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Anfred C. Santos RN,
Dramatic reform and innovation in nursing is needed to create and shape the future of nursing practice
Nursing is a dynamic profession with universal needs
BEFORE
AFTER
BEFORE
AFTER
Nursing is a dynamic profession Computer Technology can transform the
nursing profession. Clinical Information system are common to
modern healthcare.
A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process.
The computer is the most powerful technological tool to transform nursing profession prior to the new century. The computer has transformed the nursing paper based record to computer based record
Computer and internet is very essential for all settings where nurses function
Nurses are becoming more computer literate and the nursing profession is implementing practice standards for its clinical care and data standards for its nursing information technology system. (NI) Nursing informatics is specialist emerged as a new specialty in the field of professional nursing practice
Computer – is a general term referring to information technology ( IT) and computer systems. In nursing it synonymous into nursing information system ((NIS).
Computers are used to manage information in patient care, monitor quality of nursing care and evaluate care outcomes
Networks with internet are used in communicating and accessing resources and interacting w/ the patient on the (WWW).
Nursing Informatics – is refers to the integration of nursing, its information management with information processing and information technology to support the people worldwide
It is a specialty that integrates nursing, computer and information science to manage and communicated data information and knowledge in nursing practice. (AMA)
Management and processing components may be considered the functional components of informatics.
Data: 140 systolic Information: 50 year-old male, day 3 of
hospitalization, BP 140/70 Knowledge: Pt. demographics, record of
BP readings, circulation system: anatomy & physiology, pharmacokinetics of ordered medication
Decisions: That guide practice
Clinical Information system - can be used interchangeably with electronic information systems (EHR-S) computerized patient and electronic medical record.
It refers to a set components that form the mechanism by which patient records are created, used, stored and retrieved usually located within a healthcare provider setting. It includes people, data rules and procedures, processing and storage devices, communication and support facilities (institute of Medicine, 1991)
Initial cost of acquisition
Privacy and Security:
Clinician Resistance:
Integration of Legacy Systems: This poses a stiff challenge to many organizations
Easy Access to Patient Data:
Structured Information:
Improved Drug Prescription and Patient Safety:
Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilization.
Six time periods
Four major Nursing areas
Standard Initiatives
Significant land mark events ( chart)
Six time period
◦ Prior to 1960’s – simple beginnings Use of punch cards and teletypewritters.
1960’s◦ Use of computers in healthcare is questioned
◦ Studies on computers in nursing is started.
◦ Introduction of cathode ray tubes
◦ Development of Hospital Information System for financial transactions
1970’s◦ Nurses assisted in the design of HIS◦ Computers used in financial and management
functions◦ Several communities developed Management
Information sytem
1970’s◦ Nurses assisted in the design of HIS◦ Computers used in financial and management
functions◦ Several communities developed Management
Information sytem
1980’s◦ Nursing Informatics is formally accepted as new
nursing specialty.◦ Nursing Education identified need for update◦ Emergence of microcomputers/PC
1990’s◦ Computer technology became an integral part of
the healthcare setting.◦ Policies and legislation on promoting computers in
healthcare were adopted.◦ Approval of NI by ANA as a new nursing specialty.◦ Dr. Nicholas Davies excellence award is given for
excellence in health information technology, this is managed by HIMSS.
Post 2000◦ Clinical Information System became individualized
in the electronic patient record.◦ Mobile computing device were introduced◦ New technologies were utilized◦ Internet provided new means of development◦ Health Insurance Portability and Accountability
Act of 1996 was enacted.
NURSING
COMPUTERS
Computers can perform a wide range of activities that save time and help Nurses provide quality nursing care.
in
Computer systems, patient care data and NCP’s are integrated to Electronic Health Record
Need for EHR was perceived New Nursing Terminologies were recognized
by ANA
Computers linked department together. Hospital data are accessed through
computers. Hospital process goes on line Internet was utilized.
Most nursing schools offered computer enhanced courses.
Campus-wide computer systems became available.
Computer technology integrated into teaching methodologies
World wide web facilitates student-centered instructional settings.
Provides an avenue for analyzing data Softwares are available for processing
qualitative and quantitative data Research databases emerged Online access
ANA – considered as the official nursing organization that contributes in the development and recommendation of standards of nursing practice worldwide.
Joint commission on Accreditation of Hospital Organizations ( JCAHO) – focuses on the need for adequate records on patients in hospital and practice of standards in documentation of care
1961 – Healthcare Information and Management systems Society was founded
1965 – Development of one of the first hospital Information system in California
1973 – First Conference on Management Information Sytem
1981 – First National Conference on Computer Technology in Chicago
1984 – First Nursing Computer Journal is published.
1989 – graduate program in Nursing Informatics is introduced in Maryland university
1993-establishment of electronic library 1995 – first International Nursing
Informatics Teleconference held in Australia 2002-JCAHO identified clinical information
system as a way to improve safety and recommends that hospitals adopt technology.
2003 – Health Insurance Portability and Accountability Act was enacted
2004 – Establishment of the National Health Information Coordinator.
Electronic Health Record
Electronic Health Record
Historical Background of Electronic Health
Records.
Historical Background of Electronic Health
Records.
