1. nursing informatics lecture
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Transcript of 1. nursing informatics lecture
LET US PRAY
NursingInformatics
Lets Take The Relationships Deeper, Simpler & sweeter This
time Around…
True or false
1- if both statements are true2 – if statements are contradicting3 – if both statements are false
1. - the binary symbol of number 6 is 110 - the binary system was influenced from von Leibniz mechanical device.
2. - the Boolean Algebra is used for searching bibliography - the Boolean Algebra is used in searching for
database
3. - Hollentin machine is a descendant of the Jacquard loom concept . - Charles Babbage is the father of modern calculator.
4. – Hollerith machine is the origin of the Y2K - ENIAC is the exact replica of MARK 1
5. - the intuitive way for calculation is the Abacus - the Antikythera is the most intuitive machine
6. - the Pascaline was influenced by von Liebniz - the Pascaline was accepted and widely used
7. - the primary language of modern computer is the Binary system. - the logarithm inscription is currently used by modern computer.
8. - the major characteristics of the ENIAC are its movable parts. - the first generation computers used vacuum tubes.
9. - the vacuum tubes was smaller than the transistor. - the ENIAC help the US census to more faster
10. - Mark 1 is the 1st to used cathode ray tubes - Abacus on stores the computation result step by step.
Match Everything!!!1. Communicating & Interacting
with Patients2. Slide Rule3. Requires Extensive Training4. 1,000: 10 = 10x 10x105. Weaving machine6. 1st Calculator7. Equation Stating True or False8. Charles Babbage9. Charles Xavier Thomas
Colmar10.First Generation Computer
A. ArithometerB. AbacusC. Punch cardsD. Boolean AlgebraE. “Human should be in parallel
with machine”F. LogarithmsG. 1820H. ENIACI. William OughtredJ. Computer NetworkingK. Binary System
3
History of Nursing Informatics 1950 – UNIVAC 1 aka giant brains1956 – transistor was used; smaller, energy efficient1958 – Integrated Circuit (IC) by Jack Kilby
- predecessor of all micro chips1960 – mouse was invented by Douglas Engelbert
- video conferencing, multiple window screen1964 – 23RD Generation Computer using Operating System1977 – Basic Programming Language1980- Micro Soft Sytem by Bill Gates (16 bit)1981 – IBM release first PC with MS DOS
- Color graphics were extra - intel were first used
1984- Apple introduces Macintosh with 32 bit - graphics and wide screen
1992 – Apple introduced the Personal Digital Assistant2007 – first time PDA was in clinical area
UNIVAC 1
the two 19th century women• Lady Ada Lovelace – 1st computer programer
- aka Ada Byron- met Charles Babbage the developer of first computer
• Florence Nightingale – the founder of modern nursing- Birth: May 12, 1820; Florence- Start: Crimean war; she develop a pie graph,
uses statistical analysis, and develop a form for the hospitals in order to generate data and
statistics- considered the early informatics nurse
* both are mathematicians
1950s & 1960
• Prior to 1960- image of the nurses improved- nurses practice grew in scope and complexity- Increase in number of professional nurses- Growth in computer industry- Computers first use in the health facility a. office functions c. paper tape
b. punch cards d. teletypewriters
1950s & 1960
• 1960 - increase in number of health care facility
- nurse are started to be considered the centre of communication activities & information exchange- Desktop terminals were developed called CRT- Email was used 1965- HIS mainly for;
a. Accounting b. basic business c. finance
1970
• HIS - integrated more into the hospital system• MIS ( Mngt. Information System)– statistical information– billing– insurance reimbursement- chip was develop- Microprocessors introduced (1971)
1980• 1982: First international medical informatics Association
Working Conference (London, England)• 1985: Another conference in Calgary, Canada• 1985: MS release windows 1; as well as intel 386• 1986: Informatics field introduced
• PC/ Micro Computer• HIS CPRS( computer based patient record
system)• Incorporated – Documentation
– Doctors Order - Lab results– Kardex - Nurses Notes– V/S or TPR– Discharge Planning
1990 and beyond
• NI was approved by ANA (1992)• Computer become smaller, faster, and easier
to use• Internet become a tool for clinical application• Knowledge if the focal point in nursing; as
knowledge workers nurses are:a. Data gatherer d. knowledge buildersb. Information usersc. Knowledge users
Nursing Informatics the Philippines
nursing informatics.. • word were mostly unfamiliar with in the nursing
community up until 2007-2008.• Not yet found & recognized as a sub-discipline• Founded by pioneers: Philippine Medical
Informatics Society (PMIS)• PIMA official registered in 1996 mainly
composed of 11 physicians• 1st head: Dr. Alvin Marcelo
Nursing Informatics the Philippines
nursing informatics.. • 1998: several faculty of UO began formal
education & training• Dr. Herman Tolentino took postdoctoral
fellowship in medical informatics @ University of Washington.
• Dr. Alvin Marcelo later trained @ National Library of Medicine.
