Informatics in Nursing and Healthcare Assignment Paper

Informatics in Nursing and Healthcare Assignment Paper

Informatics in Nursing and Healthcare Assignment Paper

Healthcare Informatics is defined as “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick, 2015, p. 232). Nursing Informatics is a subset of informatics, specific to the field and the role of the nurse in the healthcare setting. The American Nurses Association (ANA) identified nursing informatics as “a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice” (ANA, 2001, p.17). Healthcare and nursing informatics are both vastly growing fields within the medical field and are continuously incorporating new and evolving technology. Both have been around for the past three decades, at least. The technology boom at the turn of the century has helped informatics and information systems further evolve. Enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved. With any new technology or innovation there are implications, some foreseeable and some that come to light after the unveiling of the new process or product: some impacts that are most notable are clinical, managerial, and policy implications. This paper explores the implications, (both constructive and adverse), that are the most notable in today’s healthcare world within the healthcare and nursing informatics fields.Informatics in Nursing and Healthcare Assignment Paper

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Systems that support provider order entry and decision-making are the most prominent areas for system improvement and error reduction. It has been estimated that provider order entry can reduce serious medication error and adverse drug events (ADEs) by 55%.9 However, these systems can also promote user errors if not subjected to rigorous usability testing and evaluation. Goldstein et al. demonstrate how a clinical decision support systems (CDSS) can actually potentiate errors by (1) omitting relevant data, (2) increasing data overload, (3) providing guidelines inappropriate with a patient’s profile, and (4) incorporating inaccuracies in program inputs or program logic. They propose a methodology to address unanticipated errors in guideline-based decision support systems that includes adequate training and regular system reporting as well as monitoring systems for adverse prescribing and administering practices.

Informatics is changing the face of healthcare. As technology advances, healthcare organizations and providers are able to collect, analyze and leverage data more effectively, influencing the way care is delivered, resources are managed and teams operate each day. You would be hard-pressed to find an aspect of medicine that has yet to be touched by the mass collection and analysis of data that has been ushered in by the Information Age.

One specific area that health informatics is having a significant impact on is the practice of nursing. Though the mission of nursing remains unchanged, the daily work of these professionals is being strongly influenced by informatics, with particular attention to the accuracy and communication of patient data and care.Informatics in Nursing and Healthcare Assignment Paper

Health informatics in nursing
The nursing profession is rapidly changing to keep up with advancements and new challenges in the healthcare field. As direct caregivers, nurses are in the front lines of patient care and consequently often feel the impact of changes in best practices more immediately than other healthcare professionals.

Spyros Kitsiou, Assistant Professor of Biomedical and Health Information Sciences at the University of Illinois at Chicago, reported that there are three specific challenges that healthcare is currently facing: the aging population, the incidence and prevalence of chronic diseases – such as cardiovascular disease, diabetes and pulmonary disease – and the shortage of doctors and nurses. Though these problems are diverse, there is a solution that addresses all three: data.

“A lot of these challenges can be supported by the avocation of information and communication technologies, particularly as hospitals are becoming more and more interested in reducing their costs and shifting care from hospital care to home care,” Spyros said. “Information and communication technologies, mobile health devices, wearable technologies are all becoming very, very important for supporting remote patient monitoring and home care.”

In nursing, as with healthcare in general, informatics is being used to address the challenges of the day, significantly impacting the way nurses function in patient care.

One of the primary ways that informatics has changed nursing practice is through documentation. Gone are the days of paper charts that had to be meticulously updated with handwritten notes. Today, nurses are more likely to input notes into electronic health records and other systems that keep a patient’s medical history up-to-date and easily accessible.Informatics in Nursing and Healthcare Assignment Paper

The Healthcare Information and Management Systems Society reported that as the result of electronic charting, nurses are able to obtain information quickly and efficiently, using the information to improve the daily workflow. Storing the information electronically is more easily available to all members of the care team, including the physician and other care providers, as well as staff teams at other healthcare organizations that the patient may visit. As the U.S. population becomes more mobile, it is increasingly important that their personal medical records can travel with them to any office or medical organization they may visit during their lifetime.

Health informatics is also an important part of care coordination in nursing. The ability to track staffing, workflow and communication can help nurses to identify areas where current processes can be improved. This can also help ensure that staffing levels remain adequate, which is critical for providing patients with the best possible care. If the nurse-to-patient ratio drops too low, patients are more likely to suffer adverse results. Maintaining adequate levels helps nurses provide the best possible care each day without burning out.

