Karen is a health care consultant. She participated in early Omaha System research and development at the Visiting Nurse Association of Omaha, Omaha NE from 1978 to 1993. The initial focus was to standardize documentation of interdisciplinary care in community settings and begin automation. Automated use now extends across the continuum of care in community, acute, long term care, and academic settings nationally and internationally. Karen provides consultation, conducts workshops, and writes for publication. She has authored more 110 articles and chapters, 5 books, and 70 editorials; she completed more than 500 international, national, state, and local presentations. She is on the review panels of Nursing Outlook, Public Health Nursing, and CIN: Computers, Informatics, Nursing. Karen has participated in many terminology efforts, is a member of AMIA and numerous organizations, and was elected to the American Academy of Nursing in 1988.