Nursing Informatics the Philippines
nursing informatics.. • Dr. Cito Maramba went to Coventry for
Masters in Information Science @ University of Warwick
• 2003: Proposed course in NI @ UP• 2005-2006: College of Arts & Science
(major in bioinformatics) and Master of Science in Health Informatics was offered.
Nursing Informatics the Philippines
nursing informatics.. • 1999: National Institute of Health –UP Manila
form a study group to identify the international standards for health promotion and its adaptability in the Philippines,
• “Standards of Health Information in the Philippines, v. 1999” or “SHIP99”.
• PNA was included in the group by Ms. Evelyn Protacio.
Nursing Informatics the Philippines
nursing informatics.. • despite that representation & inclusion in the
curriculum nurses in the Philippines still lag behind our foreign counterparts.
• 2008: Nursing Informatics in the undergraduates was defined by CMO#5 s.2008.
• 2009: revised & included as Health informatics in the CMO#14 first implemented in 2010 summer
Nursing Informatics the Philippines
problem encountered adaptation of an international materials which does
not suit the local needs which should be community-centered using information, communication & technology.
Lack of certification & credentialing programs in post-graduates level
Nursing Informatics the Philippines
nursing informatics.. future• due to the integration in the curriculum made an
increase in awareness & interest of NI.• Development of training, certification and credentialing
are on the process by PNIA.• Partnership with local & international NI organization• CORE X strategic platform (Competency, Organization,
Recognition, Experience & Expertise ) *thrust: - support use of health information standards
- have a nursing informatics specialist inevery hospital
Nursing Informatics the Philippines• persistent issues :
- inequities in access, cost, inefficiency - maldistribution of health care providers, and public health systems managers,
• Information and communications technologies (ICT) offer - accessible, - affordable - standard tools in the health arena.• Since 1998, the National Telehealth Center has championed its use in health
and development in the field now known as eHealth. • Theme: Putting health in the hands of the people, • Learning in four strategic areas;
a. assisting remote health professionals in their clinical decision making (telemedicine),
b. developing relevant electronic health record systems intended for government primary care centers where the poor seek care,
c. building capacities of health care and eHealth practitioners (eLearning and trainings)
d. actively advocating for policies that promote the relevant and meaningful use of ICT in health.
Nursing Informatics the Philippines• persistent issues :
- inequities in access, cost, inefficiency - maldistribution of health care providers, and public health systems managers,
• Information and communications technologies (ICT) offer - accessible, - affordable - standard tools in the health arena.• Since 1998, the National Telehealth Center has championed its use in health
and development in the field now known as eHealth. • Theme: Putting health in the hands of the people, • Learning in four strategic areas;
a. assisting remote health professionals in their clinical decision making (telemedicine),
b. developing relevant electronic health record systems intended for government primary care centers where the poor seek care,
c. building capacities of health care and eHealth practitioners (eLearning and trainings)
d. actively advocating for policies that promote the relevant and meaningful use of ICT in health.
Nursing Informatics the Philippines
• National Telehealth Center (NTHC) conducted a “webinar” • eRecords – national database• eMedicine - tele-referrals between Doctors-to-the-barrios
and PGH using mobile phones and internet technologies.• eLearning - systematic deployment of scarce trainers where
there is a greater need while providing access to up-to-date knowledge.
• eHealth Training for Educators of the Health Profession was held the National Telehealth Center, UP Manila.
• Philippine Undergraduate Research on eHealth (PUReHealth) Awards Student Orientation
Nursing Informatics the Philippines
eRecords • Data not managed is useless.• Improve efficiency of health records collection through electronic
systems for organizing health data. eReordssystem
• developed by NThC is CHITS
• a free and open source (FOSS) software designed specifically for local government health centers
• collects existing routine health data in the Field Health Services Information System (FHSIS) of the Department of Health
• Integrates them into a unified computerized system.Community Health Information Tracking System
Nursing Informatics more future..world spectrum
a. Quantity of electronic resources will multiply, as mobile device increasing power
b. Variety of devices will increase to meet the diverse needs of the practicec. Clinical decision support software will become increasingly sophisticated d. Smart cards that authenticate the user’s identitye. Increasingly life like simulation & virtual reality for educating nursing staff &
studentsf. Development in sophisticated distance patient visits (convenient home visits
follow up)g. Bioinformatics will continue to unravel information related to genetics to
formulate gene therapy h. Speech recognition will enable providers to dictate system for accurate
documentation.i. More online health services
QUIZ COVERAGE
1-20. FROM SIR CANDOG 21- 60 . THESE WEEK’S DISCUSSIONS
4 Domain Applications
1. Nursing Practice Domain Application - Electronic Health Record uses such as; a. computer generated nursing care plan
b. clinical decision making alertsc. electronic monitoring devicesd. patient specific discharge
instructionse. online evidenced based nursing resources
4 Domain Applications2. Nursing Administration Domain Application
