Regina Cole, DNP, RN, FHIMSS (Doctor of Nursing Practice – Clinical Informatics) has been immersed in academic and clinical environments for most of her career. She was a clinical practice nurse for 22 years before teaching as adjunct or assistant professor at several universities, including NYU, Emory, and Georgia State. Dr. Cole became a Board-Certified Informatics Nurse, held clinical roles as an informatics nurse specialist and served as a director of clinical informatics. After earning her doctorate in Clinical Informatics from Vanderbilt in 2013, she formed iHealth Consulting in Atlanta. As a certified volunteer for the Federal Emergency Management Agency (FEMA), Dr. Cole is contracted as an RN case manager addressing healthcare needs of medically at-risk hurricane evacuees from the U.S. Virgin Islands and Puerto Rico.
HIMSS: What do you see as the most important new innovations in digital health?
Regina: I am glad to finally see the application of data analytics. When EHR systems were first developed, we didn’t have the encryption and security to protect data back then – so we were very proud that you couldn’t get into those systems. Now we’ve learned that we need to connect systems, we can secure the data and we need to leverage and learn from rich data sources beyond the EHR, including clinical data registries, CMS [Centers for Medicare and Medicaid Services] billing, Health Department registries and others. We’re finally giving people the ability to analyze data and come up with patterns of information. For example, if you’re a 50-year-old woman who’s had hip surgery, we can analyze data on similar patients to develop patterns on outcomes and see what’s unique to a phenotype of patients. We can turn data into knowledge and wisdom, predicting patient outcomes and prescribing what would be the best approach.
HIMSS: What about the most pressing needs on the healthcare horizon?
Regina: Consumers need to feel that the information they’re providing is secure. We need people in the healthcare field who are experts in cybersecurity and not just keeping their EHRs secure. Everything is online, so we are very vulnerable if the internet goes down. We need downtime policies – for “what if” situations, like a complete electrical outage. We saw in the U.S. Virgin Islands and Puerto Rico – you can lose everything. You need to be prepared in your healthcare organization – and prepare for business continuity and disaster recovery.
Information needs to be available despite losing the technology. It’s important to know how the paper manual process worked. Doctors and nurses are coming out of school who have never used paper and never understood what it takes to order labs on a patient. When computer systems are down, they’re kind of lost. Part of their training needs to be down-time procedures, like the old order sheets.
We also need to develop better patient-centric technology solutions. Things come top-down from entrepreneurs but it’s really the clinically relevant providers who have their finger on the pulse of what hospital or ambulatory populations or those in the home need. Our clinicians should be at the table with product developers to create value-added solutions.
I assigned projects to my nursing students in Informatics at Georgia State University to look at patient needs and asked them to come up with innovative solutions that either add on a function to a tech solution or develop a novel technology to meet needs. Let me tell you, these nurses are smart cookies! They take technology in the hospital and add something on to it. My nurses are very innovative but don’t have the programming skills to create an app – so we work with Georgia Tech faculty and students to develop some of these ideas.
HIMSS: What’s the value of being on the HIMSS Innovation Committee?
Regina: You get to work with some sharp knives on that committee – and you look around and say, “What am I doing here?” I learn from the other members. We’re all from disparate businesses and we inspire each other. You don’t usually have an outlet for these thoughts! The HIMSS Innovation Committee is a vehicle to express yourself and promote creativity. We get to be like a “naïve user,” the new practitioners who can ask “Why are we doing it this way?” We come up with really good educational programs for HIMSS members. It’s fun – and you don’t want to miss the meetings! You get to share what you’re doing. In the coming year, I’ll share my ideas on FEMA [Federal Emergency Management Agency] and the information management needs of evacuated medical patients during a disaster.
HIMSS: Why do you have a passion for advancing health innovation?
Regina: Passion begins with caring. I’m a nurse and that’s what we do – we care. When I started as a nurse in ICU [intensive care unit] at New York University [NYU] Medical Center, they implemented one of the first EHR systems in the country. It was really cool … so I got the HIT [health IT] bug back then. I recognized early that those systems should be designed by experts who use them. I got my master’s and did PhD coursework at NYU, wanting to design systems based on the logic of expert practitioners, researching how experts process information, artificial intelligence and neural pattern networks.
I have a passion to keep people more independent in their home environment by leveraging technology, such as a family using [video chat] with mom to watch her take pills in the morning, or motion detectors to see how active they are, or using voice-activated [smart speakers] to order prescriptions or a [rideshare] driver. This is a real need in healthcare now – to develop solutions for the environment, be it at home or work, that optimize one’s independence and well-being. Last year, I did a presentation on this kind of assisted, adaptive “gerontechnology” for our HIMSS group.
HIMSS: Anything else on your mind?
Regina: Nurses realize the advantages of well-designed technology – and feel the pain when it’s poorly designed. We developed a specialization in this field over 20 years ago, with many talented people who’ve led the development of healthcare IT. Nurses are the primary contact with consumers and the leading health educators. Nurses really understand the information technologies of this population, are generally very practical and bring value to the table when new technology is developed. It’s key that the right players are at the table when new technologies are designed, including nurses, patients and programmers.