Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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 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,

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall The Nursing Process Assessment Diagnosis Outcomes / Planning Implementation Evaluation Each step supports: –Actual delivery of patient care –Management of each patient’s care 3

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall How Nurses Spend Their Time? Documentation Care Coordination Patient Care Activities Medication Administration Patient assessment & vital signs Hendrich et al (2008) The Permanente Journal

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall Nursing Informatics Courtesy of UAB School of Nursing

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall “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

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall “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

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall “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

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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 )

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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 )

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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 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 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 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 The shift from centralized data storage to decentralized data access

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall The shift from paper charts to e-records

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall Relying on memory to continuously using information resources

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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

Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 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 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 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 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 Types of Nursing HIT Applications 23 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 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 Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall Slide #PhotographerSource 3PoramapornNFlickr.com 5UAB School of Nursing 9Rainer GerhardsCommons.wikimedia.org 10Arnold ReinholdCommons.wikimedia.org 15NASA; Johannes HemmerlinCommons.wikimedia.org 16US Navy; VIA GalleryCommons.wikimedia.org 17Vincent J Brown; Neils van EckFlickr.com 20NASANasaimages.org 21Sonitor TechnologiesCommons.wikimedia.org 23Diane ByrneFlickr.com