Informatics in the Insurance World

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I am currently an RN working as a casemanager in worker compensation. I do have some clinical background as well as Manage Medicaid. Prior to changing into the WC I assisted with the implementation of a new computer system while working in managed madicaid and loved it. I was a "super user".My first taste of informatics.

In my new position I was asked to describe the benefits of Nursing informatics as it relates to my current position. I spurted out what I believe was the basics of Nursing Informatics ( The management of medical information, combined with the technological aplication of IT so that information can easily identified and utilized by the medical staff to provide the most positive outcomes possible to our clt).

First Question - Was this too generic and broad?

Our company is adopting a new platform for our system and nurses ('superuser) have worked on it. However I believe that again the application is not geer toward the medical staff (minority with the biggest impact) and would like to be able to put my two cents in. So I decided to enroll in school (RN-BSN ) as it seems that informatics does not come into play until you are at the master's level. But have been reading the threads and wonder if I am taking the long road to get some knowledge. I think I am interested in programimg and intergration. Do you have any suggestions - Is there additional information regarding Nursing Informatics in the Insurance arena?

I have checked several sites and have not found any specific references.

:rolleyes:Ready for the Next step just want to make sure I am heading in the right direction. :lol2:

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Specializes in informatics for 10 years.
I spurted out what I believe was the basics of Nursing Informatics ( The management of medical information, combined with the technological aplication of IT so that information can easily identified and utilized by the medical staff to provide the most positive outcomes possible to our clt).

First Question - Was this too generic and broad?

Personally, I believe that's a good answer. And if you gave specific examples of your own personal experience, even better. But if they wanted something specific, they could have also asked you, how does nursing informatics affect you personally...

So I decided to enroll in school (RN-BSN ) as it seems that informatics does not come into play until you are at the master's level.

Not sure what you mean by this---do you mean that you cannot find programs that have informatics at the bachelors level, but only at the master's level? Or do you mean that you need a master to get a job in informatics?

But have been reading the threads and wonder if I am taking the long road to get some knowledge. I think I am interested in programimg and intergration. Do you have any suggestions - Is there additional information regarding Nursing Informatics in the Insurance arena?

I have checked several sites and have not found any specific references.

:rolleyes:Ready for the Next step just want to make sure I am heading in the right direction. :lol2:

Hmmm...right direction. What do you define as programming and integration? Most roles in nursing informatics don't really involve programming per se, unless you're at a hospital where the hospital has developed their own in house software and you're hired to design/code the software from scratch.

Looks like in the past, that was something smaller hospitals did, as i have been in some that have their own in house software, but that doesnt seem to be the trend nowadays. A degree in computer science is more for the programming crowd. You learn assembly language, how to program in languages like C, Java, C++, or any other language offered by the school. An informatics degree doesn't really teach you programming (could be wrong there, so you might want to check schools for their curriculum), and at most you learn databases and basic networking.

But to clarify---most hospitals buy out of the box software that they configure to meet their workflows, and you could be hired to configure it, or maybe be the liaison between an IT department, and the nursing users. You meet with the users, analyze their workflow, then go back to the IT person and say, we need the following to be done; or you do it all.

But if you're working for a hospital that has an out of the box system, 99% of the times you won't be programming per, but more like configuring the software using proprietary tools. Now, some systems allow you to use logic to solve problems, and you do write scripts for that, but again, many wouldn't call that programming since you're not writing code in a programming language.

And about the informatics arena...informatics is really just a broad term that encompasses human computer interaction, IT, computer science, etc.

All that really changes in the insurance arena is the program being used, the (business) workflows, the user needs, etc. However, the implementation of a project remains the same in the sense that most project go through these phases: Planning , analyzing, configuring, testing, training, implementation, support.

I wouldn't worry too much about the details of nursing informatics in the insurance arena. It is really all the same, except as i said before, the product itself might change.

So first, get a clear understanding of what is it that you want to do; I believe you meant configuring and not programming, so yes, informatics is one way to go. As I tell others. You have experience as a nurse and some experience in informatics. Why not put a good resume together and apply for jobs now? From what you post it seems you have the relevant experience for a job in nursing informatics already and is really a matter of hustling for the job, but make sure you have a good resume first, and a clear understanding of what is it that you're applying for. Or you can go back to school, but that does take a bit more time. Also, if the end goal is to become an informatics director, maybe the degree thing is the best thing to do. I personally like to encourage people who have some experience to go in and apply for jobs as I'm not the school type of person! Too much time and money and I'm not going to be the next CIO or whatever that is.

