NURSING INFORMATICS

LECTURE / WEEK 1 & 2

PPT / BOOK

NURSING INFORMATICS AND COMPUTER Systematic, rational method of

SYSTEM BASICS planning that guides all nursing
actions in delivering holistic and
patient-focused care. The nursing
Nursing Process
OUTLINE process is a form of scientific
I Nursing Informatics reasoning and requires the nurse’s
II Definition of Terms critical thinking to provide the best
III Historical Perspective of Nursing Informatics and care possible to the client.
Computer
IV Computer system basics – hardware A person who has completed a
program of basic, generalized
nursing education and is authorized
I. NURSING INFORMATICS by the appropriate regulatory
 A specialty that integrates nursing, science, computer authority to practice nursing in his/her
science, and information science to manage and country. Basic nursing education is a
communicate data, information, and knowledge in formally recognized programme of
nursing practice (ANA, 2001) study providing a broad and sound
 It is a phrase that evolved from the French word foundation in the behavioural, life,
“informatique” which referred to the field of applied and nursing sciences for the general
computer science concerned with the processing of practice of nursing, for a leadership
information such as nursing information role, and for post-basic education for
specialty or advanced nursing
practice
Nurse The nurse is prepared and authorized
 To engage in the general scope
of nursing practice, including the
promotion of health, prevention
of illness, and care of physically
ill, mentally ill, and disabled
people of all ages and in all
INFROMATICS IN NURSING health care and other community
settings
 to carry out health care teaching
 To participate fully as a member
of the health care team
 To supervise and train nursing
and health care auxiliaries
 To be involved in research

Information Technology is the use of

any computers, storage, networking,
physical devices, infrastructure, and
NURSING processes to create, process, store,
 Nursing encompasses autonomous and collaborative secure, and exchange all forms of
care of individuals of all ages, families, groups and Information electronic data
communities, sick or well and in all settings Technology
 Nursing includes the promotion of health, prevention of Health information technology refers
illness, and the care of ill, disabled and dying people to the electronic systems health care
 Advocacy, promotion of a safe environment, research, professionals and increasingly,
participation in shaping health policy and in patient and patients use to store, share, analyze,
health systems management, and education are also health information
key nursing roles
 Nursing, as an integral part of the health care system, PURPOSE OF THE NURSING PROCESS
encompasses the promotion of health, prevention of  To identify the client’s health status and actual or
illness, and care of physically ill, mentally ill, and potential health care problems or needs (through
disabled people of all ages, in all health care and other assessment).
community settings  To establish plans to meet the identified needs.
 Within this broad spectrum of health care, the  To deliver specific nursing interventions to meet those
phenomena of particular concern to nurses are needs.
individual, family, and group "responses to actual or  To apply the best available caregiving evidence and
potential health problems" promote human functions and responses to health and
illness (ANA, 2010).
II. DEFINITION OF TERMS  To protect nurses against legal problems related to
nursing care when the standards of the nursing process
TERMS DESCRIPTION are followed correctly.