Key areas of challenge and the role of information technology
There are 4 key areas of care delivery that can benefit from technology:

•Decision support. Technology solutions can guide decision making directly at the point of care where it has the most powerful impact in improving quality and patient safety.
•Streamlined and integrated documentation support. The goal is to enter data once and let it proactively guide the next steps in the process of care. The paperwork burden can be substantially reduced.5
•Metrics embedded into the solution measure the intensity of care, the care provided, the impact of care on outcomes, and the comparison of care provided to best practices.
•Workflow management tools help orchestrate the numerous, simultaneous processes of caring for patients by pushing tasks to individual work lists, monitoring to ensure each task is completed, and notifying when tasks fail.
These tools support nurses in critical processes, such as medication administration, admission, patient rounding, and discharge and transfer functions, to name a few. Communication support tools (paging, list of commonly called numbers with automatic call and recall) can also provide tremendous support.Informatics in Nursing and Healthcare Assignment Paper

Siemens customers have experienced and measured significant reductions in errors and costs through the use of their clinical information systems. The benefits range from clearly quantifiable financial measures to other benefits that have a softer cost relationship.

Danville Regional Health System in Virginia, for example, has been able to prevent medication errors by the use of bar code scanning and an electronic medication-administration record integrated into the computerized patient record. This system uses bar code scanning at the point of care to ensure that the right patient receives the right drug at the right dose by the right route at the right time. The system alerts the nurse if a drug is past due, if the nurse is attempting to administer a drug that does not match the order, or if the patient is not the intended patient. The hospital has prevented an average of 12 errors per month. When looking at medication errors, transcription errors are accountable for 11% to 12% of the mishaps.6 The Ohio State University Health System has documented that they have eliminated transcription errors by using computerized physician-order entry.7 With 100% of all orders being entered into the computer system directly by physicians, there are no more illegible or incomplete orders for nurses and clerks to decipher.

Unit design
The physical layout of the patient care area should accommodate clinicians in direct care activities. Significant innovation is needed so that care delivery areas are aligned with the numerous changes in health care over the past 20 years. Some institutions are upgrading information systems and hospital physical design to reduce the time that nurses spend on charting and communication and to increase the time nurses spend with patients. HealthSouth, a rehabilitation chain based in Birmingham, Alabama, plans to build a “digital hospital, which would cut charting time by 50%.”8 In most hospitals, nurses spend too much of their time going up and down long hallways for messages to obtain the latest order, answer questions, and respond to patient requests, all of which are based on loudspeaker announcements coming through patient rooms.5
Existing technologies can integrate cell phones, roaming phones, and other handheld communication devices. Patient care could be greatly enhanced by providing access to voice messages and patient-specific information if nurses could carry multiple-purpose devices. Such practical applications can enhance workflow and satisfaction. Nurses are constantly tracking charts, phone numbers, physicians, equipment, even patients. Wireless technology, combined with rules of logic, would reduce the time spent tracking and finding resources.5 Efficiency, time reduction, and nurse satisfaction would improve drastically.Informatics in Nursing and Healthcare Assignment Paper

Nursing curriculums using authentic clinical information systems in student clinical education labs would increase students’ knowledge and proficiency when they migrate to real-life settings. Technologically informed students will also drive better decisions about the use of technology in real-life settings. Further, the student educational labs are good places to introduce and test new products and procedures before implementation in live clinical settings. In addition, staff nurses could receive updated education through the Internet to facilitate the integration of new knowledge into their practice. Access to policies, procedures, and educational information from the same device that clinicians use to document patient care would make it easier for clinicians to stay informed of new advances in health care.

One of the biggest challenges for executives is how to use expensive resources efficiently. Technology plays an instrumental role in managing workload and cost-effective staffing. Acuity data, a byproduct of patient care, can be reflected in the treatment plans and documentation performed at the point-of-care. Fed to data warehouses, nurse schedules can be developed and adjusted easily on the basis of patient-load projections. These schedules can be pushed to the nurses for immediate online retrieval.

Thus, technology can be used in the following staffing areas:

•Measuring patient dependence and patient classification schemes
•Managing workload of nursing and allied professionals
•Scheduling (staff schedules)
Executing operational business tasks related to nursing-unit management focused on quality, outcomes, costs, compliance with regulations, credentialing, risk management, case management, utilization review, costing of nursing care, budgets, and payrolls

t is three and a half years since clinicians at Cambridge University Hospitals Foundation Trust stopped keeping paper notes. Nowadays, nurses don’t reach for a clipboard at the end of a bed to record and check patient information. Instead, they use an electronic patient record (EPR), accessible from any location via a digital device.Informatics in Nursing and Healthcare Assignment Paper

Transforming the nurse’s role through technology

Helen Balsdon

According to chief nursing information officer Helen Balsdon, it is a change that has fundamentally enhanced the ability to provide excellent nursing care. That includes by removing one of nurses’ traditional bugbears: the need to decipher medical colleagues’ handwriting.

“Nurses still say one of the biggest impacts after the system went live was they could read the doctors’ writing,” she says with a knowing chuckle. “You don’t realise how much of a barrier it is, but for everybody to see the same thing, know that they can find it all there and then, it’s made looking at things much easier.

