A natural evolution of the MDS coordinator: Nurse Informaticist

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Steven Littlehale
Steven Littlehale

Jennifer Gross, BSN, RN-BC, RAC-CT, fascinates me. She describes taking a scenic route to completing her BSN — first completing a B.A. in psychology before returning to nursing school.

Jen occasionally butters me up by reminding me that I provided her first MDS class “back in the day,” but she has long surpassed my MDS expertise! Most recently, she completed a graduate certificate program in informatics. “Informatics” is a term describing the acquiring, storing, retrieving and utilization of healthcare information to create value within and across healthcare providers. It is playing a critical role in the explosion of health information technology and the push toward healthcare reform.

So why is informatics meaningful for long-term/post-acute care providers, and why now? I sat down with Jen to get her answers and found a solid career path for MDS coordinators and as well as a strategy for SNFs:

Jen: “My time as an MDS coordinator was one long learning experience.  When I first started I had no concept about RUGs, QMs, or CASPER or how the ‘system' worked. Initially, the role was very task-oriented — get the assessment done and get it to the state. Along the way, I learned more about the proper role of the MDS coordinator and the relevance it played in clinical and business operations.”

Jen joined our team 14 years ago, supporting our clients' teams to improve their assessment and care planning processes and maximize the value of the RAI process. When I asked her why she sought out a graduate certificate in informatics, her answer was sage.

“I think that I, and many MDS coordinators, have been working in informatics for years without really knowing it. I work to help our clients understand their data and put it to work for them. With a little support, they can turn their data into knowledge because informatics makes the connection between technology, data and care. For example, informatics can help a SNF prevent a rehospitalization through a predictive risk assessment. This improves the quality of care for that resident, and ultimately the performance of the entire SNF. With an informatics mindset throughout the organization, you will have better overall processes — such as staff competencies, referral partnerships, or specialty care — because the facility can identify their strengths and weaknesses.”

Jen went onto describe that her coursework covered informatics throughout the healthcare industry. She left with a renewed appreciation of the “luxury of clinical data” that the MDS provides.

“Nowhere else do you have a standardized tool that is an actual clinical assessment; you don't get that level of clinical insight from billing (claims) data or cost reports. The MDS captures lots of valuable information on our residents in areas that would be missed on a claim.” 

Jen reminded me that while electronic health record adoption in SNFs has lagged acute care and other sectors, many forward-thinking organizations have taken the initiative to adopt them. The role of an informatics professional here is key: They are needed to implement an EHR solution that fits into the clinical and business operations of an organization.

Informaticists develop policies and systems that work within the SNF's work flows.  While it's unusual for a stand-alone facility or small chain to have an informatics specialist, there are plenty of resources available to help the facility's existing clinical management staff, including the MDS coordinator, to integrate informatics concepts.

“An informatics professional should have a grounding in applied data.  I don't mean she needs to be a software developer or a statistician, but that being able to see the connections between patient data and care processes to support clinical decision making.  Informatics don't work if they can't be integrated into a facility's work processes. It's important to be able to show the value of these new systems to the people who will be using them, and incorporate their feedback for process improvement.”

Jen strongly recommends that organizations invest in informatics training for their MDS coordinators. They have years of clinical experience and insight into the data they are collecting and can identify gaps and redundancies in their systems that might not be noticed by others who aren't working with them every day. 

“There are continuing education courses available online and in person through organizations like the American Nursing Informatics Association (ANIA) and the Healthcare Information Management and Systems Society (HIMSS).”

When I asked Jen what was next for her, she continued to delight.

“There are so many possibilities for helping our clients use their data in a clinically meaningful way. Next up, I plan on getting a credential through an informatics professional organization through HIMSS, ANIA, or the American Nurses Association.  These credentials give you a professional ‘seal of approval' for your achievement, and maintaining the credential ensures that you stay up-to-date through continuing education.”

The successful SNF of the future will include a nurse informaticist on staff. A logical place to find this person is within the ranks of your MDS coordinators.

For some coordinators, it's a logical progression, expanding upon their deep understanding of how clinical data drives systems

Steven Littlehale is a gerontological clinical nurse specialist, and executive vice president and chief clinical officer at PointRight Inc.

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