RECEIVED 9 July 2014 REVISED 21 October 2014 ACCEPTED 24 October 2014 PUBLISHED ONLINE FIRST 10 February 2015 A national action plan for sharable and comparable nursing data to support practice and translational research for transforming health care Bonnie L Westra, PhD, RN, FAAN, FACMI 1 , Gail E Latimer, MSN, RN, FACHE, FAAN 2 , Susan A Matney, MS, RN, PhD-C, FAAN 3 , Jung In Park, BSN, RN 1 , Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN 4 , Roy L Simpson, DNP, RN, CMAC, FNAP, FAAN 5 , Mary Jo Swanson, DNP, RN 6 , Judith J Warren, PhD, RN, FAAN, FACMI 7 , Connie W Delaney, PhD, RN, FAAN, FACMI 1 ABSTRACT .................................................................................................................................................... Background There is wide recognition that, with the rapid implementation of electronic health records (EHRs), large data sets are available for research. However, essential standardized nursing data are seldom integrated into EHRs and clinical data repositories. There are many diverse activities that exist to implement standardized nursing languages in EHRs; however, these activities are not coordinated, resulting in duplicate efforts rather than building a shared learning environment and resources. Objective The purpose of this paper is to describe the historical context of nursing terminologies, challenges to the use of nursing data for purposes other than documentation of care, and a national action plan for implementing and using sharable and comparable nursing data for quality reporting and translational research. Methods In 2013 and 2014, the University of Minnesota School of Nursing hosted a diverse group of nurses to partici- pate in the Nursing Knowledge: Big Data and Science to Transform Health Care consensus conferences. This consensus conference was held to develop a national action plan and harmonize existing and new efforts of multiple individuals and organizations to expedite integration of standardized nursing data within EHRs and ensure their availability in clinical data repositories for secondary use. This harmonization will address the implementation of standardized nursing termi- nologies and subsequent access to and use of clinical nursing data. Conclusion Foundational to integrating nursing data into clinical data repositories for big data and science, is the imple- mentation of standardized nursing terminologies, common data models, and information structures within EHRs. The 2014 National Action Plan for Sharable and Comparable Nursing Data for Transforming Health and Healthcare builds on and leverages existing, but separate long standing efforts of many individuals and organizations. The plan is action focused, with accountability for coordinating and tracking progress designated. .................................................................................................................................................... Key words: nursing informatics, terminology, electro health records, consensus development conference, national health policy INTRODUCTION The core problems of healthcare access, quality, safety, effi- ciency, and effectiveness have been described by several land- mark reports. 1–6 These problems have been exacerbated by the recent financial crisis and by the urgent need to accommodate an estimated 32 million newly insured patients. In addition, the annual cost of harmful medical errors is estimated to be $17.1 billion (in 2008 dollars), 7 and the 63.1% of preventable injuries caused by medical errors further exacerbates healthcare expen- ditures. 8 New strategies and models to address these issues, challenges, and opportunities in the practice and delivery of healthcare are essential and have been outlined in multiple reports, including Building a Better Health System, 9 Computational Technology for Effective Health Care, 10 Digital Infrastructure for the Learning Health System, 11 and Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. 12 These reports build upon an exceptional founda- tion of Institute of Medicine (IOM) reports issued in the late 1990s and the 2000s. They share a common goal – utilizing technology and informatics to define a research agenda/strat- egy for studying the issues and challenges surrounding the transformation of the practice and delivery of healthcare. Correspondence to Bonnie L. Westra, School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall 308 Harvard Street SE, Minneapolis, MN 55455, USA; westr006@umn.edu, Tel: þ1 612-625-4470 Published by Oxford University Press on behalf of the American Medical Informatics Association 2015. This work is written by US Government employees and is in the public domain in the US. For numbered affiliations see end of article. CASE REPORT 600 Westra BL, et al. J Am Med Inform Assoc 2015;22:600–607. doi:10.1093/jamia/ocu011, Case Report Downloaded from https://academic.oup.com/jamia/article/22/3/600/772731 by guest on 15 February 2023