NURSING

INFORMATICS
Bridges to the Future
What is Informatics?
Informatics

• French word “Informatique”- referred to the field of

applied computer science that is concerned with the
processing of information.

• 1960s, computer was introduced to healthcare facilities

for basic administrative task. Today, it is called
Electronic Health Record (EHR) systems or Healthcare
Information Technology (HIT).
Informatics

•Healthcare Information Technology

(HIT) - is an all-encompassing term
referring to technology that captures,
process and generates healthcare
information.
 Computer/Electronics affects HC Delivery:

• Provision and documentation of patient care

• Education of healthcare providers
• Scientific research for advancing health care delivery
• Administration of healthcare delivery services
• Reimbursement of patients care
• Legal and ethical implications
• Safety and quality issues
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 specialty that integrates

nursing science, computer science, and information
science to manage and communicate data, information,
and knowledge in nursing practice.

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: Nursing Informatics

• 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
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
MAJOR HISTORICAL PERSPECTIVES OF
NURSING AND COMPUTERS

Seven Time Periods

Four major Nursing areas
Electronic Health Records
HISTORICAL PERSPECTIVE: Seven Time
Periods

Prior to 1960s
1930s - 1940s: Computers were first developed
1950s - 1960s: Computers were used in Health Care for basic
office administrative and financial accounting functions.
- use of punch cards to store data
- use of card readers to read computer programs,
sort and prepare data for processing
- use of teletypewriters to print output
HISTORICAL PERSPECTIVE: Seven Time
Periods

1960s
• Use of technology in healthcare setting is explored
• Studies conducted to determine how computer technology could be utilized
effectively in the healthcare industry and what areas of nursing should be
automated
• Nurses’ Station in the hospital was viewed as the hub of information
exchange, the most appropriate center for the development of computer
applications
• Development of Hospital Computer-Based Information System
HISTORICAL PERSPECTIVE: Seven Time
Periods

1970s
• Development of Hospital Computer-Based Information System that
initially focuses on physician order entry and results reporting,
pharmacy, laboratory, and radiology reports, physiologic monitoring
systems in the intensive care units, systems in care planning, decision
support, and interdisciplinary problem list.
• Computers used in financial and management functions.
• Nurses assisted in the design and implementation of HIS
• Several communities developed Management Information sytem
HISTORICAL PERSPECTIVE: Seven Time Periods

1980s
• Nursing Informatics is formally accepted as new nursing specialty.

• Nursing Education identified need for update

• Emergence of microcomputers/PC
HISTORICAL PERSPECTIVE: Seven Time Periods
1990s
• large integrated healthcare delivery systems evolved, further
creating the need for information across healthcare facilities
within these large systems to standardize processes, control costs,
and assure quality of care (Shortliffe, Perreault, Wiederhold, &
Pagan, 2003).
• Legislative activity in the mid-1990s paved the way for EHRs
through the Health Insurance Portability and Accountability Act
(HIPAA) of 1996 (public-law 104-191).
HISTORICAL PERSPECTIVE: Seven Time Periods
1990s
• 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.
HISTORICAL PERSPECTIVE: Seven Time Periods

2000s
• Use of barcoding and radio frequency identification (RFID)

• Use of smaller mobile devices with wireless or Internet access

(notebooks, tablet, PCs, personal digital assistants/PDs, and smart
cellular phones)

• Developement of clinical applications

• Home healthcare increasingly partnered with information technology for

the provision of patient care.
 RADIO FREQUENCY IDENTIFICATION

HISTORICAL PERSPECTIVE: Seven Time Periods

HISTORICAL PERSPECTIVE: Seven Time Periods

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

• Computer in Nursing—Computers can perform a wide range of activities that save

time and help Nurses provide quality nursing care.
Four Major Nursing areas

Nursing Practice
Nursing Administration
Nursing Education
Nursing Research
Four Major Nursing areas

Nursing Practice

• 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
Four Major Nursing areas

Nursing Administration

• Computers linked department together.

• Hospital data are accessed through computers.
• Hospital process goes online, Internet was utilized.
Four Major Nursing areas

Nursing Education

• 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.
Four Major Nursing areas

Nursing Research

• Provides an avenue for analyzing data

• Softwares are available for processing qualitative and quantitative
data
• Research databases emerged
• Online access
Electronic Health Records
• 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.”
Electronic Health Records

• The EHR bring uncountable advantages in primary health care detaching

such as faster access to information, and 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.
 EHR from a Historical Perspective

• 1989 – Institute of Medicine of the National Academy of Science

“Why still predominantly using paper-based records?”

• Committee deliberation resulted to 2 major conclusion:

a. Computerized Patients Record (CPR) – essential technology for healthcare
b. No national coordination for Computerized Patient Record (CPR).

