NURSING INFORMATICS IN CANADA
2001: Establishment of the Canadian
HISTORY
1. Late 18th to 19th Century: Industrial
Revolution begins in Britain, introducing
machines and advancements in transportation
and communication.
2. Mid-19th Century: Charles Babbage develops
a rudimentary computer, laying the groundwork
for future technological advancements.
3. 1950s: Information Revolution begins,
marked by the development of computer
systems like Hospital Information Systems (HIS)
for administrative purposes.
4. 1960s: Studies analyze the applicability of
computers in nursing practice, with nurses
starting to use electronic tools for patient
monitoring.
5. 1970s: HIS used for physician order entries
and results reporting, while computer
applications in nursing begin to appear in
literature.
6. 1980s: Introduction of cellular phones and
personal computers, marking increased
integration of technology into healthcare.
7. Mid-1990s: Development of the Internet
facilitates access to information and
communication, revolutionizing healthcare.
8. 2000s: Digitalization of information becomes
widespread, with electronic records, mobile
communications, and telehealth becoming
standard in nursing practice.
9. 1980s-1990s: Emergence of Nursing
Informatics (NI) in Canada, with nurses involved
in designing and implementing HIS.
10.
Nursing Informatics Association (CNIA to
represent NI interests at the national level.
11. 2006: Launch of The Canadian Journal of
0Nursing Informatics to disseminate Canadian
research in the field.
12. 2009: University of Victoria offers the first
graduate double degree program in NI.
13. 2012: Canadian Association of Schools of
Nursing (CASN) releases Nursing Informatics
Entry-to-Practice Competencies for Registered
Nurses.
14. 2015-2019: CNA Strategic Plan emphasizes
the importance of ICT in nursing education and
practice.
15. Present: Ongoing efforts to integrate NI
competencies into nursing curricula and adapt
education to technological advancements
continue.
HOW IS NURSING INFORMATICS APPLIED IN
CANADA
Canada’s nursing informatics helps to promote
the health of the people, families and
communities by the integration of nursing care
and the management of information and
communication technologies. Application of
nursing informatics in Canada was actively
initiated by certain organizations present in the
country.
• CNA (Canada Nurses Association)-
spearheaded the Nursing Informatics Project
which appoint one nurse for each participating
organization to develop and plan to
(1) develop a national consensus on definition,
competencies, and educational strategies and
priorities in nursing informatics development,
(2) identify curriculum implications strategies
for both basic and continuing nursing
education,
(3) Determine priorities for implementing
national nursing informatics education
strategies. Moreover, application of nursing
informatics in Canada was actively initiated by
certain organizations present in the country.
INTEGRATING INFORMATICS IN THE
HEALTHCARE SYSTEM
• Canada Health Infoway Inc.,- It was
committed in October of 2000 by the federal
government to support the development of a
pan-Canadian health information system to
achieve EHR. Hence, the programs and
improvements in Canada are by province. For
instance, The Alberta NetCare was created in
Alberta in 2003 by the government of Alberta.
For example:
• Alberta Netcare is an Electronic Health
Record that provides access to demographic
data, dispensed drugs, known allergies,
laboratory test results, diagnostic imaging,
immunization and other medical reports.
• The delivery of health services in Canada has
become heavily reliant on information
management and related technologies due to
the acceleration of federal and provincial
investments in ICT.
TELEMEDICINE AND
TELEHOMECARE APPLICATION
These low-cost methods of diagnosing,
treating, and monitoring disease remotely have
let Canadians remain in their homes and
communities while also advancing nursing
practice. In fact, in some parts of the nation, the
crucial coordination function that nurses play in
telehomecare is developing quite quickly
. • Ontario Telemedicine Network (OTN)
is one of the largest and most comprehensive
telemedicine networks in the world. It provides
a range of telemedicine services, including
video conferencing, remote monitoring, and
virtual visits, to patients and healthcare
providers across Ontario. OTN facilitates
consultations with specialists, mental health
professionals, and other healthcare providers,
enhancing access to care, especially in rural and
underserved areas.
• Alberta Virtual Health in Alberta
• Programme Québécois de Télésanté in
Quebec
• Many hospitals and health systems in Canada
have implemented telemedicine platforms to
provide virtual care to their patients.
• These platforms offer a range of services,
including virtual visits, remote monitoring, and
tele consultations with specialists, enabling
patients to receive care without visiting a
healthcare facility (Hunting et al, 2015).
