What is a digital nurse specialist – and could the role suit you?
Great Article from?Laura Rogers is a digital nurse specialist with Sussex Community NHS Foundation Trust, published n Nursing Standard in March 2023
What is a digital nurse specialist – and could the role suit you?
Implementing digital health technologies is about change management, improving systems and prioritising patient safety – and you’ll need superb communication skills
When my trust began implementing an electronic patient record (EPR) system six years ago, it was looking for staff to clinically assure the new system and processes being designed for clinicians.
I was interested and, with 15 years of health visiting and safeguarding experience, I felt confident that I knew about clinical risk management, so I applied. But as I knew little about health technology, I was surprised when I was offered a role with the digital clinical safety team.
What is a digital nurse specialist?
Initially digital clinical safety facilitator, my job title was changed to digital nurse specialist a year ago to reflect the professional identity of our team and offer a better description of the role.
As part of the trust’s digital clinical safety team, I see my role as an interpreter between IT and clinical services – I ask my IT colleagues questions about new digital technologies, such as new electronic monitoring or clinical systems, until I am satisfied that I understand the answers and can explain them to clinicians, ensuring new systems meet their needs in practice.
Patient safety and improving care is at the heart of my role. Digital technologies that are not designed and deployed with safety in mind have the potential to harm patients, so it is my responsibility to ensure that systems are clinically safe and designed to help clinicians and services provide excellent patient care.
The NHS Transformation Directorate says digital clinical safety refers to ‘the avoidance of harm to patients and staff as a result of technologies manufactured, implemented and used in the health service.’
What does the role involve?
Most decisions regarding the procurement of digital systems are strategic, so I am asked to support their implementation. This involves assessing the risks associated with the introduction of the system and working with clinicians, clinical and service leads and the IT project team to mitigate risks.
‘Including nurses in the design of systems not only ensures they are user-friendly, it enables nurses to take ownership of the system and lead on changes as they identify them’
I also work with the IT team to develop systems as the needs of services change, and am involved in digital innovations, such as working with the children’s continence team to develop the trust’s first patient-facing app. The team was spending a lot of time and effort sending out paper copies of symptom diaries and chasing parents to return the forms. I could see that an app would make the process easier for parents and staff and improve clinical safety by increasing the accuracy of the data received by the service.
Identifying the clinical risk inherent in the paper process helped me gather support from the digital programme manager and the app is currently in the pilot stage.
Feedback so far is promising, with 85% of parents preferring the app to the paper process. They like the user-friendly design, and the twice-daily reminders help parents maintain their child’s observations. The data is presented to nurses on a dashboard, which helps them understand children’s care needs better.
Who do digital nurse specialists work with?
Members of my team work with colleagues at all levels of our organisation. Our digital clinical safety team started with one community nurse, who was asked to advise on the digital programme at the start of the EPR implementation. Over the past six years, this has grown to a team of eight nurses – a digital clinical safety lead, six digital nurse specialists and one clinical digital innovations lead.
Between us, we are responsible for digital clinical safety for the 84 services at our community trust, including community nursing, specialist nursing and therapies, such as speech and language and health visiting.
I work closely with a project team, which consists of a project manager, business change analyst, configuration analyst and IT trainer. As the digital clinical safety lead for a number of services, attending different user groups helps me to establish effective working relationships with nurses.
I also work with service representatives, from administrators to clinical leads, so I can better understand the needs at all levels of the organisation, which I then feedback to the project team.
A day in the life of a digital nurse specialist
9am?I start the day by checking my emails. Urgent care has found a cache of 10,000 patient-related documents in the scanning workflow that have not been attached to patient records. I investigate and establish that the documents are generated by NHS 111 in case a patient attends an urgent care department.
I have a quick discussion with the clinical leads to confirm that these documents can be deleted, and then get in touch with the systems integration lead to see if it is possible to stop these documents being sent in the first place. I make a note to follow up with new processes, depending on the outcome.
10am?I attend a digital user group meeting online. As our trust covers most of Sussex community services, virtual meetings save a lot in terms of time and travel costs, with the meetings better attended than in-person events. I listen to issues about working with different systems and offer advice, update the group on digital developments and remind them about good practice, such as requesting that access to systems is removed for staff who have left the organisation.
11am?Market engagement session with a potential electronic patient records (EPR) supplier. The trust has been awarded funding through the?Digital Aspirant programme?to develop an EPR system driven by clinical needs. The new generation EPR is inspiring – some of the functions are much slicker than our current product – but the EPR is built for acute care and not suitable for the community model.
12pm?Meeting with a configuration analyst and the EPR lead for children’s services to add outcome measures to the orthotics template.?SNOMED CT?– the clinical coding vocabulary for use in electronic health records – does not offer a code that accurately describes the outcome measure, so I suggest a generic code on a specifically named template to allow the service to report on it.
