History of Health Information
Technology in the U.S.
Unit 5
Evolution of Nursing Informatics
and HIT Tools Used by Nursing
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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The Nursing Profession
• 2.7 million nurses practice in the US
• Nation’s largest health care profession
• Nurses practice in virtually all healthcare
settings:
– Inpatient
– Outpatient
– Long term care
– Hospice
– Public Health
– Emergency
American Nurses Association: Nursing’s Agenda for the Future, 2002
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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The Nursing Process
•
•
•
•
•
Assessment
Diagnosis
Outcomes / Planning
Implementation
Evaluation
• Each step supports:
– Actual delivery of patient
care
– Management of each
patient’s care
http://www.nursingworld.org/EspeciallyForYou/StudentNurses/Thenursingprocess.aspx
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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How Nurses Spend Their Time?
Patient assessment & vital signs
Documentation
Patient Care
Activities
Medication
Administration
Care
Coordination
Hendrich et al (2008) The Permanente Journal
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Nursing Informatics
Courtesy of UAB School of Nursing
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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American
Nurses
Association
1994
Definition
Component 5/Unit 5
• “Nursing Informatics is the
specialty that integrates
nursing science, computer
science, and information
science in identifying,
collecting, processing, and
managing data and
information to support
nursing practice,
administration, education,
research and the expansion
of nursing knowledge”
Health IT Workforce Curriculum
Version 1/Fall 2010
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American •
Nurses
Association
2001
Definition
Component 5/Unit 5
“Nursing Informatics is the
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. This
support is accomplished through
the use of information structures,
information processes, and
information technology”
Health IT Workforce Curriculum
Version 1/Fall 2010
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American
Nurses
Association
2008
Definition
Component 5/Unit 5
• “Nursing Informatics is the
specialty that integrates
nursing science, computer
science, and information
science to manage and
communicate data,
information, knowledge, and
wisdom in nursing practice.”
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• Nurses have been involved in
“informatics” since the 1960’s
• San Jose Hospital (1965): Nurses
recorded their observation on a
check list which is converted into
punched cards for computer entry
(Collen, M.: A History of Medical Informatics 1950-1990)
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• Institute of Living in Hartford
(1966): Nurses use machine
readable pencil “bubble sheets” to
document patient status
(Collen, M: A History of Medical Informatics 1950-1990)
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• 1974: Nursing research papers presented at
an international medical informatics
conference (MEDINFO)
– Four research paper on NI from the U.K., one
from U.S. nurses adapting and implementing an
information system at the NIH
Ozbolt and Saba (2008)
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• 1979: The Journal of Nursing
Administration features a monthly column
“automation in nursing”
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• 1980: The term “Nursing Informatics”
originated by Scholes and Barber
• 1992: NI approved as a nursing specialty
by American Nurses Association (ANA)
• 1995: ANA credentialing exam
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolution of Nursing Informatics
• According to Thompson (2005), three
main shifts catalyzed NI:
– Moving from centralized data storage to
decentralized data access
– Moving from paper charts to electronic health
records
– Moving from relying on memory to
continuously using information resources
“The Transforming Effect of Handheld Computers on Nursing Practice” Nurs Admin Q, 29(4)
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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The shift from centralized data
storage to decentralized data access
Component 5/Unit 5
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The shift from paper charts
to e-records
Component 5/Unit 5
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Relying on memory to continuously
using information resources
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolving Role of the Nursing
Informaticist
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•
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Education and support of HIT users
System implementations
Workflow analysis
Playing the role of “champion” and garnering
buy-in
• Liaison between nursing and IT
• Ensure that the nursing perspective is
represented in organizational HIT decisions
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Evolving Role of the Nursing
Informaticist
• Leadership positions within healthcare
organizations that go beyond IT
– Patient safety
– Change management
– Quality improvement
Source: HIMSS 2009 Nursing Informatics Impact Survey
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Types of Nursing HIT Applications
• Automation of documentation
– Nurse rounding tools
• Bar-coded Rx management
• Nurse staffing systems
• Telehealth
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Types of Nursing HIT Applications
• Automation of documentation
– Nurse rounding tools
• Bar-coded Rx management
• Nurse staffing systems
• Telehealth
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Types of Nursing HIT Applications
• Automation of documentation
– Nurse rounding tools
• Bar-coded Rx management
• Nurse staffing systems
• Telehealth
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Types of Nursing HIT Applications
• Automation of documentation
– Nurse rounding tools
• Bar-coded Rx management
• Nurse staffing systems
• Telehealth
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Conclusion
• The nursing profession has a strong
commitment to the specialty of nursing
informatics
• Given their training and responsibilities,
nurse Informaticists play key roles in
organizational efforts to adopt health IT
• The demand for professional nurses with
informatics backgrounds will likely
continue to rise
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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Photo Credits
Slide #
3
Photographer
Source
PoramapornN
Flickr.com
5
UAB School of Nursing
9
Rainer Gerhards
Commons.wikimedia.org
10
Arnold Reinhold
Commons.wikimedia.org
15
NASA; Johannes Hemmerlin
Commons.wikimedia.org
16
US Navy; VIA Gallery
Commons.wikimedia.org
17
Vincent J Brown; Neils van Eck
Flickr.com
20
NASA
Nasaimages.org
21
Sonitor Technologies
Commons.wikimedia.org
23
Diane Byrne
Flickr.com
Component 5/Unit 5
Health IT Workforce Curriculum
Version 1/Fall 2010
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