Finals

Unit 4: Theories, Models and Frameworks

Introduction

Informatics nurses are key persons in the design, development, implementation, and evaluation of
these technologies and in the development of the specialty’s body of knowledge.

Why do we need to understand Theories, Models and Frameworks?

• Theories, Models, and Frameworks clearly stated definitions, and foundational documents can guide
the nursing informatics learning activities for both students and faculty.

• By incorporating analogies based on clinical and other experiences, the informatics nurse can assist
the learner in understanding the relationships of data and information, computer and information
system technologies and communications and software applications to their work setting or
personal life.

• Nursing Informatics is a dynamic and evolving professional discipline.

Theories of Nursing Informatics

LEARNING THEORIES

These psychosocial theories describe ways in which persons take in and process information.

• Visually-oriented concrete thinkers who process information in a linear fashion seem to find it
easiest to adapt to the computer.

• However, newer programs and improved technology are making it easier for non-linear, non-visual
persons thinkers.

• Persons who think abstractly probably have the most difficulty with computer technology.

LEWIN'S FIELD THEORY

• This theory combines elements of psychology and sociology.

• Its focus is on motivation and motivational conflicts.

• Lewin described 3 types of conflict:

o Positive goal-positive goal

o Negative goal-negative goal

o Opposing positive and negative forces

• Lewin also described stages in the adoption of change

CONFLICTS:

 positive goal-positive goal: involves a choice based upon relative strengths of the two
options.

 For example one may have to decide which information system to buy, given a
choice between two good systems.

 negative goal-negative goal: involves a choice of the “lesser of 2 evils”.

 In this case all options are equally ill-suited to the user’s goals, but a choice has to
be made.
  Opposing positive and negative forces: This is a conflict in which options offer unequal
advantages to different sets of users.

 For example, one system may be attractive to management because it can

be used to collect and analyze detailed data. But it may be unattractive to
users because data entry is complicated and difficult to learn.

ADOPTION OF CHANGE

1. Unfreezing: Disequilibrium occurs either because individual expectations are not being met, the
individual feels uncomfortable about some action or lack of action, or a former obstacle to change no
longer exists. Three processes occur during this stage:

 discomfirmation: dissatisfaction or frustration with the current situation

 induction of guilt or survival anxiety: evidence of discomfirmation is accepted as valid.
Defensive behaviors may be seen.
 psychological safety: Survival anxiety begins to be overcome. The change information is
accepted and the individual becomes motivated to change .
2. Moving
 The innovation is examined, accepted and tried out.
 Participants incorporate it into their work and interpersonal processes.
 They see it from a new perspective.
 Good role models facilitate this process.
3. Refreezing

• The change is integrated and stabilized as part of the value system.

• It becomes accepted and seen as part of one’s routine.
SYSTEMS THEORY

• This well-known theory is build upon the following philosophic principles:

• Change in one part of the system affects the entire system.
• Input into the system from the environment is processed within the system and becomes output
back into the environment.
• There must be a built-in feedback mechanism
• Systems analysis is a systematic process of problem-solving that includes identifying a need,
defining the problem, describing the scope of the system, and setting specific, measurable goals
and objective.
MOTIVATION THEORY
 This management theory is used to help organizations introduce and cope successfully with
change.
 They emphasize individuals’ need for growth, skill development, autonomy, and a feeling that their
work is significant.
 This is particularly acute in those who are high performers. High-performers may be targeted as
early adopters who can facilitate organizational change.
 Also emphasize the importance of organizational expectations
 In terms of informatics, this would mean that organizations who expect their employees to use
technology are more likely to successfully incorporate a high level of technology use than
organizations who expect resistance.

Models of Nursing Informatics

• Models – are representations of some aspect of the real world.

 Shows particular perspectives of a selected aspect and may illustrate relationships.

 Evolves as knowledge about the selected aspect changes and are dependent on the “world
view” of those developing the model.

