Leveraging Digital Nursing for the Future

The 2024 HIMSS European Health Conference and Exhibition showcased the latest solutions and experiences in digital and informatics nursing. It was a landmark event for the European digital health community, bringing together approximately 2,500 healthcare executives, practitioners and professionals from 84 different countries at the iconic Centro Congressi La Nuvola in Rome.

The conference highlighted the invaluable contribution of nurses to digital health transformation and the importance of ensuring their inclusion at all stages of digital innovation. 

The nursing agenda was supported by members of the HIMSS European Nursing Informatics Community and the Italian Nurses Association, featuring some of the most inspiring names in the European nursing world, including a compelling keynote panel with Professor Pam Cipriano, president of the International Council of Nurses; Christine Antorini, nursing student and former Minister of Education in Denmark; and Mark Sugrue, RN, member of the HIMSS Board.

HIMSS24 Europe featured the inaugural Digital Nursing Summit — a two-part, interactive program taking a deep dive into the cutting-edge advancements in digital support for nursing care. In light of the ongoing, global workforce crisis, the second part of the summit was dedicated to digital literacy, upskilling and nursing education policy and strategies to bolster and support nurses in their vital roles. 

If you missed the scintillating panels featuring nursing voices at HIMSS24 Europe, read on for the key takeaways from each of the speakers. 

Keynote Speakers

Keynote: Pam Cipriano, President, International Council of Nurses

Key takeaway: It’s time we put more digital tools into the hands of nurses.

With over 40 years in nursing, I still believe there is no more rewarding and challenging profession.  It is an extraordinary experience where strangers, at their most vulnerable times, let you into their lives, and you make a difference. Sadly, globally the trend is for nurses to leave the profession, and it’s NOT because they fell out of love with nursing, but rather, with jobs that do not support or value them.

It’s time we put more digital tools in the hands of nurses to decrease workload, improve workflow, spark innovation and equip them not only to improve safety but also to study more ways to improve the patient experience, raise community outcomes and reduce the burden of disease through prevention and better coordination of care.

It’s also time to be more aggressive in cultivating an interest in nursing careers for mature adults seeking career change or growth, as well as more men — in most countries only 10% of nurses are men, so we are ignoring almost half the population as potential nurses.

We have the know-how to reinfuse joy in nursing. The question is do we have the will?

 

Keynote: Christine Antorini, 1st year student nurse, former Minister of Education, Denmark

Key Takeaway: From government minister to student nurse! Career change in later years can be profoundly valuable personally and to wider society.

At 59, I transitioned from being a high-flying government minister to a student nurse at the peak of my former career, driven by a desire for a more balanced and meaningful vocation. Fascinated by the dedication of nurses and healthcare professionals, I wanted to work directly with patients and their families. Denmark's nursing shortage presented an opportunity, and I enrolled at Copenhagen University College, successfully completing my first year.

The response to my career change has been overwhelmingly positive, especially from adults aspiring to enter healthcare. Unlike many, I had the financial means from my previous career to support my new education, highlighting the need for more accessible lifelong learning opportunities. My age and experience enhance my ability to communicate with patients, and while being recognized as a former Minister of Education can be surprising, it often brings smiles to patients’ faces.

Staying updated with digital tools has been challenging yet rewarding, enhancing patient care through advanced electronic health records and telemedicine. Studying with younger peers has been enlightening, and their ease with digital technologies is impressive and inspiring. My journey from minister to nurse reflects a passion for healthcare, the importance of flexible education and the irreplaceable value of the human touch in nursing.

 

Keynote: Mark Sugrue, RN, CNIO and HIMSS Board Member

Key takeaway: Call to Action !! Nurses need to lead the development, implementation and adoption of Digital Health and AI tools to support nursing practice and the delivery of safe, timely effective, equitable, evidence based, patient centred and high quality patient care.

Technology is changing rapidly. Nurses across the globe need to be involved from the very beginning and not just at the end when these new tools are being incorporated into practice.   Artificial Intelligence has the promise to support clinical practice in many ways but it comes with inherent risks including but not limited to bias.  Nurses working in collaboration with interprofessional colleagues have a responsibility and a duty to protect patients from all harm including harm introduced by technology.

 

Keynote: Olga Gershuni, RN, nursing and mental health program director/strategic advisor, Health Tech Without Border 

Key takeaway: In the midst of crisis, it is essential to care for the welfare of the nurses, first and foremost.

