The TIGER Initiative
Technology Informatics Guiding Educational Reform

National attention on health IT has accelerated since 2004 when President Bush announced plans to support adoption of electronic health records for all Americans.  In January 2005, a small group of nursing leaders and advocates met and resolved to strengthen the voice of the nursing profession in the transformation of healthcare for the 21st century. This group organized the Technology Informatics Guiding Education Reform (TIGER) Initiative.


Nursing has embraced the opportunity to reform healthcare using technology as an enabler.  In 2006, the TIGER Initiative held an interactive summit titled “Evidence and Informatics Transforming Nursing.  The summit gathered over 100 leaders from the nation’s nursing administration, practice, education, informatics, technology organizations, government agencies, and other key stakeholders to create a vision for the future of nursing that bridges the quality chasm with information technology, enabling nurses to use informatics in practice and education to provide safer, higher-quality patient care. While many of the statements resonate with a wide range of interdisciplinary health professions, the initial focus of the agenda was nurses and the nursing profession.


The TIGER Initiative was formed to raise awareness for the need to develop a U.S. nursing workforce capable of using electronic health records to improve the delivery of healthcare.  In 2004, President Bush mandated that all Americans will be using electronic health records by the year 2014.  As reported in Building the Workforce for Health Information Transformation[1], “A work force capable of innovating, implementing, and using health communications and information technology (HIT) will be critical to healthcare’s success.”  President Obama continued this momentum when he took office in 2009, proposing to “Let us be the generation that reshapes healthcare to compete in the digital age.”  Less than 30 days after taking office, President Obama signed the American Recovery and Reinvestment Act, earmarking $19 billion to develop an electronic health information technology infrastructure that will improve the efficiency and access of healthcare to all Americans.   Additional funding has recently been announced with the Department of Labor and Department of Education to increase the healthcare and HIT workforce both are high growth career opportunities.   

[1] AHIMA/FORE and AMIA, (2006).  Building the workforce. Available online at

 In addition to the substantial investment in capital, technology and resources, the success of delivering an electronic healthcare platform will require an investment in people—to build an informatics-aware healthcare workforce.  This has accelerated the need to ensure that healthcare providers obtain competencies needed to work with electronic records, including basic computer skills, information literacy, and an understanding of informatics and information management capabilities. 

A comprehensive approach to education reform is necessary to reach the current workforce of nearly 3 million practicing nurses.  Many nurses in practice today did not grow up with technology, and have not mastered basic computer skills, let alone information literacy and how to use HIT effectively and efficiently to enhance nursing practice. 

The TIGER Education and Faculty Development Collaborative team organized their efforts to engage key stakeholders and accelerate progress within the academic community.  This includes academic institutions representing all levels of nursing education, educationally-focused professional organizations, federal organizations that fund nursing education, and state boards of nursing.  This report will describe their activities and recommendations.


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