• The integration of Nursing Informatics in
Canada’s Healthcare Delivery System plays an
important role as it drives innovation to better
patient care, patient safety, enhancing
communication and collaboration, supporting
evidence-based practice, and increasing
efficiency.
INTEGRATING HEALTH
INFORMATICS IN NURSING
SCHOOL IN CANADA
The Canadian Association of Schools of Nursing
was provided funding by Canada Health Infoway
in order to support the establishment of a
nursing education culture in Canada that values
the incorporation of nursing informatics into
professional practice and curricula. While it is
expected that nursing students will be
proficient in these areas, all students may
usually access ICT support through universities
and colleges (e.g., school libraries, IT Help
Services desks, school-run ICTs workshops, etc.
Nursing student is exposed to using features of
personal computers, hand held devices, tablets,
workstations, modems, Bluetooth-enabled
devices, keyboarding, use of peripheral devices
including printers, USB flash drives, CD-ROMs,
uploading and downloading data, Online
Collaborative Learning, smart phones, mouse
and touch- pad interchangeably, etc. necessary
for the foundation of their skills as an
integration of patient care.
Moreover, they are use to enable electronic
communication such as creating email, send,
respond, attach and receive attachments,
familiarizing with the use of multimedia
presentations (e.g., videos, podcasts, blogs,
YouTube, etc.), Uses word processing,
spreadsheets and presentation graphics (e.g.,
document, spread- sheet, slideshow creation,
etc.). Navigates primary operating systems (e.g.,
Windows to manage files, determine active
printers, access installed applications, create
and delete files, etc.), Uses technology for self-
directed learning and is familiar with social
networking applications (e.g.,Twitter, Facebook,
LinkedIn, etc.).
The Canadian Nurses Portal Project, also
known as NurseOne, was developed by leaders
in nursing informatics in Canada as a national
nursing informatics plan that would help all
nurses and nursing students. This project uses
an electronic nursing method to enable their
vision. In order to promote the goals and
objectives of Canadian Nurses Association and
Canada Health Infoway, they have
implemented a project called Canadian Health
Outcomes for better information and care ( C-
HOBIC). It has provided support for the
application of standardized patient assessments
and associated records. These evaluations make
it possible to compare patient outcomes over
time and provide nurses with feedback
regarding patient outcomes. There are four
main concepts related to the project -
functional status (e.g., continence), symptoms
(e.g., pain, nausea, fatigue, dyspnea), safety
(e.g., falls, pressure ulcers), therapeutic self-
care (e.g., readiness for discharge). As a result,
these concepts are items that nurses and
nursing students will routinely assess in
healthcare settings. This standardized system
allows for the relevant and security of
databases like EHR, CDSS, and CPOE’s in
preparation for entry into the Health
Information System
Generally, the application of Nursing
Informatics in nurses and Nursing students in
Canada has a broad level of transformation and
high technology. This provides initiation of an
extremely standardized data into their
electronic health records and other health
information systems which enhanced the
standard and safety of patient care in Canada.
Nurses can make better informed judgments
and offer more individualized care by having
instant access to patient data, including medical
histories, prescriptions, and test results, via
electronic health records (EHRs) and other
health information systems. This has improved
patient outcomes and decreased the possibility
of mistakes being made when providing care.
SYSTEMS IN CANADA
1. NurseONE (www.nurseone.ca).
• NurseOne was developed by Canadian Nurses
Association (CNA) as a contemporary online
platform designed to help CNA members
remain updated, reliable, skilled, and
connected.
• it provides access to reputable, current
electronic resources needed for patient care
and lifelong learning. Such resources are e-
books, online courses, specialized libraries,
databases, curated lists of websites, and
webinars
• C-HOBIC (Canadian Health Outcomes for
better information and care). Support for
applying standardized patient assessments and
related records has been provided by it. These
assessments enable nurses to receive feedback
on patient outcomes and compare patient
outcomes across time. The initiative is centered
around four primary concepts: therapeutic self-
care (e.g., readiness for discharge), safety (e.g.,
falls, pressure ulcers), symptoms (e.g., pain,
nausea, fatigue, breathlessness), and functional
status (e.g., continence). Therefore, in
healthcare settings, nurses and nursing
students will often examine these ideas. The
relevant and secure storage of databases such
as EHR, CDSS, and CPOE's in advance of their
integration into the Health Information method
is made possible by this standardized method.
