The Evolution of the TIGER Initiative
In 2004, an executive order issued by President Bush outlined a plan focused on ensuring that every American would have an electronic health record (EHR) by 2014.1 In July 2004, a national conference called Cornerstones for the Electronic Health Record brought together leaders from across healthcare to discuss the national health information technology infrastructure. Representatives from medicine, government, information technology (IT), hospitals, and payers all had prominent places in the program. One nurse was included on a panel, but the profession of nursing was largely invisible in the proposed transformation. In the fall of 2004, a group of nurses who had been at the conference began work to ensure that the nursing profession contributed expertise to achieving the national agenda of a health IT infrastructure. In January 2005, a core group of prominent nursing leaders, dubbed the “TIGER Team” for Technology Informatics Guiding Education Reform, agreed that “utilizing informatics” is a core competency for healthcare professionals in the 21st century, as the Institute of Medicine acknowledged in Health Professions Education: A Bridge to Quality.2 There was also agreement that the majority of nurses lacked IT skills and the application of informatics competencies in their roles.
The TIGER Initiative was subsequently established as a grassroots effort in 2006, with support from more than 70 contributing organizations and a grant from the Robert Wood Johnson Foundation.3 The TIGER Initiative’s goal was to engage and prepare the nursing workforce in using technology and informatics to improve the delivery of patient care. Now, more than a decade later, numerous volunteer hours, organizations, and activities have advanced the TIGER cause.