NURSING INFORMATICS AND HEALTHCARE POLICY

HEALTHCARE POLICY AND NURSING INFORMATICS AS University of Maryland and University of Utah and
A SPECIALTY one doctoral program in NI at the University of
Maryland.
 Nurses have contributed to the purchase, design and  Finally, in 1997, an NI specialty program was
implementation of IS since the 1970s. implemented at Duquesne University in Pittsburgh
 In 1992, the American Nurses Association (ANA)  The field of NI has slowly expanded since 1992.
recognized NI as specialty.
 Attempts in 1989 to be recognized as a specialty failed, HEALTHCARE POLICY IMPACT ON NURSING
but political forces within ANA supported the requests INFORMATICS PRACTICE
when it was repeated in 1992.
 To be acknowledged as a specialty with nursing,  Nursing Shortage and Nursing Informatics Nursing has
informatics had to demonstrate a differentiated practice experienced a number of shortages in recent history
base, identify the existence of educational programs in
the field, show support from nationally recognized  Unless something is done the shortage will rise
organizations, and develop a research agenda. from 6% in 2000 to 29% in 2020 or more than
800,000 nurses short of the number needed.
NURSING INFORMATICS (NI)  The bureau of Labor Statistics (BLS) is predicting
registered nurse positions will increase more than
-The term NI first appeared in the literature in the 1980s. 600,000 between 2002 and 2012.
 To cover these new positions and replace retiring
- NI was defined as the combination of nursing, nurses 1.1 million more nurses are needed by 2012.
information, and computer sciences to manage and  Nursing organizations have been actively
process nursing data into information and knowledge for use advocating for increased federal funding to expand
in nursing practice. programs and increase loans, scholarship, and
incentives to attract more young people into
-A specialty that integrates nursing science, computer
nursing.
science, and information science to manage and
 In 2002 the AAN Commission on Workforce
communicate data, information and knowledge in nursing
launched a multiphase project to develop IT that
practice.
will help nurses in their day-to-day work, thereby
-The domain of NI is focused on data and its structures, reducing the demands of their jobs.
information management, and the technology including  Given the average age of nurses is 45.2
database, needed to manage information effectively technology devices would enable some nurses to
stay in their careers longer.
-Also includes significant use of theory from linguistics,
human-machine interface, decision science, cognitive
science, communication, engineering, library science and
 Patient Safety and Nursing Informatics
organizational dynamics.
 The IOM determined that adverse events (injuries
DIFFERENTIATED AND INTERDISCIPLINARY PRACTICE caused by medical management) occurred in 2.9
and 3.7 of admission
 As the document emphasizes, NI brings an added  When these percents were applied to the number
dimension to nursing practice that focuses on of U.S. hospital admissions it was estimated that
knowledge and skill in information and information between 44,000 and 98,000 patients dies each year
management techniques. from medical errors
 NI practice differentiates itself from other areas of  Among other strategies the report recommended
nursing practice but emphasizes its interactions with the implementation of computerized physician
informatics discipline such as mathematics, statistics, order entry (CPOE) systems to reduced
linguistics, engineering, computer science and health medication errors.
informatics.  A follow-up report, strengthens the arguments for
 NI has been described as one example of a specific using technology to improve patient safety.
domain of informatics that falls under a broader  Proposal to increase patient safety with IT have
umbrella of health informatics. made by a variety of groups.

The National Alliance of Health Information

PREPARATION FOR SPECIALTY PRACTICE Technology (NAHIT) is a partnership of divers
healthcare leaders who are working to influence
 Educational programs the use of technology to improve the patient safety,
quality and efficiency.
 Between 1998 and 1992 the Division of Nursing
(DN), Health and Human Services Administration
(HRSA), funded two Masters NI programs,
 National Information Initiatives and Nursing  Telehealth- is the use of electronic information and
Informatics telecommunication technologies to support long-
 Clinical information systems (CIS) were distance clinical healthcare, patient and
introduced in some form during the 1970s and professional health-related education, public
informatics professionals have discussed the health, and health administration.
need for system improvement, integration,
and wider dissemination since that time.
 Escalating healthcare costs and the
availability of improved and cheaper CIS are
additional driving forces.
 An additional IOM report states even more
emphatically that electronic medical records,
using standard data elements, are a critical
tool to improve patient safety.
 On April 27, 2004, Pres. George W. Bush
issued an executive order Incentives for the
use of Health Information and Technology
and establishing the position of the National
Health Information Technology Coordinator.

National Health Information Infrastructure

 This voluntary initiative, involving a three
stage process over 10 years, is intended to
improve the effectiveness, efficiency, and
overall quality of health and healthcare in
the United States.
 NHII calls for comprehensive knowledge-
based networks that integrate clinical, public
health and personal health information to
improve decision making by having
information available to providers.

HEALTH INSURANCE PORTABILITY AND

ACCOUNTABILITY ACT (HIPAA)

 HIPAA was passed in 1996 and is intended to

improve public and private health programs by
establishing standards to facilitate the efficient
transmission of electronic health information
(Public Law, 104-191, 1996).
 HIPAA preempts state law and payer specific
variations of data standards; mandates input from
private, standard setting organizations.

NATIONAL AGENDA FOR NURSING INFORMATICS

 DN, HRSA is responsible for setting national

policy to guide the preparation of the nursing
workforce, including the preparation of the
area of the NI.
 DN convened the National Nursing
Informatics Workgroup (NNIWG) to make
recommendations to the National Advisory
Council for Nurse Education and Practice
(NACNEP)

Telehealth and Nursing Informatics

 Telehealth services have been provided for about

50 years but telehealth remains an underutilized
tool for nursing and NI.