Nurses Transforming Healthcare Through Informatics
Nursing Informatics Research Year in Review
Spring 2017 – Winter 2018
Trends in Clinical Informatics: A Nursing PerspectiveApril 27, 2017
Nurses Transforming Healthcare
Through Informatics
Andrew PhillipsPhD, RN
Nurses Transforming Healthcare Through Informatics3
Conflict of Interest
Andrew PhillipsHas no real or apparent conflicts of interest to report.
Nurses Transforming Healthcare Through Informatics4
Learning Objectives
• Evaluate themes that impact nursing informatics. • Identify gaps in nursing informatics research. • Generate logical next steps in advancing nursing
informatics research.
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Methods – Scoping Study
Arksey and O’Malley1
•Step 1 – Identify the Research Question •Step 2 – Identify Relevant Studies •Step 3 – Study Selection (Iterative process which can change over time )
•Step 4 – Charting the Data •Step 5 – Collating, summarizing, and reporting the results •Step 6 – Consultation – This is you guys
1Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International journal of social research methodology, 8(1), 19-32.
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Step 1: Research Question
•What trends and themes emerge from a survey of the published literature in the area of nursing informatics during the past year
•Make meaning of current and past themes – historical context.
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Step 2: Identify Relevant Studies
•Search Strategy−Databases: PubMed and CINAHL −Search terms
• ((“nurse” or “nursing”) AND “informatics”) OR “nursing informatics”
•Publication Dates 3/1/2017 – 2/28/2018
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Step 3: Study Selection
Inclusion and Exclusion Criteria•Inclusion criteria: Research, contributes to nursing informatics knowledge base, prototype development and testing, clinical care delivery focus; informatics
•Exclusions: Articles that focused on informatics education programs, nursing education, nursing students
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Search Results (flow chart)
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Nurses Transforming Healthcare Through Informatics11
Step 4: Charting the Data
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21%
6%
27%
0%
33%
1%12%
Research by Setting (%)2017-2018
Ambulatory
Community/Public Health
Continuum of Care
Health Professional/Expert Panel
Hospital
LongTerm Care
Other (Theory/Design/Standards)
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3% 0% 3% 0%
58%
0%
16%20%20%
5%13%
48%
7% 7%6%12%
73%
3% 6%15% 16%
23%
4%
41%
1%8% 10%
16%11%
25%15% 15%
28%19%
0% 0%
51%
2% 1%
21%
6%
27%
0%
33%
1%
12%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Ambulatory
Community/Public
Health
Continuum of C
are
Health Profess
ional/Exp
ert Pan
el
Hospital
LongTerm Care
Other (Theory/
Design/Standard
s)
Not Applic
able
Research Setting (%)By Year
2012-2013 2013-2014 2014 - 2015 2015 - 2016 2016 - 2017 2017-2018 2018-2019
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49%
1%
3%
2%
5%1%
3%2%
17%
0
By Country (%)2017-2018
USA UK Korea Middle East Canada Tiawan China Australia Other
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0 0 0 0 0 0 0 0 0
62%
5%2%
9%
2%4%
65%
6%3% 3% 2%
14%
61%
8%
3%
7%
1%
13%
49%
1%3% 2%
5%
1%3% 2%
17%
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
USA UK Korea Middle East Canada Tiawan China Australia Other
Research Country (%)By Year
2014 - 2015 2015 - 2016 2016 - 2017 2017-2018 2018-2019
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5%
2%
7%
25%
0%
15%
3%
11%
24%
4%
4%
2%
7%
0% 5% 10% 15% 20% 25% 30%
Transitions
Standards/Terminologies/HIE
Technology Acceptance
TeleHealth/Mobile
Social Media
Implementation/Workflow
Human Factors
Patient Empowerment
Clinical Documentation/Documenetation
Big Data/Data Use
Public Health
Simulation
Other
Topic (%)2017-2018
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5%2%
7%
25%
0%15%
3%
11%
24%
4%
4%
2%7%
By Topic (%)
TransitionsStandards/Terminologies/HIETechnology AcceptanceTeleHealth/MobileSocial MediaImplementation/WorkflowHuman FactorsPatient EmpowermentClinical Documentation/CDSBig Data/Data Use
Public HealthSimulationOther
Telehealth/Mobile
Documentation/CDS
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0%
5%
10%
15%
20%
25%
30%
Transition
s
Standards/T
ermino
logies/H
IE
Technolo
gy Acc
eptanc
e
Technolo
gy Acc
eptanc
e-Pati
ent
TeleHea
lth/M
obile
Social M
edia
Implem
entat
ion/Work
flow
Human Facto
rs
Patient
Empowerm
ent
Clinica
l Docu
mentat
ion
Clinica
l Decis
ion Sup
port
Big Data/
Data Use
Public
Health
Hand O
ffs
Communicatio
n
Simulatio
n
Technolo
gy Dev
elopment
Other
Topic (%)by Year
2014 - 20152015 - 20162016 - 20172017 - 20182018 - 2019
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Step 5 – Collating, summarizing, and reporting the results
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Themes Identified
1. Clinical decision support (errors) and clinical documentation still main focus ~50% of studies.• Use of EHR data greater for
predictive tools – disease progression, deterioration
• New tools related to AI and machine learning, natural language processing
2. Patient Empowerment/Self-care• Disease management• Continuum of care (keep patients out
of hospital)3. Technology Acceptance by
Patient(Portals, Telehealth, Mobile)
3. Telehealth Standards
4. Social Media lacking from data (buried in telehealth?)
5. Use of telehealth to address health disparities and access
6. Patient Reported Data− Sustainability of patient facing
technologies7. Patient clearly recognized as
stakeholder8. Big Data Continues
• Data Mining and Use, AI, Machine learning
• Public and Population Health genomic, pharm, other
9. Inter-professional Care, Care Coordination, Shared Decision Making
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Representative Citations
Hewner, S., Sullivan, S. S., & Yu, G. (2018). Reducing Emergency Room Visits and In-Hospitalizations by Implementing Best Practice for Transitional Care Using Innovative Technology and Big Data. Worldviews on Evidence-Based Nursing, 15(3), 170-177.
Mosley, J. D., Feng, Q., Wells, Q. S., Van Driest, S. L., Shaffer, C. M., Edwards, T. L., ... & Thompson, W. (2018). A study paradigm integrating prospective epidemiologic cohorts and electronic health records to identify disease biomarkers. Nature communications, 9(1), 3522.
Reading, M., Baik, D., Beauchemin, M., Hickey, K. T., & Merrill, J. A. (2018). Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers. Applied clinical informatics, 9(04), 772-781.
Reading, M. J., & Merrill, J. A. (2018). Converging and diverging needs between patients and providers who are collecting and using patient-generated health data: an integrative review. Journal of the American Medical Informatics Association, 25(6), 759-771.
Saleh, S., Alameddine, M., Farah, A., El Arnaout, N., Dimassi, H., Muntaner, C., & El Morr, C. (2018). eHealth as a facilitator of equitable access to primary healthcare: the case of caring for non-communicable diseases in rural and refugee settings in Lebanon. International journal of public health, 63(5), 577-588.
Topaz, M., Murga, L., Gaddis, K. M., McDonald, M. V., Bar-Bachar, O., Goldberg, Y., & Bowles, K. H. (2019). Mining fall-related information in clinical notes: Comparison of rule-based and novel word embedding-based machine learning approaches. Journal of biomedical informatics, 90, 103103.
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Nurses Transforming Healthcare Through Informatics
Step 6 – Consultation
Feedback and Professional Input…