 Data, Information, Knowledge – identified as current metastructures or overarching concepts

for nursing informatics with specific definitions in the scope and standards of Nursing
Information Practice

TRANFORMATION FROM DATA TO KNOWLEDGE

Data- “discrete enteties that are described objectively without interpretation” and would include some
value assigned to a variable.
 Example: Systolic Bp, Nursing intervention, Patient problem, Outcome

Information- reflects interpretation, organization, or structuring of data (ANA, 2001b, p.6).

The result of processing data

Raw Facts

Transformation

(Through the application

Of context to give

Meaning)

Data Processing

Information

• In 1996, Turley introduced a model that accurately illustrates the intersection of the sciences that
contribute to nursing informatics, adding cognitive science to Graves and Corcoran’s definition to
include such topics as problem-solving, memory, language processing, mental models and visual
attention (see Figure 2).

Knowledge- emerges from the transformation of information

• “Knowledge is information that is synthesized so that relationships are identified and

formalized” (ANA, 2001 b, p.6).

• Processing of information does not always result in the development of knowledge

• Knowledge is necessary to processing data and information

• Knowledge itself may be processed to generate decisions and new knowledge (Graves &
Corcoran, 1989).
 • More than three decades have passed since the inception of the term informatics, and the
definitions continue to be modified slightly to adjust for continuing advances in practice and
technologies. However, there is general agreement that informatics is focused more on the
information than on the technology (Hersh, 2009).

Models of Nursing

Registered Nurses as Knowledge Workers

• Atomic level data- are the foundation for the transforming process by which knowledge work is
accomplished.

• Are raw, uninterpreted facts with values, and cannot be further subdivided. These data captured at
the source in the course of clinical care are very useful in tracking the effectiveness of nursing
decisions and are amenable to inclusion in electronic information systems as well as multiple forms
of manipulation (Graves & Corcoran, 1989; Zeilstorff et al., 1993).

• Knowledge work is the exercise of specialists knowledge & competencies (Blackleaf, 1995).

Information & Knowledge

Information System

Analysis

Combination

Aggregation

Summarization

Atomic Level data

• Competencies

Banners (1982) work, built on Dreyfuss model of skill acquisition- describes the evolution of novice
to expert.

Expert Level
 ↑

Proficient

Competent

Advanced Beginner

Novice

Novice- having no experience with the situations and related content in those situations and related
content in those situations where they are expected to perform tasks.

Advance Beginner- marginally demonstrates acceptable performance having built on lessons learned in
their expanding experience base

Competent- reflects mastery and the ability to cope with and manage contingencies

Proficient- continued practice, combined with additional professional experience and knowledge allows
the nurse to evolve in proficient knowledge.

Expert level- has developed the capacity to intuitively understand the situation and immediately target
the problem with minimal effort or problemPopulati
solving
on
Health

EHR
Personal
Healthcar Health
e Provider

Healthcare Provider
• Promotes quality patient care
• Access to complete accurate patient data 24/7
• Includes provider notes clinical order decision support programs practice guidelines

Personal Health
• Personal health record
o Maintained and controlled by individual and family
• Non-clinical information
o Self-care tracker and directories of healthcare and public health service providers
• Other supports
o Manage wellness and healthcare decisio-making

Population Health
• Information on health of population and influences on that health
• Helps stakeholders identify and track health threats
o Assess population health
o Create a monitor programs and services
o Conduct research
• Clinical Information Systems(CIS) is designed to support clinical nursing practice. It requires not
only understanding of professional nursing practice process but also technology that is the
application for the science to function electronically.
Purpose:
o The purpose of the monograph is to revisit and reformulate the principles and guidelines for clinical
information systems to support professional nursing practice in light of events, learning, and other
forces of the past 10 years.
o The new generation of information systems must extend beyond meeting basic information needs
towards providing support for professional nursing practice to improve patient outcome.

Organizing Framework of Clinical Information Systems

Key Concepts:
o Professional nursing practice process understanding
o Technology
o Policy, regulation, and standard
o Information systems
o Human factors
o Technology adoption
o System utilization
o Professional nursing practice
Professional nursing practice process understanding is the explicit identification of related nursing
activities that when correctly performed, satisfy the nursing practice goal. This concept provides the
foundation for defining the functional requirements of an information system useful for nurses.

