What is Informatics?

1
What is Informatics?

• Chris Curran, PhD, RN
• M8120
• September 4, 2001

2
Goethe, 1810

• The modern age has a false sense of superiority
  because it relies on the mass of knowledge that
  it can use, but
• what is important is the extent to which
  knowledge is organized and mastered.

3
Terms

• Medical Informatics
• Healthcare Informatics
• Nursing Informatics

4
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
5
First Definition Nursing Informatics

• The application of computer technology to all
  fields of nursingnursing service, nurse
  education, and nursing research.
• (Scholes and Barber, 1980, p. 70)

6
Definition Nursing Informatics

• Nursing informatics is a combination of nursing
  science, information science, and computer
  science to manage and process nursing data,
  information and knowledge to facilitate the
  delivery of health care.
• (Graves Corcoran, 1989)

7
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. 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
8
Definition Medical Informatics

• The scientific field that deals with biomedical
  information, data and knowledge-their storage,
  retrieval, and optimal use for problem-solving
  and decision-making.
• (Shortliffe Perreault, 2001)

9
The Metastructures, Concepts, and Tools of
Nursing and Nursing Informatics
Source ANA. (2001, proposed). The Scope of
Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the
Informatics Nurse Specialist
10
What Informatics is Not

• Synonymous with computer technology

11
Facts

• Recognized as a specialty for registered nurses
  by the American Nurses Association in 1992.

12
Computers cantbut Humans can

• Perceive data and information
• Abstract data and information
• Make decisions that involve values and risk
  preferences

13
Scope of Informatics

• Data, information, knowledge and wisdom
• Communication and information management
• Types, capabilities, and limitations of
  technology
• Legal and ethical considerations of information

14
Key Concepts

• Data
• Information
• Knowledge
• Wisdom
• Knowledge Workers
• Decision Making
• Informatics Competencies
• Workflow

• Technology
• Hardware
• Software
• Electronic Standards
• System Architecture
• Internet / WWW
• Database

15
Data, Information and Knowledge(Blum, 1986)

• Data are discrete entities that are described
  objectively without interpretation,
• Information is data that are interpreted,
  organized, or structured, and
• Knowledge is information that is synthesized so
  that relationships are identified and formalized

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Wisdom

• Wisdom is the appropriate use of data,
  information and knowledge in making decisions and
  implementing nursing actions.

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Knowledge Workers

• Definition Knowledge work is non-repetitive,
  non-routine work consuming considerable levels of
  cognitive activity (Drucker, 1993).
• Bring their knowledge, skills, judgment, and time
  to the organization

18
Information Processed Quantity vs. Quality
(Patel, 1997)
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Decision Making

• Models
• Information Processing
• Decision Analysis
• Skill Acquisition
• Uncertainty
• Biases

20
Decision Making

• Process vs Outcome
• Critical Thinking vs Decision Making

21
Workflow

• Process Mapping
• Low Level vs High Level Processes

22
Systems Architecture

• Integrated
• Distributed

23
Overarching Standards of Practice for the
Informatics Nurse Specialist

• 1. Incorporates theories, principles and concepts
  from appropriate sciences into informatics
  practice such as information, systems, and change
  theories implementation methods, organizational
  culture, and database structures.
• 2. Integrates ergonomics and human-computer
  interaction principles into informatics solution
  design, selection, implementation and
  evaluation. 
• 3. Systematically determines the social, legal,
  and ethical impacts of an informatics solution
  within nursing and health care.

Source ANA. (2001, proposed). The Scope of
Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the
Informatics Nurse Specialist
24
Informatics Nurse Specialist Standards of Practice

• Standard I. Identify the Issue or Problem
• Standard II. Identify Alternatives
• Standard III. Choose and Develop a Solution
• Standard IV. Implement the Solution
• Standard V. Evaluate and Adjust Solutions

Source ANA. (2001, proposed). The Scope of
Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the
Informatics Nurse Specialist
25
Informatics Nurse Specialist Standards of
Professional Performance

• Standard I. Quality of Nursing Informatics
  Practice
• Standard II. Performance Appraisal
• Standard III. Education
• Standard IV. Collegiality
• Standard V. Ethics  
• Standard VI. Collaboration
• Standard VII. Research
• Standards VIII. Resource Utilization
• Standard IX. Communication

