August 2022

Turning SINI’s I Toward Innovation

August 3, 2022    |  

Innovation underscored every aspect of this year’s 31st annual Summer Institute in Nursing Informatics (SINI), hosted entirely virtually for the second consecutive year July 14-15 by the University of Maryland School of Nursing (UMSON). The conference, themed “Embracing Health Care Complexity Through Informatics Innovations,” welcomed nearly 150 participants worldwide for a two-day schedule full of keynote presentations and three tracks of health care informatics information focused on Patient Care Management, Precision Medicine, and Informatics Education. Poster presentations; a fireside chat about informatics platforms; and Application Alley, a spotlight on health care app design, rounded out the agenda.

From left, Rebecca Love, Charles Friedman, and Kathleen McCormick.

From left, Rebecca Love, Charles Friedman, and Kathleen McCormick.

Jane M. Kirschling, PhD, RN, FAAN, the Bill and Joanne Conway Dean of UMSON, welcomed attendees and thanked Barb Van de Castle, DNP ’14, ACNS, OCN, RN-BC, UMSON assistant professor, and Charlotte Seckman, PhD, RN-BC, FAAN, retired UMSON associate professor, who served as co-chairs of this year’s event, in addition to the other 14 members of the planning committee.

“This is a noteworthy year,” Kirschling said. “It is our second completely virtual conference and although last year’s virtual institute was precipitated by the uncertainties of the COVID-19 pandemic, the benefits of being virtual quickly became clear. One of the most significant was the ability to more easily engage colleagues from around the United States and internationally.” She also made mention of a uniquely 2022 phenomenon, adding: “I must say, as we look at the state of air travel this summer, I think we can be doubly appreciative of this virtual format.”

Kirschling also recognized 2022 as the year in which Mary Etta Mills, ScD, MS ’73, BSN ’71, RN, NEA-BC, FAAN, professor, retired, just shy of 50 years on the UMSON faculty. Mills led development of the world’s first nursing informatics master’s program, in 1988, and its first PhD program with a nursing informatics concentration, in 1991, both at UMSON. “In addition to her teaching, her interdisciplinary research has focused on developing the field of nursing informatics education and application and advancing health services administration and education through strategic academic-service partnerships,” Kirschling added.

The focus of informatics, however, Kirschling explained, is squarely on the future. “We cannot lose sight of the capacity for nursing informatics to help us address the critical issues surrounding health disparities and with it, the importance of developing systems that help others navigate the technology that offers so much promise,” Kirschling said. “This is reflected in this year’s conversations about shaping the future through empowering nurses to innovate, create, and collaborate on innovations and transforming health care through Learning Health Systems.”

Kirschling then turned the virtual mic over to Rebecca Love, MSN, BS, RN, FIEL, a nurse executive, nurse entrepreneur, and chief clinical officer of IntelyCare Inc., a tech-enabled nurse staffing platform for U.S. health care organizations. Love co-founded and is president of nonprofit organization SONSIEL: The Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders.

In a highly energetic presentation, “Thought Leadership Toward Innovations in Nursing,” Love explained the concept of thought leadership — facing exceptional challenges by effecting exceptional change — and made the case that nurses must lead the transformation of the U.S. health care system. “We are not going to solve the fundamental challenge,” she argued. “There are plenty of nurses. What is not working is the system itself. That is something we can change. This change must be led by nurses.”

She said that across nursing history, nurses have served as thought leaders but have been portrayed as angels, “which has negatively impacted nurses’ historical impact,” she explained. “The sentiment of being an angel has left nurses’ thought leadership out of history. It became what was expected of them. The creation of nursing in and of itself is an example of most extraordinary thought leadership. The foundation of nursing was based on challenging the conventional medical practice.”

Love encouraged nurses to participate in social media to “highlight your superpower,” she said, to engage others, to influence policy, and to publish in platforms where they can reach non-nurse populations. She argued that as nurses become more visible, they will facilitate others’ positions as thought leaders, as a rising tide lifts all ships. And nurses are already doing exactly this: “How do we combine thought leadership and innovation?” Love asked. “They combine at the moment that you can make something better, which inherently describes what we do every day as nurses.”

“It is going to be nurses who save the future of our health care system,” she added. “It is now your time to find your seat at the table. We are not going to be invited; we are going to have to demand a seat.”

Hearkening back to UMSON’s storied history of building careers in nursing informatics, this year’s conference also included a tribute to nursing informatics pioneer Virginia K. Saba, EdD, RN, FACMI, FAAN, who passed away last November after a brief illness. Offering the tribute to Saba was SINI Distinguished Lecturer Kathleen A. McCormick, PhD, RN, FAAN, FACMI, FHIMSS, a senior practitioner, researcher, and policy executive in evidence-based health care, health informatics, bioinformatics, and gerontology.

“Her most memorable legacy and impact that she had was on CCC, the clinical care classification,” said McCormick, who with Saba co-authored Essentials of Nursing Informatics. Now in its 7th edition, released in 2021, the book is considered a classic in nursing informatics.

Both Saba and McCormick focused their careers on increasing the number of nurses working in nursing informatics, McCormick said. The need continues; according to the American Medical Informatics Association, 70,000 nurse informaticians will be needed in the next five years.

McCormick challenged SINI attendees to work on using standardized nursing terminologies in their practice and in their research.

“My friend and colleague lives through us. We are the Virginia Saba legacy, and it’s for us to continue it. That's my challenge,” McCormick said.

Endnote speaker Charles Friedman, PhD, the Josiah Macy Jr. Professor of Medical Education and chair of the Department of Learning Health Sciences at the University of Michigan Medical School, wrapped up the conference with a presentation on learning health systems (LHS), a method to improve individual and population health. Since 2007, it has become widely recognized and increasingly adopted around the world. 

“Health systems become learning health systems when they can, continuously and routinely, improve health by marrying discovery to implementation,” said Friedman, editor-in-chief of the open-access journal Learning Health Systems. The LHS idea was developed in 2006 by the Institute of Medicine, now the National Academy of Medicine, and published in 2007.

In an LHS:

  • characteristics, events, and context are captured as data to learn from
  • trusted knowledge generated from analysis of the data is rapidly available to support strategies and decisions
  • improvement is continuous and enduring through ongoing cyclic activity
  • an infrastructure creates a system that enables improvement to occur routinely and with economy of scale
  • all of this becomes part of the entity’s culture.

For there to be improvement in any particular problem — say, preventing falls in a nursing home — one must take new knowledge and actually do something with it. In a learning health system, the group that tries to solve the problem is the same group that analyzes the data, designs new solutions, and finds a way to implement those solutions in one continuous cycle without “handing it off” to another group of stakeholders.

According to Friedman, in the past 10 years, LHS initiatives have sprouted up in many places, at all levels of scale, including in organizations such as Intermountain Healthcare, Geisinger, and the Mayo Clinic; in learning networks such as ImproveCareNow and EPINET, which is funded by the National Institutes of Health; and in Quebec, British Columbia, Michigan, Indiana, Switzerland, Scotland, England, Saudi Arabia, and through the Veterans Health Administration, elsewhere in the United States.

“Someday, we might see a global learning health system, and if any experience has taught us the need for a global learning health system, certainly the COVID-19 pandemic has done that,” he said.