Marlon Rey Anacleto, RN,MAN Professor

RESEARCH 1
History of Informatics in a country

History of NI
Standards or Terminologies used

Technology used in healthcare

New Trends and updates in Informatics or NI Deadline: MAY 3, 2012 11:59PM Email at adventcaremkt@gmail.com

CRITERIA IN REPORTING
Presentation Content Substance Individual participation 20 % 30 % 20 %

Relevance of Information
Creativity Total

10 %
20 % 100 %

Nursing Informatics in Asia

Korea 1970s computer intro 1987- KOSME 1993-1994 NI was taught in Universities 200-1000 active members as of 1995

PROGRESS REPORT
HEI 21-25 % teach HI both in Medical and Nursing 2001 introduction of informatics as a graduate course. Masters Degree offering Research Applications for Health informatics distance education standardization of terminologies and standards in vocabulary and documentation. AI use in Nursing DX

STANDARDS USED
HL7
http://www.hl7.org/documentcenter/public_temp_CA4631C5-1C23-BA170C08329F2EE95ED3/training/IntroToHL7/player.html

ISO/ TC 215 http://www.iso.org/iso/iso_technical_committee?commid=54960 ICD 10 ( KSCD ) SNOMED http://en.wikipedia.org/wiki/SNOMED NANDA NOC NIC ICNP HHCC

TECHONOLOGY TRENDS
WLAN TABLET PDA Telehealth telepathology Teleradiology PACS- Pictures Archiving and Communication System

JAPAN

Population: 127 million Number of Hospitals: 10,000 hospitals Number of Nurses: About 750,000 Number of Medical Doctors: 260,000 Number of Dentists: 90,000 Number of Pharmacists: 230,000

JAPAN
1970S 1980 Hosted the IMIA MEDINFO80 with the establishment of the JAMI. 1980s introduction of HI 1995-2003 start of independent creations of HI in more than 50 hospitals. standardization of terminologies and standards set.

PROGRESS REPORT
1990s introduction of computers to elementary students 2004 NI in education 486 schools NI as a specialty is not accredited- hospital based

STANDARDS USED
E-Japan ICD 10 2003 japanese version MISDC Omaha System CPOE HL7 DICOM

TECHNOLOGY TRENDS
TeleHealth Telemedicine PACS

CHINA

Population 1.3 Billion as of 2000 Aging population 6.96 % Relatively more educated Ratio 1 nurse : 1000 population

HI awareness started due to SARS leads to the formation of CMIA CSMI CHIMA 20 Hospitals started as core group in Informatics

EDUCATION
1983-2001 120 schools 3 yr Nursing course Computer subject is an elective NI in China includes: Nursing Quality Management Staff Management Nursing Information Management Training Clinical Skills for Staff Nurses Lack of National Standards and low level of Computer literacy

THAILAND
65 million population Recently launched UNIVERSAL HEALTHCARE COVERAGE 1997- 2004 NI was introduced thru MOPH Development of NMDS ICNP launched NIS in Nursing called Healthware 2000

THE FUTURE OF NI
Bar Coding

Bioinformatics/ Computational Biology- is the application of computer science and information technology to the field of biology and medicine. Bioinformatics deals with algorithms, databases and information systems, web technologies, artificial intelligence and soft computing, information and computation theory, software engineering, data mining, image processing, modeling and simulation, signal processing, discrete mathematics, control and system theory, circuit theory, and statistics. Commonly used software tools and technologies in this field include Java, XML, Perl, C, C++, Python, R,MySQL, SQL, CUDA, MATLAB, and Microsoft Excel. Claims Processing- Insurance Claims Client Server System- ATM Data Warehousing-In computing, a data warehouse (DW) is a database used for reporting and analysis. The data stored in the warehouse are uploaded from the operational systems (such as marketplace, sales etc. The data may pass through an operational data store for additional operations before they are used in the DW for reporting.