“Our rapid response, our falls coordinators, tissue viability, all of those teams that work peripatetically, are saying: ‘I can look at the record [from anywhere], I can triage where I go, I can give advice, I can prioritise where I go, when I go, and I’ve got all of that information at my fingertips to be able to keep an eye and track things

As technology advances, so does its influence in healthcare. Nurses must now be tech savvy to navigate online charting systems, update health records, schedule care and more. In days past, patient information was kept in carefully filed, handwritten charts. Now, technology in nursing has made it easier than ever to keep patient info efficiently recorded and stored.

“There can be temporary drawbacks when a technology is first implemented, but these are outweighed by the long-term benefits of the technology,” explains Anthony Sartor, registered nurse. “It’s of vital importance that nurses are given the necessary education to use new technologies that are being introduced in their workplaces.”

Technological advances aren’t likely to slow down any time soon. So what are the repercussions of integrating tech into nursing? Is there a general consensus about its ability to help or hurt the system? Join us as we dig deeper.

What are some recent examples of technology changes in nursing?
One of the biggest technological changes that’s arisen in the field of nursing is electronic charting. Instead of filling out charts with pen and paper, most nurses are now required to review information and fill out charts online. Many patients can now also access their own medical records and test results through these online patient portals. This assists in closing the communication gap and getting information to patients quickly and efficiently.

Other updates, according to RightPatient, include pagers or cell phones for enhanced communication between nurses, doctors and patients, GPS tagging and tracking of medical equipment, enhanced diagnostic devices, smarter alarm systems and lifting devices that allow nurses to lift patients without injuring themselves.

What are the benefits of technology in nursing?
“I view the main benefits of technology in nursing as improving patient care—both in terms of how optimal and efficient care are being delivered,” says Sartor. “I find that much of the technology is being implemented to improve nurses’ communication with other nurses, physicians and patients.”

Generally speaking, technology is used to make life easier, and it’s making a big difference in how the nurses do their jobs. Medical personnel can now communicate quickly when there’s an emergency, and there’s no risk of losing or wrecking files due to bad handwriting or spilled substances.Informatics in Nursing and Healthcare Assignment Paper

The end game for a nurse is to help people and save lives. With technological advances making their jobs easier and advancing care for patients, the amount of people nurses can help is likely to increase.

“The benefits are significant,” explains Simon Frey, co-founder of Pivot Health. “Nurses can deliver a greater patient experience and contribute to better healthcare outcomes. Technology can automate more routine or less value-adding elements of the patient experience, helping nurses to significantly improve customer satisfaction and engagement.”

What are some potential drawbacks?
While technology certainly helps with communication and spurs other efficiencies, there can be a learning curve when new technology is implemented.

“A drawback I’ve observed is a lack of ability to communicate effectively,” says Sartor. “For example, when charting electronically, it’s extremely important that the application provides enough options to allow nurses to properly convey their information. Many of my co-workers become frustrated because they aren’t able to express themselves and properly communicate patient information on the application.”

There are also some privacy risks that come with these advancements. Real people are developing these technologies, and sometimes, the wrong people can get a hold of important information and there can be a breach in patient confidentiality.

“Technology allows for the storage of unprecedented amounts of patient data,” says Sartor. “It’s vital that companies ensure this data is being stored securely and that databases can’t be infiltrated illegally.”

Another important consideration when it comes to nursing and technology is how it affects interactions with patients.

“In some ways, you get more face-to-face time with your patient because additions to the electronic record are made in real-time,” says Sharon M. Weinstein, a former RN. “In other ways, you lose valuable patient time while being brought up to speed on new technologies.”

How will electronics continue to evolve in the field of nursing?
The use of technology in medical devices is skyrocketing forward, and that bodes well for the general public. As researchers, scientists, engineers and doctors continue to make leaps forward with these innovations, more lives will be saved and more patients will receive assistance.

When it comes to nursing, many of the advances center on communication and the ability for nurses to complete their jobs accurately and efficiently.Informatics in Nursing and Healthcare Assignment Paper

“I believe technology will continue to evolve nursing as more workplace applications—both mobile and desktop—are introduced to allow staff to better communicate with each other,” says Sartor. “Additionally, I think there is a rising trend of technology being used to give patients better access to their plan of care and the ability for them to communicate with nurses through a technological medium without the need for face-to-face interaction.”

The world of nursing is fascinating
Does reading about the technological advances in the field of nursing get you excited for what a career in nursing could look like for you? If you’re looking for more resources, blogs are a particularly great way to read up on what’s current, as well as what’s up-and-coming in the world of nursing. Check out these 30 nursing blogs that are a must read for both current and aspiring nurses.

