Innovation underlined every aspect of this year’s 31st Annual Summer Institute in Nursing Informatics (SINI), which was hosted entirely virtually by the University of Maryland School of Nursing (UMSON) on July 14-15 for the second consecutive year. The conference, themed ‘Embracing Health Care Complexity Through Informatics Innovations’, welcomed nearly 150 participants worldwide for a two-day program of keynote presentations and three tracks of information on healthcare informatics focusing on Patient Care Management, Precision Medicine and Informatics Education. poster presentations; a fireplace chat about computing platforms; and Application Alley, a spotlight on healthcare app design, completed the agenda.
Jane M. Kirschling, PhD, RN, FAAN, the Bill and Joanne Conway Dean of the University of Maryland School of Nursing, welcomed those in attendance 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 co-chaired the event this year, alongside the other 14 members of the planning committee.
“This is a remarkable year,” Kirschling said. “It is our second fully virtual conference and while last year’s virtual institution was accelerated by the uncertainties of the COVID-19 pandemic, the benefits of being virtual quickly became apparent. One of the most important was the ability to more easily involve colleagues from the United States and internationally.” She also reported on a unique phenomenon from 2022, adding: “I have to say, when we look at the state of air traffic this summer, I think we can appreciate this virtual format doubly.”
Kirschling also recognized 2022 as the year in which Mary Etta Mills, ScD, MS ’73, BSN ’71, RN, NEA-BC, FAAN, professor, retired, just 50 years at UMSON faculty. Mills led the development of the world’s first masters program in nursing informatics, in 1988, and his first PhD program with a concentration in nursing informatics, in 1991, both at UMSON. “In addition to teaching, her interdisciplinary research has focused on developing the teaching and application of nursing informatics and advancing healthcare administration and education through strategic partnerships between academic services,” Kirschling added.
However, the focus of computer science, Kirschling explained, is entirely on the future. “We must not lose sight of the capacity of nurse informatics to help us address the critical issues surrounding health inequalities, and with it the importance of developing systems that help others navigate the technology that holds so much promise,” Kirschling said. “This is reflected in this year’s conversations about shaping the future by empowering nurses to innovate, create and collaborate to innovate and transform healthcare through Learning Health Systems.”
Kirschling then handed over the virtual microphone to Rebecca Love, MSN, BS, RN, FIEL, a nurse director, nurse entrepreneur and chief clinical officer of IntelyCare Inc., a tech-assisted staffing platform for nurses in the US. Love is co-founder and president of the 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—meeting exceptional challenges by effecting exceptional change—and argued that nurses must lead the transformation of the American health care system. “We’re not going to solve the fundamental challenge,” she argued. “There are plenty of nurses. What doesn’t work is the system itself. That’s something we can change. This change must be led by nurses.”
She said nurses have served as opinion leaders throughout the history of nursing, but have been portrayed as angels, “which has negatively affected the historical impact of nurses,” she explained. “The feeling of being an angel has left the thought leadership of nurses out of history. It became what was expected of them. The creation of nursing itself is an example of extraordinary thought leadership. The foundation of nursing was based on challenging conventional medical practice.”
Love encouraged nurses to engage in social media to “highlight your superpower,” she said, to engage others, influence policy and publish on platforms where they can reach non-nursing populations. She argued that as nurses become more visible, they will facilitate others’ position as opinion leaders as a rising tide lifts all ships. And nurses are already doing just this: “How do we combine thought leadership and innovation?” asked love. “They combine in the moment when you can make something better, which inherently describes what we as nurses do every day.”
“It will be nurses who will save the future of our health care system,” she added. “Now is your time to find your place at the table. We are not invited; we will have to claim a seat.”
Harking 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 short illness. The Saba tribute was presented by SINI Distinguished Lecturer Kathleen A. McCormick, PhD, RN, FAAN, FACMI, FHIMSS, a senior practitioner, researcher, and policy officer in evidence-based healthcare, health informatics, bioinformatics, and gerontology.
“Her most memorable legacy and impact she had was on CCC, the clinical classification of care,” said McCormick, who co-authored with Saba on Nursing Informatics Basics. 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 remains; according to the American Medical Informatics Association, 70,000 nurse informatics are needed in the next five years.
McCormick challenged SINI attendees to work on using standardized nursing terminologies in their practice and research.
“My friend and colleague lives through us. We are the legacy of Virginia Saba and it is up to 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, concluded the conference with a presentation on learning health systems (LHS), a method to improve the health of individuals and people. Since 2007, it has been widely recognized and increasingly adopted around the world.
“Health systems become learning health systems when they can continuously and routinely improve health by combining discovery with 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:
- features, events, and context are captured as data to learn from
- trusted knowledge generated by analyzing the data is quickly available to support strategies and decisions
- improvement is continuous and sustainable through continued cyclical activity
- an infrastructure creates a system that makes it possible to improve routinely and with economies of scale
- all of this becomes part of the entity’s culture.
To improve on a particular problem, for example, preventing falls in a nursing home, one has to gain new knowledge and actually do something about it. In a learning health system, the group trying 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 over” it to another group of stakeholders.
According to Friedman, over the past 10 years, LHS initiatives have sprung up in many places, at all scales, including organizations like 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.
“One day we may see a global learning health system, and if any experience has taught us that there is a need for a global learning health system, then the COVID-19 pandemic certainly has,” he said.