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 To help the nurse perform in a systematically organized  Automation in public health agencies began as a result
way their practice. of pressure to standardize data collection procedures
 To establish a database about the client’s health status, and provide state-wide reports on the activities and
health concerns, response to illness, and the ability to health of the public
manage health care needs.  In the 1970s, conferences sponsored by the Division of
Nursing (DN), Public Health Service (PHS), and the
III. MAJOR JISTORICAL PERSPECTIVE OF National League for Nursing (NLN) helped public health
NURSING INFORMATICS AND COMPUTER and home health nurses understand the importance of
nursing data and their relationship to new Medicare and
1930s – EARLY 1940s Medicaid legislation requirements passed in 1966
 The conferences provided information on the
 Computers were first developed usefulness of computers for capturing and
aggregating home health and public health
PRIOR TO 1960 information
 Increasing number of transistors or chips placed in an  Additional government-sponsored conferences
integrated circuit focused on educational uses of computers for
 Use of computers in the healthcare industry did not occur nurses
until the 1950s and 1960s  The Clinical Center at the National Institutes of Health
 There were only a few experts nationally and implemented the Technicon Data System (TDS) system;
internationally who formed a cadre of pioneers that one of the earliest clinical information systems (called
adapted computers to healthcare and nursing which was Eclipsys & Allscripts) was the first system to include
undergoing major changes nursing practice protocols.
 Several professional advances provided the impetus for  The first point-of-care blood glucose monitor became
the profession to embrace computers as a new available for use in the clinical setting in 1970
technological tool  The devices became smaller and more widespread
 Computers were initially used in healthcare facilities for in the 1980s
basic office, administrative, and financial accounting  Bitzer (1966) reported on one of the first uses of a
functions computerized teaching system called PLATO, which was
 These early computers used punch cards to store data implemented to teach classes in off- campus sites as an
and card readers to read computer programs, sort, and alternative to traditional classroom education.
prepare data for processing
 Computers were linked together and operated by paper 1980s
tape using teletypewriters to print their output  The field of nursing informatics exploded and became
 As computer technology advanced, healthcare visible in the healthcare industry and nursing.
technologies also advanced Technology challenged creative professionals in the use
of computers in nursing
1960s  The microcomputer or personal computer (PC)
 During the 1960s the uses of computer technology in emerged
healthcare settings began to be explored  Revolutionary technology made computers more
 Questions such as “Why use computers?” and “What accessible, affordable, and usable by nurses and
should be computerized?” were discussed other healthcare providers
 Studies were conducted to determine how computer  Served as dumb terminals linked to the mainframe
technology could be utilized effectively in the healthcare computers and as stand-alone systems
industry and what areas of nursing should be automated. (workstations)
 The nurses’ station in the hospital was viewed as the hub  User-friendly and allowed nurses to design and
of information exchange; therefore, numerous initial program their own application
computer applications were developed and implemented  The automated dispensing cabinets (ADCs) were
in this location introduced in the 1980s
 Increasingly complex patient care requirements and the  The computer controlled ADCs replaced
proliferation of intensive care units (ICUs) required that medication carts and drug floor stock
nurses become super users of computer technology as  Tracking of medications occurred at the point of
nurses monitored patients’ status via cardiac monitors care
and instituted treatment regimens through ventilators  The use of ADCs in the clinical setting has resulted
and other computerized devices such as infusion pumps in the reduction of medication errors.
 A significant increase in time spent by nurses  Starting in 1981, national and international conferences
documenting patient care, in some cases estimated at and workshops were conducted by an increasing
40%, as well as a noted rise in medication administration number of nursing pioneers to help nurses understand
errors prompted the need to investigate emerging and get involved in this new emerging nursing specialty
hospital computer-based information systems  Many mainframe healthcare information systems (HISs)
emerged with nursing subsystems
1970s  These systems documented several aspects of the
patient record, namely, provider order entry and
 During the late 1960s through the 1970s, hospitals results reporting, the Kardex reporting, vital signs,
began developing computer-based information systems and other systems-documented narrative nursing
which initially focused on computerized physician order notes using word-processing software packages.
entry (CPOE) and results reporting; pharmacy, Discharge planning systems were developed and
laboratory, and radiology reports; information for used as referrals to community, public, and home
financial and managerial purposes; and physiologic healthcare facilities for the continuum of care.
monitoring systems in the intensive care units; and a few  Nurses began presenting at multidisciplinary
systems started to include care planning, decision conferences and formed their own working groups within
support, and interdisciplinary problem lists HIT organizations, such as the first Nursing Special
 Interest in computers and nursing began to emerge in Interest Group on Computers which met for the first time
public health, home health, and education during the during SCAMC (Symposium on Computer Applications
1960s to 1970s in Medical Care) in 1981.

