What is Informatics Chris Curran Ph D RN

What is Informatics? Chris Curran, Ph. D, RN M 8120 September 4, 2001

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. Goethe, 1810

Terms Medical Informatics Healthcare Informatics Nursing Informatics

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

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)

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)

Definition: 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

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)

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

What Informatics is Not… Synonymous with computer technology

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

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

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

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

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

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

Knowledge Workers Definition: Knowledge work is nonrepetitive, non-routine work consuming considerable levels of cognitive activity (Drucker, 1993). Bring their knowledge, skills, judgment, and time to the organization

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

Decision Making Models n n n Information Processing Decision Analysis Skill Acquisition Uncertainty Biases

Decision Making Process vs Outcome Critical Thinking vs Decision Making

Workflow Process Mapping Low Level vs High Level Processes

Systems Architecture Integrated Distributed

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

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

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

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

Schwirian Model (1986) Source: Schwirian, P. M. (1986). The NI pyramid-A model for research in nursing informatics. Computers in Nursing, 4(3), 134 -136.

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), 60 -70.

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: Mc. Graw Hill, 661 -665.

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

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

Informatics Competencies: Three Areas Computer Literacy n a set of skills that allow individuals to use computer technology to accomplish tasks. Informatics Knowledge n 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 n the technical ability to use tools and techniques to improve information and knowledge access, integration, management and use.

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

Experienced Nurse: Informatics Competencies Understands the value of data and information Uses technology to trend 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

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 decisionmaking

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

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

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

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

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

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