Breaking barriers

When Kari Miller, DNP ’14, was working late-night nursing shifts in the emergency room at Regions Hospital in St. Paul more than two decades ago, health care information systems often felt more like a foe than a friend.

“I had to use the computer to get a bedpan, use the computer to get a pill, use the computer to get any documentation done. And every time I had to do that, it took time away from the care of my patient,” she recalls. “The way the systems were designed at that time were clumsy and labor intensive. They weren’t intuitive for the nurse and their critical thinking needs. They were designed by IT people who didn’t fully understand how our work was different than other industries.”

Today, Miller improves those systems so they align with nursing care processes while also harnessing data that can improve the profession and health. As director of clinical informatics at Optum, the Doctor of Nursing Practice (DNP) in nursing informatics graduate manages technical solutions that ease nursing documentation burden, monitor quality of care and allow the company to assess the quality of clinical processes and services provided.

“I really enjoy the challenge of bringing order to chaos,” she says. “I’m always looking for where I can help organize variability, provide service to simplify while improving the value of what is being delivered.”

Happy accident

Miller worked as a nurse in a variety of hospital units while crisscrossing the country—five moves in 10 years due to family circumstances, the last of which brought her to Minnesota. After getting her nursing degree from San Diego State University in her native Southern California, Miller found her groove in the emergency room and had a particular fondness for evening shifts.

But she stepped away from the profession for almost a decade, initially to care for her two young children after her daughter experienced a serious illness. When she returned to nursing in a training role at the University of Minnesota Medical Center in 2008, she also applied to the DNP program to advance her career.

“I knew that I needed a new skill set, because I had been out of nursing for a while,” says Miller, who was looking to transition from direct patient care.

Pursuing informatics was, in her words, “kind of an accident.”

She started her DNP program planning to specialize in integrative health and healing, but a required informatics course unlocked an unexpected interest.

“I didn’t know what it was,” she says, “and as I got into it, it sparked my left brain: analytics, using data to understand patient outcomes and the quality of care provided and technology design to influence how clinicians work and control quality—all of the things that I cared about in nursing. I wanted to be part of the solution for health care redesign and showcase what nurses provide.”

Optimal fit at Optum

Miller credits her DNP experience with both instilling the technical and leadership skills that set her on her way. While she was in the DNP program, she was promoted into a management role at the medical center, then joined Optum and moved into her current director position—all while balancing schoolwork and working full time.

At Optum, she’s built award-winning software for nursing documentation, drawing on her analytical side and clinical experience as well as her artistic background. Before pursuing nursing, she studied fine art for two years. And during her nursing hiatus, she painted murals and worked as a technical trainer for a decorative paint company. Miller even created murals for Prince at Paisley Park, including a black light treatment in the late musician’s Galaxy Room.

“To be able to use that creative side to visualize how a system works from end to end is key for designing computer systems,” says Miller, whose work at Optum earned her the 2019 March of Dimes Minnesota Nurse of the Year award in the innovative and non-traditional nursing category. “I applied that ability to this IT world and love it, absolutely love it.”

She’s keen to share that enthusiasm for the field. She started a nursing informatics community of practice at Optum that’s quickly grown to about 200 members. And the School of Nursing honored her work with current DNP students with a preceptor of the year award in 2019.

“If you want to make nursing better, our tools better, get into technology and understand the challenges. You can influence the barriers of technology and build the tools that make us smarter and faster to help us measure the quality of nursing,” she says. “For nurses who want to help us as a profession, nursing informatics is a way to make a difference in a different way than direct patient care.”