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As we look at the data and information exchange requirements that are necessary to achieve sharable, comparable quality data based upon evidence, nursing data standards and their relationship to quality and effectiveness of clinical care are essential concepts to understand. This paper will describe three exemplars that outline the steps necessary to harmonize data, and a perspective on several key concepts as follows:

  • The relationship between quality initiatives and the need for nursing data standards.
  • The current state of nursing data standards and information sharing.
  • Three exemplars for the use of structured data in nursing at Partners HealthCare, Intermountain Healthcare, Kaiser Permanente, and the Department of Veterans Affairs, and steps necessary to harmonize data.
  • Capabilities and infrastructure requirements for electronic health records (EHRs).
  • Recommendations for setting priorities to solve key clinical problems in healthcare such as pain management, pressure ulcer prevention, and fall prevention which can be impacted by nursing care.

In the United States, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 is leveraged to reward hospitals and eligible providers for Meaningful Use (MU) of certified EHRs, with incentives paid by the Centers for Medicare & Medicaid Services (CMS).At the core of these national reform initiatives, the incentivized adoption of EHRs by eligible hospitals and providers improves care quality and better manages care costs. It also helps to meet clinical and business needs, since capturing, storing, and displaying clinical information from EHRs when and where it is needed improves individual patient care while providing aggregated, cross-patient data analysis.