Information Science
1.3.1: Lesson 1: Definition of Terms
Definition of Terms
Computer Science
 The study of algorithms for solving computation problems
(Saba et al., 2015)
Data
 The fundamental elements of cognition (Gudea, 2015).
Health Information System (HIS)
 refers to a system designed to manage healthcare data
which includes systems that collect, store, manage and
transmit a patient’s electronic medical record (EMR); a
hospital’s operational management or a system supporting
healthcare policy decisions (Brook, 2020).
Informatics
 the use of information technology (IT) in healthcare.
Information
 Refers to data that are processed using knowledge; data
that are interpreted, organized or structured
 An interdisciplinary field primarily concerned with the
analysis, collection, classification, manipulation, storage,
retrieval, movement, dissemination and use of information.
Knowledge
 Information that has been synthesized so that relationship
Nursing Informatics
 The specialty that integrates nursing science with multiple
information management and analytical sciences to identify,
define, manage, and communicate data, information,
knowledge, and wisdom in nursing practice (ANA, 2015).
 A field of nursing that incorporates nursing, computer, and
information sciences to maintain and develop medical data
and systems to support the practice of nursing, and to
improve patient care outcomes.
Nursing Science
 The development of theories and practical concepts for
improving how clinicians and patients administer care and
manage conditions. It merges the worlds of natural, applied,
and human science into a multi-dimensional lens that
explores new and better ways to deliver health services.
Wisdom
 The appropriate and ethical use of knowledge to manage
human problems (Saba et al., 2015)
Lesson 2: Concepts on Nursing Informatics
Nursing Informatics
- the specialty that integrates nursing science with
multiple information management and analytical sciences to
identify, define, manage, and communicate data, information,
knowledge, and wisdom in nursing practice (ANA, 2015).
- 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, 2009).
Diagram 1.
Nursing Science
 The development of theories and practical concepts for
improving how clinicians and patients administer care and
manage conditions.
 It merges the worlds of natural, applied, and human
science into a multi-dimensional lens that explores new and
better ways to deliver health services.
Computer Science
 The study of algorithms for solving computation problems.
 This includes theory, design, development, and application.
 Through computer science, algorithms can be identified
which results to automated solutions.
Information Science
 Focuses on the gathering, manipulation, classification,
storage and retrieval of recorded knowledge.
 It tries to understand problems from the perspective of the
stakeholders and applies information and technology to
solve problems.
Aspects of Nursing Affected by Nursing Informatics
1. Provision and documentation of patient care.
2. Education of health care providers
3. Scientific research
4. Administration of health care delivery services
5. Reimbursement for patient care
6. Legal and ethical implications
7. Safety and quality issues
Evolution of Nursing Informatics

 Nurses has always been involved in gathering and

recording data.
 Florence Nightingale – credited as one of the 1st
statistician to collect data and use data to change the way
care was delivered to the patient.
 Pioneers in nursing informatics recognized the potential
changes that computers can do in health care.
 Harriet Werley – approached IBM to explore use of
computers in health care
 More nurses became involved with developing strategies to
use computers in health care.
 Conduct of informatics research, integration of informatics
in nursing curriculum
Theories, Models and Framework Related to Nursing
Informatics
1. Schwirian’s Model (1986)
 developed by Patricia Schwirian
 proposed a model intended to stimulate and guide
systematic research in nursing informatics.
 a model that provides a framework that
enables identification of significant needs that can foster
research.

Lesson 3: Theories, Models and Framework Related to

Nursing Informatics
  Developed by James Turley
2. Foundation of Knowledge Model  Nursing informatics is the intersection between the
discipline-specific science (nursing) and the area of
 Developed by Dee McGonigle and Kathleen Garver informatics.
Mastrian in 2009
 A model that proposes that humans are organic 3 core components of informatics:
information systems constantly acquiring, processing,
and generating information or knowledge in both their 1.Cognitive science
professional and personal lives
2.Information science
 KA – knowledge acquisition
 KP – knowledge dissemination 3.Computer science
 KG – knowledge generation
 KP – knowledge processing

3. Turley's Model (1996)

4. Benner’s Level of Expertise Model 2. Advanced Beginner
Persons who demonstrates acceptable performance having
built on lessons learned in their expanding experience base;
needs supervision
3. Competent

