Chapter 1
Introduction: The Evolution
of Health Informatics
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Informatics increasingly playing
an important role in our
healthcare landscape. Why?
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
2
Federal Initiatives to Drive Health
Information Technology




April 27, 2007: President George W. Bush signs the
Executive Order 13335.
February 17, 2009: The American Recovery and
Reinvestment Act creates the Health Information
Technology for Education and Clinical Health Act
(HITECH)
HIT as one area to stimulate the economy and
improve health care quality
Federal Financial Incentives

Eligible professionals (EPs) who adopt and
“meaningfully use” certified EHRs are eligible for
Medicare and Medicaid financial incentives.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
3
Vision: Learning Health System
(LHS)
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4
Goal: Quadruple Aim

Triple Aim



Better care
Better health
Lower costs
Better
Health for
the
Population
Better Care
for
Individuals
Lower Cost
through
Improvement
Improved
Provider
Satisfaction
5
Introduction

Health informatics incorporates processes,
procedures, theories, and concepts from:

Computer and informatics sciences
 Health sciences (e.g., nursing or medical science)
 Social sciences (e.g., cognitive and organizational
theories)

Nurses and other healthcare professionals apply
computer and information sciences to healthcare
problems.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
6
Health Informatics

Dates to the 1950s

Informatics: The study and use of information
technology to the arts, sciences, and professions;
and its use in society as a whole
 Medical informatics: Branch of informatics that
focuses on disease diagnosis and management
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
7
History

1960s – Experimentation & establishment of
terms



1968 – Russian A.I.Mikhailov informatik
• Early 1970s – term medical informatics
1971 – El Camino (CA) with Lockheed
installed world’s first computer aided medical
information system
See text for detailed history
General Trends in the Development
of Knowledge within a Discipline
Professional Organizations
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
9
Journals



New journals began to be published in the
1960s.
The first peer-reviewed informatics journal,
Computers in Biomedical Research, began
publishing in 1967.
The first journal article using the term nursing
informatics was indexed in MEDLINE and
Cumulative Index to Nursing and Allied
Health Literature (CINAHL) in 1986.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
10
Professional Organizations







American Medical Association
(AMA)
International Medical
Informatics Association (IMIA)
Symposium on Computer
Applications in Medical Care
(SCAMC)
American Association for
Medical Systems and
Informatics (AAMSI)
American College of Medical
Informatics (ACMI)
American Medical Informatics
Association (AMIA)
Healthcare Information and
Management Systems Society
(HIMSS)







Alliance for Nursing Informatics
(ANI)
American Health Information
Management Association (AHIMA)
Council on Computer Applications
in Nursing
National Forum on Computers in
Healthcare and Nursing
Capital Area Roundtable on
Informatics in Nursing (CARING)
American Nursing Informatics
Association (ANIA)
Association of Record Librarians
of North America (ARLNA) 
American Association of Medical
Record Librarians (AAMRL)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
11
Naming the Specialty
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
12
AMIA Position: Biomedical Informatics
and its Areas of Application and Practice
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
13
Hierarchy of Informatics
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
14
Educational Programs


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1950s: Educational programs began.
1964: One of the earliest medical informatics departments
was established.
1977: First computer-related nursing course was
conducted.
1984: Integrated Advanced Information Management
Systems (IAIMS) grant program was announced.
2009: The Health Information Technology for Economic
and Clinical Health (HITECH) Act gave funding to
programs.
2012: Medical informatics and nursing informatics were
both established as subspecialties of health informatics.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
15
Certification


ANCC Nursing Informatics
2011 breakdown of the Certified Professional
in Healthcare Information and Management
Systems (CPHIMS) certification:

68.5%—Registered nurse
 18.3%—Medical physician
 8.8%—Registered pharmacist
 4.4%—Other
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
16
Educating the Informatics
Specialist



Informatics nurse specialist is educated at the
Master’s and doctoral levels.
Translators between clinical practice and health IT
professionals must have clinical knowledge and
technical expertise.
Informatics nurse specialist designs, builds, tests,
implements, and maintains health IT systems that
support clinical practice and comply with regulatory
requirements.

Includes knowledge about health informatics and
terminology standards.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
17
Informatics Competencies Map

Educating nurses for today and tomorrow to
support the evolving LHS is important.

Competencies Matrix of HIT and informatics
skills (Box 26-1)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
18
Varied Career Pathways


Interview Activity
Watch Video – link is provided in Module 1
19
Future Work Skills - 2020
.
20