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Informatics & Technology in Nursing
This document provides an overview of informatics and technology in nursing. It discusses how health information and health IT can help improve care delivery and reduce errors. Informatics is presented as an interdisciplinary field that draws from areas like computer science, nursing, and other health disciplines. Nursing informatics applies informatics principles and technologies to support evidence-based practice, standards, research, and tools that promote safe and effective nursing care.
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Informatics & Technology in Nursing
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- 2. 2003 M.D. (First‐Class Honors) (Ramathibodi) 2009 M.S. in Health Informatics (U of MN) 2011Ph.D. in Health Informatics (U of MN) 2012 Certified HL7 CDA Specialist • Deputy Executive Director for Informatics (CIO/CMIO) Chakri Naruebodindra Medical Institute • Lecturer, Department of Community Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University nawanan.the@mahidol.ac.th http://groups.google.com/group/ThaiHealthIT www.SlideShare.net/Nawanan Introduction
- 3. • Health & Health Information • Health IT •Informatics as a Discipline • Nursing Informatics • Summary Outline
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- 5. Let’s take alook at these pictures...
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- 8. ER - ImageSource: nj.com Healthcare (On TV)
- 9. (At an undisclosednearby hospital) Healthcare (Reality)
- 10. • Life‐or‐Death • Difficult to automate human decisions –Nature of business – Many & varied stakeholders – Evolving standards of care • Fragmented, poorly‐coordinated systems • Large, ever‐growing & changing body of knowledge • High volume, low resources, little time Why Healthcare Isn’t Like Any Others
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- 12. To treat & to care for their patients to their best abilities, given limited time & resources Image Source:http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen) What Clinicians Want?
- 13. • Safe • Timely •Effective • Patient-Centered • Efficient • Equitable Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p. High Quality Care
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- 15. Shortliffe EH. Biomedicalinformatics in the education of physicians. JAMA. 2010 Sep 15;304(11):1227-8. “Information” in Medicine
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- 18. Health & Health Information • Health IT • Informatics as a Discipline •Nursing Informatics • Summary Outline
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- 20. (IOM, 2001)(IOM, 2000)(IOM, 2011) Landmark IOM Reports
- 21. • To Erris Human (IOM, 2000) reported that: – 44,000 to 98,000 people die in U.S. hospitals each year as a result of preventable medical mistakes – Mistakes cost U.S. hospitals $17 billion to $29 billion yearly – Individual errors are not the main problem – Faulty systems, processes, and other conditions lead to preventable errors Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US: Regulating Healthcare ‐ Lecture d Patient Safety
- 22. • Humans arenot perfect and are bound to make errors • Highlight problems in U.S. health care system that systematically contributes to medical errors and poor quality • Recommends reform • Health IT plays a role in improving patient safety IOM Reports Summary
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- 24. Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine RamathibodiHospital To Err Is Human 2: Memory
- 25. • Cognitive Errors- Example: Decoy Pricing The Economist Purchase Options • Economist.com subscription $59 • Print subscription $125 • Print & web subscription $125 Ariely (2008) 16 0 84 The Economist Purchase Options • Economist.com subscription $59 • Print & web subscription $125 68 32 # of People # of People To Err Is Human 3: Cognition
- 26. • It alreadyhappens.... (Mamede et al., 2010; Croskerry, 2003; Klein, 2005; Croskerry, 2013) What If This Happens in Healthcare?
- 27. Mamede S, vanGog T, van den Berge K, Rikers RM, van Saase JL, van Guldener C, Schmidt HG. Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents. JAMA. 2010 Sep 15;304(11):1198-203. Cognitive Biases in Healthcare
- 28. Croskerry P. Theimportance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003 Aug;78(8):775-80. Cognitive Biases in Healthcare
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- 30. • Medication Errors –DrugAllergies –Drug Interactions • Ineffective or inappropriate treatment • Redundant orders • Failure to follow clinical practice guidelines Common Errors
- 31. Why We NeedICT in Healthcare? #1: Because information is everywhere in healthcare
- 32. Why We NeedICT in Healthcare? #2: Because healthcare is error-prone and technology can help
- 33. Why We NeedICT in Healthcare? #3: Because access to high- quality patient information improves care
- 34. Why We NeedICT in Healthcare? #4: Because healthcare at all levels is fragmented & in need of process improvement
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- 36. Hospital A HospitalB Clinic C Government Lab Patient at Home Health Information Exchange
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- 38. Biomedical & Health Informatics asa Discipline
- 39. • “Biomedical informatics(BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health.” (AMIA, 2012) Biomedical Informatics
- 40. • Provide Patient-CenteredCare • Work in Interdisciplinary Teams • Employ Evidence-Based Practice • Apply Quality Improvement • Utilize Informatics Core Competencies of Health Professionals (IOM, 2003)
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- 43. Biomedical/ Health Informatics Computer & Information Science Engineering Cognitive & Decision Science Social Sciences (Psychology, Sociology, Linguistics, Law & Ethics) Statistics & Research MethodsMedical Sciences & Public Health Management Library Science, Information Retrieval, KM And More! Informatics & Other Fields
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- 46. • Nursing Informaticsis the “science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide.” (IMIA Special Interest Group on Nursing Informatics 2009). Nursing Informatics AMIA Nursing Informatics Working Group
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- 48. • Standards tosupport evidence-based practice, research, and education • Data and communication standards • Research • Information presentation and retrieval to support safe patient centered care • ICT to address inter-professional workflow needs across care • Development, design, and implementation of ICT • Healthcare policy to advance the public’s health Core Areas of Nursing Informatics AMIA Nursing Informatics Working Group
- 49. • Nursing InformaticsStandards – Omaha System Examples of Nursing Informatics Works
- 50. • Health ITin Clinical Settings – Electronic Nursing Records – e-Kardex – Careplanning – Electronic Medication Administration Records (e-MAR) – Barcoded Medication Administration – Other nurse-related workslows Examples of Nursing Informatics Works
- 51. Ordering Transcription DispensingAdministration CPOE Automatic Medication Dispensing Electronic Medication Administration Records (e‐MAR) Barcoded Medication Administration Barcoded Medication Dispensing Medication Process
- 52. • Health ITfor Consumers/Patients – Personal Health Records – Telemedicine – Web Sites for Patient Education & Engagement – mHealth & Social Media Examples of Nursing Informatics Works Images from HealthVault.com, American Telecare, Inc. & WHO
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- 55. • Information isimportant & everywhere in healthcare (and nursing) • Health IT helps improve quality of care and reduces errors by health workers • Informatics is an interdisciplinary field, with nursing informatics as one key sub-field • Nursing informatics plays important roles in today and future’s patient care Summary