:cool:

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Thank You for responding... I apologize in advance because I have not quite mastered the cut and paste option.

In response to your question regarding my RN-BSN. I am a busy single mom and I looked for online courses to obtain a BS in nursing informatics and couldn't find much of anything. If you are aware of some schools that offer an online program please let me know. I would prefer NI to having my BSN.

"So first, get a clear understanding of what is it that you want to do; I believe you meant configuring and not programming, so yes, informatics is one way to go. "

You are correct I did mean configuring...... I think:confused:

I was a super user and loved it but I think I would like to take it a step further.

As I tell others. You have experience as a nurse and some experience in informatics. Why not put a good resume together and apply for jobs now?

I love the company I work for however I'm not living my dream in my current position. I mention nursing informatics and upper managment has said we hear you..... we see your intrest.. but we don't know how to help you.... and the truth of the matter is I don't know how to help myself...... So I signed up for school... I want to go back I just don't want to spend the next year getting my BSN when I could be getting a degree NI. I want to be whomever that person is that supports the superuser.

I don't have a clear path yet so I thought I would reach out to those that are in the "know"

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Specializes in informatics for 10 years.

In response to your question regarding my RN-BSN. I am a busy single mom and I looked for online courses to obtain a BS in nursing informatics and couldn't find much of anything. If you are aware of some schools that offer an online program please let me know. I would prefer NI to having my BSN.

Allright, I understand now, and you're absolutely correct---there are not bachelors in nursing informatics and that's because I'm assuming nursing informatics is considered a branch of nursing. A rough analogy, but is like trying to find a bachelor's degree in intensive care nursing, and as you know, you can't do that.

I mean, maybe a nursing school out there gives students the option to take 2 rotations in intensive care nursing, and maybe a student can come out and say, i graduated from nursing school with an emphasis on intensive care nursing, but that student can't say, i graduated with a bachelor's degree in intensive care nursing. Well, silly example, but you get the point. :D

I love the company I work for however I'm not living my dream in my current position. I mention nursing informatics and upper managment has said we hear you..... we see your intrest.. but we don't know how to help you.... and the truth of the matter is I don't know how to help myself...... So I signed up for school... I want to go back I just don't want to spend the next year getting my BSN when I could be getting a degree NI. I want to be whomever that person is that supports the superuser. I don't have a clear path yet so I thought I would reach out to those that are in the "know"

Does the company you work for have an IT department? Assuming that your company has an IT dept, maybe the right question to ask your company would be, what jobs are available in the IT department of this company? I would then look at the list to see what's available and maybe look for jobs where people are 'configuring' applications, or training users in the system.

Since you mention the insurance world...I'll assume that you work for a health insurance company so out of curiosity i wanted to see what computer jobs they have. I google health insurance, and of course a few companies came up. I picked one and went to the careers section. Like most companies out there, they divide their career section into departments. They had one section as information technology. I clicked to see the jobs in the area, and here is one: Documentation/Configuration Analyst. It doesn't say nursing informatics, but I'm willing to bet they do something similar to what a nurse informaticist would do, except that they might be using an application geared for the insurance world. So what job titles exist in the IT section of your company? Hopefully they have an IT department....

Also, don't limit yourself to the title of nursing informatics. Yes, the nursing informatics title is a nice way to label the specialty, but i'm yet to hold the title of 'nursing informatics' or 'nurse informaticist.' My job titles have been, clinical analyst, application consultant, application analyst, clinical support analyst, etc.

So those in the 'know' as you say, could tell you, yes, get your BSN, then possibly get your masters in nursing informatics, and then look for a job. Or somebody like me would say, look for jobs right now, but don't just think of 'nursing informatics' when looking for these jobs. You could apply to vendors, hospitals, insurance companies, etc. Look for health care companies, look for jobs under the information technology section, and see what job titles would apply to you. The documentation/configuration analyst for example, i think is one that would be interesting to you, but titles will vary by company, obviously. :)

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Thank you for your insight and direction. I think I have been to hung up on the title. I will let you know how it all goes. Thank you very much!