Decision Support-A decision support system (DSS) is a computer-based information system that supports business or organizational decision-making activities. DSSs serve the management, operations, and planning levels of an organization and help to make decisions, which may be rapidly changing and not easily specified in advance. DSSs include knowledge-based systems. A properly designed DSS is an interactive software-based system intended to help decision makers compile useful information from a combination of raw data, documents, and personal knowledge, or business models to identify and solve problems and make Disease Management Outcomes-system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant EHR-Clinical Information System Computer-Based Patients records-Hospital High Speed Networks- 3G, 4G LTE, CDMA, Wifi networks, WIMAX HIPAA Compliance Smart CardsLaboratory Information Management System-

FUTURE TRENDS
Medication Error prevention Mobile computing technologies Outsourcing Devices POC computing Practice Management Prescription Management Scheduling Security upgrades Speech recognition Standards Supply Ordering TeleHealth Vocabulary integration interface Web Portals access to consumers

TRENDS IN HEALTH AFFECTING IT

Demographics Growth in Chronic Diseases Emerging infectious diseases Changes in health seeking behaviour towards the net Focus on quality= Focus on IT Security and biodefense Genetic Revolution

EMERGING INFECTIOUS DISEASES

FLU RESPIRATORY INFECTIONS HIV/AIDS DIARHEAL DISEASES TB MALARIA MEASLES PERTUSIS TETANUS MENINGITIS SYPHILIS ANTIOBIOTICS RESISTANT DISEASES

PRACTICE APPLICATIONS
According to Nightingale: Decision making must be based upon the use of accurate data

According to Graves and Corcoran

A combination of computer science, information science, and nursing science designed to assist in the management and processing of nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care

AMERICAN NURSES ASSOCIATION

A specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, and research and to expand nursing knowledge. The purpose of nursing informatics is to analyze information requirements; design, implement and evaluate information systems and data structures that support nursing; and identify and apply computer technologies for nursing.

STANDARDS FOR PRACTICE

Competencies 1. Computer literacy skills 2. Information literacy skills 3. General informatics competencies identify, collecting, recording

STANDARDS OF PRACTICE
According to: Problem Solving Framework Assessment Diagnosis Identification of outcomes Planning Implementation Evaluation

NURSING DOCUMENTATION
NANDA NIC HHCC Home Health Clinical Care Omaha System NOC NMMDS Nursing Management minimum data standards PCDS Patient Care Data Set PNDS Peri Operative Data Set SNOMED CT NMDS ICNP International Classification for Nursing Practice ABC Codes Alternative Billing Codes LOINC Logical Observation Identifiers Names and Codes

OMAHA SYSTEM
PROBLEM RATING SCALE OUTCOME
Concepts 1 2 3 4 5 Knowledge: No knowledge Minimal knowledge Basic knowledge Adequate knowledge Superior knowledge

Ability of the client to remember and interpret information Behavior: Not appropriate behavior Rarely appropriate behavior Inconsistently Usually appropriate appropriate behavior behavior Consistently appropriate behavior

Observable responses, actions, or activities of the client fitting the occasion or purpose Status: Extreme signs/ symptoms Severe signs/ symptoms Moderate signs/ symptoms Minimal signs/ symptoms No signs/ symptoms

Condition of the client in relation to objective and subjective defining characteristics

CONSUMERS USE OF INFORMATICS

PHR Personal Health Record ICD 9/10 CPT4 UMLS Unified Medical Language System e.g. RecordSmart, Myhealth123, Health-Minder, WebMD, Personal Health Manager

MyDiabetes.com MyAsthma.com

DECISION SUPPORT
Usually integrated in some health websites to monitor patients health record. Other medical sites offer DSS protocols such at www.mayoclinic.com, WebMD, www.lungusa.com

NURSES ROLE IN CONSUMER

AND

PATIENT COMPUTING
a.

Scope and Standards of NI practice Nursing areas expertise applied to consumer and patient computing Special consideration in designing applications for patients and consumers.

a.

a.