Q&A With Chris Wierz, Principle and Co-Leader of IT Practice, Witt/Kieffer
It’s one of the oldest known professions, and yet, the role of the nurse never seems to stop evolving. As technology plays an increasingly larger role in how care is delivered, the need has emerged for a leader that can bridge the interests of nursing and technology.
Enter the Chief Nursing Informatics Officer (CNIO), a role that was first designated in 1992, but is now starting to get its due — as well as a seat at the table alongside CMIOs and CIOs. According to a Witt/Kieffer report, the CNIO plays a dual role in improving outcomes by combining “traditional frontline care duties with innovative evidence-based processes and practices that are applicable to nurses and, by extension, all caregivers.”
And now, the industry finally seems to be taking notice. The report found a significant hike in respondents who hold the CNIO role (14 percent in 2014, compared with 4 percent in 2011), which Chris Wierz believes is encouraging. “I think it’s very important that nursing has a strong voice in the IT space,” said Wierz, now Principal and Co-Leader of IT Practice at Witt/Kieffer.
But the news wasn’t all great; many either don’t understand, or simply underestimate the value these leaders bring. It’s a cause Wierz is happy to take up, having served as a “computer nurse” before the CNIO term was born. In this interview, she discusses the findings of the study, why reporting relationships are so critical, how the field of nursing has evolved, and what she hopes to see happen in the future.[To read part 1 of the interview, click here.]
Gamble: The benefits of having a CNIO seem to be pretty clear, so what are the biggest barriers that prevent organizations from hiring one?
Wierz: It’s interesting. In the first survey we did, people were saying, ‘If we have a CNIO, then we’ll need to hire a CPIO (chief pharmacy information officer) and a CRIO (chief research information officer).’ When you think of it that way, there are organizations that aren’t equipped to add another C-suite leader to their structure. It may also be an issue with titles—some organizations have a director of nursing informatics who is doing the job of a CNIO.
And of course, budgetary constraints are a big part of it. But it’s also true that some organization just don’t understand the role. There’s a need for clarity. There was a comment in the survey that people understand the importance of it, but they need to socialize it across the organization and show the importance of it in order for it to actually come to fruition.
Gamble: It’ll be interesting to see what happens with the role in the next few years. Any thoughts on how it might continue to evolve?
Wierz: One thing that really struck me was the salary. When we presented the findings, we were really surprised that the majority of salaries are between $115,000 and $120,000. My gut tells me it’s going to increase, and I hope it will as things move forward. But it’s up to individuals to articulate their value and make the case. I think that’s what we’re going to see across the board.
It’ll be interesting to see whether organizations start thinking about a chief clinical information officer role, but that tends to be more on the physician side than on the nursing side. I think there’s still some evolution. We do still need clarity — the role is not perfectly clear to everybody, but I think the organizations that do have these roles have figured out how to make them work and why they’re so critical.
Gamble: As far as the CIO’s perspective, any thoughts on how they can build and maintain a strong relationship with the CNIO?
Wierz: I think most CIOs understand the strength of that role and the need for collaboration. I also look to the chief nursing executive (CNE) to stand up and make his or her voice heard as well from an IT perspective. Oftentimes when we go into organizations, the CNE is not necessarily someone leaders think is important to speak with when we start doing a CIO search, and that’s an oversight. I think it’s important for CNEs to really articulate their needs to the CIO and to the CEO. We’ve found that the CIOs whose organizations have a CNIO really understand the value that this person brings as an interpreter and a conduit between clinicians and what IT is trying to accomplish.
Gamble: And I’m sure it can also influence things if a CIO has a nursing background.
Wierz: Exactly. When you have a CIO with a nursing background, it provides a whole different dimension to that relationship.
Gamble: Sure. And for CIOs whose background is more rooted in technology or business, I’m sure it’s very beneficial to partner with the CNIO and try to gain that perspective.
Wierz: Absolutely. When think of the CIO role today, it’s very transformative. It’s very business-focused. And the CNIO needs to be in lockstep with that and understand the business aspects in order to make those decisions. When they can demonstrate the emotional intelligence and collaborative skills needed to be able to articulate these decisions from a business perspective, their value can be seen across the organization.
Gamble: Looking back at your own experience as a ‘computer nurse,’ I’m sure it’s been interesting to see how nursing has evolved over the years.
Wierz: Oh yes, it’s been terrific to see. I’m very proud of the fact that nursing has stepped up and embraced technology to improve bedside care. There are so many things that are happening around analytics and being able to use data to improve care, improve efficiency, and lower costs, and the CNIO is smack in the middle of all of that. It’s been wonderful to watch.
Gamble: I’m sure you have some great stories from your time in nursing.
Wierz: I do. I remember one in particular where the printer was printing out lab results in a critical care unit and it was dropping numbers. When you’re talking about things like hemoglobin, you do different things with different values. I remember having to explain that, and when I think about it now, it takes my breath away a little bit. Of course there were other things that were done to mitigate it, but we had to explain that we change our care plan based on these numbers. If these numbers are not right, we need to stand up and take notice. This is a critical issue. It’s not something that can wait until tomorrow.
Gamble: Nursing really has come a long way.
Wierz: It has. Personally, I don’t think I could do it today. When I think about the patients I took care of compared with the patients that are admitted today and everything that’s being done on an outpatient basis, it’s a very different role. My hat goes off to those who are doing it today.
Gamble: Definitely. Well, I want to thank you so much for sharing your perspectives and talking about the research Witt/Kieffer has done in this area. It’s really interesting, and I hope we can speak again in another few years.
Wierz: Thank you, Kate. I’d like that.