At Health Tech Without Borders (HTWB), our mission is to support vulnerable populations during crises. The organization was established just days after the war in Ukraine began in late February 2022. One of the first organizations to support us was HIMSS, which published our call to action. We were truly grateful for their support. Our first initiative was to provide telehealth consultations to the Ukrainian population, which was particularly crucial due to the widespread destruction of infrastructure and the resulting collapse. Telehealth is a powerful tool and can be utilized almost immediately. However, we must never forget the importance of ethical principles, contextual knowledge and targeted engagement, which address actual needs through active listening. As part of our mission, we soon realized the need to support clinicians' mental health. This led to the launch of the Help the Healer Heal (3H) program, providing vital peer-to-peer support. Given the inevitability of wars and disasters, it is crucial to support our future healthcare professionals. To this end, we tailored educational and well-being support for nursing students at a Ukrainian nursing school, anticipating their vulnerabilities and addressing their needs. Nurses are the heart of any healthcare system, and disasters leave the healthcare systems of affected countries heartbroken.

 

Digital Nursing Summit Speakers

Dr Mette Maria Skjoeth, Head of Department, Odense , University Hospital, Denmark

Key Takeaway:

Worldwide, nurses play an important  role in enhancing healthcare for individuals suffering from various diseases. As the glue of the healthcare system, nursing roles are evolving amidst a workforce crisis driven by a shortage of healthcare professionals. To address this issue, digital transformation could offer the  solution, enhancing accessibility to healthcare services. As nurses constitute the largest group in healthcare with the highest degree of direct patient contact, it is imperative that they are at the forefront of this digital shift. 

Strong leadership is essential to support and encourage digital transformation within nursing. My  presentation highlighted the importance of leadership in facilitating this change, emphasising the need to bolster nurses' competencies for the future. The presentation also showcased a successful case of automated self-testing for chlamydia, where nurses developed an award-winning digital intervention. This case underscores the potential of nursing innovation, leading to digital tools to revolutionise healthcare delivery and the critical role nurses play in this transformative process.

 

Matthew Little, CNIO, Gloucester Hospital Trust (Speaking in the Digital Nursing Summit)

Key takeaway: It is essential to listen to the needs of nurses, doctors and all AHP when implementing a digital solution.

Developing a digital solution or an Electronic Patient Record system for healthcare requires recognizing the critical need for collaboration and connection. To ensure success in any clinical setting, it is essential to involve and listen to the voices of nurses, doctors and other healthcare professionals during implementation. Creating an effective clinical system that truly enhances patient care demands the involvement of both clinical staff and patients. While this may seem straightforward, large-scale projects often shift focus to funding, timelines and deliverables, sidelining the crucial input of those who will use the system daily.

As clinicians, we have a responsibility to ensure our voices are included in the digital programs, consistently prioritising patient needs. Key points discussed in our recent session include starting with the patient and working backwards, engaging in two-way conversations to understand requirements, recognizing that implementing a digital solution involves a hospital-wide cultural change and embracing the unknown by leveraging the diverse skills and experiences of staff. By focusing on these principles, we can develop digital solutions that not only meet clinical needs but also enhance patient care and satisfaction

 

Helle Sorensen RN, Project and development manager in health and social care, Östersund Municipality, Sweden 

Key takeaway: It’s about changing the way we work and focusing on the benefits of innovation.

My presentation focused on the importance of structuring improvement and innovation proposals from employees. Organisations should ensure they are well aligned and have strong insights into actual needs, and nurses and care staff are particularly relevant to this, as they have a profound understanding of the daily work challenges.

Once a new solution or system is ready for implementation, the next challenge is to actually change the way you do your daily work — the organisation needs to focus on change management and link it to the benefits and effects that were initially identified.

To evolve toward new practice and reap the positive benefits of change, it’s important that the organisation continually follows-up, evaluates, considers feedback and is results driven. When visible progress is highlighted, it drives motivation.

 

Dr Walter de Caro, President of Italian Nurses Association, Italy

Key takeaway: Let’s unlock the potential of nurses through digitalisation, reimagining a new mindset in healthcare.

The presentation covered several key areas within the evolving healthcare landscape, focusing on the role of nurses. It highlights the increasing responsibilities of nurses, which includes advanced clinical care, ethical decision-making, leadership, technological integration and team collaboration. Also presented were Italy's digital health ecosystem and the National Recovery and Resilience Plan - Next Generation EU, toward healthcare transformation. 

The importance of digital health literacy for both healthcare professionals and patients, and the role of nurses in combating online disinformation were underlined, as well as the necessity of education in nursing informatics and the development of new curricula and tools, such as the Nuric project funded by the EU. Leadership in managing the digital transformation of healthcare is pivotal, with various leadership models discussed, and the main barriers to building a 21st century healthcare system are not technical but rather institutional, process-related and workflow-related.