Technology is the application of science to work, and includes physical devices, programs, and ways of
organizing work. Information technology enables implementation of the functional requirements that are
necessary to support applications that meet the needs of nurses and other clinicians.

Policy, regulation, and standard influences all concepts in the organizing framework and may shape
their manifestation at any point in time. Healthcare policy and emerging national and international
standards, combined with economic forces, impact the adoption of technology and require healthcare
organizations to remain responsive to continually changing requirements for capturing, storing and
communicating data.

Information systems reresenting the technical implementation of functional requirements, including

application features and functions as well as the interfaces by which uses interact with an application. The
design and implementation of information systems may influence the degree to which users adopt and
utilize the system in their work.

Human factors defined as the set of characteristics that underlie an individual or group’s interaction with
a system, can also influence the extent of a system’s adoption and use. Human factors also influence
information systems design.
Technology adoption is the degree of acceptance and use of an information system within the
performance of professional nursing practice. The extent of technology adoption influences the scope and
depth of system utilization by individuals and organizations.

System utilization determines sand impacts the data and information derived from the information
system.

Data and information about professional nursing practice informs and enhances our understanding
of the processes of professional nursing practice. System utilization and the data and information derived
from an information system also support validation of current knowledge and facilitate the synthesis of
new knowledge.

TERMINOLOGIES

Terminologies
• To convey important data and information to others, the communication must be understood by the
listener and be interpreted as having meaning. This is best accomplished by using standard
communication formats and terminologies and recognize conventions for describing the concepts
being presented.

Concepts Representation: involves the set of terms and relationships that describe the following
o Phenomena
o Process
o Practices of discipline (eg. Nursing)

Ways of Representation
o Data elements o Vocabularies
o Classifications o Languages
o Nomenclatures
Why are informatics nurses and nurse scholars so interested in terminologies?
• Nursing terminologies focus on the patient and care process, not in reimbursement and mortality,
and are increasingly important as EHRs become an integral component of healthcare services
delivery.
• Nursing terminologies are used to capture, store, and manipulate data in EHRs
Terminologies used in Nursing Informatics

NANDA- North American Nursing Diagnosis Association

• A conceptual system that guides the classification of nursing diagnoses in a taxonomy (study of
classification) and include definitions and defining characteristics.
NIC- Nursing Intervention Classification
• Contains 514 nursing interventions that describe the treatments nurses perform, updated linkages
with NANDA diagnosis and core interventions identified for 44 specialty practice areas.

NOC- Nursing Outcomes Classification

• Has 330 researched based outcomes to provide standardization of expected patient, caregiver,
family, and community outcomes for measuring the effect of nursing interventions.
• Each outcomes features a definition, a set of specific indicators, measures to facilitate clinical
information and references

CCC- Clinical Care Classification

• Is a research-based nomenclature designed to standardize the terminologies for documenting
nursing care in all clinical care settings.
• Are designed to assess and document nursing care and also to classify and code care over time,
accross settings, population groups, and geographic location.

Ohama System
• Originally developed for use in home health practice and is now used in all clinical settings. It
includes an assessment component (Problem Classification Scheme), an intervention component
(Intervention Scheme), and an outcomes component (Problem Rating Scale for Outcomes).

Perioperative Nursing Data Set (PNDS)

• Provides a universal langugage for perioperative nursing practice and education and a framework
to standardize documentation.
• Can be used in all perioperative settings and has been integrated into numerous commercial
information systems for the operating room environment.

SNOMED CT
 • Is a core clinical terminology containing over 357,000 healthcare concepts with unique meanings
and formal logic based definitions organized into multiple hierarchies.

ABC Codes
• Provide a mechanism for coding integrative health interventions by clinician by state location for
administrative billing and insurance claims.

Patient Care Data Set (PCDS)

• Includes terms and codes for patient problems, therapeutic goals, and patient care orders.

