Q&A with Beth M. Kilmoyer, DNP, RN-BC, Nurse Informaticist at Mercy Medical Center in Baltimore, Maryland
Beth Kilmoyer is the Nursing Informatics Manager at Mercy Medical Center, a 300-bed Magnet hospital in downtown Baltimore. She has a diploma in nursing from Lancaster General Hospital School of Nursing, a BSN and School Nurse Certification from Millersville University, an MS in nursing informatics from University of Maryland, and a Doctor of Nursing Practice and Nurse Educator Post Master's Certificate from The Johns Hopkins University School of Nursing. Dr. Kilmoyer says you don't need to be a "techie" to be in informatics—"What you must be is creative, innovative and willing to make changes with information technology."
Q: What motivated you to become a nurse?
A: I wanted a sustainable career and to feel a sense of self-worth when helping people, so nursing fulfilled my altruistic personality. Also, family members who were nurses (my mom and two aunts) were influential when I saw the successful, rewarding careers they had.
Q: When did you first become interested in nursing informatics?
A: I wanted to pursue an advanced nursing degree and thought about the future. Technology was everywhere and making its way into healthcare. I attended a Sigma Theta Tau event at my alma mater, Millersville University, and Ramona Nelson (one of nursing informatics' pioneers) conducted a presentation on the subject matter. The topic really sparked my interest, so I started investigating and found University of Maryland at Baltimore had the best master's in nursing informatics program. About a year later, I moved to Baltimore, started the program and began my nursing informatics career.
Q: How did you make the transition to nursing informatics?
A: My first job as a systems analyst was at the hospital where I was working as a nurse, so I knew the culture of the organization, which was helpful. During this time I was still working clinically since I truly enjoyed the patient interaction; however, over time, I had to stop working clinically because I ended up working too many days in a row.
I had great preceptors and role models at my first NI job, and they assisted me with the transition into working in the field through their knowledge and guidance. Additionally I was involved in several NI organizations (such as The Capital Area Roundtable in Nursing Informatics-CARING) that offered programs about the practical implications and applications of NI.
Q: Can you describe Mercy Medical Center and the services offered?
A: Mercy Medical Center is a 300-bed Magnet hospital in downtown Baltimore, Maryland. The hospital was recognized by US News & World Report as a high-performing hospital in the areas of cancer, diabetes & endocrinology, gastroenterology, geriatrics, gynecology, nephrology, neurology & neurosurgery, orthopedics, pulmonology and urology. Mercy recently opened the Mary Catherine Bunting Center, a brand new state-of-the-art inpatient tower. Even as a mid-size facility, Mercy is highly automated and has many implemented technology systems and programs.
Q: When and how did you start at Mercy?
A: I started working at Mercy in 2005. Susan Finlayson, Senior VP of Patient Care Services, wanted to build the nursing informatics team as the hospital was moving forward with new technology initiatives. A former NI classmate was working at Mercy and recommended me for the job.
Q: What's it like working at Mercy?
A: Working at Mercy is exciting as there is always something happening. The hospital and nursing divisions have aggressive technology strategic plans so there is always an ongoing project at all times.
Q: Typically, what are your day-to-day responsibilities as a nurse informaticist?
A: When involved in a project, like I am now with designing and implementing a new electronic health record, I lead a team of clinical nurses. The nursing team is reassigned from patient care to the informatics project team and fulfills the role of subject matter experts to develop the system to meet the clinical end-users' needs. We meet several days a week revising nursing documentation and information management of patient care processes involved in the electronic health record. This team will also be involved in training and supporting the end-users. Additionally, I monitor ongoing operations for the technology systems I support. These activities include evaluating and communicating system changes and enhancements to support continuous quality improvements, monitoring system issues, and planning for the future system initiatives. Also, one of my "other duties as assigned" is taking pictures for the nursing division. Since the camera is digital and the pictures are downloaded to the computer it was only natural that I do this, but I do it because I like to be involved in and am proud of everything Mercy nursing does!
Q: Can you share a motivational story about working in nursing informatics?
A: Thinking back to when I was practicing as a clinical nurse, performing patient assessments and administering medications, I never would have thought I'd one day know how to read architectural drawings when planning the installation for a nurse call system for a new hospital. The opening of the Mary Catherine Bunting Center allowed me to experience a once-in-a-career opportunity to be involved in the planning and opening of a new hospital. I led the clinical informatics team during the planning and implementation of the new technologies for the new hospital in 2009-2010.
Q: Are there other areas of interest for you as a nurse informaticist, either clinically or educationally, that you plan to pursue?
A: Education. I have been an adjunct faculty at several universities for the past 10 years at the undergraduate, graduate and doctoral levels. Currently I am teaching an online Healthcare Informatics course for The Johns Hopkins University. The course includes synchronous online meetings, experiences in the virtual world of Second Life and a group project utilizing innovative presentation methodologies. Student projects have been utilized in many healthcare settings from Baltimore city schools to global health initiatives.
Also, evidence-based practice related to informatics. Applying evidence into practice, especially informatics practice is another area of interest. Presenting and disseminating experiences about informatics projects from Mercy to contribute to the informatics body of evidence is something I really enjoy doing.
Q: What are the greatest challenges you face in your job?
A: Balancing system functionalities and incorporating changes into nursing workflow. One system change usually impacts several systems and processes, so you need to think about all of the potential implications from point A to point Z, and then analyze how it impacts nursing workflow, while thinking about everything and anything else it could possible impact.
Q: What do you like most about your job? What do you dislike most?
A: Like Most: Still being able to positively impact patient outcomes even though I am not providing direct patient care.
Dislike Most: Computers shouldn't have downtime, so that means there is little downtime for me. (Trying to make light of the fact that I am really busy!)
Q: What do you feel is of the greatest concern to nurses today?
A: Utilizing technology to its fullest potential without letting it overwhelm them. Patient care is still the priority and nurses must understand the reasons why we are utilizing the technologies in the ways we are, and how information technology can assist in helping the healthcare team manage and organize the care for our patients.
Q: What is the most rewarding part of your job?
A: Working with the nursing staff and multidisciplinary team. I will always be a nurse and have nurses' best interests at the forefront when developing and planning technology initiatives, systems and projects.
Q: What advice do you have for others thinking of entering nurse informatics?
A: If you love nursing and technology, it's the best of both worlds. You don't have to be a "techie" to be in informatics. What you must be is creative, innovative and willing to make changes with information technology. Informatics is much more than computers in healthcare—it is about re-designing and re-engineering current nursing practices through the application of automation and technologies to impact and improve patient outcomes. It's an exciting job!
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