How Can Health Systems Effectively Serve Minority Communities? Use Electronic Health Records to Discover How to Improve Outcomes.
To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Bonnie L. Westra, PhD, RN, FAAN, an associate professor at the University of Minnesota School of Nursing, responds to the question, “What are the challenges, needs, or opportunities for health systems to effectively serve minority communities?” Westra is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program.
Electronic health records (EHRs) are rapidly proliferating and contain data about health or the lack thereof for minority communities. Evidence-based practice (EBP) guidelines can be embedded in EHRs to support the use of the latest scientific evidence to guide clinical decisions. However, scientific evidence may not reflect differences in minority communities served.
As a first step to compare the effectiveness of EBP guidelines for minority populations, practicing nurses and nurse leaders need to advocate for implementation of EBP nursing guidelines in EHRs. Additionally, EBP guidelines must be coded with national nursing data standards to compare effectiveness within and across minority communities. Nurse researchers need to conduct comparative effectiveness research to learn how to optimize EBP guidelines for minority communities through the reuse of EHR data and to derive patient-driven evidence.
The University of Minnesota School of Nursing is leading the way through development and implementation of a national action plan to create sharable/comparable nursing data for “big data” science. Integration of standardized coding of nursing data, along with data from other disciplines, affords the opportunity to discover new knowledge of the most effective interventions to improve health disparities.
As a result of the 2013 Nursing Knowledge Big Data and Science to Transform Health and Healthcare conference, the American Nurses Association is increasing its lobbying for nurse-sensitive clinical quality measures derived from EHRs for Meaningful Use of EHRs in Stage 3. The National Institute for Nursing Research is forming a nursing informatics research collaborative as part of the nursing special interest group within Clinical Translational Science Institute funded academic health centers. Nursing informatics organizations are advocating for consistent standards in the design and optimization of EHRs.
The Nursing Knowledge Conference will be held again June 5-7, 2014, to acknowledge accomplishments and continue to evolve the national action plan for sharable/comparable nursing data that can be used for big data science to discover what care works best to improve outcomes and tailor interventions to various minority communities.