Health Information Technology (Health IT) is a broad term that describes the technology and infrastructure used to record, analyze, and share patient health data. Various technologies include health record systems, including personal, paper, and electronic; personal health tools including smart devices and apps; and finally, communities to share and discuss information. Some of this technology can tell the patient whether they need to go on a diet too, and most of the time the golo diet is what they should be doing or they should be taking Gynexin pill for gynecomastia like most men should be doing.

The purpose of Health IT is to provide better care for patients and help achieve health equity. Health IT supports recording of patient data to improve healthcare delivery and allow for analysis of this information for both healthcare practitioners and ministry of health/government agencies. This data is used for the implementation of policies in order to better treat and prevent the spread of diseases.

Health IT improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers. In low and middle-income countries (LMIC) the need for reliable and affordable medical record software is paramount. The OpenMRS community helps meet this specific need by developing and supporting the Open Medical Record System – an open-source electronic health record (EHR) platform, specifically designed for low-resource environments, and is completely free.Informatics in Nursing and Healthcare Assignment Paper

OpenMRS is implemented in over 500 facilities in Uganda alone.

The use of Health IT in medical clinics improves the quality of healthcare that is delivered by providing accurate patient records and allows doctors to better understand the patient’s medical history. Having a comprehensive patient history empowers doctors to more accurately treat ailments and prevent over-prescribing medications which can be fatal. Without medical records, physician’s would need to depend on the patient’s memory, which can lead to inaccurate medical history due to forgetfulness, complex drug names, and ailments affecting the patient’s recollection.

Patients that suffer from disease and ailments directly benefit from Health IT because of the improved level of care. The benefits of electronic health records include: Better health care by improving all aspects of patient care, including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity.

The OpenMRS community brings together software developers, senior medical and health care staff, implementers and organizers from around the globe with a wide range of skill sets to work collaboratively to develop the software to support health care in these areas. OpenMRS’ global community of over 1,200 volunteers from over 60 different countries and is the backbone of the software. Developers from all over the world contribute code to the reference application as well as provide technical support to their local implementing clinics. The OpenMRS community brings together software developers from around the globe with a wide range of skill sets to work collaboratively to develop the software to support health care in these areas. In addition, the community has a large pool of senior medical and healthcare staff, who are also informaticians, to mentor and guide the design of that software. Lastly, we engage organizations, implementers and health care team members from those areas that need our software to provide input into the design and the prioritization of features.

Evidence-based practices have long been an essential part of nursing. Today, determining those best practices involves the use of health informatics. Analyzing the mass quantities of data collected regarding patient care and outcomes helps to determine how best to treat these conditions and situations in the future. The more data that is collected and analyzed, the more accurate the resulting conclusions tend to be, providing the best possible information for determining how best to care for patients in the future.Informatics in Nursing and Healthcare Assignment Paper

The growing role of informatics in nursing has also created a number of new job titles for those with clinical experience and an interest in working with data.

A nursing career in informatics
Nurses at every level now work with informatics through patient records and other technology. However, some nurses choose to specifically focus their career on the intersection of informatics and clinical practice. There are a number of career options available in this lane, including the following:

Clinical informatics specialist
Nursing informatics specialist
Clinical analyst
Clinical informatics manager
Clinical informatics coordinator
Nursing informatics analyst
These roles can be found at every level and facet of healthcare organizations, including leadership and management, advocacy, risk analysis, compliance, consultation, research, evaluation and education. As informatics becomes a more prominent component of the nursing field, job opportunities will likely continue to develop.

While health informatics roles are open to professionals from a variety of backgrounds, nurses are particularly well-suited for these roles due to their knowledge of clinical workflow, previous healthcare education and experience with healthcare technology and information systems.

If you already have a clinical background in nursing, your next step en route to one of these jobs is to pursue training specifically in health informatics. Though there are several ways to do this, one option is to earn a Master of Science in Health Informatics degree. In a master’s program, you will take courses on important topics such as healthcare information systems, healthcare IT vendor management, health information systems analysis and design and organizational issues in health informatics to prepare for a career in health informatics.

To complete your higher degree while continuing to work in the field, consider enrolling in UIC’s online Master of Science in Health Informatics degree program. The convenient online format makes it easier than ever for you to balance your academic pursuits with existing professional and personal responsibilities. And UIC’s program is a great fit for nurses and others who wish to enter the informatics field from a clinical background.Informatics in Nursing and Healthcare Assignment Paper

“People who are interested in integrating their clinical knowledge with the application of information technology or vice versa, would be very much interested in our program,” Kitsiou said. “And people who would like to even transition, make a career change and transition to healthcare would definitely be interested as long as they have a basic understanding of the healthcare system and also the application of IT.”

