A nurse's role in Administration differs significantly from that in bedside care. A nurse in
Administration handles coding and the coordination of an EHR for a patient. For example, a nurse
coordinating the care of a patient in utilization management needs to know ICD coding to
determine the proper coverage for a patient and the proper reimbursement for a provider when
submitting information for insurance coverage. Additionally, an ICU nurse needs to know the
objective and subjective data to enter the EMR to be coded later for payment. All subjective and
objective information needs to be managed under strict guidance because it is private health
information, and if this information is not managed correctly, HIPPA can be violated. At my place
of employment, we are lucky enough to be able to serve over 3 million patients, meaning we have
access to many different forms of healthcare technology. With the number of employees that it
takes to run a system this large, it is not surprising that all the departments use healthcare
information technology in different ways. With nurses being the most abundant health information
technology users (Zadvinskis, 2018), their roles and functions will vary between industry and
setting of employment.
Each company within different industries will have standards for its employees to meet, and
healthcare is no exception to this. An Occupational Health nurse, also known as an employee
health nurse, is a nurse who recognizes and prevents health issues in an occupational setting. They
also assess workers’ health in regards to their job duties (Gaines, 2020) and promote the health
and wellbeing of employees. An occupational health nurse will be using healthcare information
technology to monitor the employees under their care, but will not be using the technology to
treat illnesses from non-work-related exposures. This differs from a clinic nurse, who frequently
uses technology to assist the physician with diagnostic and treatment efforts for patients due to a
wide variety of exposures.
Another example of this would be a surgical nurse. Due to working with them frequently at my job,
I am very familiar with their job duties. These nurses do not use healthcare information technology
to diagnose or treat patients, but they will use it to document procedures done during surgery and
to document all timings and equipment used during surgery for billing purposes.
The wide variety of roles that a healthcare information technology user can hold is vast but
properly obtaining and storing patient information is a priority for all health information managers
regardless of the actual position they hold. With the nature of technology, it is changing often to
meet the needs of the users and the people it serves. This requires frequent updates and training
in protocols with every change to a system to ensure the proper care and management of patient
information is taken. Health care informatics is a broad term inclusive of many roles and aspects of
using data to improve health care, while nursing informatics tends to focus on patient care ("The
Difference Between Health Care and Nursing Informatics," 2018). Roles and uses of technology
differ depending on the healthcare institution and specialty. Healthcare professionals such as
coders, health information managers, health insurance managers, medical transcriptionists, and
other healthcare professionals vary in their roles and functions. Nurse informatics helps implement
new processes, validate data, and support patient care. All these professionals have various
educational backgrounds and training. Nursing staff within a hospital setting have access to
different information than those in private practice. The level of care may differ within other
facilities. The ED staff provides episodic care for acutely ill patients for whom historical information
may be limited or completely missing (Aronsky, Jones, Lanaghan, & Slovis, 2008). In a hospital
setting for example the number of patients may be higher with fewer recurring visits. Private
practices may have a long-standing list of recurring patients. Despite obligations to "protect the
patient's secrets", there are daily challenges to protecting privacy and confidentiality in the unique
setting of the emergency department (Geiderman, Moskop, & Derse, 2006). In teaching hospitals,
more providers and nursing individuals may have full access to all patient information. Teaching
hospitals have students rotating through clinical every single year which causes a constant change
in who may have access. One example of uses of technology that differs within the hospital setting
is dispensing of medication. In private practice, the provider may give samples of medication but
typically gives a prescription to be filled. On the other hand, within a hospital setting, a provider
will prescribe a medication to be dispensed by nursing staff through a secure system. Specific data
may be collected depending on the specialty for example infectious diseases or cancer data.
Depending on specialty-specific data may be accessible to nursing staff within those specialties.
During my six years as a medical assistant, I was able to have a firsthand look at the different roles
within a private practice. Nurse Practitioners along with Physician assistants can consult, diagnose,
and treat a patient under the direct supervision of a physician. Registered nurses are certified to
conduct specialized administration of medication and perform specialized procedures. RNs may
have access to patients' charts other clinical personnel may have limited access. Each state also
differs. In Oklahoma, medical assistants have access to more in-depth clinical documentation.
Medical Assistants are also allowed to assist in specialized procedures unlike in New York state.
The role and scope of practice of everyone will always help in the management of information.
Some roles may overlap therefore specific outline of each role will help other team members
understand who will manage patient care and healthcare information for that patient.
References
Aronsky, D., Jones, I., Lanaghan, K., & Slovis, C. M. (2008). Supporting Patient Care in the
Emergency Department with a Computerized Whiteboard System. Journal of the American Medical
Informatics Association, 15(2), 184–194. https://doi.org/10.1197/jamia.m2489
Geiderman, J. M., Moskop, J. C., & Derse, A. R. (2006). Privacy and Confidentiality in Emergency
Medicine: Obligations and Challenges. Emergency Medicine Clinics of North America, 24(3), 633–
656. https://doi.org/10.1016/j.emc.2006.05.005
The Difference Between Health Care and Nursing Informatics. (2018). Retrieved January 14, 2022,
from Capella University Blog website: https://www.capella.edu/blogs/cublog/healthcare-
informatics-vs-nursing-informatics
A Nurse Informaticist: 3 Essential Responsibilities. (2021, February 2). Health Catalyst.
https://www.healthcatalyst.com/insights/nurse-informaticist-3-essential-responsibilities
Gaines, K. (2020, June 10). How to Become an Occupational Health Nurse. Nurse.Org. Retrieved
June 15, 2022, from https://nurse.org/resources/occupational-health-nurse/
Zadvinskis, I. M., Garvey Smith, J., & Yen, P. Y. (2018). Nurses’ Experience With Health Information
Technology: Longitudinal Qualitative Study. JMIR Medical Informatics, 6(2), e38.
https://doi.org/10.2196/medinform.8734
Bowie, M. J. (2019). Essentials of Health Information Management: Principles and Practices (4th
ed.). Cengage Learning.
