nursing.

Experience Required

Prior experience in management in the health care environment (3-5 years). Experience with personal computers (2-3 years). 

Special Knowledge, Skills, Abilities

PC hardware troubleshooting experience helpful. Demonstrated ability to function well under pressure.

IS

Master’s degree; works closely with Medical IS Director, Medical Records Director, and the  Director of Professional Nursing, but reports to the CIO; several  Clinical Information System Associates report to the Coordinator. (Most are nurses, one HIS professional, & one lab.) 

Director, Information Services 

Sr. Associate Chief Operating Officer (also a nurse)

We do not have a department of nursing in the old sense. The clinical areas are grouped into clinical business units, which then report up to the four ACOOs. Our COO is also a nurse. Our department (IS) is composed of the clinical team and a LAN team. The clinical team is composed of 8 Nursing Informatics System Specialists plus an informatics nurse with a Ph.D who is part time with the School of Nursing and part time with us.We are also in the process of developing a career ladder for the NISS similar to a clinical ladder concept. These are bright people, in high demand by recruiters, and if you want to keep them you’ll need to give them a way to work their way up.

The clinical team supports the clinical information systems in the ICUs, perioperative, women’s, children’s, oncology, and intermediate care units. We are in the processing of searching for an ED system and also doing Intranet development. We collaborate with but do not report to MCIS (Medical Center Information System) which is the large IT department that supports the infrastructure of the Health System. That has been a deliberate strategy despite attempts by IT to absorb us.

The strategic planning for clinical systems is done by the CIO, two physicians, and me.

Director of Clinical Systems

IS (CIO)

I have found in my experience it is better to report up to IS. More technical support available. But there needs to be a very close working relationship with the business line management.

Clinical Systems Coordinator 

IS

(None—IT professional’s comments)

I wanted to comment on the reporting structure of the NI person reporting to the physician lead. In my experience, this does not make a lot of sense.At least for us, our physician is really a medical type with limited IT background. He is a vision-type guy, but really has limited understanding about what he is asking to have done.  I would recommend if the NI folks are going to be hands-on IS folks that they report to someone with the technological  knowledge that understands the impacts of what they're asking to be done.

Title not shared

IS

I have reported to Nursing as well as IS during my Informatics career.The most significant factor I have found is whether your organization has a Chief

Information Officer or someone on the Executive team with knowledge about clinical systems.

I will never again work for an IS Director who reports to a Chief Financial Officer, neither of whom understand the importance of clinical systems.

I currently report to IS but I participate in the Patient Services Leadership group and work closely with Nursing. Our CIO is great and realizes the importance of clinical systems and has educated the Executive team. It's great.

In writing job descriptions for NI, I highly recommend the ANA Scope of Practice for NI & Standards of Practice for NI.

Director, Clinical Information Systems (Dartmouth-Hitchcock recruitment advertisement)

VP-IS

Responsibilities: Co-development, implementation, maintenance of CIS. Requires Master’s degree (Computer/Information Science or clinical or administrative equivalent). Five years experience with computer systems and demonstrated leadership experience (management, clinical, or IS).

Director of Nursing Informatics and Nursing Management Services (Mount Sinai recruitment advertisement)

Nursing VP

Master’s degree in Nursing and earned doctorate required. Vision of use of IT to support nursing practice, research, communication and consultation.

Director of Clinical Informatics, Home Care (Mount Sinai recruitment advertisement)

Unknown

Overall project management, policy and procedure development, communication end-user support issues to internal and external IS personnel. BSN degree required, Master’s degree and nursing informatics experience preferred.

Nursing

Primary responsibilities: Clinician computer education coordination, project management for clinical systems (planning, implementation, training coordination, and evaluation) for nursing and home care. Upcoming projects—physician order entry and nurse documentation.

Assistant Director for Clinical Informatics 

Unknown

Manages informatics nurses and other staff involved in clinical information system implementations. 

Clinical Analyst 

IS

The integrated approach with clinicians and techies working as a unit seems to work best and is useful when there is a lot of development work going on. If the systems are complex and the local technical people are doing a lot of configuration and development they need people with a clinical background who also know enough technical language to know what is possible to work closely on that development— report to IS.

If the environment is one where you are implementing a vendor package with little local work, (individualization is being done by the vendor) and the local technical people are responsible for keeping the network running smoothly etc. then staying within a pure clinical group may work equally well, and it may work better (reporting to Nursing rather than IS) if there is resistance to computerizing, since the people doing it are part of the “us” group. 

Clinical Informatics Systems Associate (Equivalent to Director)

Nursing VP; matrix report and management functions reporting to CIO

4 positions out of our Patient Care Services Department at a Director level to support both the profession of nursing and quality of patient care. Our titles are ‘systems associates’ and support the following areas: Quality, Professional Practice, Finance, and Clinical Informatics. These positions require a Masters degree. Responsibilities include assistance/involvement in writing the IS strategic plan and quality scorecard.