Logical Observation Identifiers Names and Codes (LOINC)

• Originated as a database of standardized laboratory terms for results reporting for chemistry,
hematology, serology, microbiology, and toxicology.
• Includes about 32,000 terms, including a clinical poprtion with codes for observation at key satges
of the nursing process, including assessments, goals, and outcomes
Example of entries:
• Vital signs, hemodynamic values, intake/output, ECG, obstetric ultrasound, cardiac
echo, urologic imaging, gastroendoscopic procedures, pulmonary ventilator management,
selected survey instruments and other clinical observation.

International Classification for Nursing Practice (ICNP)

• It includes nursing phenomena (nursing diagnosis), nursing actions (nursing interventions), and
nursing outcomes. The ICPN facilitates cross-mapping of local terms and existing vocabularies and
classifications.

Nursing Management Minimum Data Set (NMMDS)

• It includes terms that describe the context and environment of nursing practice, and includes terms
for nursing delivery unit/service, patient/client population, care delivery method, personnel
characteristics, and financial resources.

UNIT 5 : PRACTICE APPLICATION

I. NURSING PROCESS

NURSING PROCESS is a patient-centered and goal oriented processes by which nurses deliver
effective care to patients which involve assessment, nursing diagnosis, planning,
implementation and evaluation. It is a cyclical, repetitive and ongoing process of nursing care
and healthcare delivery. It is not only focused on ways to improve the patient’s physical needs,
but also on social and emotional needs as well.

• Effective communication between nurses and patient encourage consistency of

healthcare delivery for the patient and provide a comfort level for the nurse as well.

1. ASSESSMENT

• Nursing assessment involves collecting vital data and fundamental information

necessary for the next process. These data are gathered by the nurse through physical
assessment, interviewing, and observing, and involve the use of basic senses.
• Other relevant data such as drug orders, laboratory and x-ray examination results, and
information from other caregivers can also ne integrated in the system.
• Computer-enhanced automated nursing assessment can mitigate recording error
and gathering erroneous data by integrating it to the statistical information system. Vital
data can be coupled to the basic data and derived the necessary additional information.

2. DIAGNOSIS

• Nursing diagnosis involves proper comprehension of the patient’s condition and

response. Diagnostic process is complex and utilizes aspect of intelligence, critical
thinking, and deeper thoughts of understanding.
• It involves the interpretation of human behavior related to health. It provides the
basis of selection of nursing intervention to achieve outcomes for which the nurse is
accountable.
• It can be best executed when there is a strong evidence of such results; evidence-
based diagnosis can be enhanced through computer based methods. Integration of all
health information system offers sharing of techniques, strategies, success processes
medication performance, good tactics and simple medication approach.
• The automated system can provide predictive values which can facilitates
diagnosis and decision process.
 3. PLANNING

• Setting priorities, predicting expected outcome and establishing time tables are the main
ingredients and components of nursing care planning. It sets a stage for writing nursing
actions by establishing nursing pathways to streamline the activity, response and
directions.
• Nursing care planning can be further enhanced through computer simulation; the
computer program can predict results and test if the expected results match with the
available data. Computer program can also prepare time table and optimal schedule and
efficient strategies that is streamline in the nursing care process.

4. IMPLEMENTATION

• Nursing implementation is the action phase of the nursing process. It will detail the
specific actions and activities the nurse needs to execute based on the plans.

a. Independent nursing actions – are those actions that needs own discretion and self
judgment that does not require written guidelines and validation activities.
b. Dependent nursing action or Collaborative actions – involves actions that requires
mutual decision making. (eg. MD’s order and referral to other specialist)

àNursing documentation should capture these very important actions

executed and should be even more definite than what is generally found in
the physician orders.

• Computer simulations can further enhance the decision making process of a nurse.
The nurse can verify the next action involve and can also predict the possible solution to
the situations involved. The nurse can also search for other possible options and
solutions that is readily fit to the condition.

