CNO’s Discuss Healthcare Reform: Part 2

Great information was shared at the Health Information Management Systems Society’s (HIMSS) Dallas-Fort Worth Chapter’s Q2 Educational Event.   Mary Stowe, VP and CNO at Children’s Medical Center Dallas, and Claudia Wilder, VP and CNO at Baylor University Medical Center, were the speakers on the panel for this event, and they provided so much knowledge to those in attendance.  Click on the video below to view a live recording from the event which will also be available for viewing soon at

Live Recording:  CNO Panel Discussion at DFW HIMMS Event

Live Recording: CNO Panel Discussion at DFW HIMMS Event

DFW HIMSS CNO Panel Discussion Summary: Part 2

As a CNO, what is your experience with patients’ expectations of technology?

Patients are becoming more informed, and they are striving to be more educated consumers when it comes to healthcare.  They often come to the hospital after visiting Google to research their condition.  They believe they know what they have and what treatment they need, and they don’t understand if care isn’t instantaneous and matching what they found on the web.  Being informed is a good thing, but the internet does not always provide accurate information.  Fortunately, patients and families have been flexible in understanding this issue.  Also, patient portals are also becoming the norm because patients want to be able to complete hospital paperwork at home and have the doctor know what their condition is once they arrive.  Lastly, patients always want the best technology available when it comes to their care.  Patients are becoming more and more informed and want the best, fastest, most advanced technology and care.

What is the key difference between a CMO and a CNO?

These two roles are becoming more similar over time, and their partnership regarding patients and practice is vital.  CMO’s used to focus more on medical practices alone, and they were basically trained as entrepreneurs.  Now, they are evolving into business partners instead.  They are becoming more educated on the business aspect and becoming more focused on best practices.  Lastly, they are becoming more actively involved in the clinical care of patients.  For instance, approximately 90% of physicians were involved in the recent, clinical care based GoLive roll out at Baylor University Medical Center.

What keeps you up at night as a CNO in the midst of healthcare reform?

Leadership has to wonder if everyone on staff can and will keep up with technology.  Some embrace it and some don’t ever remember life without it, but this is not always the case, especially with the older generation.  Technology is going to continue to move forward, and we hope that everyone involved in patient care can keep up.  If anyone in this industry resists technology, they will suffer greatly as a result.  Another thing that will keep a CNO up at night is the issue of integration.  Will new technologies be able to integrate with the older technologies we have in place?  Moving forward, integration is key!  Lastly, CNO’s worry about healthcare reform causing a financial hardship on hospitals.  The government payers have changed and healthcare consumers will change accordingly.  Consumers are becoming more informed, and they want the best care and most advanced technology available, but they want it all at the lowest price the industry can offer.  To make things worse, Dallas is about 5 years behind on “fee for service” and charges are not taken for all services, which hurts the bottom line.  Like any business, it is difficult to provide the best technology and care while maintaining the cheapest price.  Consumers will need to understand this basic business model.  Also, Medicare simply does not pay enough to keep us in business, and that is certainly a concern.

Where are Informatics taking nursing?

To be most successful and effective, Clinicians need to run Informatics, not IT.  Clinicians should communicate issues, and IT should resolve those issues.  Collaboration is key!   Clinicians have been in “Informatics” a long time, but now the government has begun to force the issue and put the pressure on.  It is essential to partner with the IT experts by telling them what we need.  Furthermore, it is important for clinicians to be able to accept if there is a better way to do something than the way the clinicians have created.  Honesty and open communication between IT and Clinical is imperative.  “That’s not possible” is not a good answer, and solutions need to be found for resolution of issues.  Where there is a will there is a way, but it might not be what you had in mind, so stay flexible.  The ultimate goal is to make informatics work for patients by improving their care.

How are CNO’s using Informatics to improve patient care?

Data keeps us informed, accurate, and most effective.  It drives quality and best outcomes and allows us to track and fix errors quickly.  We can’t fix everything at once, so we are focusing first on the top initiatives, and then we will go from there.  People become complacent with too many initiatives being driven at once.  If we stick to one or two streamlined data alerts that are most important, it will help us move forward at a workable pace.  Development of clinical informatics teams will help make data information relevant and useful.

From a CNO’s perspective, how do you see nursing changing as a result of electronic charting?

Real-time information is key.  Clinicians must collaborate with IT to create Real-time processes.  This will enable us to access more relevant information than ever before.  This has allowed us to standardize care as needed and individualize care as needed.  Clinicians are starting to learn the value of accurate information, and real-time information is even better.  Real-time charting will cause a revolution!  It is anticipated that free-text charting will go away or be very minimized within the next 5 years.  Clinicians need to be able to use 1 device, such as an iPhone, for coding, billing, EMR, etc.  Electronic charting will also help any patient be able to track and access their healthcare history when needed.

What best prepared you for the role of Chief Nursing Officer?

Education played a large a part in preparation for the role of CNO.  Continuing education and being a life-long learner are important.  Always volunteer to help with projects and tasks when you can so that you can stay involved and stay tuned in.  It can certainly be beneficial to have experience working in non-profit facilities as well as for-profit facilities, and even facilities or companies that are merging.  This will teach you so much about financial responsibility.  Experience working on diverse teams and learning how to work with all types of people will prepare you for a leadership role and help you learn how to negotiate, resolve conflict, listen effectively, and more.  Having great mentors and co-workers will prepare you for a successful future as well, and on a personal note, having the support of your family as you grow in your career is priceless!

This sums up another great event held by the Dallas-Fort Worth Chapter of HIMSS!  A special “Thank You” to the panelists Claudia Wilder and Mary Stowe for sharing your knowledge and expertise, and also to the Board of DFW HIMSS for all of your hard work and for hosting another outstanding event!