2. Entry to Practice Informatics Competencies
for Nurses.
• In 2011, the Canadian Association of Schools
of Nursing (CASN) secured funding from
Canada Health Infoway to develop entry-to-
practice nursing informatics competencies and
a toolkit to support faculty delivering the
essential content.
• The competencies were created using
consensus-based, iterative process, involving
key stakeholders from across Canada.
• The toolkit provides strategies and methods
(e.g., relevant content, examples of integration
within existing courses, down loadable slide
presentations) to support faculty with the
assimilation of informatics content into
undergraduate curricula (CASN, 2013) • The
national development of entry level nursing
informatics competencies has been a key step
to ensuring that this occurs. In conjunction with
nursing faculty members’ use of the supporting
resource toolkit, there is an expectation that
these competencies will have an impact on
nursing curricula across Canada.
COMPARATIVE STUDIES
• The Canadian Nurses Association (CNA) -
stated that registered nurses and other
stakeholders in healthcare delivery require
information on nursing practice and its
relationship to client outcomes (CNA, 2006).
• The creation of a coordinated system to
collect, store, and retrieve nursing data in
Canada is essential for health human resource
planning, and to expand knowledge and
research on determinants of quality nursing
care.
• Across Canada, it has been an instrumental to
advancing and supporting nurses’ involvement
in health informatics. To effectively achieve this
vision IT is being supported by a variety of
initiatives:
1. CNA and its provincial and territorial
affiliates,
2. Academy of Canadian Executive Nurses
(ACEN),
3. Canadian Association of Schools of Nursing
(CASN),
4. Canadian Nursing Informatics Association
(CNIA),
5. and other nursing informatics interest groups
across Canada.
• Their collective efforts have included:
(a) active dissemination of relevant
information,
(b) provision of opportunities for informatics
education,
(c) development of entry to practice
competencies,
(d) promotion and deployment of nursing data
standards, and
(e) development of a national nursing report.
• Nursing informatics - remains an emerging
field in the Philippines.
• Bachelor of Science in Nursing - it was a
critical content in their Curriculum, Policies, and
Standards in 2008.
• Philippine Nursing - influenced and evidently
made various of interpretations and
adaptations.
• Nursing Informatics in PH
1. affect the focus of nursing with the
integration of information and communication
technologies into nursing service delivery
systems continue to exist.
2. initiated within a Caring viewpoint, was
addressed and illuminated
3. the better understanding of the contributions
of Nursing Informatics on Philippine Nursing
from a historical perspective and declaring its
implications for Philippine Nursing Practice.
(Faustorilla, J. F. 2020).
Canadian nurses utilize information from
various sources to enhance practice and
improve care quality and safety. Additionally,
having accessible data on practice outcomes
enables the profession to showcase nurses'
indispensable contributions.
Information and communication technology
(ICT)
1. Canada has made significant investments
across all healthcare sectors, including acute
care, long-term care, primary care, public
health, and community-based nursing.
2. Canadian healthcare environments still rely
on a mix of electronic and paper records for
information management.
3. Electronic Health Record (EHR) remains a
work in progress for numerous settings.
Consequently, there's a lack of standardization
in nurses' documentation of care plans,
interventions, and outcomes, including the
absence of standardized data capture methods
and clinical terminology that can be easily
coded for use in information systems.
Allan Benito (2024)
 to be effective within the local
healthcare system a community-
focused approach to utilizing
information, communication, and
technology in nursing practice
needs to be tailored.
 there is a lack of certification and
credentialing programs at the post-
graduate level, compounded by a
scarcity of local nursing informatics
experts.
 this emerging field is yet to be fully
embraced and acknowledged within
the nursing community as a
specialized area.
Philippine Nursing Informatics Association
(PNIA) efforts are ongoing to address these
challenges. This includes:
 The development of training,
certification, and credentialing
programs.
 PNIA is also forging partnerships
with both local and international
nursing and health informatics
organizations. These initiatives are
aligned with PNIA's CORE X strategic
platform, focusing on Competency,
Organization, Recognition,
Experience, and Expertise.
 Additionally, there is a concerted
push to advocate for the adoption of
health information standards across
the Philippines and to ensure the
presence of nursing informatics
specialists in every hospital
nationwide.
