ANGELES UNIVERSITY FOUNDATION

Angeles City

COLLEGE OF NURSING
NCM 0110 – NURSING INFORMATICS
SUMMER, AY 2019-2020

COMPUTERS AND NURSING

A. Introduction to Nursing Informatics

Computer – is a machine that manipulates data according to a set of instructions.

- A programmable machine capable of performing a series of logical and arithmetic operations.

One of the most frequent uses of a computer in healthcare is the conversion of data into
information.
- As an electronic device, the computer uses a series of 0s and 1s to describe data and to
represent information. (IRENE JOOS)

The First Computers: Computing Devices and Mechanical Computers

- Abacus - Pascaline
- Logarithms - Punched card
- Slide rule - Difference engine
- Calculating clock - Hollerithdesk
Origin of Healthcare Informatics

- Nightingale emphasized documenting health.

- Nurses have serious problems in the workplace
o Top four problems of nurses in the workplace
1. Documentation is excessive
2. Turnaround is too long
3. Nursing processes are inaccurate
4. Communication is poor

How automated information system grew in the Philippines

In early 1970s- automated billing

In the mid 1970s- information process

In late 1970s- inclusion of pharmacy section, formation of integrated system

In early 1980s- laboratory and imaging departments

In the middle of 1980s- automated the process of order entry

 In the middle of 80s to late 90s- creation of interfaced systems

In early to mid 2000s – ORACLE

In the late 2000s- Hospital Information System

❖ Nursing Informatics- is defined as the combination of computer science, information and

communication technology and nursing science to enhance nursing informational processes in the
field of care, administration, research and education.

❖ Is the "science and practice (that) integrates nursing, its information and knowledge, with
management of information and communication technologies to promote the health of people,
families, and communities worldwide." (IMIA Special Interest Group on Nursing Informatics 2009).
The application of nursing informatics knowledge is empowering for all healthcare practitioners in
achieving patient centered care.

Goal of Nursing Informatics

“To improve the health of populations, communities, families, and individuals by

optimizing information management and communication. “(CNIA, 2003, p. 1).

Nursing Information Systems

• When time and energy are at a premium, using a Nursing Information System (NIS) in acute care
settings can assist in applying nursing knowledge and wisdom to everyday care

• Documentation can be more timely, more complete, and more accurate when captured at the
“point of origin”, usually the client’s bedside in acute care settings.

Engaging with a “Virtual” client

• While engaging with the virtual representation of a client, the nurse must strive to envision and
experience the client's three-dimensional body and being in order to accurately advise, assess,
diagnose, and interact fully and dynamically.

• This perceiving must occur within a virtual network environment, where both body-sense and
body-awareness are combined with digital information.

Electronic Health Record (EHR)…

• A longitudinal electronic record of patient health information generated by one or more encounters
in any care delivery setting. Included in this information are patient demographics, progress notes,
problems, medications, vital signs, past medical history, immunizations, laboratory data and
radiology reports.
 EHRs….

• The EHR has the ability to generate a complete record of a clinical patient encounter, as well as
supporting other care-related activities directly or indirectly via interface - including evidence-
based decision support, quality management, and outcomes reporting.

Electronic Health Record

Historical Perspective

“The Electronic Health Record (EHR) is a longitudinal electronic record of patient health
information generated by one or more encounters in any care delivery setting. Included in this
information are patient demographics, progress notes, problems, medications, vital signs, past
medical history, immunizations, laboratory data, and radiology reports.

The EHR has the ability to generate a complete record of a clinical patient encounter, as
well as supporting other care-related activities directly or indirectly via interface—including
evidence-based decision support, quality management, and outcomes reporting.”1

The first known medical record was developed by Hippocrates, in the fifth century B.C.
He prescribed two goals:

❖ A medical record should accurately reflect the course of disease.

❖ A medical record should indicate the probable cause of disease.

These goals are still appropriate, but electronic health records systems can also provide
additional functionality, such as interactive alerts to clinicians, interactive flow sheets, and
tailored order sets, all of which cannot be done be done with paper-based systems.

Features EHR

• Wide scale computer-based patient record

• Complete collection of individual’s health related data
• Database format
• All data from different systems
• Data can be integrated to obtain in a different level of information
• Each element or data has to be defined
• Closed and secured system

Benefits obtained from EHR are as follows:

• Alert clinicians if an order they are entering could cause a problem

• Notification system that alerts clinicians to clinically significant events
• Visual posting system that alerts healthcare providers to issues specifically related to a
patient on opening of a patient’s electronic chart including crisis notes, a diverse reactions
and advance directives.
 • Template for automatic creation of reports.
• Clinical reminder to alert actions like exams and immunization, patient education, lab tests
that need to be performed.
• Remote data viewing to see patient record at other institution

EHR’S Key Capability

1. Longitudinal collection of electronic health information for and about persons, where it is defined
as information pertaining to health of an individual or healthcare provided to an individual.
2. Immediate electronic access to person and population-level information by authorized, and only
authorized, users;
3. Provision of knowledge and decision support that enhances the quality, safety and efficiency of
patient of patient care;
4. Support of efficient processes for healthcare delivery.

Community Health Information Tracking System

CHITS is short for the Community Health Information Tracking system, a free and
open source software electronic health record system for local government health centers in the
Philippines. CHITS was created by Dr. Herman Tolentino through a grant from the International
Development Research Centre of Canada. Since 2004, CHITS has been expanding to rural
health units around the country.

CHITS is being managed by the UP Manila – National TelehealthCenter.

The Community Health Information Tracking System (CHITS) is a low cost computerization
initiative for local health centres that aims to automate the core processes in the health center and
contribute to effective and efficient delivery of services.

Key program components:

❖ With CHITS, patient care has improved and patient visits are more efficient,
❖ Vertical health care programs of the Department of Health (DOH) which disintegrates into the
health centers and managed by a public health nurse or midwife are now integrated by CHITS
❖ CHITS features an appointment and scheduling system
❖ Patients can be monitored
❖ The system also allows community health workers to send SMS messages to report injuries and
receive training on health surveillance via their mobile phones.

Open Medical Records System

OpenMRS is a software platform and a reference application which enables design of a

customized medical records system with no programming knowledge (although medical and
systems analysis knowledge is required).
At its core is a concept dictionary which stores all diagnosis, tests, procedures, drugs and other
general questions and potential answers.

OpenMRS is a client-server application which means it is designed to work in an environment where

many client computers access the same information on a server.

PREPARED BY:

(SGD) ROLANDO L. LOPEZ JR., RN, MN

(SGD) CARLO G. TOLENTINO, RN, MN

Nursing Informatics Instructors

REVIEWED BY:

(SGD)JENIE C JUNIO, RN, MAN

Level II Coordinator