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I happen to be a programmer and a nurse and I know people frequently get the terms 'configure' and 'programming' confused. But there is the possibilty of writing computer code in the informatics area if you have the desire to do so. Meaningful Use requires that the software system being implemented has a decision support system in place-we call this process 'rules and workflow'. This does require writing code and passing parameters between modules and not all nurses are interested in this level of technical detail. Thus some hospitals may let the vendor set this up for them. Some let their in-house programmers do it-but they usually need a clinician for the requirements. Most vendors hold classes to train those interested in learning and most hospitals would be happy to oblige since this is usually the cheaper option.

Hope this helps.

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That does sound interesting. Can you give me a little more information? I currently work in a bussiness setting not a hospital although I am sure that probably doesn't matter. The way the company I currently work for has it's IT positions mostly in the New England (Conn,Mass,NH.) So walking in or having easy access to the IT department is not possible. If I decided to take a course how would I decide which one to take?

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Specializes in Informatics, Education, and Oncology.

Greetings Csmgr2info,

Per the American Nurses Association (ANA)/ ANCC:" Nursing informatics (NI) is the specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice."

Informatics come "into play" in every level of nursing education, practice and patient care - NOT just at the Master's level.

An advance degree is not required to gain entry into this specialty or to increase your knowledge about it.

To increase your knowledge about the specialty

1) Start by visiting the ANA/ANCC Nurisng Informatics (NI) website:

http://nursingworld.org/HomepageCategory/NursingInsider/Archive_1/2008NI/Jan08NI/RevisedNursingInformaticsPracticeScopeandStandardsofPractice.aspx

http://www.nursecredentialing.org/Certification/NurseSpecialties/Informatics.aspx

2) Continue to utilize this forum

3) Join your local and national NI professional organization

http://www.allianceni.org/members.asp

http://www.ania-caring.org

http://www.amia.org/programs/working-groups/nursing-informatics

4) Read foundational texts on the subject.

http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Dstripbooks&field-keywords=nursing+informatics

5) Utilized experienced Informatics Nurses as mentors. Feel free to contact me off line for additional quesitons and please continue to post here!

I am currently an RN working as a casemanager in worker compensation. I do have some clinical background as well as Manage Medicaid. Prior to changing into the WC I assisted with the implementation of a new computer system while working in managed madicaid and loved it. I was a "super user".My first taste of informatics.

In my new position I was asked to describe the benefits of Nursing informatics as it relates to my current position. I spurted out what I believe was the basics of Nursing Informatics ( The management of medical information, combined with the technological aplication of IT so that information can easily identified and utilized by the medical staff to provide the most positive outcomes possible to our clt).

First Question - Was this too generic and broad?

Our company is adopting a new platform for our system and nurses ('superuser) have worked on it. However I believe that again the application is not geer toward the medical staff (minority with the biggest impact) and would like to be able to put my two cents in. So I decided to enroll in school (RN-BSN ) as it seems that informatics does not come into play until you are at the master's level. But have been reading the threads and wonder if I am taking the long road to get some knowledge. I think I am interested in programimg and intergration. Do you have any suggestions - Is there additional information regarding Nursing Informatics in the Insurance arena?

I have checked several sites and have not found any specific references.

:rolleyes:Ready for the Next step just want to make sure I am heading in the right direction. :lol2:

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Hey,

I'm not certain about any one particular course you could take, it really depends on what you want to do. General organizational and analytical skills are the best. Knowledge of Microsoft Office especially Excel (in my experience) is valuable. The majority of what we've been dealing with is refining our processes and policies. There's a lot of that to do. Technical work really cannot proceed until you get all that worked out. It's easy to hide bad process and workflows in paperwork. All that comes to light once you start to try applying technology a to it.

We've just had a round of hiring and my manager hired people with no technical background, mainly nurses, who showed enthusiasm and courage in seeking the job. So I think that you're enthusiasm should speak for itself. If you do land a job, you can be as technical as you want. Our job duties range from education through writing reports and workflows.

It's really up to you.

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