Persons who exhibit enhanced mastery and the ability to cope

with and manage many contingencies

4. Proficient

Person who have undergone evolution through continuous

practice of skills, combined with professional experience and
knowledge

 Originally proposed by Hubert Dreyfus (1080) as a Appreciates standards of practice as they apply in nursing
learning theory and later expanded by Patricia Benner as informatics.
a nursing theory
 Every nurse must be able to continuously exhibit the 5. Expert
capability to acquire skills.
Individual with mastery of the concept and capacity to intuitively
Levels: understand the situation and immediate target the problem with
minimal effort or problem solving.
1. Novice
5. Graves and Corcoran’s Model
refers to Individuals with no experience of situations and related
content in those situations where they are expected to perform
 developed by Dr. Judith Graves and Dr. Sheila
tasks.
Corcoran in 1989
 Nursing informatics as the linear progression - from data
into information and knowledge
6. General System Theory
 authored by Ludwig von Bertalanffy (1940s)
 relates to the properties of a system as a whole
 focuses on the organization and interdependence of
relationships within a system
7. Cognitive Learning Theory
 developed by Jean Piaget
 focuses on the internal mental processes which includes
insight, information processing, memory and perception.
 based on the idea that people mentally process information
they received rather than simply responding to an external
stimuli.
 Nurses must be proficient in the use of the technologies
and must focus their caring to the person and not to the
machines.
 Technology brings the patient closer to the nurse.
Conversely, technology can also increase the gap between
the nurse and the one being nursed
9. DIKW Framework/Model/Pyramid
 Originated from the poet T.S.Eliot (1934)
 Data, information, knowledge, and wisdom are
considered overarching concepts (metastructures)
supporting all of nursing and informatics practice
 Each building block is a step towards a higher level.
 Each step answers different questions about the initial data
and adds value to it.

7. Theory of Technological Competency as Caring in

Nursing
 developed by Rozzano Locsin
 It is illustrated through the practice of nursing grounded in
the harmonious coexistence between technology and
caring in nursing.
Examples:

An illustration on the development of data into wisdom given

the process it would undergo.
Example #2 : CHN Setting
DATA
A 3 y.o. boy was brought to
the health center by his
mother
cc:
 intermittent stomach
ache
 frequent scratching of
the anal area
 protruding abdomen
 actual weight less than
ideal body weight
INFORMATION
Nurse perform further physical
assessment and interview with
the mother:
weight : < less ideal; child is
underweight
Abdomen : circumference is
higher than expected in
reference to body structure;
distended; protrusion of
umbilical area noted; pain
upon palpation noted with
guarding reflex
Interview and observation
results:
 anal area has blisters
and skin irritation due to
scratching.
 child's feet are dirty
(evidence of not wearing
any footwear)
 Mother reports passing
out of "worm"

