Industry Spotlight: CARING is at the Heart of Nursing Informatics

By: Donna Carroll, Editor, The MEDITECH Community Bulletin

Around this time last year, I was writing an article examining the role which Nursing Informatics (NI) professionals play in the implementation and management of healthcare information systems. As I look back, I realize the phenomenal growth the NI field has undergone in just one year’s time. But, what many people don’t realize is just how long NI professionals have actually been present in the healthcare IT field. Although NI professionals were not named as such in the early 1980’s and did not receive the same attention which they do today, there was one small group of visionary nurses who believed in the importance of their work and foresaw the value of a professional network in their field. Those few nurses were the co-founders of what is known today as CARING.

CARING is a nursing informatics organization whose mission is to advance the delivery of quality healthcare through the integration of informatics in practice, education, administration, and research. The organization was developed by area nurses in 1982 as a non-profit undertaking to provide a forum for the advancement of automated healthcare information systems. Some of their stated objectives include:

• Provide educational experiences including contact-hour events

• Publish educational and informational articles

• Act as a clearinghouse for seminars, positions and speakers

• Provide a professional network for healthcare information systems professionals

I recently had the opportunity to visit with three members of CARING’s Board of Directors (BoD) to hear their perspectives on the importance of the NI field and how membership in the organization can benefit NI professionals in the advancement of their careers.

Susan K. Newbold, PhD, RN-BC, FAAN, FHIMSS

Susan Newbold is an Associate Professor of Nursing Informatics at the Vanderbilt University School of Nursing. She has a PhD, is a Board Certified Informatics Nurse (RN-BC), a Fellow of the American Academy of Nursing (FAAN), and a Fellow of Healthcare Information and Management Systems Society (FHIMSS). Susan is also one of the co-founders of CARING and currently serves as the Membership Chair on CARING’s BoD. By her own admission, it is clear that Susan never misses an opportunity to recruit a new member. At the time we spoke, she had just signed up a new member from Iceland, adding the 31st country to the organization’s membership. One of their recruitment strategies is to offer trial memberships to students, thereby jump-starting their opportunities for networking and career development in the NI field.

QUESTION: As one of the founding members of CARING, what were your reasons for starting the organization?

Founded in 1982, CARING was originally organized by three nurses from the greater Washington, D.C. / Maryland / Virginia area who were user liaisons for the IBM Patient Care System. We called ourselves the Nursing Medical Information System Roundtable, and later changed our name to the Capital Area Roundtable on Informatics in NursinG, now CARING. At the time, there were no formal education programs for nurses working with computer systems – only classes by vendors and on-the-job training. Paula "P.J." Hallberg, Susan McDermott, and I met to determine our roles in the development and implementation of IBM’s Patient Care System in our hospitals. Through attendance at the Symposium for Computer Applications in Medical Care (SCAMC, which is now AMIA), we met other "computer nurses." Our early meetings were held almost monthly in the metropolitan Washington, D.C. area, and newsletters were later introduced to help announce meeting minutes and organizational updates.

CARING's influence quickly grew beyond the Washington, D.C. area as other nursing informatics groups were initiated and collaborated with the assistance of CARING members. CARING has steadily grown in number and benefits over the years.

QUESTION: Tell us a little about the CARING members and their typical background?

Today CARING has nearly 1700 members from 50 states and 31 countries with new and renewing members almost daily. Twenty (20%) of our members are certified in Nursing Informatics. Many have higher degrees in nursing -- masters (59%) and PhDs (8%). Many of our members are pioneers in nursing informatics and luminaries in the field. Half of our members work in hospitals. Most nurses were trained on the job.

QUESTION: I’m sure you’ve seen the NI field grow and change in many ways over the years. What are some of the more significant changes that you’ve observed?

There have been many changes in the field of nursing informatics. Today we are "informatics" nurses rather than "computer" nurses as in the early days, now reflecting that we do much more than support a piece of hardware. Now we have education at the certificate, masters, post-masters, doctorate of nursing practice (DNP) and PhD levels, some of which is on-line. I teach at Vanderbilt School of Nursing where we have on-line masters, post-masters, DNP, and PhD programs available for informatics nurses. There are more conferences available to the informatics nurse today, such as the joint ANIA/CARING conference being held this month in Maryland. We have changed with the growth of technology. We can communicate with each other through our active e-mail list and web-based meetings. Also, nursing informatics is spreading to the nurse at the bedside. As hardware and software became less expensive and more available, it is becoming ubiquitous in the healthcare environment and translators are needed to select and implement systems in healthcare. We are working to unite various nursing informatics groups through the Alliance for Nursing Informatics, and to speak with one voice.

Stephen Prouse, MS, RN-BC

Another BoD member we spoke with is Steve Prouse. Steve is also a Board Certified Informatics Nurse (RN-BC) and is currently Director of Applications for Upper Chesapeake Health System in Maryland, a MEDITECH site. He has been a member of CARING since 2001, and a BoD member for the past 3 years. Steve is currently Secretary of the Board and Webmaster for the CARING web site.

QUESTION: As the Director of Applications for a MEDITECH facility, tell us about your own philosophy regarding the role of NI specialists?