Over the past 4 years, we have hired 4 nurses into Senior System Analyst roles and have also developed a role of IS Coordinator, all reporting to IS, in support of developing project management and interdepartmental teams. One of the IS Coordinators supports clinical related projects.

Nurse Consultant (NIH recruitment advertisement)

Nursing

Provides leadership, direction, and technical expertise in the planning, development, implementation, and evaluation of nursing information systems to assure the delivery of consistently high quality nursing care at the Clinical Center and provides technical support to executive, management, and clinical staff. Additional focus on research. Master’s degree preferred. One year professional nursing experience sufficiently related to specialty.

http://ohrm.cc.nih.gov/POS/vacancy/1105.html

Nurse Systems Specialist 

Nursing

BASIC FUNCTION: Responsible for directing the administration and twenty -four hour operation of the Nursing Operations and Support Department. Analyzes, develops, and revises computerized information systems. Establishes goals, objectives, standards, policies, systems, and programs for Nursing Services. Supports and upholds objectives of Nursing and Hospital Administration. 

EDUCATION:Master’s Degree or Bachelor of Science in Nursing required according to years of experience and other formal education.Formal education in business and information systems management required.

EXPERIENCE / QUALIFICATIONS: Master’s Degree in Informatics and four (4) years acute care hospital nursing experience with at least three (3) years in asupervisory position required OR Bachelor’s Degree and six (6) years experience with at least four (4) years in a supervisory position.

Current license to practice as a Registered Nurse required.

Clinical Analyst 

Administrative Manager 

Surgical Services line role: I report ultimately to a physician, but am separate from IS. 

Ambulatory Clinical Information Services Director

IT

I currently have 5 clinical analysts within my department -3 nurses and 2 pharmacists.These individuals work closely with 3 other clinical analysts that report up through the Division of Medicine / Surgery.

This is a somewhat simplistic description of the division of labor between the 2 groups but...The analysts reporting through Medicine / Surgery are ‘user liaisons’ that forward requests to IT, then help with the analysis and design of new products or enhancements and do most of the training for our Core order entry / results reporting system. The analysts within ACIS share responsibility for analysis and design, and have additional responsibility for application building / unit testing and some project management, for the Core system.

We also support an EMR system that is being used exclusively in the ambulatory areas and the ACIS analysts support all implementation activities related to EMR, without assistance from the Medicine / Surgery analysts. My preference would be to have a clinically oriented person in the project management role but this person would need to have a strong background in both project management and system life-cycle management / technical implementation as well as a clinical background - and those individuals are far and few between.There are also 3 clinical analysts in the department - Hospital Information Systems; and another 4 nurse analysts within the department of Nursing Informatics.

I hope this helps although I don’t consider this to be an optimum model by any means.The current organizational structure here is based on ‘history’ and we are working on trying to improve it.

Clinical Informatics Manager

IS (1 of 4 IS Managers reporting to CIO)

Position Purpose:

Manages the development, implementation, training, evaluation, and maintenance of all Clinical Informatics projects.Coordinates and facilitates communications with areas that interface with the Clinical and Physician Services areas in relation to automated information. Education, Experience, & Skills (Minimum Requirement): 

A Bachelor’s Degree and formal education as a Registered Nurse is required.Three years experience in a nursing leadership level position at a health care institution of similar size and complexity. Must be knowledgeable of new trends in clinical management and information systems, and be able to apply data processing technology for the clinical and physician services areas. Must have a thorough knowledge of Nursing practices and principles typically gained through graduating from an accredited school of nursing.

Licensure/Certification Requirement:Must be licensed as a Registered Nurse in the state of (XX)

Clinical Systems User Project Manager

IS now but expected to transition to Operations

The Director of Medical Records assumed the responsibility as the “user” champion for our Clinical Information Systems project.She back filled many of her day to day responsibilities in Medical Records and hired an RN (internal manager completing study in IS) to a role titled Clinical Systems User Project Manager.The Director of Medical Records reported to VP of Ancillary Services.

The Medical Records Directorhas accepted another job and the User Project Manager now reports to me (until we figure out next steps).

I believe that this role should report through operations, not IS.Any clinical project should be a partnership between IS and the user community.I see the project manager and lead in IS and the “user” champion or User Project Manager as equal peers (respectively).A project’s success is based on the collaboration of these two to four leaders (dependent on project structure) and each following through on unique responsibilities.Change management, process re-design, training, etc. belong with the user community or Informatics Nurse.

We don’t currently have a Medical Informatics role.My thinking is that the Informatics Nurse may matrix to the Medical Informatics position, but I see the Informatics Nurse reporting through operations to influence and/or have real authority to meet job expectations.