Participating in national standards initiatives: A call to action

National standards and nurses 

The Office of the National Coordinator for Health Information Technology (ONC) was established in 2004 with two primary mandates: (1) provide counsel to the Department of Health and Human Services (HHS), and (2) develop an action plan for linking all health records through an interoperable system that protects privacy; connects recipients of care, providers, and payers; reduces errors and costs; and improves health.3 Interoperability is the ability of two or more systems or components to exchange information and to use the information that has been exchanged.4 David Brailer, MD, PhD, was appointed as the National Coordinator of Health IT and served for two years. His successor, Robert Kolodner, MD, and Alicia (Bradford) Morton, MS, RN-BC, the only nurse employed by ONC, joined their team more than two years ago.

In 2005, ONC established the American Health Information Community (AHIC) as a federally-chartered advisory committee.5 AHIC makes recommendations to HHS about creating digital and interoperable health records, encouraging market-led adoption of recommendations, and ensuring privacy and security. Lillee Gelinas, RN, MSN, FAAN, Vice President and Chief Nursing Officer of VHA, Inc., is the sole nurse on the 18-member panel. Lillee is also the Chair of the Electronic Health Records Workgroup and the Co-chair of the AHIC Successor, Inc. Transition Planning Team.

ONC awarded two contracts during 2005 that are especially relevant to nurses:

In 2008, AHIC Successor, Inc. was established as a public-private partnership to replace AHIC. Before the announcement of new board members, the Alliance for Nursing Informatics (ANI) considered nurse candidates who met the selection criteria, and submitted three nominees. When the 15-member Board was announced in September, physician, provider, and business representatives were included, but no nurse was selected. ANI Co-chair, Joyce E. Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, and other ANI representatives met with AHIC Successor, Inc. leaders to discuss priorities, their shared vision, and the need to involve nurses. Together, they identified multiple opportunities for nursing involvement such as providing input on prioritization of the 2009 Value Cases and participating in committee assignments. Subsequently, Linda Fischetti, RN, MS, Veterans Health Administration, was named as the federal liaison to the AHIC Successor, Inc. board.

Implications for nurses 

Much work remains despite nurses having made significant contributions to the development and integration of healthcare standards. It is imperative that nurses take action by becoming informed and involved as individuals, employees, and members of organizations. Select from the following list or develop your own action plan:

The inauguration of a new president will result in committee leader and member changes and create opportunities for those who are willing to participate in standards initiatives. Only if nursing is truly involved will the profession be able to take advantage of standards activities to enhance practice and client care. A true interdisciplinary health care–public partnership is necessary if EHRs will be widely adopted by 2014, based on recognized standards, and will be relevant to nursing practice.1 The health and well-being of individuals, families, and communities depends on increased nursing preparedness and participation.