12.30pm?Daily catch-up with the team. As we no longer work in an office together, these daily sessions have become a lifeline. We keep each other up to date with our work, ask for opinions or just have a chat. We review the list of items that have been requested for change, such as changing a letter format, and share out the workload.
‘Despite the differences in our roles and responsibilities, we are all in the same boat – nurses who are keen to direct the course of digital health because we know that will be best for patient care’
1pm?I attend a free lunchtime webinar from the King’s Fund, which is about examining the hybrid model of delivering care for long-term conditions. I use my work mobile to listen to the webinar while going for a lunchtime walk. The patient representative’s experience of digital health is particularly interesting – they explain how virtual consultations with the consultant are saving them time and travel costs and facilitating multidisciplinary working as the physiotherapist is able to join the meeting from another location.
2pm?Catch up on project work. I look through the issues log for a community neuro rehab services project to see what is outstanding. Several clinicians have logged the issue of forgetting to obtain consent from the patient to share their record and I decide that a link needs to be added to the assessment template.
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The list of outstanding issues for this project is long and it’s unlikely that we will have completed it by the end of the project in two weeks’ time. I decide which items need to be addressed before the end of the project and which can be handed over to the business-as-usual IT team.
3pm?Meeting with digital patient communication group. We have identified the need for two-way communication between services and patients, such as sending out questionnaires for protected characteristics or depression and anxiety scales, which can be completed digitally by the patient and are automatically embedded in the EPR. Neither of the two products currently available at the trust offer a suitable solution, so we discuss the best strategy to develop the products with suppliers.
4pm?Monthly digital discussion group. The group started on?FutureNHS, with a chief nurse information officer from the west of England asking for support from fellow digital nurses. It has since grown, with nurses from acute and community settings across the country attending. The group is friendly and supportive. Despite the differences in our roles and responsibilities, we are all in the same boat – nurses who are keen to direct the course of digital health because we know that will be best for patient care.
The Health Education England programme lead for nursing digital readiness has joined today’s session and is talking about plans for developing digital nursing careers and the?digital health leadership programme?– a fully funded course aimed at clinical and non-clinical digital change leaders in health and social care in England. The course content looks interesting, and I really need to widen my expertise of digital tech, but I am wondering if my kids are old enough for me to take on the extra time to engage in academic study.
5pm?I check my emails for any outstanding tasks that need to be completed before finishing for the day.
What band is the role?
My role is?band 7,?but as there is currently no national structure for digital nursing, banding and job titles are not standardised across the NHS. My responsibilities could be part of a chief nursing information officer’s (CNIO) role in another trust.
What skills and qualifications do you need for the role?
While the job description for my role says that a relevant qualification or specialist interest in health informatics is essential, I had neither of these when I started – just a keen interest in change management, improving systems and patient-centred care.
Your nursing knowledge and an attitude of not being afraid to ask are more important than your IT experience. When working directly with front-line staff, compassion and people skills are important, as colleagues often struggle with the frustrations of digital systems and the pace of change.
Good leadership and communication skills are also essential for the role. When implementing the EPR system, moving from paper records to a digital system caused fundamental changes to nursing practice, for which nurses were unprepared.
Including nurses in the design of systems not only ensures they are user-friendly and help nurses provide the best patient care, it enables nurses to take ownership of the system and lead on changes as they identify them.
What should I do if I am interested in a role like this?
As a first step, get involved in any digital transformation that is happening in your service – the digital team is always on the lookout for user input. You could also get involved in a digital user group, and if you have ideas for digital change, get in touch with the digital programme lead at your trust to see how they can support you.
There are a range of programmes addressing the need to increase digital knowledge in the clinical workforce. Some are aimed at front-line clinicians, such as the?nurse-led improvement projects in digital health from The Burdett Trust for Nursing, while others are for those interested in digital clinical leadership, such as Health Education England’s digital health leadership programme and the?Topol digital fellowship.
The RCN also has a comprehensive resource on?digital roles and innovations, and you can contact your trust’s chief nurse information officer to find out about digital nursing roles.
As there are so few of us, digital nurse specialists are good at networking and there is a large community on Twitter where we exchange experiences, ideas and information. Look for the hashtags #digitalhealth, #digitalnursing and #digitalclinicalsafety.
You could also join?Digital Health Networks,?a best practice community for digital health leaders that has a lot of resources, including free webinars on a range of topics.
FutureNHS?is another useful resource for networkings. A virtual platform, this has thousands of ‘workspaces’ that you can join, including the digital nurse network, community nursing digital nurse network and digital primary care.
Laura Rogers is a digital nurse specialist with Sussex Community NHS Foundation Trust
Further information