The presentation emphasised the need to unlock the potential of nursing through digitalization, focusing on resilience, reimagination and reengineering for a new mindset in healthcare. It advocates for leadership education, policy changes and the integration of informatics into nursing practice, to fully harness the benefits of technological advancements and improve healthcare delivery.

 

Ian Green, RN, Snomed UK

Key takeaway: Standardising nursing care terminology is key to improving quality and delivery of nursing care.

This presentation, Using ICNP and SNOMED in the EHR, highlights the SNOMED CT and ICNP collaboration, which has brought together two leading terminologies to support digital recording of nursing care in the EHR. The collaboration offers the opportunity for enhancing nursing practice by providing links between nursing practice and research, utilizing real world data.

The approach also offers the opportunity to standardize care plans in practice, as shown by pilot implementations in Norway, which supports the quality improvement and delivery of nursing practice.

 

Sinead Hanley, Executive Director of Nursing, Galway Clinic, Ireland

Blackrock Health Galway Clinic has been to the forefront of developing an EHR that is user friendly and providing a record of care that the organisation, the RN and the patient can rely on. As an executive director of nursing, my focus must be to ensure that there is evidence of care, treatment and follow up captured within the EHR that is auditable while also capturing the relationship between the patient and the nurse.

At HIMSS24 Europe, we were asked many questions about how we achieved that balance between “ticking boxes” and meaningful person-centred communication. This highlighted for us that nursing content, which forms the biggest structured elements within the EHR, needs design and investment to capture the art as well as the science of nursing.

 

Catherine McCabe, Associate Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland

Key takeaway: It is imperative to standardise undergraduate digital health curriculum for nurses and midwives and support “clinical champions” for digital health competencies.

Ireland’s recently launched Digital Health Framework 2024-2030 provides a blueprint  for the development of digital health infrastructure and capacity. It highlights the current deficiencies in digital health and emphasizes the need to expand nurse education, particularly at the undergraduate level, to enhance digital health knowledge and skills.

Documents such as the Digital Capability Framework for Health and Social Care (2020) and the Digital Health Competency Standards and Requirements for Undergraduate Nursing and Midwifery Education Programmes (NMBI 2023) aim to standardise the content, ensuring graduates possess the necessary competencies, knowledge and skills related to digital health. This is crucial for integrating digital health technologies into nursing practices, enhancing workflow management and maintaining individualised patient care. The involvement of nursing professionals is expected to improve the quality of health data, which is vital for effective digital health solutions.

There is a notable issue with the inconsistency of postgraduate nursing and midwifery digital health education in Ireland. The framework underscores the importance of clinical “champions” who can support digital health competencies and development across all healthcare contexts. Effective digital health initiatives require collaboration among all stakeholders, including patients, to ensure sustainable and impactful outcomes.

 

Outi Ahonen, PhD, RN,  Principal Lecturer, Digital Department, Social, Health and Sport, Laurea University of Applied Sciences, Finland  

Key takeaway: Every nurse is a digital nurse and should actively participate in developing digital services.

In Finland, we are proud to have published a digital social and health services strategy for nurses, authored by the Finnish Nursing Association. The aim of the strategy is to support good quality and client-oriented care through digital health services and multi-channel service models.

Another objective was to foster more discussion around the role of nurses in developing and running digital services and strengthening public participation. We need to spread this debate and information to a wider audience in Europe. 

Primarily, it's important that every nurse receives basic digital competencies during their education, but there is also great potential and opportunity to drive professional development and skill building in digital transformation in health care to nurses later in their career.

Secondly, it's important that nurses have the opportunity to take part in transdisciplinary development work to bring nurses and patients voices to the development discussion.

 

Professor Natasha Phillips RN PhD, Founder Future Nurse, School of Health & Society, University of Salford, Manchester (Ex CNIO NHS England)

Session: Supporting the Workforce of the Future

It was wonderful to have such a strong nursing presence at HIMSS this year.  I chaired a fantastic session on preparing the workforce where Pam Cipriano grounded the discussion in the challenges we face today with a global shortage of nurses and other clinical staff. Exacerbated by the pandemic and an exhausted workforce, combined with poor, inefficient technology and a workforce lacking the digital health literacy skills to work with technology or lead innovation. One of the panellists, Hela Ghariani  recognised this challenge in France, where a national programme was implemented with 119 million euro investment in workforce education, leading to national standardised competencies and curriculum for all new healthcare professionals.

