Some of the major milestones in nursing
informatics history in the Philippines which
includes the participation of the Philippine
Nurses Association (PNA) in the development
of Standards for Health Information in the
Philippines (SHIP) in 1999, the formation of the
Master of Science in Health Informatics
(MSHI) which began in 2005 and the formation
of the Philippine Nursing Informatics
Association (PNIA) in 2010 as a sub-specialty
organization of PNA for nursing informatics.
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
physicians.
Organization was headed by Dr. Alvin Marcelo.
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 o 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. They were later followed by other
physicians such as Dr. Micheal Muin and Dr.
Ryan Bañez. 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) and was later
approved to be offered starting academic year
2005-2006. In 1999, a study group was formed
headed by the National Institute of Health of the
University of the Philippines Manila. 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
CHED as a Catalyst
In 2008, Nursing Informatics course in the
undergraduate curriculum was defined by the
Commission on Higher Education (CHED)
Memorandum Order 5 Series of 2008. This was
later revised and included as Health Informatics
course in CHED Memorandum Order 14 Series
of 2009. This will be first implemented in the
summer of 2010
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
They were joined by founding members Ms.
Sheryl Ochea, a graduate of MAster of Science
in Nursing major in nursing informatics at
Xavier University (Ohio, USA), Ms. Alexrandra
Bernal, a graduate student and telehealth nurse
of the National Telehealth Center, Ms. Pia
Pelayo, a former telehealth nurse and a project
coordinator of the National Epidemiology
Center, Department of Health and Mr. Sid
Cardenas, also a telehealth nurse. Other
founding members include Mr. Noel Bañez, Ms.
Rona Abcede, and Mr. Harby Ongbay
Abellanosa.
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.
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. Other programs are
expected to be slowly delivered with PNIA's
CORE X strategic platform which stands for
Competency, Organization, Recognition,
Experience and Expertise. 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.
INFORMATICS THEORY
Nursing informatics is an established and
growing area of specialization in nursing. All
nurses employ information technologies in their
practice. 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.
Informatics is a science that combines a
domain science, computer science, information
science, and cognitive science. Thus, it is a
multidisciplinary science drawing from varied
theories and knowledge applications.
Healthcare informatics may be defined as the
integration science, and cognitive science to
assist in the management of healthcare
information. Healthcare informatics is a sub
discipline of informatics.
Nursing Informatics as a Specialty
The scope of nursing informatics practice
includes activities such as developing and
evaluating applications, tools, processes, and
strategies that assist registered nurses in
managing data to support decision-making. This
decision-making can encompass any and all of
the following areas of nursing practice; client
care, research, education, and administration.
Information handling—the process involved in
managing data, information, and knowledge—
includes naming, organizing, grouping,
collecting, processing, analyzing, storing,
retrieving, transforming, communicating data
and information.
The core phenomenon of nursing is the
nurse, patient, health, and environment. Nursing
informatics is interested in these core
phenomena, decision-making, data, information,
and knowledge, as well as information
structures and technologies
Models evolve as knowledge about the selected
aspect changes and are dependent on the “world
view” of those developing the model. It is
important to remember that different models
reflect different viewpoints and is not
necessarily competitive; that is, there is no one
“right” model.
Data are “discrete entities that are described
objectively without interpretation” and would
include some value assigned to a variable
Information reflects interpretation,
organization, or structuring of data (ANA,
2001b). Information is the result of processing
data. Knowledge emerges from the
transformation of information. “Knowledge is
information that is synthesized so that
relationships are identified and formalized” The
Healthcare Information and Management
Systems Society (HIMMS) has recently
established a certification program that may be
of interest to informatics nurses. Certification
available include CPHIMS (Certified
Professional in Healthcare Information and
Management Systems), CHS (Certified in
Healthcare Security), CHP (Certification in
Healthcare Privacy), and CHPS (Certified in
Healthcare Privacy and Security).
EHR health record database supported by
computer, electronic, and communications
tech
American Society for Testing and Materials
(ASTM) Standard E 1384-02a (ASTM, 2004, p.
31) defines the HER as “any information related
to the past, present, or future physical/mental
health, or condition of an individual.nologies.
Nursing terminologies offer systematic,
standardized ways of describing nursing practice
and include data sets, taxonomies,
nomenclatures, and classification system.
Nomenclatures are terms for labels for
describing concepts in nursing such as
diagnoses, interventions, and outcomes.
Classifications are the ordering entities,
including nomenclatures, into groups or classes
based on their similarities (Gordon, 1998).
Taxonomy is the study of classification and
simultaneously refers to the product of a
classification.
Why are informatics nurses and nurse
scholars so interested in terminologies?
Nursing terminologies focus on the patient and
care process, not reimbursement or mortality,
and are increasingly important as EHRs become
an integral component of healthcare services
delivery.
NANDA
Nursing Intervention Classification (NIC)
Nursing Outcome Classification (NOC)
Clinical Care Classification (CCC) [Formerly
Home Health Care Classification (HHCC)]
Omaha System
Perioperative Nursing Data Set (PNDS)
SNOMED CT
ABC Codes