With the right informatics training combined with your clinical background and existing medical knowledge, you could make a difference in patient care in a healthcare organization through a career in health informatics

Despite automated drug alert systems, adverse drug events (ADEs) comprise a significant portion of medical errors and contribute approximately $2 billion in increased hospital costs.1 In addition to the implementation of clinical decision support systems to prevent errors, other types of system automation are effective in detecting the actual occurrence and prevention of ADEs. Einbinder and Scully demonstrate that retrospective analysis using an electronic clinical data repository is an efficient and powerful method to evaluate rules and criteria to detect ADEs. Murff et al. devised an electronic screening tool for discharge summaries to detect, not only ADE’s, but all adverse events (AEs). Their retrospective method identified adverse events in 31% of charts sampled, of which 52% were adverse drug events.

Defining, detecting and preventing adverse events (including adverse drug events) remains a challenge. Informatics programs that incorporate systems and information theory, software application development, and project design methodology, combined with extensive clinical experience in the development and evaluation of computerized systems, can be very influential in promoting systems that both detect and prevent adverse events. System evaluation, specifically quality assessment and improvement, is often neglected in informatics education and clinical applications. Collaborative teams of informatics educators, students, clinicians, and vendors have the combined knowledge and skills to develop quality improvement models that build safety in at all stages of the system development life cycle (SDLC).

Knowledge Representation
The development of ontological models has been consistently associated with knowledge representation in clinical informatics.10,11 The papers in this section describe ontological models for clinical processes that facilitate our detection and understanding of errors.Informatics in Nursing and Healthcare Assignment Paper

Advani et al. propose an approach for evaluating and consistently scoring clinician adherence to medical guidelines that employs an ontology. The model allows for the quality assessment of clinician actions and patient outcomes. By creating a structure of guidelines that include both a guideline adherence algorithm and an intention recognition algorithm, the system allows for a “dynamic plan revision” that incorporates patient specific data and may result in a “plan substitution.” This sophisticated approach to automated clinical guidelines attempts to address the issue of potential errors when clinical guidelines may not “match” a specific patient situation. The quality indicator language (QUIL) incorporates “annotated knowledge” to validly use point-of-care guidelines for quality assessment.

Stetson et al. propose developing an ontology that represents the intersection of medical errors, information needs, and communication space. Based on the premise that adverse events occur in a complex environment and involve information-seeking behavior, clinical communication, and information technology, the authors propose building an ontology that captures these three concepts. The proposed ontology will build on the some of the existing semantic definitions in the UMLS Semantic Network in an attempt to re-use knowledge. This novel approach will further illuminate the factors that contribute to adverse events and provide a basis for informaticists to provide system solutions and promote future informatics research.

Finally, Nebeker et al. propose the development of a taxonomy of adverse drug events to counter the ambiguity of the current definitions and promote a prospective classification to facilitate future research. The authors categorize medical events by (1) drug and disease and (2) intent of person directing the drug use. In the first category, a distinction is made among the relation of disease, drug effect, and adverse event; in the second category, the authors differentiate between provider- and patient-directed therapy.

Human Factors and Communication
Much research related to human errors has been done in the fields of cognitive science and human factors engineering, although generally the focus has been on non-medical domains, such as aeronautics or nuclear reactors. Recently, more attention is being paid to the nursing arena.12–16 Zhang et al. provide a good entry for informatics students into the cognitive science/human factors literature by citing many of the important studies that address errors. A hierarchical model of medical errors is presented in which causes can be attributed to any (or all) of six levels: individuals; individual-technology interaction; distributed systems; organizational structures; institutional functions and national regulations. The remaining papers in this section analyze errors at the first four levels of the hierarchy.

Zhang et al. argue for a taxonomy of medical errors based on the cognitive mechanism(s) involved because problems attributable to different mechanisms will have different solutions. As a basis for developing such a taxonomy, students are introduced to classic papers such as Reason’s definition of human errors2 and Norman’s cognitive theory of human action17 as well as a preliminary taxonomy of errors.18

The other papers can help students learn how informatics can be used to improve nursing work processes and communication, and thereby safety. Focusing on errors at the individual or individual-technology interaction levels of the system hierarchy of medical errors, Weinger and Slagle describe key concepts in human factors (workload and vigilance) that can affect clinicians’ awareness of potentially dangerous conditions, as well as a methodology to evaluate clinicians’ perceived workload, knowledge and decision processes, and detect “nonroutine” events that require clinical intervention. Although described for an anesthesia domain, the methods are equally applicable for nursing and medicine.Informatics in Nursing and Healthcare Assignment Paper

McKnight et al. and Moss et al. explore errors at the level of distributed systems or organizational structures, focusing on adverse events that result from communication problems. McKnight et al. introduce students to Coiera’s concept of “common ground.”19 In addition, the authors describe research identifying specific information needs and communication difficulties of physicians and nurses that might contribute to errors. Although both groups identified gaps in information access that could result in poor clinical outcomes, the gaps were quite different, suggesting the need for very different informatics solutions. Moss et al. describe a data collection tool to analyze the communication involved in the coordination of patient flow by an operating room charge nurse. The paper also describes the evaluation of a specific communication artifact, the Operating Room Board, which might be the focus of an informatics solution to communication errors.