Similar recommendations have been made through various reviews here in the UK but are yet to take hold and be funded. Having led one such review, Phillips Ives, that was disheartening.  However this motivated my return to the UK with renewed vigour to influence this through the development of a Future Nurse Global Innovation Community - watch this space for more on that!

The closing keynote focused on nursing was particularly touching, and infused me with renewed energy to tackle digitally enabled nursing by demanding technology that supports the care we give, as well as being central to the design of the new models of care.. At Future Nurse our expert clinical and technical teams work with organisations to deliver person centred transformation. Without this relentless focus on people centred design we can't realise the benefits for both those delivering care and those they care for.

 

Pam Cipriano, President - International Council of Nurses

Session: Supporting the Workforce of the Future

Nurses faced immense challenges during the pandemic, with stories of feeling undervalued, unprotected and overworked, yet they continued to show up and care for patients despite fear and fatigue.

This has led many to leave their jobs or object to working conditions. The solutions to retaining the nursing workforce include creating a safe and respectful work environment, investing in adequate staffing, fair pay, professional development and digital technologies.

Nurses must be empowered to work to their full potential and scope of practice, with adequate training and digital literacy, and it's crucial to involve them in designing technologies that meet their needs, as emphasized by the International Council of Nursing’s Charter for Change.

 

Winnie O’Neill, Nursing & Allied Health Project Manager, Blackrock Health- Galway Clinic. In session “One Click Too Many - Reducing Operational Burden on Clinical Staff” 

Key takeaway: A focus on active input and engagement of nurses in all EHR implementation.

At the Galway Clinic, we believe there are certain key factors in successfully implementing an Electronic Health Record system that reduces the operational burden on clinical staff. Crucial to this process is the active input and engagement of nursing and allied health professionals throughout all stages of the implementation. The EHR system must not only support but also enhance existing clinical workflows to ensure seamless integration.

A strong focus on clinical content and its governance is essential for establishing Nursing and Allied Health documentation standards. Clinical documentation should be evidence-based, and the EHR must offer clinical decision support tools that enable the efficient and effective documentation of patient assessments and care plans. To maintain the EHR's effectiveness, the clinical content must be regularly reviewed and updated to ensure it remains relevant.

Finally, infrastructure considerations are critical. The system requires robust and reliable hardware, as well as dependable WiFi, to facilitate bedside documentation and other care processes, ensuring that the EHR supports clinical staff in their roles without adding unnecessary burdens.

 

Michele Hardiman, Nurse Practice Development Education and Research Facilitator,  Galway Clinic, Ireland.

Session: Work Smarter not Harder - How Clinical Decision Support Can Drive Better, Safer Clinical Care

Key takeaway: The EHR should work for us at the bedside, rather than nurses having to adjust their practice.

Blackrock Health Galway Clinic is really leading the way in the UK/Ireland/ European setting, as we have strived to redesign the nursing content with the aim of helping nurses work smarter not harder.

Our efforts will ensure the electronic record is adapted to work for nurses and allied health professionals at the bedside rather than us having to adjust our practice to fit into content supplied by the vendor.

Adjusting the content needs to be culturally adapted to individual countries and professional standards. Working collaboratively with end user helps to ensure the record stays relevant and ensures buy-in; adding pop-up prompts helps to stimulate critical thinking making it easier to ensure all aspects of care are assessed.

There was huge interest in our contribution at the conference with many downloading our published paper and reaching out to ask questions from our team Sinead, Michele and Winnie.

 

Olga Visnevetsky, RN / Lead Nurse Care Coordinator for the ADLIFE project in Israel

Session: Tackling Chronic Diseases with Digitally Integrated Care

Key takeaway: Nurses were found to be the most efficient case managers to coordinate integrated digital care.

As one of the principal nurse practitioners involved in The ADLIFE project, my presentation highlighted the truly pivotal role that nurse coordinators play in this HORIZON 2020 Innovation project, which aims to provide a digitally supported integrated care solution for patients with advanced chronic diseases (CHF and COPD). 

It was found that nurse coordinators were extremely successful case managers and coordinators of care. They were the most consistent users of the digital platforms, performing the intake evaluation of patient functional and social status, taught both clinicians and patients how to use the platforms, performed ongoing monitoring of patient status, coordinated with the GPs and the specialists and supported patients and caregivers.

Furthermore, they empowered patients to take an active role in managing their health. A core conclusion is that for digitally supported integrated care to succeed, there must be some form of case manager who is the main user of the system and coordinates the rest of the multidisciplinary team in its use. In ADLIFE, we found that this was done best by nurse coordinators.