• Computer-based Patient Record Institute created 1992

• CPR Project Evaluation Criteria in 1993
• Four major areas: management, functionality, technology and
impact
 EHR from a Historical Perspective

• The criteria reflects the journey of nations paper-based to electronic

capture of health data.

• Nicholas E. Davis Award of Excellence Program - with multiple

revisions and terminologies updated from computerized patients record,
to Electronic Medical Record, and more recently the Electronic Health
Record.

• Davies Award of Excellence Program under Healthcare Information and

Management and Systems Society (HIMSS) if offered in four categories:
Enterprise(1995); Ambulatory Care(2003); Public Health(2004);
Community Health Organization(2008)
Dr. Nicholas e. Davies “the Davies program”

• 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.
Dr. Nicholas e. Davies “the Davies program”

• 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
Dr. Nicholas e. Davies “the Davies program”

• 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 Healthcare Information Management
Systems Society (HIMSS)

• 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 Management Systems
Society (HIMSS)

• 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, inno vation, and community affiliations.
The Healthcare Information Management
Systems Society (HIMSS)

HIMSS 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
EMR/EHR systems:Implementation, Strategy, Planning, Proj ect
Management and Governance– Strategy
History of
Nursing Informatics
in the Philippines
The Philippine nursing community have long
sought to keep up with increasing use of
information and technology in the healthcare
system.
DIKW Theory is an important aspect of
nursing informatics – one that is often
neglected due to time and context.

has evolved over the years across a variety

of disciplines and is one of the most
embraced in nursing informatics and
“considered by some as the canon of
information science and knowledge
management” (Gackowski, 2012, p. 93) and
one of the most widely recognized theories
in informatics (McDowell, 2021).
Major Milestones in Nursing Informatics

1. Participation of the Philippine Nurses Association

(PNA) in the development of Standards for Health
Information in the Philippines(SHIP) in 1999.
2. The formation of the Master of Science in Health
Informatics (MSHI) which began in 2005.
3. Formation of the Philippine Nursing Informatics
Association (PNIA) in 2010 as a sub-specialty
organization of PNA for nursing informatics.
Introduction:
The words "nursing informatics" were
unfamiliar among the nursing community until the
year 2008. There were only a handful of people
with knowledge and experience in nursing
informatics but the discipline have not yet found its
recognition as a sub-specialty of nursing arts and
science in the country. The origin of this budding
discipline indirectly came from the pioneers of
health informatics in the Philippines.
 The Philippine Medical Informatics Society
(PMIS) and its founders had strong influence in
the development of health informatics in the
Philippines. The PMIA was officially registered
under the Securities and Exchange Commission
in 1996 by its board composed of eleven
physician. The organization was headed by Dr.
Alvin Marcelo.
Origins
Since 1998, several faculty members of the University of the
Philippines began formal education and training.

▪Dr. Herman Tolentino took a post-doctoral fellowship in

medical informatics at the University of Washington.

▪Dr. Alvin Marcelo followed a year later for his training at

the National Library of Medicine.

▪Dr. Cito Maramba went to Coventry for his Masters in

Information Sciences at the University of Warwick.
▪By the year 2003, a Master of Science in
Health Informatics was proposed to be
offered by UP-Manila College of Medicine
(major in medical informatics) and the
College of Arts and Science (major in
bioinformatics)
This group identified international standards for
health information and their adaptability in the
Philippines. The document is referred to as the
"Standards of Health Information in the Philippines,
1999 version" or "SHIP99".

Representatives from various sectors collaborated on

this project including the Philippine Nurses
Association (PNA) in the person of Ms. Evelyn
Protacio.
Organization

Early in 2009, Mr. Kristian R. Sumabat and Ms. Mia

Alcantara-Santiago, both nurses and graduate students
of Master of Science in Health Informatics at the
University of the Philippines, Manila, began drafting
plans to create a nursing informatics organization.

In February 2010, they began recruiting other nursing

informatics specialists and practitioners to organize a
group which later became as the Philippine Nursing
Informatics Association.
Issues and Challenges

Like many other disciplines, nursing informatics

face many challenges while in its infancy stage. The
inclusion of informatics as an integral part of the
undergraduate curriculum has been one of the most
influential factors for the increased awareness and
interest in this field of nursing. However, the
contents of the curriculum was adapted from
international materials which does not match the
local needs.
Lack of certification and credentialing
programs in post-graduate levels are also
absent with the scarcity of local nursing
informatics experts. This new field has yet
to gain acceptance and recognition in the
nursing community as a sub-specialty.
Future Direction
▪ Development of training, certification and credentialing
programs are in the pipeline for the Philippine Nursing
Informatics Association.

▪Future partnerships with local and international nursing

and health informatics organizations have started as well.

▪It is also a major thrust to support the use of health

information standards in the Philippines and to have nursing
informatics specialists in every hospital in the country.
THANK YOU!