Introduction:
An electronic record composed of health information regarding an individual patient that exists as part of a complete system designed to provide access to, and management of, such information.
The EHR is developed and managed by the health facility or provider. The term Electronic Health Record has largely replaced the older “Electronic Medical Record.”
On the other hand, Nicholas E. Davis Excellence awardees shows differences that make one distinct from the other
Variable years spent in EHR program development.
Different external agenda and societal challenges.
Application of new technologies and techniques.
On the other hand, Nicholas E. Davis Excellence awardees shows differences that make one distinct from the other
Variable years spent in EHR program development.
Different external agenda and societal challenges.
Application of new technologies and techniques.
The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems
The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems
Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program.
Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program.
Promote the vision of EHR systems through concrete examples
Understand and share documented value of EHR systems
Provide visibility and recognition for high impact EHR system
Share successful EHR implementation strategies Encourages and recognizes excellence in the
implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy
Promote the vision of EHR systems through concrete examples
Understand and share documented value of EHR systems
Provide visibility and recognition for high impact EHR system
Share successful EHR implementation strategies Encourages and recognizes excellence in the
implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy
The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.
The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.
HIMMS Vision - Advancing the best use of information and management systems for the betterment of health care
HIMMS Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation, and community affiliations
HIMMS Vision - Advancing the best use of information and management systems for the betterment of health care
HIMMS Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation, and community affiliations
The 4major criteria in the initial assessment of
awardees identified by the CPRI Workgroup on
CPR Systems are as follows:
The 4major criteria in the initial assessment of
awardees identified by the CPRI Workgroup on
CPR Systems are as follows:
Management - the organizational aspects of EHR implementation; strategy, planning, project management and governance
Functionality - delivered by the EHR to meet the organizational objectives and the needs of patients and end-users
Technology - technical design and architecture that enable the EHR to deliver the required functionality and performance
Value - concrete return on investment as well as intrinsic value derived from the implementation of the EHR
Work lists to remind staff of planned nursing interventions
Electronic Medical Record (EMR) and Computer-Based Patient Record (CPR)
Monitoring devices that record vital signs and other measurements directly into the client record (electronic medical record)
Computer - generated nursing care plans and critical pathways
Automatic billing for supplies or procedures with nursing documentation
Reminders and prompts that appear during documentation to ensure
comprehensive charting
Automated staff scheduling
E-mail for improved communication
Cost analysis and finding trends for budget purposes
Quality assurance and outcomes analysis
Computerized record-keeping
Computerized-assisted instruction
Interactive video technology
Distance Learning-Web based courses and degree programs
Internet resources-CEU's and formal nursing courses and degree programs
Presentation software for preparing slides and handouts-PowerPoint and MS Word
Computerized literature searching-CINAHL, Medline and Web sources
The adoption of standardized language related to nursing terms-NANDA, etc.
The ability to find trends in aggregate data, that is data derived from largepopulation groups-Statistical Software, SPS
An electronic record composed of health information regarding an individual patient that exists as part of a complete system designed to provide access to, and management of, such information. The EHR is developed and managed by the health facility or provider. The term Electronic Health Record has largely replaced the older “Electronic Medical Record.”
It is much more than an electronic replacement of existing paper systems. The EHR can start to actively support clinical care by providing a wide variety of information services. However, it is hard to understand what information is really important to clinical care and what is simply occasionally desirable.
The EHR bring uncountable advantages in primary health care detaching such as the faster access to information, the updated information, it allows having a clinical process with all the patient clinical information and an easier access to information (ex: allows the simultaneous access from different locations).
Recognizable efforts in the development of EHR are distinguished by the Nicholas E. Davis Awards of Excellence Program whose history describes the improvement of EHR in different settings.
The Computer-Based Patient Record Institute (CPRI), founded in 1992, was an organization representing all the stakeholders in healthcare, focusing on the clinical applications of information technology. It was among the first nationally based organizations to initiate and coordinate activities to facilitate and promote the routine use of Computer-Based Patient Records (CPRs) throughout healthcare.
The CPRI group on CPR Systems Evaluation developed the CPR project evaluation criteria in 1993 which became the basis in assessing accomplishments of CPR projects and provided the Foundation of Nicholas E. Davies Awards Excellence Program
The Program was named after Dr. Nicholas E. Davis, an Atlanta-based physician, president elect of the American College of Physicians, and member of Institute of Medicine (IOM) committee in improving patient records. He was killed in a plane crash just as the IOM report on CPRs was being released
The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology, specifically EHRs, for healthcare organizations, private practices and public health systems.
Nowadays the Nicholas E. Davies Awards Excellence Program is managed by the Healthcare Information Management Systems Society, and has the following program objectives:
Promote the vision of EHR systems through concrete examples
Understand and share documented value of EHR systems
Provide visibility and recognition for high impact EHR system
Share successful EHR implementation strategies Encourages and recognizes excellence in the
implementation of EMREHR systems: Implementation, Strategy, Planning, Project Management and Governance– Strategy
The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.
Vision - Advancing the best use of information and management systems for the betterment of health care
Mission - To lead change in the healthcare information and management systems field through knowledge sharing, advocacy,
collaboration, innovation, and community affiliations
