nursing informatics lecture anfred

Anfred C. Santos RN,

Dramatic reform and innovation in nursing is needed to create and shape the future of nursing practice

Nursing is a dynamic profession with universal needs

BEFORE

AFTER

BEFORE

AFTER

Nursing is a dynamic profession Computer Technology can transform the

nursing profession. Clinical Information system are common to

modern healthcare.

A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process.

The computer is the most powerful technological tool to transform nursing profession prior to the new century. The computer has transformed the nursing paper based record to computer based record

Computer and internet is very essential for all settings where nurses function

Nurses are becoming more computer literate and the nursing profession is implementing practice standards for its clinical care and data standards for its nursing information technology system. (NI) Nursing informatics is specialist emerged as a new specialty in the field of professional nursing practice

Computer – is a general term referring to information technology ( IT) and computer systems. In nursing it synonymous into nursing information system ((NIS).

Computers are used to manage information in patient care, monitor quality of nursing care and evaluate care outcomes

Networks with internet are used in communicating and accessing resources and interacting w/ the patient on the (WWW).

Nursing Informatics – is refers to the integration of nursing, its information management with information processing and information technology to support the people worldwide

It is a specialty that integrates nursing, computer and information science to manage and communicated data information and knowledge in nursing practice. (AMA)

Management and processing components may be considered the functional components of informatics.

Data: 140 systolic Information: 50 year-old male, day 3 of

hospitalization, BP 140/70 Knowledge: Pt. demographics, record of

BP readings, circulation system: anatomy & physiology, pharmacokinetics of ordered medication

Decisions: That guide practice

Clinical Information system - can be used interchangeably with electronic information systems (EHR-S) computerized patient and electronic medical record.

It refers to a set components that form the mechanism by which patient records are created, used, stored and retrieved usually located within a healthcare provider setting. It includes people, data rules and procedures, processing and storage devices, communication and support facilities (institute of Medicine, 1991)

Initial cost of acquisition

Privacy and Security:

Clinician Resistance:

Integration of Legacy Systems: This poses a stiff challenge to many organizations

Easy Access to Patient Data:

Structured Information:

Improved Drug Prescription and Patient Safety:

Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilization.

Six time periods

Four major Nursing areas

Standard Initiatives

Significant land mark events ( chart)

Six time period

◦ Prior to 1960’s – simple beginnings Use of punch cards and teletypewritters.

1960’s◦ Use of computers in healthcare is questioned

◦ Studies on computers in nursing is started.

◦ Introduction of cathode ray tubes

◦ Development of Hospital Information System for financial transactions

1970’s◦ Nurses assisted in the design of HIS◦ Computers used in financial and management

functions◦ Several communities developed Management

Information sytem

1970’s◦ Nurses assisted in the design of HIS◦ Computers used in financial and management

functions◦ Several communities developed Management

Information sytem

1980’s◦ Nursing Informatics is formally accepted as new

nursing specialty.◦ Nursing Education identified need for update◦ Emergence of microcomputers/PC

1990’s◦ Computer technology became an integral part of

the healthcare setting.◦ Policies and legislation on promoting computers in

healthcare were adopted.◦ Approval of NI by ANA as a new nursing specialty.◦ Dr. Nicholas Davies excellence award is given for

excellence in health information technology, this is managed by HIMSS.

Post 2000◦ Clinical Information System became individualized

in the electronic patient record.◦ Mobile computing device were introduced◦ New technologies were utilized◦ Internet provided new means of development◦ Health Insurance Portability and Accountability

Act of 1996 was enacted.

NURSING

COMPUTERS

Computers can perform a wide range of activities that save time and help Nurses provide quality nursing care.

in

Computer systems, patient care data and NCP’s are integrated to Electronic Health Record

Need for EHR was perceived New Nursing Terminologies were recognized

by ANA

Computers linked department together. Hospital data are accessed through

computers. Hospital process goes on line Internet was utilized.

Most nursing schools offered computer enhanced courses.

Campus-wide computer systems became available.

Computer technology integrated into teaching methodologies

World wide web facilitates student-centered instructional settings.

Provides an avenue for analyzing data Softwares are available for processing

qualitative and quantitative data Research databases emerged Online access

ANA – considered as the official nursing organization that contributes in the development and recommendation of standards of nursing practice worldwide.

Joint commission on Accreditation of Hospital Organizations ( JCAHO) – focuses on the need for adequate records on patients in hospital and practice of standards in documentation of care

1961 – Healthcare Information and Management systems Society was founded

1965 – Development of one of the first hospital Information system in California

1973 – First Conference on Management Information Sytem

1981 – First National Conference on Computer Technology in Chicago

1984 – First Nursing Computer Journal is published.

1989 – graduate program in Nursing Informatics is introduced in Maryland university

1993-establishment of electronic library 1995 – first International Nursing

Informatics Teleconference held in Australia 2002-JCAHO identified clinical information

system as a way to improve safety and recommends that hospitals adopt technology.

2003 – Health Insurance Portability and Accountability Act was enacted

2004 – Establishment of the National Health Information Coordinator.