KNOWLEDGE
based on the signs and symptoms
manifested by the child,
observations by the nurse and the
verbalization of the mother
suggest that the child might be
suffering from parasite
infestation.
Lesson 4: Standards of Practice
WISDOM
As a community health nurse,
the following actions are
taken:
Conduct of health education
regarding:
 Importance of proper
hygiene and handwashing
 Environmental
sanitation and wearing of
appropriate footwear
 Proper nutrition
Advise mother to submit the
child's stool for examination.
Subject child for deworming
Give instructions for follow-up
check up at the health center
Standards of Practice for Nursing Informatics
 16 standards
 Provides framework for practice and set of competencies to
serve as indicators or evidences to compliance to the
standards.
2 components:
1. Standards of Practice for NI (6 standards)
2. Standards of Professional Performance for NI (10
standards)
Standards of Practice for Nursing Informatics
Standards Competencies
The nurse informaticist (NI)
collects comprehensive data and
information relevant to the patient
care. The NI uses workflow
Standard 1 Assessment
analysis to examine current
practice and potential impact of
an informatic solution on the
workflow.
The NI analyzes and validates the
Diagnosis, data collected during assessment
Standard 2 Problems to identify problems, diagnosis
and Issues and opportunities for
Identificatio improvement.
 n Standards Competencies
The NI observes and applies
The NI identifies expected Standard 7 Ethics ethical principles in the
outcomes practice of nursing.
Outcomes (goals and objectives) for a The NI addresses the need for
Standard 3 Identificatio plan. Documents outcomes as education, attains knowledge
n Standard 8 Education
measurable goals. and competence need for
nursing practice.
The NI develops the plan in
collaboration with other HCWs The NI integrates evidence
Standard 4 Planning Evidence-
which will include strategies, and research into practice and
based
alternatives and recommendation. Standard 9 demonstrates application and
Practice and
integration of evidence -base
The NI uses specific evidence- Research
and research into practice.
based actions and processes to
resolve diagnosis, problems or The NI contributes to the
Implementat issues. Coordination of activities, Quality of quality and effectiveness of
Standard 5 Standard 10
ion implementing informatic solutions Practice practice in nursing and
and conducts consultation to informatics.
monitor the implementation of the The NI communicates
Communicatio
plan. Standard 11 effectively by using a variety of
n
methods.
The NI demonstrates
The NI evaluates progress leadership skills in
Evaluation towards achievement of Standard 12 Leadership professional practice which
Standard 6
outcomes and employs includes mentoring and
systematic evaluation of outcome. problem solving.
The Ni collaborates with the
Standards of Professional Performance for Nursing health consumer in the
Informatics Standard 13 Collaboration
practice of nursing and nursing
informatics.
 The NI performs self- - defined as hardware, software, integrated technologies or
Professional related licenses, intellectual property, upgrades or packaged
evaluation and is able to
Standard 14 Practice solutions sold as services that are designed for or support the
identify areas of strength and
Evaluation use by healthcare entities or patients for the electronic creation,
need improvement.
The NI uses appropriate maintenance, access or exchange of health information.
resources in the practice of (HITECH Act, 2009).
Resource nursing. Facilitate - the area of healthcare that oversees the technology systems
Standard 15
Utilization modification of practice as the healthcare providers use to manage patient data (Brooks,
profession and technology 2019).
evolve.
The NI supports nursing - refers to the electronic systems health care providers and
Environmental practice in a safe and healthy patients use to store, share and analyze information (ONC, n.d.)
Standard 16
Health environment. Support healthy
communities
Health Information Technology for Economic and Clinical
2.3.1 Lesson 1 : Use of Information Technology in Health Health (HITECH) Act of 2009
Care Settings
- sought to change the situation by providing each person in the
Health Information United States with an Electronic Health Record (EHR)
- refers to the data related to a person’s medical history. - a nationwide HIT infrastructure be developed so that access
to a person's EHR will be readily available to every healthcare
- These valuable data include patient's diagnoses,
provider who treats the patient
procedures or surgeries a patient has undergone, a
physician’s clinical notes, or lab results recorded by a
health technician. (American Health Information Management
Association) Health Information Management (HIM)

Health Information Technology (HIT) - incorporates the data that go into the systems; also analyzes
and protects the data (AHIMGA)

4 Basic Functions of HIM
 Health information management encompasses coding
and revenue cycle, informatics, data analytics, and
information governance.
 Coding and revenue cycle management includes
assigning diagnostic and procedural codes for billing to
managing the revenue flow from the patient registration to
final discharge.
 Informatics oversees the technology aspects of managing
health information, whereas data analytics manages the
integrity of data through mapping and quality improvement
processes.
 Information governance focuses on HIM operations and
compliance and ensures protection of protected health
information (PHI)
Benefits of Health Information Technology (HIT)
1. Increased Patient Safety
Health information systems can :
 store, display and integrate patient information such as lab
results, medical imaging which can be retrieved for
reference
 perform program security checks that could alert medical
personnel of adverse effects the patient might experience
on a certain medication before it is prescribed
 promotes availability of information needed for decision-
making
2. Efficient Care Coordination
 Information technology systems allow multiple medical
professionals simultaneously involved in a patient’s care to
record, disseminate, and share information system
 Allows health staff to document and share every facet of a
patient’s treatment and data. which can result to a more
seamless experience for caretaker and patient alike.
3. Enhanced Performance Analysis
 Staff performance, patient care and stability, and institution
efficiency could be tracked
 Compute staffing decisions based on individual skillsets
 Allow treatment decisions to be made proactively based on
past performance data
 Patients could submit feedback anonymously regarding
their level of care
 Accrediting bodies could utilize performance metrics to
evaluate the institution
4. Increased Patient Information Accessibility
 Allow instant access to patient records to any member of
the health team
 Provides access to patient files allowing patients to be
more involved in their care.
 Patients appear to become more engaged in their care
(Rozembaum and Bates 2013) through information
available on the internet.
5. Reduced Operational Costs
 Allocate resources and save significant amounts of money,
energy, time, and supplies
 Arrange medical personnel to best serve patients
 Allow better management of supplies
 Inventory can easily be done
Technology Informatics Guiding Education Reform (TIGER)
Initiative
 created in 2004
 to collaborate with nursing stakeholders to create a vision,
action, and strategies to improve nursing education,
practice, and patient care delivery through the use of health
information technology
 defined the competencies recommended for the NI
discipline
Competencies of Nursing Informatics
1. Basic Computer Skills
 Information and communication technology concepts
 Computer use and managing files
 Word processing
 Spreadsheets
 Database use
 Presentation
 Communication and web browsing
3. Information Literacy
 Establish the character and extent of the information
needed
 Efficiently and effectively access needed information
 Appraise information and the sources critically
 Integrates appropriate information into his/her knowledge
base and value system
 Use information effectively, as an individual or team
member, to achieve a specific purpose
 Evaluate outcomes of information use
3. Information Management
 Verbalize the importance of HIS with clinical practice.
 Have knowledge of types and clinical and administrative coordination
uses of HIS
 Ensure confidentiality of protected patient health  Leadership, including
information. management and
 Assure access control in the use of health information administration
systems.  Integrity and
 Ensure the security of health information systems. compliance management
 Possess user skills, including navigation, decision support,  Policy development and
and output reports. advocacy
 Understand the principles of health information system use
by healthcare professionals and consumers are based.

