History of Health Information Technology in the U

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 2010 1

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 – Outpatient – Long term care – Hospice – Public Health – Emergency American Nurses Association: Nursing’s Agenda for the Future, 2002 Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 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/Especially. For. You/Student. Nurses/Thenursingprocess. aspx Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 3

How Nurses Spend Their Time? Patient assessment & vital signs Documentation Patient Care Activities Care Coordination Component 5/Unit 5 Medication Administration Hendrich et al (2008) The Permanente Journal Health IT Workforce Curriculum Version 1/Fall 2010 4

Nursing Informatics Courtesy of UAB School of Nursing Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 5

American Nurses Association 1994 Definition Component 5/Unit 5 • “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” Health IT Workforce Curriculum Version 1/Fall 2010 6

American • Nurses Association 2001 Definition Component 5/Unit 5 “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” Health IT Workforce Curriculum Version 1/Fall 2010 7

American Nurses Association 2008 Definition Component 5/Unit 5 • “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. ” Health IT Workforce Curriculum Version 1/Fall 2010 8

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) Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 9

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 1950 -1990) Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 10

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 2010 11

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 2010 12

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 2010 13

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 2010 14

The shift from centralized data storage to decentralized data access Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 15

The shift from paper charts to e-records Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 16

Relying on memory to continuously using information resources Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 17

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 2010 18

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 2010 19

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 2010 20

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 2010 21

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 2010 22

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 2010 23

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 Component 5/Unit 5 Health IT Workforce Curriculum Version 1/Fall 2010 24

Photo Credits Slide # 3 Photographer Source Poramaporn. N 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 Component 5/Unit 5 Health IT Workforce Curriculum 1/Fall 2010 Version 25