Electronic Health Record

Electronic Health Record

Historical Background of Electronic Health

Records.

Historical Background of Electronic Health

Records.

Introduction:

An electronic record composed of health information regarding an individual patient that exists as part of a complete system designed to provide access to, and management of, such information.

The EHR is developed and managed by the health facility or provider. The term Electronic Health Record has largely replaced the older “Electronic Medical Record.”

On the other hand, Nicholas E. Davis Excellence awardees shows differences that make one distinct from the other

Variable years spent in EHR program development.

Different external agenda and societal challenges.

Application of new technologies and techniques.

On the other hand, Nicholas E. Davis Excellence awardees shows differences that make one distinct from the other

Variable years spent in EHR program development.

Different external agenda and societal challenges.

Application of new technologies and techniques.

The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems

The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems

Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program.

Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program.

Promote the vision of EHR systems through concrete examples

Understand and share documented value of EHR systems

Provide visibility and recognition for high impact EHR system

Share successful EHR implementation strategies Encourages and recognizes excellence in the

implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy

Promote the vision of EHR systems through concrete examples

Understand and share documented value of EHR systems

Provide visibility and recognition for high impact EHR system

Share successful EHR implementation strategies Encourages and recognizes excellence in the

implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy

The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.

The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.

HIMMS Vision - Advancing the best use of information and management systems for the betterment of health care

HIMMS Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation, and community affiliations

HIMMS Vision - Advancing the best use of information and management systems for the betterment of health care

HIMMS Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation, and community affiliations

The 4major criteria in the initial assessment of

awardees identified by the CPRI Workgroup on

CPR Systems are as follows:

The 4major criteria in the initial assessment of

awardees identified by the CPRI Workgroup on

CPR Systems are as follows:

Management - the organizational aspects of EHR implementation; strategy, planning, project management and governance

Functionality - delivered by the EHR to meet the organizational objectives and the needs of patients and end-users

Technology - technical design and architecture that enable the EHR to deliver the required functionality and performance

Value - concrete return on investment as well as intrinsic value derived from the implementation of the EHR

Work lists to remind staff of planned nursing interventions

Electronic Medical Record (EMR) and Computer-Based Patient Record (CPR)

Monitoring devices that record vital signs and other measurements directly into the client record (electronic medical record)

Computer - generated nursing care plans and critical pathways

Automatic billing for supplies or procedures with nursing documentation

Reminders and prompts that appear during documentation to ensure

comprehensive charting

Automated staff scheduling

E-mail for improved communication

Cost analysis and finding trends for budget purposes

Quality assurance and outcomes analysis

Computerized record-keeping

Computerized-assisted instruction

Interactive video technology

Distance Learning-Web based courses and degree programs

Internet resources-CEU's and formal nursing courses and degree programs

Presentation software for preparing slides and handouts-PowerPoint and MS Word

Computerized literature searching-CINAHL, Medline and Web sources

The adoption of standardized language related to nursing terms-NANDA, etc.

The ability to find trends in aggregate data, that is data derived from largepopulation groups-Statistical Software, SPS 

An electronic record composed of health information regarding an individual patient that exists as part of a complete system designed to provide access to, and management of, such information. The EHR is developed and managed by the health facility or provider. The term Electronic Health Record has largely replaced the older “Electronic Medical Record.”

It is much more than an electronic replacement of existing paper systems. The EHR can start to actively support clinical care by providing a wide variety of information services. However, it is hard to understand what information is really important to clinical care and what is simply occasionally desirable.

The EHR bring uncountable advantages in primary health care detaching such as the faster access to information, the updated information, it allows having a clinical process with all the patient clinical information and an easier access to information (ex: allows the simultaneous access from different locations).

Recognizable efforts in the development of EHR are distinguished by the Nicholas E. Davis Awards of Excellence Program whose history describes the improvement of EHR in different settings.

The Computer-Based Patient Record Institute (CPRI), founded in 1992, was an organization representing all the stakeholders in healthcare, focusing on the clinical applications of information technology. It was among the first nationally based organizations to initiate and coordinate activities to facilitate and promote the routine use of Computer-Based Patient Records (CPRs) throughout healthcare.

The CPRI group on CPR Systems Evaluation developed the CPR project evaluation criteria in 1993 which became the basis in assessing accomplishments of CPR projects and provided the Foundation of Nicholas E. Davies Awards Excellence Program

The Program was named after Dr. Nicholas E. Davis, an Atlanta-based physician, president elect of the American College of Physicians, and member of Institute of Medicine (IOM) committee in improving patient records. He was killed in a plane crash just as the IOM report on CPRs was being released

The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems.

Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program objectives:

Promote the vision of EHR systems through concrete examples

Understand and share documented value of EHR systems

Provide visibility and recognition for high impact EHR system

Share successful EHR implementation strategies Encourages and recognizes excellence in the

implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy

The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.

Vision - Advancing the best use of information and management systems for the betterment of health care

Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy,

collaboration, innovation, and community affiliations