1. Section Editor(s): Alexander, Mary MS, RN, CRNI(R), CAE, FAAN

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We're well into the year 2013, and that means there is less than a year before a large number of the provisions of the Affordable Care Act (ACA) will take effect. For all health care professionals, that means big changes for nurses and for our organizations, especially in the area of health information technology.

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The ACA, signed into law in 2010, and the Health Information Technology for Economic and Clinical Health Act of 2009 both commit the US health care industry to using enhanced technology systems, such as electronic devices and applications, to improve communication between patients and health care professionals, thus creating better patient outcomes and reducing the costs of health care by eliminating overlap and paperwork.1 Electronic health records, health information exchanges, and personal health records will provide electronic resources for practitioners and patients. Diagnostic and therapeutic devices are also an important part of the equation, and ultimately they should all be able to share data. The US government will provide monetary incentives for using the technology efficiently.2


Some organizations have already begun to develop their new, integrated systems; they began to do so soon after the ACA was signed into law. Many others, however, will have to rush to meet the 2014 deadlines. It seems unlikely, though, that all the proposed changes will be completed on schedule. One of the reasons for delays is the difficulty in achieving interoperability-the ability to share data and improve clinical decision making and outcomes. I think everyone is familiar with lack of interoperability on a basic level. PCs and Macs aren't compatible; iPhones and Android phones have different operating systems. But think about the complex devices you work with every day and the time it will take for all of them to "talk" to each other and provide the entire health care team, as well as the patient and caregivers, with the information they need to ensure smooth communication and better diagnoses and treatments. We'll have to depend on software and application vendors to create interfaces, raise the funds (albeit with government assistance) to pay for improvements, and develop and participate in extensive training.3


But nurses have always been up to the challenge. Our infusion nursing specialty has undergone vast changes since the first INS meeting 40 years ago. Yet we've managed to keep up with the technological revolution. Think of the vital connection infusion nurses make between patients and technology. Our knowledge and expertise position us to contribute valuable information as we identify solutions that will impact patient care and safety. As "super" end-users of high-tech devices and equipment, we provide input that address issues such as standardizing work flow, identifying potential patient safety hazards, determining the appropriate data elements for collection, and measuring outcomes, to name a few. I'm confident that we will continue to do our part to "connect the dots" as we integrate the benefits of health information technology to ensure that our patients receive safe, quality care.


Mary Alexander




1. Bill Summary & Status 111th Cong, 2009-2010. H.R.1.CRS Summary. Accessed January 28, 2013. [Context Link]


2. Institute of Medicine. Health IT and patient safety: building safer systems for better care. Published November 8, 2011. Accessed January 24, 2013. [Context Link]


3. Association for the Advancement of Medical Instrumentation. 2012 Summit Report: Medical Device Interoperability: A Safer Path Forward. Arlington, VA: AAMI; 2012:10-16. [Context Link]