-reporting statistical data- planning resources- budgeting- documentation such as;a. workload measurement systemb. online policy, manual and procedurec. staff scheduling systemsd. internal emaile. cost analysisf. patient tracking system
4 Domain Applications 3. Nursing Education Domain Application
- computer revolutionized education process- online courses/distant education- home study/university without walls- services such as;a. online registration, scheduling, attendance, grade managementb. computer based tutorialsc. remote library accessd. webcastinge. simulation labs
4 Domain Applications
4. Nursing Research Domain Application- analyze nurses data (stats and trends)- this includes;a. computerized literature b. software that process quantitative & qualitativec. reference and other related studies
Standards Initiative 1. Nursing practice standard2. Nursing Data standard3. Health Care Data Standards Organization
type of HISa. early HISb. early ambulatory care information systemc. early computerd. early educational application
Standards Initiative 1. Nursing practice standard2. Nursing Data standard3. Health Care Data Standards Organization
type of HISa. early HISb. early ambulatory care information systemc. early computerd. early educational application
Electronic Health Recorda. Patient safety - Computerized Provider Order Entry (CPOE) allows
physician to enter orders or findings directly to the computer. With most includes ;-electronic medication administration record preventing errors in medication administration. -bar coding vs clients ID band
- associated with written orders 1. illegibility2. inaccurate abbreviations
- Clinical decision support software provides;1. dose calculations 2. warns the prescriber of any patients allergy, drug to drug interaction3. drug contra indication4. considers relevant lab result
Electronic Health Record
1974 – Marc Lalonde indicated that;“there is a lack of a uniform and integrated system for maintaining health records of individuals because essential data were scattered in many location”
2002 – Roy Romanow “to take full advantage of the potential of information, evidence and ideas in the health care system, thus infrastructure must be in place, in support it recommended the HER”
…to the futurea. Quantity of electronic resources will multiply significantly due to
mobile devicesb. Devices will increase to meet the four domains of nursingc. Support software will become increasingly sophisticated like;
- Recognizing when patient assessment falls outside the normal ranges, prompting communication to the physician.
d. Smart card- authenticate users identity allowing access to computers.
e. Use of virtual reality for educating studentsf. Telecommunication – TELEHEALTHg. Bioinformatics – gene functions or gene therapiesh. Speech recognition – saves timei. Online health care services – information for self management
EHR & EMR
• primarily on storage of patients record electronically• Downside: medico-legal issues exposure by practitioners
such as violation of right to privacy• From paper based to electronic version of patient record• Issues:• 1. Who is responsible for Management of data• 2. What are patients rights and expectations• 3. How to obtain consent without physician• 4. How to make it inaccessible to unauthorized people• 5. Are the information reliable• 6. What are the medical liability issue arising from this
EHR vs EMR
• HER is a secure and private lifetime record of an individual’s health and care history, available electronically to authorized health care providers
• Distinctions:- EMR refers to an electronic version of the paper record that doctors have long
maintained;- EMR holds all medical information gained from individual physician’s care;- EMR has depth- EHR is a compilation of core data from multiple sources and it may be
comprised of many different e-records submitted by different providers in different jurisdictions;
- EHR has breathed because it contains all record from EMR - EHR does not necessarily contain all the information from EMR
• accountability, privacy, security, confidentiality, accountability, liability
Davies Award of Excellence• Named after Dr. Nicholas E. Davies; advocated for the
development of patient record• Its is as award program that bring to national attention
excellence in the implementation of computerized medical records
• Philosophy: health care organization benefit when collective experiences and lessons are shared.
• Criteria1. Organizational/Acute Care2. Ambulatory Care3. Public Health care
Informatics
• French word “informatique”; the computer milieu
• 1970-1980 : nursing informatics broadly defined as the use of computer technology to support all aspects of nursing practice
• 1996: Turley introduced the Nursing informatics model
History of Nursing Informatics
150 & 100 BC – Antikythera mechanism3000 – 500 BC – Abacus (Greeks,Romans, Chinese, aztecs)1632- Slide rule by William Oughtred1642- Pascaline by Blais Pascal1694- Binary System by Gottfried Wilhem von Leibniz
(computer language)1804 – Weaving Machine by Joseph Marie Jacquard
using punch cards.1820 – Arithometer by Charles Xavier Thomas de Colmar
(first real calculator)
Antikythera mechanism
History of Nursing Informatics 1822-1871 – Difference engine; analytical engine;
connected relationship between mathematics & machines
1854 – Boolean Algebra or Arithmetic; that any equation can be stated as either true or false
1889- Punch Cards by Herman Hollerith; used first for US census (from 7 years to 6 mos.)
-IBM was founded1931- Bush Differential Calculator1944- Mark I by Howard H. Aiken ( a 150 feet long with
500 miles of wiring)
History of Nursing Informatics 1946 –First Generation Computers (1st electronic
computers) ENIAC (Electronic Numerical Integrator & Computer)-18,000 vacuum tubes, 70,000 computer resistor and 5 million soldered joints- 1,000 more faster-world first complete computer
1947 – Transistors by William Shockely, John Bardeen, Walter Brattain- smaller that vacuum tube- started the 2nd generation computer
Computers
NursingInformatics