Several factors drive the incorporation
of information and communication
technology (ICT) into nursing practice
in Canada:
1. Canada's healthcare principles,
which prioritize universality and
accessibility, underscore the
importance of utilizing ICT to
ensure fair healthcare provision.
2. Demographic changes, including
an aging population and rising
rates of chronic illnesses,
necessitate the implementation
of ICT solutions such as
telemedicine and telehomecare
to support nursing practice.
3. The shifting healthcare
landscape, particularly the
emphasis on primary care and
the expanded responsibilities of
nurse practitioners, underscores
the crucial role of nursing in
utilizing ICT to enhance patient
care.
Key organizations and initiatives play a
crucial role in facilitating the integration of
information and communication
technology (ICT) into nursing practice:
 Canadian Institute for Health
Information (CIHI),
 Canada Health Infoway,
Canadian Nurses Association
(CNA),
 Canadian Nursing Informatics
Association (CNIA)
they ensured that nursing perspectives are
considered in healthcare information
management strategies and the
development of electronic health records
(EHRs). Programs like NurseONE and Entry
to Practice Informatics Competencies for
Nurses aim to provide nurses with the
necessary skills and tools to effectively
utilize ICT for patient care and decision-
making.
According to the study of Claro, P. J.,
Estuar, M. R. J., Villamor, D. A., Bautista,
M. C., Pulmano, C., & Sugon, Q. (2024,
January 3)
 In the Philippines, the utilization of
Electronic Medical Records (EMR) in
primary healthcare facilities
reportedly increased by 2015, and
by 2020, there was an expansion in
the coverage of public health
facilities with EMRs.
 Despite the presence of EMR
systems in these facilities, some
areas still relied on paper-based
methods for encoding patient data.
 An examination of EMR usage logs
from selected Rural Health Units
(RHUs) in the country, conducted
one to two years post-EMR
implementation, revealed that EMR
adoption was still at a basic level.
 Users primarily utilized features
related to editing health records,
while more advanced features were
utilized by only a few users.
 EMR usage logs track information
about the system, user, or record
involved in each feature, as well as
the actions performed at different
levels of detail. Originally intended
for monitoring record access, it
became evident that mining usage
logs could provide valuable insights
into direct EMR usage, including the
duration and patterns of use across
features, and offer a comprehensive
understanding of clinical workflows.
 This understanding has implications
for enhancing the quality, safety,
efficiency, and cost-effectiveness of
healthcare.
 In Education the Philippines
describes having nursing informatics
as part of the curriculum, policies
and standards and its influence in
the Nursing community and system.
In Canada on the other hand it
discussed the presence of
specialized programs and
organizations as well as the
integration of the principles to
nursing education across the
country to achieve their goals
 In terms of practice, the Philippines
explores the roles of nurses in
informatics, and highlights the
scarcity of certified nursing
informatics experts. It also discussed
how important systems that support
informatics are and utilization of
informatics tools in clinical practice.
In Canada, they have made
significant investments in
Information and Communication
Technology (ICT) across all
healthcare systems emphasizing
how they integrate informatics into
their roles and practice and how
they utilize informatics to improve
patient care outcomes.
 Despite being advanced, some
Canadian healthcare facilities still
use paper documentation, while the
Philippines is still adopting
 Electronic Health Records (EHRs)
across their healthcare systems.
Overall, the role of informatics in
both countries are significant to help
with patient care
interest, lead to burnout,
dissatisfaction, and turnover, create
role ambiguity, conflict, and
resistance.

ADVANTAGES

 It helps nurses access accurate

patient information
 It helps to prevent errors,
duplication, and waste Helps in
saving time and resources while
avoiding harmful events
 Enhance communication and
collaboration among healthcare
professionals, patients, and families,
building trust and teamwork.
 It can support professional
development and lifelong learning
for nurses
 Can empower nurses and patients,
promoting patient-centred care,
shared decision-making, and self-
care.

DISADVANTAGES

 Requires adequate training and

education Can be costly and complex
 Demanding technical support and
maintenance that may result in
system failures
 Can have ethical and legal issues
that can involve privacy and
confidentiality
 Increase workload and stress
 Changing the role and identity of
nurses which can challenge the
values, beliefs, and culture of
nursing.
 All of these potential issues can be
time-consuming, unreliable,
inconsistent, insufficient, raise
ethical dilemmas and conflicts of