Digitisation in the Year of the Nurse

Kate Renzenbrink, Chief Nursing and Midwifery Information Officer at Bendigo Health, is encouraging nurses and midwives to lead the digital transition and use informatics to improve patient care.

Digitisation of Australian health care is transforming how patients are navigated through the system and is changing the working lives of doctors, nurses, midwives and allied health professionals.

Kate Renzenbrink is currently working at Bendigo Health to support the implementation of the electronic patient record and to ensure the nursing and midwifery workforce has the health informatics skills to meet the challenges of contemporary practice.

She spoke to Hospital + Healthcare about the exciting space of health informatics and digital health.

“Patient care and safety is a critical part of the role of nurses and midwives. Digital health is about collecting, accessing and sharing patient information and overcoming barriers to continuity of care. What we’re aiming for is a flow of information through the health system that stays secure and private but supports the best possible care.

“Electronic patient records are one such tool to overcome barriers presented by multiple systems and sources of information.”

With the explosion of health technologies and information platforms that are available, it’s an exciting time for the nursing profession to shape how the digital environment is built, to get the best outcomes for patients in their care.

Overcoming fragmentation

Kate explained that the aim of electronic system design is to mitigate fragmentation in systems and information flows. Hospitals operate multiple systems, but continuity of care is needed. This can be achieved by connecting information to the patient. In this patient-centred approach, a patient’s health information goes with them in the form of the EMR.

Curation: a solution to information overload

Confronted with an abundance of information, nurses need to be able to access relevant information quickly. Health information systems and software should be designed to facilitate curation of information to provide healthcare workers with information relevant to their role. It is hoped that, moving forward, machine learning can be employed to filter large volumes of data to grow the knowledge base to help nurses and midwives carry out their work. Less time spent on chasing patient information means more time to plan care with patients.

Nurses and midwives spend 40% of their time documenting. Documenting patient information and procedures undertaken acts as a record of care, but Kate explained that the design of e-systems should also enable nurses to work dynamically, including forecasting goals for the patient such as expectations of care. Electronic documentation incorporated into a connected information system needs to engineer out duplication and allow a flow of accessible, searchable information across transitions of care.

Training considerations

Kate said that when designing digital training programs for nurses and midwives it is important not to assume familiarity with digital interfaces.

“While some may find systems intuitive, others may not, but it is important to provide the required training to ensure that everyone has the ability and support to adapt to this new way of working.

“For some nurses and midwives in clinical roles, the digital aspects of the job may be confronting — clinical strengths and expertise don’t necessarily translate to digital competency, so a respectful, supportive approach will be needed to bridge skill gaps,” she said.

Training nurses in the use of digital tools will need to go beyond the orientation session — peer-to-peer elbow support is needed as well as on-demand availability of a whole range of learning tools, which meet the needs of busy nurses and midwives 24/7.

Another important consideration that Kate highlighted is disaster recovery and what happens in the event of a system outage. Ironically, in these situations newer nurses may not have experience of documenting on paper, so knowledge of older, more static systems will still be needed.

Nursing informatics leaders

Kate underscored the importance of developing the next generation of digitally competent nurses and midwives.

“Digital health needs to be incorporated into all subjects of undergraduate and postgraduate courses. Nurse informatics, however, is an emerging nursing speciality, revolving around the core components of gathering and sharing patient data,” she explained.

“It’s an integral part of contemporary practice and there are huge opportunities for nurses to lead the way in digital health. We need nurses and midwives who are happy speaking health IT and clinical languages.”

Image credit: Kim Selby Photography.