5. EVALUATION

• Evaluation of the processes using computers with large amounts of patient data, help
identify outcomes patients are likely to achieve based on individual problems and needs,
and estimate the time frame for reaching outcome goals.
• During nursing evaluation, use the computer to record and store observations, patients’
responses to nursing interventions, and your own evaluation statements. You may also
use information from the shared information of the strategies and future actions relevant
to the service.
•

NURSING DOCUMENTATION

It focuses mainly on health assessments, clients’ care plans, medications, administration records,
nursing notes and discharge plans. All of these processes can be automated and enhanced with the use of
computer system.

The computer can store standard nursing care plans in a format determined by the hospitals and
clinics, to be used by nurses as the basis for developing individualized clients care plan. It can also perform
drug dosage calculation faster and more accurately. Nurses notes can be entered quickly by choosing
statements, appropriate for a particular client from multiple pre-programmed choices.

BENEFITS OF NURSING INFORMATICS TO PRACTICE APPLICATION

Nursing Informatics or Nursing Information System (NIS) are computer systems that manage clinical
data a variety of healthcare environments, and made available in a timely and orderly fashion to aid
nurses in improving patient care.

Some of the Key Features of Nursing information System

 PATIENT CHARTING: Nursing assessments, care plan and nursing notes can be entered into the
automated system with the graphical user interface. The data are stored in the central repository
system such as data warehouse for enhanced retrieval and accessibility of data when needed.
These data are then translated into information via statistical information system that are
embedded in the system.
 CLINICAL DATA INTEGRATION: Data and information can be shared to other department. With
proper authority, these data and information can also be access by other entity and can be
retrieved, viewed and analyzed by nursing staff and then integrated into the client’s care plan.
 DECISION SUPPORT: Decision support module can be added to nursing informatics system, and
they provide prompts and reminders, along with guides to disease linkages between
signs/symptoms, online access to medical resources can also be available.
 OPTIMAL OPERATION OF HOSPITAL AND CLINICS: Better drug administration, nursing staff
scheduling, wards and rooms monitoring, patient profiling and patient mapping, and billing details.
 BETTER CARE PLANNING: Time spent on care planning is reduced, while the quality of while the
quality of what is recorded is improved. This makes for more complete care plans and more
complete assessments and evaluations.

II. CRITICAL CARE APPLICATION

CRITICAL CARE NURSING is an area of expertise within nursing that focus specifically with
human responses to life-threatening problems. A critical care nurse is responsible to ensure that
critically ill clients and seriously conditioned individuals, in addition, critical care nurse or staff
should ensure that families of the medically ill clients should receive optimum care.

 Intensive Care Units (ICU)

 Pediatric Intensive Care Units (PICU)
 Neonatal Intensive Care Units (NICU)
 Cardiac Care Units (CCU)
 Cardiac Catheter Laboratory
 And other special areas

CRITICAL CARE APPLICATIONS are areas where patients require complex assessment, high-
intensity medication, continuous therapy and interventions, and unrelenting nursing attention
and continuous watchfulness.

CRITICAL CARE NURSES work in a wide variety of applications, filling many responsibilities
and work around. Examples are bedside clinicians, educators, guidance, researchers, report
managers, advocate, specialists and practitioners. They need to keep pace with the latest
information and develop skills to manage new treatment methods and technologies.

CRITICAL CARE INFORMATION SYSTEM will provide real-time resource utilization data and
management of information and access critical care areas through the integration of the
medical facilities in the critical care or intensive care unit to an intelligent computer system
which is capable of processing all of these data. It also enables the electronic collection of
hospital and patient-specific critical care data of the entire patient in the critical care areas
which can be processed to create a patient profile which generate real-time and historical
reports on indicators including bed occupancy, delayed discharges, readmission rates and
outcomes.

