The Rise of the CNIO

Nursing Informatics is emerging as one of the fastest growing areas of nursing professional development.

Nursing Informatics graduate programs are increasing, with nurses looking to informatics as the next step in their career.

Certainly, Meaningful Use as part of the HITECH Act, which provides financial incentives for hospitals and providers to implement and adopt the use of the electronic health record, has added to the awareness of nursing informatics and the corresponding need for nursing informatics executives.

As well, the demand for and growth of technology solutions, especially mobility, within the healthcare setting add to the need for informatics nurses to oversee, support, and manage the staff’s expectations, utilization, and adoption of these technologies.

Within many organizations, there is also an increasing understanding of the need for an executive nursing leader to provide both operational and strategic guidance for the use of these technologies, especially the electronic health record (EHR) by nursing.

The chief nursing informatics officer (CNIO) position is rapidly emerging as organizations seek to manage and support this growth in technology and develop strategies for outcomes management, nursing efficiencies, and safe patient care.1


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Growing Prominence

While nursing informatics has been an emerging discipline since the 1960s, it has become more prominent since the 1990s.

Nursing informatics certification through the American Nurses Association Credentialing Center (ANCC) was recognized in 1994, and there are now more than 1,000 RNs certified in nursing informatics.

According to the Health Information Management Systems Society (HIMSS) Nursing Leadership Survey in 2011, there are more than 3,000 nursing informaticists, 75% of whom work with implementing systems in hospitals.

However, only 8% of organizations had a role defined as a “CNIO” or “Nursing Informatics Executive Leader.” Therefore, there is a definite need for CNIOs, and many organizations are starting to develop these executive positions.

CNIO Defined

So, exactly what is a CNIO? What do they do, and how does this impact organizations?

In my role as CNIO for a large integrated healthcare delivery network, one key component is to provide a strategic direction for nursing’s use of technology. Another component is to ensure the alignment of the information technology initiatives with nursing’s strategic plan.

I feel it’s important to focus on nursing workflows, efficiencies, and outcomes, both to ensure adoption of the technology and to show clinical and financial value.

Areas where the CNIO might impact nursing workflows to improve outcomes can range from identifying ways within the EHR to help nurses comply with regulatory requirements, to empowering nurses to optimize their practice through use of technology, such as improving efficiencies through device integration of vital signs and hemodynamic data from critical care systems.

It is also important that the CNIO be aware not only of regulatory requirements, but also other key federal and state initiatives that can be impacted by nurses’ use of technology.

Certainly Meaningful Use has a strong nursing component, and the CNIO’s ability to evaluate and monitor nursing specific indicators, e.g., ensuring optimal workflows for supporting patient engagement or barcode medication compliance-are critical to an organization’s ability to meet these requirements.

Central to the CNIO role will be use of analytics and managing the transition of nursing practice to become more outcome-focused.

The reason for adopting technology (and why I get up every morning) is to ensure that nurses have the tools to provide the best patient care possible. As we move across the continuum from data to information to knowledge to wisdom, nurses need to transition from being data collectors to data interpreters.

The CNIO, in collaboration with other nursing leaders, can ensure that they have the workflows, tools, and knowledge to provide quality patient care, as measured and demonstrated through analytics.


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A Look Ahead

The professional development of the CNIO will continue to grow and become more clearly defined and standardized in its scope of practice.

The American Organization of Nurse Executives and HIMSS have released position papers aligning nursing informatics with the Robert Wood’s Johnson Future of Nursing Report.

Both identify the CNIO as key to engaging in transformational activities and bridging new care models by enabling the right technology for the care setting.


Furthermore, AONE states that, “One can expect a growing demand for this strategic and operational role to permeate the majority of organizations to support the entire care delivery team to changes in the healthcare environment.”2

Therefore, it can be said nursing informatics in general – and the CNIO role specifically – is on the rise.

The future is bright for nurses looking at informatics as not only a good career move, but also for advancement to executive nursing positions within an organization.

References for this article can be accessed here.

Mary Beth Mitchell, MSN, RN, BC, CPHIMS, is Chief Nursing Informatics Officer, Innovative Technology Solutions, Texas Health Resources.

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