Protecting Confidentiality
Increasingly, clinical and genomic data collected as part of routine patient care are being made available to the research community as a way to support evidenced-based practice, conduct epidemiological studies, or develop predictive models. For researchers, using available data is very cost-effective-and for some types of studies is the only realistic way to collect the volume of data needed.20–22 However, there is a safety issue in the use of large data sets—protecting patients’ privacy.23,24 The two papers in this section identify, from an informatics perspective, the challenges in balancing patient privacy concerns with research needs.

Dreiseitl et al. identify a potential problem in the algorithms used for ambiguating data, a technique to assure privacy protection. Given sufficient computational power for a brute-force solution, “disambiguation” can ultimately result in retrieving information about specific individuals. Thus, anonymization techniques facilitate the release of large data sets for research, but may be insufficient for assuring patient privacy. Anonymization techniques also have implications for subsequent data use. One way to protect patient privacy is to eliminate any and all data elements that might be used as identifiers. Taken to the extreme, this may render the data set useless. However, if less restrictive algorithms are applied, patient privacy may be at risk. Ohno-Machudo, Vinterbo and Dreiseitl investigate the degree to which anonymization degrades the quality of the data set.

Implications for Nursing Informatics Curricula
Creating a safe patient environment is a very complex issue that will require the combined knowledge and skill of clinical informaticists, informatics faculty, researchers, and system designers. This milieu cannot be developed without vigorous informatics education informed by the novel approaches described in this selection of papers. Further implications for nursing informatics education include: (1) the standardization and defining of terms and taxonomies that represent knowledge of the domain and can be linked to a “patient-centered” ontology that also supports other disciplines; (2) student projects that require informatics students and developers to work collaboratively to improve current systems, particularly clinical decision support systems to prevent and detect adverse errors; (3) project development content that prepares students to conduct rigorous usability testing, provide appropriate system training, and adopt quality improvement models to evaluate the effectiveness and accuracy of automated systems; and (4) emphasis on communication, information needs, and complex clinical environmental issues as they relate to systems engineering and implementation. Finally, informatics faculty should work together with system designers to expand the development of collaborative, safety-related student informatics projects in a “real-time” laboratory environment.

Today’s modern medicine requires doctors to be constantly aware of new developments, new medications, and new procedures. With the influx of patients into the medical system, it is more essential than ever that the health care industry keep up. Health informatics is the combination of informational science, health care and computer technology. In the 1950s, health care experts realized the need to integrate health records of patients along with the use of computers. Originally, this process was called medical computing. By the 1970s, health informatics had taken over the medical world by storm. Doctors’ offices, hospitals, and small clinics were all using patient record keeping via computer to help better track treatment and patient progress.Informatics in Nursing and Healthcare Assignment Paper

There are many benefits to using health informatics. Through the use of computers, the Internet and various medical databases, doctors can better learn how to treat patients more effectively. The data retrieved by the use of heath informatics provides statistical information that can have a profound effect on how medicine is distributed, surgeries are performed, and how healing is tracked. It also helps hospitals better track patients’ past records so they can be treated faster in the future. The use of health informatics has opened up the doors for clinics to be more capable of treating patients in a more efficient manner, and helps these clinics refine their current process to make it more streamlined.

Medical software and record keeping programs are constantly being upgraded, and new programs are provided to help keep more accurate and detailed records of patients. This can also help to speed up the check-in process for patients when they arrive at a hospital or doctor’s office. Hand held portable devices are now also being used so that nurses and doctors can easily move throughout a large hospital or clinic, while still being able to access information at the touch of a button. Health informatics are also used at dentist offices so oral surgeons and dentists can coordinate patient treatment. This integration has provided medical professionals with an easy to use, fast method of accessing patient’s past medical history.

New technology can be an integral part of medicine, and health informatics is no exception. Through detailed patient medical records, clinics and hospitals have access to much more information, and can retrieve this information quicker than ever before. The development and combination of computer and medical science has opened the doors for medical specialists, and given patients a better chance at getting the best treatment possible.

