History of Nursing Informatics in Canada

Brief History “Registered nurses need to be able to demonstrate their unique contribution to the health of Canadians within Canada’s rapidly evolving health care system. Basic, essential nursing information is required by nurses, employers, researchers, educators, policy makers, and clients so that informed decisions can be made about nursing’s role in the changing health care system," - Canadian Nurses Association, 1993: Policy Statement on Health Information: Nursing Components,

The CNA spearheaded an initiative, the National Nursing Informatics Project, to begin to develop a national consensus on definition, competencies, and educational strategies and priorities.

Nursing informatics began to evolve as nurses participated in the early initiatives in hospital information system adoption in various health agencies across the nation.

By the late 1980’s, most hospitals had at least a rudimentary information system that required nurses to enter common data

Nursing Minimum Data Set The Nursing Minimum Data Set was the first major Canadian Nurses Association informatics initiative beginning in centralized national health data system being planned by the Canadian Institute of Health Information (CIHI)

COACH Canadian Organization for the Advancement of Computers in Health or COACH, founded in 1975, has actively initiated professional protocols for using computer systems in Canadian health care.

Canadian Nursing Informatics Association In 2001, a new group, the Canadian Nursing Informatics Association (CNIA) received emerging group status from the CNA and affiliate status in 2003.

Canadian Nursing Informatics Association Mission: To be the voice for Nursing Informatics in Canada. The CNIA is the culmination of efforts to catalyze the emergence of a new national association of nurse informaticians.

Goals To provide nursing leadership for the development of Nursing/Health informatics in Canada. To establish national networking opportunities for nurse informaticians. To facilitate informatics educational opportunities for all nurses in Canada. To engage in international nursing informatics initiatives. To act as a nursing advisory group in matters of nursing and health informatics. To expand awareness of Nursing Informatics to all nurses and the healthcare community.

Health informatics Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems.

Provincial and territorial programs eHealth Ontario was created as an Ontario provincial government agency in September It has been plagued by delays and its CEO was fired over a multimillion-dollar contracts scandal in Alberta Netcare was created in 2003 by the Government of Alberta. NetCARE interface capabilities are being included in electronic medical record products which are being funded by the provincial government.

Classification Standard for Health Interventions CIHI completed the development of a new Canadian Classification for Health Interventions (CCI) that is currently being implemented in a number of provinces. The classification contains a comprehensive list of diagnostic, therapeutic, support and surgical interventions, allowing for the standardized collection of health interventions, regardless of the service provider or service setting.

Client Outcomes Ontario Nursing and Health Outcomes Project has done significant work in identifying client outcomes that are sensitive to nursing. The client outcomes that have been identified to date include: functional status, self-care, symptom control (dyspnea, nausea, fatigue, pain), patient satisfaction with nursing care, adverse occurrences such as nosocomial infections, patient falls and decubitus ulcers.

Privacy, confidentiality and security of health information Individuals and organizations responsible for the development of systems designed to collect, process, store, and share health information have a responsibility to ensure that these systems are secure in order to maintain the integrity and confidentiality of personal information.