ISSUES IN INFORMATICSBy: FILAMAE JAYAHR CADAY, RN

COMPUTERS in

NURSINGNURSING PRACTICE

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

NURSING EDUCATION

NURSING MANAGEMENT

NURSING RESEARCH

Nursing Informatics and Healthcare Policy as a SpecialtyNI is a specialty that integrates nursing science, computer science and information science to manage and communicate data, information and knowledge in nursing practice. NI facilitates the integration of data information and knowledge to support patients, nurses and other providers in their decision making in all roles and settings.

NI Differentiated Interdisciplinary PracticeNI differentiates itself from other areas of nursing practice but emphasizes its interaction with informatics disciplines such as math, statistics, linguistics, engineering, computer science and health informatics. NI is a specific domain of informatics that falls under a broader umbrella of health informatics (others are medical informatics, dental informatics and consumer informatics)

Preparation for Specialty Practice( Educational Programs)the Division of Nursing (DN), Health and Human Services Administration (HRSA)funded two Masters NI programs, University of Maryland and University of Utah and one doctoral program in NI at University of Maryland in 1988-1992. In 1992, the American Nurses Association (ANA) officially established the role of the informatics nurse specialist, shortly after which they began offering the first credentialing exam in 1995.

Preparation for Specialty Practice( Educational Programs)The ANAs Scope and Standards of Nursing Informatics Practice (2001) identifies three progressive levels of NI competencies: the beginning nurse, experienced nurse, and informatics nurse specialist. As the specialty of NI has become more defined, nurses have sought out more learning opportunities and have benefited from the emergence of more formal NI education programs.

Preparation for Specialty Practice( Educational Programs)in 1997, NI specialty program opened in New York University and in 1998 at Duquesne University in Pittsburgh. The American Nursing Credentialing Center (ANCC) began administering an informatics nurse certification exam in November 1995. The exam topics cover areas of basic IT, information and knowledge management, system development, human factors and NI models, theories, and professional practice. a final requirement for a specialty in representation by at least one organization as NI has the support of both nursing and multidisciplinary organizations.

Healthcare Policy Impact on Nursing Informatics PracticeIn 2004, President G.W. Bush issued an executive order creating The Decade of Health Information Technology with a goal of establishing an electronic health record (EHR) for every American in the next 10 years. One of the reasons for this order was the release of findings from the Institute of Medicine (IOM) studies concluding that information technologies hold the promise to transform health care practice and facilitate patient safety One of Centers for Medicare and Medicaid Services (CMS) most important initiatives is to assist practitioners in making care more effective and less costly, particularly by promoting adoption of health information technology the Technology Informatics Guiding Educational Reform (TIGER) Summit in 2006 collaborated with colleagues from key federal agencies and healthcare organizations and articulated a vision for the future of nursing that enables nurses to use informatics in practice and education to provide safe, quality care.

NATIONAL INFORMATICS INITIATIVESThe presidential initiative to provide an electronic health record to all Americans by 2014. The Nationwide Health Information Network works to build a secure, nationwide health information infrastructure to connect health providers, consumers and others supporting health and healthcare. The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrations health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care.

NATIONAL INFORMATICS INITIATIVESThe American Recovery and Reinvestment Act of 2009 (ARRA) provided for the creation of an Health IT Policy Committee under the auspices of the Federal Advisory Committee Act (FACA), the committee is charged with making recommendations to the National Coordinator for Health IT on a policy framework for the development and adoption of a nationwide health information infrastructure, including standards for the exchange of patient medical information.

NATIONAL INFORMATICS INITIATIVESARRA 2009 also provided for the creation of an HIT Standards Committee under the auspices of the FACA that is charged with making recommendations to the National Coordinator on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. Initially, the HIT Standards Committee will focus on the policies developed by the Health IT Policy Committee. The Federal Health Architecture Initiative (FHA) represents a unique opportunity to build partnerships across communities of interest throughout the nation's health care environment in the development of a truly integrated and effective health information exchange network.

NATIONAL INFORMATICS INITIATIVESThe National Committee on Vital and Health Statistics (NCVHS) serves as the statutory [42 U.S.C. 242k(k)] public advisory body to the Secretary of the Department of Health and Human Services in the area of health data and statistics. In that capacity, the Committee provides advice and assistance to the Department and serves as a forum for interaction with interested private sector groups on a variety of key health data issues. Agency for Healthcare Research and Quality (AHRQ) - A science partner, working with the public and private sectors to build the knowledge base for what worksand does not workin health and health care and to translate this knowledge into everyday practice and policymaking.

NATIONAL INFORMATICS INITIATIVESNational Governors Association State Alliance for e-Health Work to improve the nation's health care system and enable states to increase the efficiency and effectiveness of health information technology (HIT), the NGA Center formed a collaborative body known as the State Alliance for e-Health (State Alliance) that provides a nationwide forum through which stakeholders can work together to identify inter- and intrastate-based health information technology policies and best practices and explore solutions to programmatic and legal issues related to the exchange of health information. PEHRC (Physicians Electronic Health Record Coalition) will assist physicians, particularly those in small- and medium-sized ambulatory care medical practice, to acquire and use affordable, standards-based electronic health records and other health information technology to improve quality, enhance patient safety, and increase efficiency and taking practical steps to educate physicians about the value and best use of electronic health records (EHR), and to assist them in selection of systems, as well as to help focus the market on high-quality and affordable products.

NATIONAL INFORMATICS INITIATIVESThe eHealth Initiative and the Foundation for eHealth Initiative to drive improvement in the quality, safety, and efficiency of healthcare through information and information technology and that consumers, health care providers, and those responsible for population health will have ready access to timely, relevant, reliable and secure information and services through an interconnected, electronic health information infrastructure to support better health and healthcare. Connecting for Health Markle is a public-private collaborative designed to address the barriers to development of an interconnected health information infrastructure. The ability to deliver medical information where and when it is needed in a private and secure manner will help to improve the quality of care, reduce medical errors, lower costs and empower patients.

NATIONAL INFORMATICS INITIATIVESHealthcare Information and Management Systems Society (HIMSS) is exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health, shapes and directs healthcare public policy and industry practices through its advocacy, educational and professional development initiatives, which are designed to promote information and management systems' contributions to quality patient care. HIMSS EHR Association (EHRA) offers unmatched experience and expertise, and provides a forum and structure for EHR leaders to work toward standards development, interoperability, the EHR certification process, performance and quality measures, HIT legislation, and other EHR issues. The EHR Association helps HIMSS establish its strategic direction and official positions on issues related to the electronic health record.

NATIONAL INFORMATICS INITIATIVESThe American Health Information Management Association (AHIMA) is a community of professionals engaged in the field of health information management. AHIMA provides support to members and works to strengthen the industry and profession. Health information management professionals serve the healthcare industry and the public by managing, analyzing, and utilizing data vital for patient care and working to make this information accessible to healthcare providers when it is needed most. The American Medical Informatics Association (AMIA) is the leading academic/scholarly organization in the United States dedicated to the research, development, and application of medical informatics in the support of patient care, teaching, research, and healthcare administration. AMIA intends to be, for medical informatics, what the ACP is for internal medicine.