Lesson 2 : Roles of Nurses in Nursing Informatics

 Research and
 Systems integration evaluation
 Process and workflow  User training
design  Educational and
 Information technology professional development
security
 Analysis
 Data integration Clinical Informaticist Roles:
1. Lead change
 Clinical application
support  Serve as agent of change to move people out of their
 Clinical transformation comfort zone
 Clinical champion  Use shared governance and hold sponsors and
 Consultation stakeholders accountable
 Patient care
2. Promote standardization
 eliminate silos
 promote adherence to clinical and technical standards
3. Develop relationships and credibility
 Collaborate with other departments to realize full potential
of records
4. Implement and optimize
 Analyze data to optimize system use and patient outcomes
 Prepares new system functionality through workflow,
policies, procedure, education
5. Provide though leadership
 Develop clinical system strategies with hospital leaders
Lesson 3 : Health Information System
Health Information System (HIS)
 Refers to a system designed to manage healthcare data.
 This includes systems that collect, store, manage and
transmit a patient’s electronic medical record (EMR), a
hospital’s operational management or a system supporting
healthcare policy decisions.
 It is linked to the health informatics that focuses mainly on
the administrative functioning of hospitals and
clinics/nursing homes.
 It has different implementations and is an integrated and
comprehensive information system designed to deliver
every administrative operation in the healthcare industry.
Types of Health Information System
1. Subject and Task-based Health Information Systems
 Subject-based health information system is related to any
patient or healthcare professionals organization
Example: Electronic Health Record (EHR)
Electronic Patient Record
 Task-based health information system is associated with
particular tasks such as admissions/ discharge system or
operating theatre.

2. Strategic or Operational Health Information Systems
 Allows the assessment of an organization regarding the
spread of digitization in its information system
 Permits the highlighting of inappropriate or uneven
development in systems
 Provide output information related to possible hospital
requirements in the future by projecting the capacities of
the hospital
3. Clinical and Administrative Health information Systems
 Provides information in the form of hospital episode
statistics and its reports to the DOH.
 It is designed to make provision for retrospective data entry
(patient information is generally entered after their
discharge) and to provide details for each care episode.
 The information containing diagnosis data, outcomes, and
processing can be classified as clinical.
4. Financial and Clinical Health Information Systems
 Allows easy access to patient costing and helps in
monitoring a patient’s usage of different departments.
 This is done by tagging the various deliverables (recorded
in the clinical system management) with their associated
prices.
 It has the capacity of invoicing as well as following up any
non-payment incident.
5. Decision Support Health Information Systems
 Used to get the computer attempting to perform parts of the
processing usually done by the user after converting the
data into clinically relevant information
 Presents the health information in a manner (flagging,
sorting, classifying) beneficial to cognitive processing.
 Facilitates the user’s decision making.
BENEFITS OF HEALTH INFORMATION SYSTEMS (HIS)
Data analytics
 The healthcare industry constantly produces data and HIS
help gather, compile and analyze health data to help
manage population health and reduce healthcare costs.
 The healthcare data analysis can improve patient care.
Collaborative care
 Patients often need to treatments from different healthcare
providers. HIS allow healthcare facilities to access common
health records.
Cost control

 Using digital networks to exchange healthcare data creates

efficiencies and cost savings.

Population Health Management

 HIS can aggregate patient data, analyze it and identify

trends in populations.
 The technology also works in reverse - clinical decision
support systems can use big data to help diagnose
individual patients and treat them.