1. Chris Curran, PhD, RN M8120 September 4, 2001
What is Informatics?
Chris Curran, PhD, RN
M8120
September 4, 2001

2. The modern age has a false sense of superiority because it relies on the mass of knowledge that it can use, but
what is important is the extent to which knowledge is organized and mastered.
How one displays data, in order to gain information and knowledge, matters. The display of data directly impacts how much information one gleans from the data.
This presentation will talk about:
When are graphs appropriate, and if so, what type do I use?
How do I design the graphical display to maximize its effectiveness.
Applications of graphs to clinical data.
Goethe, 1810

3. Terms
Medical Informatics
Healthcare Informatics
Nursing Informatics

4. Goal of Nursing Informatics
“The goal of nursing informatics is to improve the health of populations, communities, families and individuals by optimizing information management and communication. This includes the use of technology in the direct provision of care, in establishing effective administrative systems managing and delivering educational experiences, supporting life-long learning and supporting nursing research.”
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

5. First Definition: Nursing Informatics
“The application of computer technology to all fields of nursing—nursing service, nurse education, and nursing research.”
(Scholes and Barber, 1980, p. 70)

6. Definition: Nursing Informatics
Nursing informatics is a combination of nursing science, information science, and computer science to manage and process nursing data, information and knowledge to facilitate the delivery of health care.
(Graves & Corcoran, 1989)

7. Definition: Nursing Informatics
Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics 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 and information technology.
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

8. Definition: Medical Informatics
The scientific field that deals with biomedical information, data and knowledge-their storage, retrieval, and optimal use for problem-solving and decision-making.
(Shortliffe & Perreault, 2001)

9. The Metastructures, Concepts, and Tools of Nursing and Nursing Informatics
Nurses, patients, health, environment
Nursing data, information, and knowledge
Content of information
Design, structure and presentation of information as it impacts nurses’ decision-making
Using information applications and technology
Optimizing information structures, applications and technology for use in managing and communicating data, information and knowledge
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

10. What Informatics is Not…
Synonymous with computer technology

11. Facts
Recognized as a specialty for registered nurses by the American Nurses Association in 1992.

12. Computers can’t…but Humans can…
Perceive data and information
Abstract data and information
Make decisions that involve values and risk preferences

13. Scope of Informatics Data, information, knowledge and wisdom
Communication and information management
Types, capabilities, and limitations of technology
Legal and ethical considerations of information

14. Key Concepts Data Information Knowledge Wisdom Knowledge Workers
Decision Making
Informatics Competencies
Workflow
Technology
Hardware
Software
Electronic Standards
System Architecture
Internet / WWW
Database

15. Data, Information and Knowledge (Blum, 1986)
Data are discrete entities that are described objectively without interpretation,
Information is data that are interpreted, organized, or structured, and
Knowledge is information that is synthesized so that relationships are identified and formalized

16. Wisdom
Wisdom is the appropriate use of data, information and knowledge in making decisions and implementing nursing actions.

17. Knowledge Workers
Definition: Knowledge work is non-repetitive, non-routine work consuming considerable levels of cognitive activity (Drucker, 1993).
Bring their knowledge, skills, judgment, and time to the organization
Unless these can be applied to meet the organization’s goals, the knowledge worker is useless to the organization.

18. Information Processed: Quantity vs. Quality (Patel, 1997)

19. Decision Making Models Uncertainty Biases Information Processing
Decision Analysis
Skill Acquisition
Uncertainty
Biases

20. Decision Making Process vs Outcome
Critical Thinking vs Decision Making

21. Workflow
Process Mapping
Low Level vs High Level Processes

22. Systems Architecture
Integrated
Distributed

23. Overarching Standards of Practice for the Informatics Nurse Specialist
1. Incorporates theories, principles and concepts from appropriate sciences into informatics practice such as information, systems, and change theories; implementation methods, organizational culture, and database structures.
2. Integrates ergonomics and human-computer interaction principles into informatics solution design, selection, implementation and evaluation. 
3. Systematically determines the social, legal, and ethical impacts of an informatics solution within nursing and health care.
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