Last year my role changed from managing just the clinical applications to encompass all applications: clinical, financial, and administrative. Part of me wishes I could just limit my scope to the clinical realm, but they are all so tightly woven that I find it necessary to understand all the applications in some depth. The informatics specialists in my organization bridge their clinical expertise with new and existing technologies to optimize patient safety, satisfaction, and clinician efficiency. They support those who provide our core product—patient care—and provide them with the tools necessary to safely and effectively guide, document, and administer all aspects of care. I believe they need to possess three unique characteristics: (1) the desire to solve complex problems and get things done; (2) knowledge of the organization, its culture and politics; and (3) the ability to tap into lessons learned from past clinical experiences. Technical and computer strengths are necessary, but are not on the top of my list when bringing on new team members. I can teach the technology, it's those other skills I can't teach.

QUESTION: How can other MEDITECH customers benefit from joining an organization such as CARING?

CARING provides networking and educational opportunities outside the MEDITECH circuit. The MEDITECH community is rather tight with MUSE, the MEDITECH-L, MIX road shows, and now MEDITECH's own Nursing Information Workshop. However, CARING can provide the MEDITECH community with additional perspective outside the MEDITECH domain.

We do have numerous MEDITECH users as members of CARING. I would estimate that in the Maryland area alone, approximately 50% of our members are from MEDITECH sites.

QUESTION: As webmaster for the CARING web site, tell us about some of the site features which are available to members.

Some of the hallmark features of the web site include our membership database and the ability for members to find one another using its advanced search capabilities. Other features include a calendar of events, an active job board, and the newsletter repository.

Edward A. Stern, RN

Ed Stern, one of CARING’s newest BoD members, has perhaps a more technical background than many in the organization. An RN by trade, Ed worked for the American Red Cross for many years and participated in the international deployment of office automation technology, as well as development of the organization’s Internet strategy. Ed actually left the healthcare industry for a period of time where he focused his career in the pure play technology marketing world with some internet start-ups. He then returned to the healthcare industry a number of years ago. Ed is now an independent consultant in the NI field where he works on a variety of informatics related projects for a diverse client base. Ed has been a member of CARING for approximately 4 years and was elected to the BoD last year. His focus in NI is ‘out-of-the-box’ thinking. He works with CARING members to try to look beyond the traditional avenues for NI professionals. His personal interests are to educate the non-NI world about the importance of nursing informatics and to try to find new areas where NI professionals can bring value to others. Another one of Ed’s responsibilities as a BoD member has been to assist with the evaluation and selection of a new Job Board for CARING. The new CARING Job Board will be launched in April or May, and one of the features includes a searchable resume database.

QUESTION: What are some of the special industry events that CARING hosts or sponsors?

CARING is a member-focused organization. We enable our network of members to create their own growth within our organization. We also co-host an annual national education conference. In fact, this is the second year we’re co-hosting the joint ANIA/CARING conference which takes place this April 17th to 19th at the Gaylord National Resort and Convention Center on the banks of the Potomac River in suburban Washington, D.C. This year’s theme focuses on “Monuments and Milestones for the Future”. The conference is primarily focused on education, offering CEU hours for different sessions. There are several different workshops to attend, an exhibitor hall, and plenty of networking opportunities.

CARING also provides various webinars to our members. Webinar content ranges from formal training with CEUs to “tips and tricks” and case studies which our members would like to share. Additionally, we support regional efforts of some of our CARING members. Since the member network is our biggest asset, we try to assist any of our members’ efforts to grow this very young nursing base profession.

QUESTION: What are some of the various benefits that CARING members enjoy?

CARING is about the people. Since NI is still a relatively new field, it is defined, re-defined and expanded daily. What one person thinks of tomorrow can be shared with a few thousand peers in real-time as a CARING member. You can enhance your ideas, share your ideas, and even formulate new ones with the help of your CARING peers. Some of the specific benefits which CARING membership offers are:

• access to a network of 1700 informatics professionals in 50 states and 31 countries

• an active e-mail list with the option to have messages in digest format

• an on-line, searchable membership directory

• quarterly newsletter and on-line archive

• job bank with employer-paid postings

• reduced rate for the Computers, Informatics and Nursing journal subscription

• annual CARING luncheon during AMIA and annual dinner during SINI

• membership in the Alliance for Nursing Informatics, www.allianceni.org

• meetings and conferences around the nation and the world

QUESTION: Why did you want to join CARING and seek appointment to the BoD?

NI is a very young nursing profession. As an NI professional on a daily basis I take my skills and abilities as a Nurse and combine them with my background in Information Technology. This is a relatively young concept (when you compare it to nursing history). The NI professional has great potential as a career for many nurses, and an even bigger impact on nursing practice as we advance further towards an electronic clinical realm. Anything I can do to be a part of and assist those efforts as a member of the CARING BoD is my pleasure.

In talking with these three members of CARING’s Board of Directors, it’s easy to sense the dedication and commitment to their chosen field. CARING’s slogan of “Connecting, Sharing, & Advancing Healthcare Informatics” says it all. That kind of enthusiasm and passion is why CARING is at the heart of Nursing Informatics.

To learn more about CARING, please visit their web site at www.caringonline.org.