The Rise of the Senior Nurse Informaticist

Nursing informatics is gaining prominence on a national scale, especially with the recent elevation of Judy Murphy, R.N., to the No. 2 spot at the Office of the National Coordinator for Health IT (ONC). As Deputy National Coordinator for Programs and Policy, she oversees the ONC offices of standards and interoperability, provider adoption support, state and community programs, and policy and planning.

Compensation on the Rise
According to the 2011 HIMSS Nursing Informatics Workforce Survey, the average nurse informaticist salary increased 17 percent from 2007 and 42 percent from 2004. HIMSS reported that this particular metric spoke volumes to the importance and value of nurse informaticists in the healthcare industry today.

Linda Hodges, senior vice president and leader of the executive search practice at the Oak Brook, Ill.-based Witt Kieffer, also sees a dramatic uptick in salaries across the board for CNIOs, chief medical information officers (CMIOs), and CIOs with clinical systems experience. “Some of that is being driven by meaningful use and organizations’ desire for and interest in hiring these people,” she says, “and there’s also competition from the consulting firms and vendors for people with these skill sets.” Hodges adds that most of the vice president-level nursing informatics positions her firm has placed recently at large health system or academic medical centers have been paying in the $200,000 to 250,000 range (plus bonus).

Linda Hodges

Murphy is seeing salary ranges that are all over the map, some right on target, but some “dismally low.” “I’m not sure the industry has completely figured this out, but I do see that a fair number [of organizations] generally recognize that this is an executive position that warrants a $200,000-plus salary level,” she adds.

Janine Gesek, R.N., director, clinical informatics, Virtua Health, a four-hospital system headquartered in Marlton, N.J., says a shortage of skilled professionals is driving the salary increase since there is such a demand for clinical skills. Kara Marx, R.N., CIO at Methodist Hospital, a 460-bed hospital in San Gabriel Valley, Calif., agrees that there is a shortage of qualified nursing informaticists, which is reflected in compensation packages. “If you were to ask me in my department, who was the last role to have a salary adjustment—just for market increase—it is informaticists,” she says.

Kara Marx

Inconsistent Title, Reporting Structure
As the chief nursing informatics position evolves, a range of titles and reporting structures is emerging that is largely shaped by the individual healthcare organization. As reflected in the industry, the nursing executives interviewed for this article had a variety of titles from director of clinical informatics to vice president of information services to chief of clinical informatics. (Interestingly, no one interviewed for this article actually had the CNIO title.) Many report seeing this position more at large academic medical centers, rather than at smaller rural hospitals. Karen Carroll, R.N., Ph.D., manager of clinical informatics at Children’s Memorial Hospital in Chicago, says the title is dependent on the needs and culture of the particular organization. “A nurse in a nursing informatics leadership position  is most successful when they participate in  the policy, direction, and funding of informatics projects within an organization, and that the position should be on par with the chief medical information officer,” she says.

Hodges says that she has been seeing mostly director and vice president-level titles and adds that some nursing informatics executives have commented in a Witt/Keifer survey that organizations have been balking at adding the new CNIO title because they say they already have too many C-level titles. “It’s a title that when we’re doing our searches, most of the people that we talk with who are qualified really want that [CNIO] title,” Hodges says. She sees a parallel to the organizational resistance that some had to the CMIO title years back, which diminished over time as organizations began embracing the CMIO role.

Patty Sengstack, R.N., D.N.P., deputy chief information officer and  chief of clinical informatics, National Institutes of Health (NIH) Clinical Center, sees a variety of titles across the nation. She found herself genuinely puzzled by the HIMSS position statement. “They mentioned two titles in the HIMSS position statement, which I thought was interesting because I had never heard of this ‘nursing informatics executive’ before,” she says. “There’s nobody I know across the nation that uses that title. I thought well, ‘there’s a new one.’”

Gesek was at a conference recently and saw “quite a mix in terms of titles and their specific roles and responsibilities.” She adds: “I think that is probably why this role hasn’t really been seen that much because it really hasn’t been well defined.”

Janine Gesek, R.N.