24. Informatics Nurse Specialist Standards of Practice
Standard I. Identify the Issue or Problem
Standard II. Identify Alternatives
Standard III. Choose and Develop a Solution
Standard IV. Implement the Solution
Standard V. Evaluate and Adjust Solutions
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

25. Informatics Nurse Specialist Standards of Professional Performance
Standard I. Quality of Nursing Informatics Practice
Standard II. Performance Appraisal
Standard III. Education
Standard IV. Collegiality
Standard V. Ethics  
Standard VI. Collaboration
Standard VII. Research
Standards VIII. Resource Utilization
Standard IX. Communication
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

26. Theoretical Models Schwirian (1986) Graves & Corcoran (1989; 1995)
Staggers and Parks (1993)
ANA Scope and Standards Document (2001)

27. Schwirian Model (1986)
Source: Schwirian, P. M. (1986). The NI pyramid-A model for research in nursing informatics. Computers in Nursing, 4(3),

28. Graves and Corcoran Model (1989; 1995)
Source: Graves, J. R., Amos, L. K., Huether, S., Lange, L., & Thompson, C.B. (1995). Description of a graduate program in clinical nursing informatics. Computers in Nursing, 13(2),

29. Staggers and Parks Nurse-Computer Interaction Framework (1993)
Source: Staggers, N. & Parks, P. A. (1993). Collaboration between unlikely disciplines in the creation of a conceptual framework for nurse-computer interactions. In M. E. Frisse, (ed.). Proceedings of the Sixteenth Annual Symposium on Computer Applications in Medical Care, NY: McGraw Hill,

30. ANA Scope & Standards Model (2001)
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of Practice and Professional Performance for the Informatics Nurse Specialist

31. Informatics Competencies
Levels of Competency
Beginning Nurse
Experienced Nurse
Informatics Nurse Specialist
Informatics Innovator
Types
Computer Skills
Informatics Knowledge
Informatics Skills

32. Informatics Competencies: Three Areas
Computer Literacy
a set of skills that allow individuals to use computer technology to accomplish tasks.
Informatics Knowledge
a set of cognitive processes that allows the individual to recognize what, when, and where information is needed and to locate, evaluate, and use that information appropriately.
Informatics Skills
the technical ability to use tools and techniques to improve information and knowledge access, integration, management and use.

33. Beginning Nurse: Informatics Competencies
Has basic computer skills
Uses applications
Uses sources of data
Uses technology for care delivery, communication, and decision support
Respects and protects patients’ rights to privacy and confidentiality of information

34. Experienced Nurse: Informatics Competencies
Understands the value of data and information
Uses technology to trend and aggregate individual and population-based patient information for decision support and communication
Evaluates quality of information sources
Advocates for technology solutions that improve care delivery

35. Informatics Nurse Specialist: Informatics Competencies
Uses advanced systems and tools to manage, evaluate, integrate, and communicate data, information and knowledge
Assesses current capabilities and limitations of technology and their impact on users and organizations
Manages IT projects across the systems life cycle
Actively seeks to improve the information and knowledge available for clinical decision-making

36. Informatics Innovator: Informatics Competencies
Conducts research related to nursing informatics
Influences top-level decisions and policy design which impact clinical information management
Builds theoretical models of NI
Evaluates system level informatics initiatives

37. Roles of the Informatics Nurse Specialist
Project Management
Consultation
Education
Research
System Development
Decision Support/Outcomes Management
Policy Development
Entrepreneur

38. Information Needs and Tools for Practice
Sound Clinical Decision Making
Evidence Based Practice
Standardized Vocabularies
Clinical Information Systems

39. Electronic Patient Records: Development Constraints
Need for standards in clinical terminology
Concerns about data privacy, confidentiality and security
Data entry challenges
Integration of records and other information resources

40. Research Priorities Brennan, Zielstorff, Ozbolt, & Strombom, 1998)
Standardized language/vocabularies
Technology development to support practice/ patient care
Data base issues
Patient use of information technologies
Using telecommunications technology for nursing practice
Putting technology into practice
Systems evaluation issues
Information needs of nurses and other clinicians
Nursing intervention innovations for professional practice
Professional practice issues

41. Assumptions to be Challenged
Organization of electronic systems
Desktop metaphor
EMR
Chronological structure
Set of processes to be supported by technology