Source ANA. (2001, proposed). The Scope of
Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the
Informatics Nurse Specialist
26
Theoretical Models

• Schwirian (1986)
• Graves Corcoran (1989 1995)
• Staggers and Parks (1993)
• ANA Scope and Standards Document (2001)

27
Schwirian Model (1986)
Source Schwirian, P. M. (1986). The NI
pyramid-A model for research in nursing
informatics. Computers in Nursing, 4(3),
134-136.
28
Graves and Corcoran Model(1989 1995)
Source Graves, J. R., Amos, L. K., Huether, S.,
Lange, L., Thompson, C.B. (1995). Description
of a graduate program in clinical nursing
informatics. Computers in Nursing, 13(2), 60-70.
29
Staggers and Parks Nurse-Computer Interaction
Framework (1993)
Source Staggers, N. Parks, P. A. (1993).
Collaboration between unlikely disciplines in the
creation of a conceptual framework for
nurse-computer interactions. In M. E. Frisse,
(ed.). Proceedings of the Sixteenth Annual
Symposium on Computer Applications in Medical
Care, NY McGraw Hill, 661-665.
30
ANA Scope Standards Model (2001)
Source ANA. (2001, proposed). The Scope of
Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the
Informatics Nurse Specialist
31
Informatics Competencies

• Levels of Competency
• Beginning Nurse
• Experienced Nurse
• Informatics Nurse Specialist
• Informatics Innovator
• Types
• Computer Skills
• Informatics Knowledge
• Informatics Skills

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Informatics Competencies Three Areas

• Computer Literacy
• a set of skills that allow individuals to use
  computer technology to accomplish tasks.
• Informatics Knowledge
• a set of cognitive processes that allows the
  individual to recognize what, when, and where
  information is needed and to locate, evaluate,
  and use that information appropriately.
• Informatics Skills
• the technical ability to use tools and techniques
  to improve information and knowledge access,
  integration, management and use.

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Beginning Nurse Informatics Competencies

• Has basic computer skills
• Uses applications
• Uses sources of data
• Uses technology for care delivery, communication,
  and decision support
• Respects and protects patients rights to privacy
  and confidentiality of information

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Experienced NurseInformatics Competencies

• Understands the value of data and information
• Uses technology to trend and aggregate individual
  and population-based patient information for
  decision support and communication
• Evaluates quality of information sources
• Advocates for technology solutions that improve
  care delivery

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Informatics Nurse Specialist Informatics
Competencies

• Uses advanced systems and tools to manage,
  evaluate, integrate, and communicate data,
  information and knowledge
• Assesses current capabilities and limitations of
  technology and their impact on users and
  organizations
• Manages IT projects across the systems life cycle
• Actively seeks to improve the information and
  knowledge available for clinical decision-making

36
Informatics Innovator Informatics Competencies

• Conducts research related to nursing informatics
• Influences top-level decisions and policy design
  which impact clinical information management
• Builds theoretical models of NI
• Evaluates system level informatics initiatives

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Roles of the Informatics Nurse Specialist

• Project Management
• Consultation
• Education
• Research
• System Development
• Decision Support/Outcomes Management
• Policy Development
• Entrepreneur

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Information Needs and Tools for Practice

• Sound Clinical Decision Making
• Evidence Based Practice
• Standardized Vocabularies
• Clinical Information Systems

39
Electronic Patient Records Development
Constraints

• Need for standards in clinical terminology
• Concerns about data privacy, confidentiality and
  security
• Data entry challenges
• Integration of records and other information
  resources

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Research PrioritiesBrennan, Zielstorff, Ozbolt,
Strombom, 1998)

• Standardized language/vocabularies
• Technology development to support practice/
  patient care
• Data base issues
• Patient use of information technologies
• Using telecommunications technology for nursing
  practice
• Putting technology into practice
• Systems evaluation issues
• Information needs of nurses and other clinicians
• Nursing intervention innovations for professional
  practice
• Professional practice issues

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Assumptions to be Challenged

• Organization of electronic systems
• Desktop metaphor
• EMR
• Chronological structure
• Set of processes to be supported by technology