Patient Care Data Set (PCDS)
Logical Observation Identifiers Names and
Codes (LOINC)
International Classification for Nursing Practice
(ICNP)
Nursing Management Minimum Data Set
(NMMDS)
American Medical Informatics Association
(AMIA)
Healthcare Information and Management
Systems Society (HIMSS)
National League for Nursing (NLN)
Society for Health Systems (SHS)
Association for Computing Machinery (ACM)
American Society for Information Science and
Technology (ASIS&T)
•Electronic Health Records also known as
“Electronic Medical Records or Computerized
Patient Records” are found more useful when
the number of data being process are highly
prioritized and/or a large data are being stored.
One issue that arises in the conversion of paper-
based data into electronic format, the scanned
material may exist in many formats, sizes,
media types and qualities.
Types of Data Stored in
HER
• Patient profile
• Results of medical examination
• Medical history
• Development of health condition
and status
• Results of laboratory test
• Information about
allergies, illness, immunization, disorder and
diseases.
• Medicine taken and its compatibility
with drug interaction
• Records of appointment
• Billing records
Issues in Electronic Health
Records System
•Integration and synchronization of historical
records and incoming records
•Readiness of the profile system
•Continuing preservation of the data
warehouse and its associated facilities.
•Purchasing of computer system, specialized
networking and communication system and
sophisticated software.
•Preservation of integrity and security of
data.
•Conversation of historical data into
electronic data.
•Continuous updating of storage capacity
•Computer system may experience shot term
crashing, bugs, virus, etc.
•Start-up costs and software maintenance
costs.
•Additional manpower to support the
computer-based process.
•Responsibility and ownership of electronic
health records.
•Data can be altered
•System crashes
• There are 3 main factors that potentially affect
the dependability of the system, causing the
integrity, reliability and performance of the
system to significantly drop.
1. An error in the healthcare
information system is the
discrepancy between actual results
and behavior from the expected or
the reference condition or expected
performance.
2. a fault is sometimes due to computer
program bug which is considered a
defect in systems. The presence of a
fault in health information system
may or may not lead to failure.
3. failure Is a condition in which the
system performs unnecessarily, or
the function is contrary to its
specification or the expected
condition. An error may not
necessarily cause a failure; however,
a persistent fault can have an impact
that mitigates a failure condition.
Nursing minimum data set(NMDS)
provides a formal structure for electronic
healthcare data elements and components
to support nursing care in all settings.
Minimum Data Set provides the specific
reference information for the user such as
the drug uses, dosage requirement, and
direction for use, active ingredients, dates,
and other relevant information.
3 categorical scheme or elements
1. Nursing Care Elements
• Nursing Diagnosis
• Nursing Intervention
• Nursing Outcome
• Nursing Care Intensity
2. Patient Demographic Elements
• Personal Identification
• Date of Birth
• Sex
• Nationality
• Residence
3. Service Elements
• Unique facility or agency number
elements
• Unique patient health record number
• Unique number of principle registered
nurse
• Episode admission
• Discharge or termination date
• Disposition of patient
• Expected payer for medical bill
Nursing is the protection promotion,
optimization of health and abilities,
prevention of illness and injury, alleviation
of suffering through the diagnosis and
treatment of human response and
advocacy in the care of individuals,
families, communities and populations.
Early 2004
• Further reinforces the recognition of
nursing
as a cognitive profession
First assessment• Data collection begins
nursing process.
Second step• Diagnosis/problems different
reflects the interpretation of data and
information gathered during assessment.
Third step • Outcomes identification
Fourth step • Planning
Fifth step • Implementation
Nursing Process • Interactive, includes
numeric feedback loops and incorporates
activities throughout the sequence.
Informatics and Healthcare Information
•Informatics-science that combines a
computer science, information science and
cognitive science.
Medical informatics
 • Used in Europe • Established a certification program that may be
of interest to informatics nurses
• More clearly a sub-domain
Four Nursing Care Elements
healthcare informatics and
• Nursing Diagnosis
health informatics may
• Nursing Intervention
mean informatics used in
• Nursing Outcome
educating healthcare
• Intensity of Nursing Care
client and/or the general

public
Patient or client demographic elements address
• Evolves so will the clarity personal identification;

in definition of terms and • Date of birth

scopes of practices • Gender

• Addresses the study and • Race

management of healthcare • Residence

information Seven Service Elements

1985(Kathryn Hannah) • Unique facility or service agency number

• Proposed a definition that • Unique health record number of patient/client

nursing informatics is the use of • Unique number of principal registered nurse

information technologies in provider

relation to any nursing • Episode admission or encounter data

functions and action of nurses • Discharge or termination date

Coraves and Coreoran • Disposition of patient/client

• Presented a more complex • Expected payer

definitions of nursing informatics.

The four elements

• Raw mat (nursing

related information)

• Technology(a computing system)

• Users(nurses, students, and context

• goals or objectivetoward which the preceding

elements are directed

ANCC

• Life Cycle

-System, planning, analysis, design,

implementation, and testing, eval, maintenance
and support

Information management and knowledge

generation

• Data, information, knowledge .

Professional practice, trends and issues

• Roles, Trends and issues , ethics Models and

theories

• Foundations of nursing informatics, nursing

healthcare data sets.

Healthcare Information and Management

System Society