 The Medical Information Bus (MIB) provides a generalized method of attaching patient
monitoring devices to a common interface. It also has the ability to “filter”, store and
select information sent for inclusion into the clinical medical record on the clinical
computer system
 Bed side monitoring system such as heart rate from the ECG, parameters from arterial
and pulmonary arterial invasive blood pressures, temperatures, arterial saturation and
heart rate from pulse oximetry, infusion pumps, ventilators and other equipments are
now transmitting clinical information for use in clinical data reporting and decision
making.
 The manual and automatics information collected is used for complete computerized
charting and for computerized decision making.
 ADVANTAGES OF CRITICAL CARE INFORMATION SYSTEM

 Intelligently integrates and process physiologic and diagnostic information and store
it to secure clinical repository
 Creates trends analysis with graphical representation of results
 Offline simulation can be performed to test the condition of the patient
 Provide clinical decision support system
 Provide access to vital patient information
 Provide feedback and quick evaluation of the patient condition and provides alert

III. AMBULATORY CARE APPLICATION

AMBULATORY CARE covers a wide range of health care services that provided for clients who
are not admitted overnight to a hospital. These services are performed at outpatient clinics, ER,
primary care centers and others.

AMBULATORY CARE INFORMATION SYSTEM provides automated processing of data and

information such as allergies and medical alerts, client accounting system, registration
management for booking of appointments, client registration, emergency management and
many more.

 With this system, the client waiting time is optimized through effective queue
management.

ADVANTAGES OF AMBULATORY CARE INFORMATION SYSTEM

 Real-time and easy access to clients’ medical records by healthcare providers

 Improved workflow, which allows more time for comprehensive patient counseling
and review
 Reduced errors with the availability of various automation engines – drug interaction
engine; medical alert engine; etc
 Automated and integrated back-end processes such as pharmacy, billing, etc
 Improved clinical outcome analysis – enhanced research productivity through data
mining and facilitate institutional handling of managed care challenges in a timely
manner
 Improvement in hospital inventory management
 Better monitoring & management of costs – prescription, consumables, doctor’s fee,
etc

IV. COMMUNITY HEALTH APPLICATION

COMMUNITY HEALTH INFORMATION SYSTEM is a collective term for the methodical

application of information sciences and technology to community and public health process.

Environmental factors are among the common concern of the community health information
system. It also emphasizes on the prevention of diseases, medical intervention and public
awareness.

One of the key goals of community health informatics is the effective and timely assessment
involves monitoring and tracking the health status of the population which includes identifying
and controlling disease outbreaks and epidemics. By relating health status to a variety of
demographic, geographic, environmental, and other risk factors, it is possible to develop a
correlation and identify risk factors that contribute to health problems.
 Policy development in community health is based on science, but it is also derived from values,
beliefs, and opinions of the society it serves.

Hospital Information System, Clinical Information System, EHR focused more on individual and
single resource contrary to community health information system which focused on information
about majority of populations.

PRIMARY FOCUS OF COMMUNITY HEALTH INFORMATION SYSTEM

 Preventing, identifying, investigating and eliminating communicable health problems

 Accessibility of data and information, through communication
 Educating and empowering individuals to adopt healthy lifestyle
 Facilitate the retrieval of data
 Effective transformation of data into information
 Effective integration of information to other disciplined to concretized knowledge and
create better understanding
 Creation of computerized patient records, medical information system
 Central repositories of all data such as data warehouse

ADVANTAGES OF COMMUNITY HEALTH INFORMATION SYSTEM

 Consistent exchange of response

 Disease tracking
 Data and information sharing
 Building strategies
 Early detection and monitoring of disease and sickness
 Control of spread of disease
 National alertness and preparedness
 Building strong communication
 Maintain strong relation between nurses and other healthcare providers
 Continuous coordination of the healthcare professionals
 Synchronization of the decisions
 Streamlining of the process
 Effective management of data and information
 Optimal operation of hospital and clinics

V. EMERGENCY PREPAREDNESS AND RESPONSE

EMERGENCY AND RESPONSE PROCESS is to halt the spread of diseases, infection, widespread
sickness, epidemics, etc. Dengue outbreaks, for example, immediately spread in many areas,
because there is lack of preparation, emergency measures and proper response of the
healthcare providers, government, and most specially the public.