Healthcare Informatics is defined as “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick, 2015, Pg. 232). Nursing Informatics is a subset of informatics, specific to the field and the roll of the nurse in the healthcare setting. The American Nurses Association (ANA) identified nursing informatics as “a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice” (ANA, 2001, Pg.17). Healthcare and nursing informatics are both vastly growing fields within the medical field and are continuously incorporating new and evolving technology. Both have been around for the past three decades, at least. The technology boom at the turn of the century has helped informatics and information systems further evolve. Enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved. With any new technology or innovation there are implications, some foreseeable and some that come to light after the unveiling of the new process or product. Some impacts that are most notable are clinical, managerial, and policy implications. This paper will explore the implications, both constructive and adverse, most notable in today’s healthcare world within the healthcare informatics and nursing informatics fields.Informatics in Nursing and Healthcare Assignment Paper

Clinical Implications
The use of informatics is seen in a multitude of processes within the clinical setting. Whether inpatient or outpatient, clinicians and patients utilize online portal systems, electronic medical records, data collection devices such as vital sign machines and glucometers, as well as personal data devices and email, to name a few. When considering these systems and how they affect the process and flow of the clinical setting, it is important to not only consider the technology at hand but also the workflow and the data collection process. Norris, Hinrichs, & Brown, tell us “gaps are present between the technology and the process. Informatics can help bridge that gap. Skills needed include understanding of data collection, storage, and extraction, in addition to an appreciation for the power of data to drive and inform practice” (2015, p. 11-12). Healthcare informaticists, especially nursing informaticists, are the prime group to help bridge that gap. Without a strong clinician presence in the building and implementation process, gaps will remain. With healthcare informaticists involved in the development, a strong product can be delivered that is usable to all members of the healthcare team.

President Obama signed the American Recovery and Reinvestment Act (ARRA) into law in 2009. This law includes the Health Information and Technology for Economic Clinical Health Act (HITECH). HITECH formulated the Meaningful Use (MU) program under the Centers for Medicare and Medicaid Services (CMS). Meaningful Use incentivizes providers to use their Electronic Health Records (EHR) by financially rewarding them when demonstrating their use, but also poses a threat by penalizing them if not used in the future (Norris, Hinrichs, & Brown, 2015). These Acts greatly impact both nursing and the healthcare field clinically. Providers who do not typically use an EHR are now finding themselves in a learning curve while still maintaining their patient caseload, and providing comprehensive care. However this vast amount of data collection across a multitude of healthcare settings has provided opportunity in enhancements of care. While the initial rollout of these initiatives may cause chaos, the benefits of these initiatives will allow clinicians to provide comprehensive, safe, evidence-based care to all of their patients. Health care staff will be able to quickly and safely access pertinent information on their patients throughout the health institution and beyond.Informatics in Nursing and Healthcare Assignment Paper

In addition to enhancements in care and improved evidence-based practice, the increased amount of data collected by EHRs and other data systems has created a massive amount of data that hospitals and health care organizations now have to manage and analyze. “This has led to increased demand for professionals who are well versed in both informatics and medicine. To meet this demand, the American Medical Informatics Association spearheaded the establishment of professional-level education and certification for physicians in informatics” (Simpao, Ahumada, Galvez, & Rehman, 2014, p. 45). We are now seeing a new influx of healthcare professionals entering this sub-specialty. The needs for these professionals to collect, interpret, and study the data and the operation of information systems is crucial to the success and usability of these systems. Lehman, Shorte, & Gundlapalli (2013) stated that “it is reasonable to predict that the number of leadership positions in clinical informatics with titles and roles such as chief medical informatics officer, chief health informatics officer, directors of clinical informatics, and lead of EHR implementation, etc., will increase in the near future” (p. 528).

Managerial Implications
The use of healthcare informatics is not only prevalent in the clinical setting but also in the managerial setting. In our society, communication comes in a multitude of applications: verbal, physical, and now electronic. We often find that individuals can contact us by using various applications such as telephone, fax, pager, instant messenger, email, and so on. It is crucial for those in managerial positions to utilize these information systems to aid their work and the work of their staff while being mindful to set limits and standards. Time management is a prevalent issue in the healthcare setting, thus the use of informatics to aid and organize and not create barriers is essential. However, these expansive communication tools can create stress and feelings of intake overload. Marquis & Huston (2013) suggested “to reduce interruptions and distractions, individuals should shut off their email, isolate themselves, and make sure the environment around them is working to strengthen their willpower and focus” (p. 189). Healthcare professionals need to ensure that they are utilizing informatics to aid their work and time management, not impeding them. Marquis & Huston (2013) go on to note that “creating a workspace that has a desk with enough clear space to do your work, good lighting, and a comfortable chair” is crucial (p.190).Informatics in Nursing and Healthcare Assignment Paper

