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The Future of Data-Driven, Value-Based Care

Nurses Leading Innovation
November 14, 2016
The Future of Data-Driven, Value-Based Care

On the surface, big data and nursing may seem unrelated. However, nurses contribute to the collection of big data every day by capturing health information via electronic health record (EHR) systems. But how is this data being used?

John M. Welton, Ph.D., RN, FAAN, a professor at the University of Colorado College of Nursing in Aurora, Colo., and Ellen Harper DNP, RN-BC, MBA, FAAN, vice-president and chief nursing officer of Cerner Corporation in Kansas City, Mo., discussed the value of healthcare data in their presentation, “Big data and nursing care: What would Florence say?” at the 2016 American Nurses Association Annual Conference last spring. We followed up with John to learn more about how big data is transforming nursing practice.  

NN: How does “big data” create value for healthcare systems?

John: In a very simplistic view, systems that collect healthcare information can help inform providers and policy makers how to achieve better population health and improve patient experience at lower costs. With “big data,” we have the emerging capability to analyze large amounts of data that get down to the individual nurse-patient level to identify patients at risk for adverse events. This new information will allow nurses and other members of the healthcare team to lower costs by improving the quality and outcomes of care.

NN: Why is big data relevant to nurses?

John: As we work to develop better data extraction, visualization and analytic methods, we are giving healthcare providers the ability to utilize large numbers of patients and variables to identify small effects that are clinically meaningful. Better and timelier data will, hopefully, improve clinical decision making and outcomes.

NN: How do you feel nursing research specifically is changing?

John: One of the potential benefits of the big data revolution is the ability to conduct studies quicker and with many more variables than have been possible. In the near future, new methods will look at small changes in large volume of healthcare data being collected and results will be reported and implemented into practice in months, rather than years or decades.

NN: How can nurses use big data to make optimal clinical decisions?

John: Researchers are currently working on developing real-time measures of nursing performance and linking it to workload and patient acuity. For example, bar-coding drugs administered by nurses at the bedside substantially improves safety by ensuring the right person gets the right medication at the right dose at the right time. We can use these data to calculate the time difference between when a medication was due and when it was given. Small or large delays can indicate high workload, process delays, as well as nurse or patient characteristics that influence medication administration. This example of real-time data use can provide information much quicker back to bedside nurses and nurse leaders.

NN: Does implementing health IT tools create a higher demand for different (or new) types of nursing specialties? If so, which ones?

John: One of the most needed nursing specialties is informatics. These are nurses who have deep clinical experience as well as expertise in information and healthcare technologies. Part of the need is having informatics nurses available at the design and implementation phase of building and deploying electronic health record (EHR) technologies. On the back end, these nurse specialists will work in teams to extract data for meaningful uses to aid clinical care, management decisions and policy making.

NN: Can you describe a few examples of practical strategies for nurses to make health care data actionable?

John: A good example is measuring the added value of nursing care and individual nurses. We now have the ability to identify each nurse caring for a patient so we can determine the best nurse for a given situation to meet a persons needs. For example, the data can help us identify  optimum pain assessment and management strategies and monitor nursing practice, for example identify patterns of PRN opioid and non-opioid medication administration by nurses in an inpatient environment. High volume, high velocity data will provide feedback to nurses and other clinicians to ensure optimum care and best practices. Ultimately big data will help identify and facilitate development of nursing care systems that produce the best nursing care at the best price.

To view the presentation from “Big data and nursing care: What would Florence say?” visit the American Nurses Association website. To learn more about the role of an Informatics Nurse, visit  To learn more about the impact of nurses on our nation’s health care system, including an example of the benefits of bar-coding drugs, watch "Nurses: Their Vital Role in Transforming Healthcare," a half-hour documentary narrated by Joan Lunden.

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