Through the effective use of technology, the healthcare industry can have immediate and
instantaneous processed information, and in this way nurses and other healthcare providers can
have a proper preparation for emergency and execute correct and timely response to the
prioritized individuals.

Through the effective use of National Health Information System (NHIS) it will link all hospitals,
practices and health practitioners as well as students in the country through the used of
computer-based communications channels. The EHR, HIS, CIS, etc are integrated through a
central database system that are controlled and protected by a government health institution
such as the Department of Health. With this, it can IMPROVE HEALTHCARE SERVICES by
 providing healthcare professionals better data access, quicker data retrieval, readily translated
data into information, more versatile data output and presentation, less mathematical skills, no
need to memorized index, patient profile, tables for references and good visualization of the
results.

Segregation of data should also be captured in the reporting system to eliminate redundancy of
data and maintain integrity of results. Repetition of data inputs should be eliminated so that
proper response and effective preparedness should be manifested.

Data tracker should be incorporated in the hospital information system through public and
community health systems.

To enhance the emergency preparedness and response system, a special system such as
national electronic disease surveillance system can be coupled and integrated to national
information system.

UNIT 6: PATIENT AND CONSUMER HEALTH INFORMATICS

The ultimate goal of the health informatics is to bridge the gap between the healthcare system,
information system and technology, communication system and health science. Healthcare and
nursing focused on patient and consumer service particularly on:

 Developing an effective way to communicate with the client and customer without
sacrificing the ultimate responsibilities of the nurse
 Development of system for the improvement of existing information and communication
system
 Participate in the implementation of the integration of nursing informatics in the Philippines
 Development information system to support of client care and effective healthcare delivery
system
 Removal of redundant systems of entering and recording the same data
 Strengthen the decision process of the nurses and healthcare providers
 Eliminate transcription errors
 Manage patient waiting time to reduce delay
 To humbly serve clients

NURSING INFORMATICS in the Philippines id relatively very young and the scope is enormous. It
finds application in the conceptualization of clinical decision support systems of nurses and
healthcare providers, development of computer systems, networks, and communication systems
and in the study of the very essence of medicine and nursing. It is evaluated based on the nursing
output, such as treatment of clients, how to handle clients, delivery of service and healthcare
provided based on the available information and how effectively that information is communicated
from nurses to clients.

PATIENT AND CONSUMER HEALTH INFORMATICS provides support they need to better manage their
health decisions using the effective facilities, nursing and healthcare provider skills and other tools.
This system also provides opportunity to manage certain aspects healthcare without going to the
hospital and clinics.

Internet-Based Health Information System increases accessibility of information provided by

the Internet, and especially the World Wide Web protocols. When a healthcare provider suggests a
medication or treatment to illness, disorder and sickness, it can be done remotely via a
communication protocol.

e-Health is defined as the application of Internet and other related technologies in the healthcare
industry to improve the access, efficiency, effectiveness and quality of clinical and business
processes utilized by healthcare organizations, practitioners and clients in an effort to improve the
health status of clients.
The quality control of health information on the internet in dependent of its main components:
 Proper education to the client
 Encouraging the self regulation of providers of health information
 Proper evaluation of the information
 Correct implementation of enforcement and sanctions in cases of dissemination of
fraudulent or harmful information

SECURITY is achieved by addressing its components such as integrity, privacy, availability,

confidentiality and accountability. The data and information should not be made available or
disclosed to unauthorized persons. The data should not be altered or shattered in an unauthorized
manner. However, availability of data and information should be granted only to authorize person.
Accountability is the ability to audit the processes and raw data which interact with the information
to determine its appropriateness.

THREATS exist to computer system and information:

1. Wicked code such as viruses, Trojan horses and worms
2. Malicious code often takes benefit of vulnerabilities in operating system software
*proper use of programs and software such as antivirus and other potential threat of virus
*responsibility for protecting the security of computerized information assets
*organizations must perform an information security risk assessment which serves as the
foundation for an assurance plan