Quote: Nurses Needed on EHR Build Teams
A recent online discussion with nurses highlighted a common frustration with EHR systems, with one participant urging, "We spend so much time clicking that we’re not at the bedside. We need nurses on build teams." The comment reflects a widespread belief that direct involvement of frontline clinicians is essential for creating efficient and effective EHR workflows.
- A primary source of frustration for ICU nurses is the design of EHRs, which can lead to redundant data entry, excessive clicking, and poorly designed interfaces that increase cognitive load and documentation time. One study found that usability issues such as data redundancy and cumbersome navigation were significant contributors to documentation burden in critical care settings. - To transition from a clinical role to nursing informatics, it is highly recommended to gain additional education and certifications. The most recognized credential is the Nursing Informatics Certification (NI-BC) from the American Nurses Credentialing Center (ANCC), which requires an active RN license, a bachelor's degree, two years of full-time RN experience, and specific hours of practice and continuing education in informatics. - For nurses working in a hospital system that uses Epic, such as Memorial Hermann, pursuing certifications or training directly from Epic can be highly beneficial. Epic offers programs like the Nurse SmartUser, designed for nurses to improve efficiency and become EHR best practice resources within their teams. - Artificial intelligence (AI) is increasingly being integrated into ICU settings to support clinical decision-making by analyzing vast amounts of patient data to predict deterioration, forecast sepsis onset, and optimize treatment plans. These AI-driven tools can enhance a nurse's ability to provide proactive care by identifying subtle trends that may not be immediately apparent. - Interoperability standards are crucial for the seamless exchange of patient data between different healthcare systems. HL7 FHIR (Fast Healthcare Interoperability Resources) is a modern standard that uses web-based technologies to allow systems like EHRs, lab systems, and mobile apps to communicate with each other more effectively. - Federal regulations from the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) mandate greater interoperability and prohibit "information blocking". These rules require the use of standardized APIs, like those based on FHIR, to give patients more control over their health data. - EHR optimization projects that actively involve frontline nurses in redesigning workflows can significantly reduce documentation time. For instance, a project at UCHealth that removed unnecessary flowsheet options cut documentation time for acute care nurses by an average of 18 minutes per 12-hour shift, saving over 64,800 hours annually. - A significant barrier to effective EHR use and adoption is the high patient-to-nurse ratio and the limited time nurses have for documentation. A survey showed that 65% of nurses felt they did not have a voice in EHR changes, and 39% did not feel they could ask for fixes, contributing to burnout.
