Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 1 History of Health Information Technology in the U.S. Unit 5 Evolution of Nursing

Component 5/Unit 5Health IT Workforce Curriculum

Version 1/Fall 20101

History of Health Information Technology in

the U.S.

Unit 5Evolution of Nursing

Informatics and HIT Tools Used by Nursing



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 – Hospice– Outpatient – Public Health– Long term care – Emergency

American Nurses Association: Nursing’s Agenda for the Future, 2002

2



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

3



How Nurses Spend Their Time?

Documentation

CareCoordination

Patient Care Activities

Medication Administration

Patient assessment & vital signs

Hendrich et al (2008) The Permanente Journal



Nursing Informatics

Courtesy of UAB School of Nursing



• “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”

1994

Definition

American Nurses

Association



• “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”

2001

Definition

American Nurses

Association



• “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.”

2008

Definition

American Nurses

Association



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)




• 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)




• 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)




• 1979: The Journal of Nursing Administration features a monthly column “automation in nursing”




• 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




• 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)



The shift from centralized data storage to decentralized data

access



The shift from paper charts to e-records



Relying on memory to continuously using information

resources



Evolving Role of the Nursing Informaticist

• 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



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



Types of Nursing HIT Applications

• Automation of documentation– Nurse rounding tools

• Bar-coded Rx management

• Nurse staffing systems

• Telehealth







• Telehealth







• Telehealth




23




• Telehealth



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

Photo Credits



Slide # Photographer Source

3 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

Documents

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 1 History of Health Information Technology in the U.S. Unit 5 Evolution of Nursing