Information systems in the managerial role often consist of interpreting information and modifying data to be utilized in decision-making processes. Managerial programs facilitate payroll functions, streamline material control, and assist with financial and administrative factors of their role (Pacheco de Souza, Santiago & Izu, 2015, p.7284). As seen in clinical implications, Meaningful Use also plays a role in the role of the manager. It is important for “nurse managers to utilize information from the EHR to show Meaningful Use and are important to the process of determining how information is organized and categorized within the EHR” (Biddle & Milstead, 2016, p.12). Without a nurse manager and other administrator identification of how to best capture and report Meaningful Use information, the healthcare organization may not be compliant with this aspect of the HITECH Act.
The continuously growing field of informatics is of great benefit to healthcare managers at all levels. Using this growing technology can greatly benefit their role and improve the function of their staff. Pacheco de Souza, Santiago, & Izu (2015) go on to acknowledge that this advancing technology “should be utilized as a management tool, giving power and autonomy to nurse managers in more efficient use of available technological resources” (p.7285). One example of this is where a unit may identify incomplete documentation on a given point of care. The nurse manager can then construct a workgroup of colleagues who are involved in the process including an IT specialist. Once this group identifies the issues and improved processes, they can present their recommendations to administration, ultimately improving documentation in the EHR (Biddle & Milstead, 2016). Thus, healthcare information systems can improve communication, time-management, and delivery of information amongst staff and patients.Informatics in Nursing and Healthcare Assignment Paper

Policy Implications
As previously noted in clinical implications and managerial implications, the amount of data that is now available from EHRs and other forms of information systems, is larger than healthcare providers have ever dealt with. Policy makers are now able to utilize this data to inform their decision-making about public-health issues. It is crucial now, more than ever, that epublic health staff are available at various levels of the health system to develop skills and knowledge to better utilize existing datasets. Adair (2012) identified guidelines to help public health officials understand, interpret, and best utilize this influx of information. “These guidelines were developed to assist public health officials assess the quality of existing health data, and effectively utilize such data to compute indicators to inform health sector policy-making” (p. 53). If policymakers are not able to thoroughly understand data derived from the utilization of electronic health records, patient portals, and other data sources, then people cannot expect them to make sound judgments when voting on new laws.

In this age of technology it is important that healthcare providers, managers, and informaticists are mindful of adhering to HIPAA regulations to ensure that growing technology is incorporated in current policies. With the use of EHRs and mobile health applications there is an increased “liability for healthcare organizations if there is a breach in patient confidentiality or privacy, which is why organizations must have policies in place that guide the use of telehealth and communication” (Biddle & Milstead, 2016). Ensuring proper policy is in place and that changes are made as needed when new technology is introduced is crucial.Informatics in Nursing and Healthcare Assignment Paper

McGowan, Cusack, and Bloomrosen (2012) wrote, “since 2006, the American Medical Informatics Association (AMIA) has convened an annual investigational Health Policy meeting to examine Cutting edge issues in healthcare and health information technology (health IT) policy” (p. 460). These meetings will identify and discuss potential issues with health IT and informatics as well as develop a plan and report to present to our nation’s policymakers so they are well informed when making and voting for pertinent policies and laws (McGowan, Cusack, & Bloomrosen, 2012). It is important that health professionals, information technology developers, and policymakers are able to communicate and work together in the interest of delivering the most efficient and safest patient care.

Meaningful Use is one example of health policy and health informatics working together. The initiative behind Meaningful Use was to encourage the use of Electronic Health Records in all health systems nationwide. However with this initiative, some providers may find themselves not being truthful in their documentation in order to meet the incentives set by the HITECH legislation. McGowan, Cusack, and Bloomrosen (2012), identified that “with the mandate for meaningful use of health IT by providers, there is ample opportunity for inappropriate and even fraudulent or illegal activities, ranging from lack of oversight to deliberate misrepresentation” (p. 461). Although dishonorable, some providers may lie to ensure their practice is able to receive the best monetary incentive by adhering to Meaningful Use measures and may alter their documentation to fit the criteria.Informatics in Nursing and Healthcare Assignment Paper

McGowan, Cusack, and Bloomrosen (2012) also identified policy concerns with health IT and informatics when discussing federal and state roles. Often federal and state regulations and health IT initiatives lack coordination. “Without explicit guidelines, proprietary state systems may be created, with many not being able to connect to the national health information infrastructure and some not acknowledging the healthcare systems that cross state lines” (McGowan, Cusack, and Bloomrosen, 2012, p.462). It is crucial that not only health professionals and government coordinate their objectives and policy, but also governing officials of the state and federal government. Conflicting or uncoordinated health initiatives may lead to patient and public mistrust as well as financial complications with both the government and health organizations.

Health informatics and nursing informatics are very relevant in evolving health systems. New technology and initiatives are constantly being developed. These new innovations do not go without implications in the clinical setting, managerial setting, and the policy setting. It is crucial that all participants whether it is the nurse, manager, provider, politician, lobbyist, or President of the United States remain coordinated. Multidisciplinary unity is crucial to ensure public trust in our health systems and to provide safe and effective patient care. Informatics in Nursing and Healthcare Assignment Paper


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