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 The American Nurses Association approved the  Wireless, point of care, regional data- base projects, and
formation of the Council on Computer Applications in increased IT solutions proliferated in healthcare
Nursing (CCAN) environments, but predominately in hospitals and large
 The CCAN board developed a yearly Computer Nurse healthcare systems
Directory on the known nurses involved in the field,  The use of bar coding and radiofrequency identification
conducted computer applications demonstrations at the (RFID) emerged as a useful technology to match the
ANA annual conferences, and shared information with “right patient with the right medication” to improve patient
their growing members in the first CCAN newsletter safety
Input-Output  Smaller mobile devices with wireless or Internet access
 The first edition of this book Essentials of Computers for such as notebooks, tablet PCs, personal digital
Nurses published in 1986, were used for educational assistants (PDAs), and smart cellular telephones
courses introduced in the academic nursing programs, increased access to information for nurses within
and workshops conducted on computers and nursing hospitals and in the community
 In 1989, the ANA renamed the CCAN to the Steering  The Internet which appeared in 1995 provided a means
Committee on Databases to Support Clinical Nursing for the development of clinical applications. Also,
Practice, which later became the Committee for Nursing databases for EHRs could be hosted remotely on the
Practice Information Infrastructure (CNPII) Internet, decreasing costs of implementing EHRs
 The purpose of the CNPII was to support  One of the first ONC initiatives was the Healthcare
development and recognition of national health Information Technology Standards Panel (HITSP) which
data standards was designed to determine what coding systems were
used to process patient care data from admission to
1990s discharge
 Large integrated healthcare delivery systems evolved
 In 1992, the ANA recognized nursing informatics as a 2010
new nursing specialty with a separate Scope of Nursing  Designed the “Meaningful Use” (MU) program which was
Informatics Practice Standards, and also established a to be implemented in three stages of legislation
specific credentialing examination for it consisting of regulations which built onto each other with
 The demand for NI expertise increased in the the ultimate goal of implementing a complete and
healthcare industry and other settings where interoperable EHR and/or HIT system in all U.S.
nurses functioned, and the technology revolution hospitals
continued to impact the nursing profession.  Nurses have always been involved with all phases of MU
 In 1997, the ANA developed the Nursing Information and as well as all other legislation, from the implementation
Data Set Evaluation Center (NIDSEC) to evaluate and of systems to assuring usage and adaptation to the
recognize nursing information systems. The purpose evolving health policy affecting the HIT and/or EHR
was to guide the development and selection of nursing systems. Thus, the field of nursing informatics (NI)
systems that included standardized nursing continues to grow due to the MU regulations which
terminologies integrated throughout the system continue to impact on every inpatient hospital in the
whenever it was appropriate. There were four high-level country
standards:  To date, the majority of hospitals in the country has
 Inclusion of ANA-recognized terminologies established HIT departments and has employed at least
 Linkages among concepts represented by the one nurse to serve as a NI expert to assist with the
terminologies retained in a logical and reusable implementation of MU requirements
manner;
 Data included in a clinical data repository IV. COMPUTER SYSTEM BASICS – HARDWARE
 General system characteristics  Given the essential nature of computers in maintaining
 Computer hardware—PCs—continued to get smaller society, nurses today should know the basics of
and computer notebooks were becoming affordable, computer parts and how they work
increasing the types of computer technology available  Computer hardware is defined as all of the physical
for nurses to use. Linking computers through networks components of a computer
both within hospitals and health systems as well as  The basic hardware of a computer composes the
across systems facilitated the flow of patient information computer’s architecture, and includes the electronic
to provide better care. circuits, microchips, processors, random access
 By 1995, the Internet began providing access to memory (RAM), read-only memory (ROM), the BIOS
information and knowledge databases to be integrated chip, and graphic and sound cards
into desktop computer systems  Computers and associated software programs were
 It revolutionized information technologies developed to assist with hospital bed assignment, nurse
 The Internet moved into the mainstream social staffing and scheduling support, and computer-based
milieu with electronic mail (e-mail), file transfer charting
protocol (FTP), Gopher, and Telnet, and World  Today, many of the hospital’s communication processes
Wide Web (WWW) protocols greatly enhanced its
are computer based, including programs that support
usability and user-friendliness
patient communication with the system (often called
 The Internet was used for high-performance
patient portals), ordering from labs, radiology, pharmacy,
computing and communication (HPCC) or the
and dietary, and all the other services that are ordered
“information superhighway” and facilitated data
to support patient care
exchange between computerized patient record
 Major advances in miniaturization and computer:
systems across facilities and settings over time
 Non-invasive visualization of human body’s internal
structure, metabolic and movement functions
2000s  Computer-enhanced surgical instruments enabled
 In 2004 an executive order 13335 established the Office surgeons to insert endoscopy tools that allow for
of the National Coordinator for Health Information both visualization and precise removal of dis-
Technology (ONC) and issued a recommendation eased tissues, leaving healthy tissues minimally
calling for all healthcare providers to adopt interoperable damaged and the patient
EHRs by at least 2014 or 2015

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 Computers allow for distance visualization and  Defined as any equipment that translates the computer
communication with patients in remote areas. information into something usable by people or other
Telemedicine is now being used to reduce the machines
impact of distance and location on accessibility and  Output can be in the form of text, data files, sound,
availability of healthcare graphics, or signals to other devices
 Output devices are the monitor (display screen) and
REQUIRED HARDWARE COMPONENTS OF A printer
COMPUTER  Other commonly used output devices include storage
 Attached to the motherboard, which is the heart of any devices such as the USB drive (also known as flash or
computer thumb drive) and optical media
 Thin, flat sheet made of a firm or flexible non
conducting material on which the internal
components — printed circuits, chips, slots
 Main circuit board that connects the different parts
of a computer together
 Key component of a computer is called the BIOS chip
(Basic input/output System)
 Computer program stored on a permanent (non-
volatile) memory chip on the motherboard
 Controls several essential operations of a
computer, including start-up, performing a self-test Infusion Pump Heart Monitor
of the system to ensure the operating system can
function, and communication with input and output
devices
STORAGE MEDIA
 Includes the main memory but also external devices on
MEMORY which programs and data are stored
 The most common storage device is the computer’s hard
 Storage media
drive
 Electronic storage devices or chips on the motherboard
 Other common media include external hard drives, flash
of a computer
drives, and read/write digital versatile disks (DVDs), and
 Includes the locations of the computer’s internal or main
compact disks (CDs)
working storage
 Hard Drive
 Random Access Memory (RAM)
 Main storage device of many personal computers
 Working memory used for primary storage
and is typically inside the case or box that houses
 Used as temporary storage by the CPU and other
other internal hardware
processors for holding data and commands the
 USB/Flash Drive
processors are actively using
 A form of a small, erasable, programmable, read-
 Also known as main memory, RAM can be
only memory (EPROM), a bit like the ROM chips in
accessed, used, changed, and written on
a computer
repeatedly
 It functions a bit like a removable hard drive that is
 Read Only Memory (ROM)
inserted into the USB port of the computer
 Form of permanent storage of a computer
 Optical Media
 It carries instructions that allow the computer to be
 Include compact disks, digital versatile disks, and
booted (started), and other essential machine
Blu-Ray
instructions
 Other Storage Device
 Data and programs in ROM can only be read by the
 Zip drives (mini magnetic tape device)
computer and cannot be erased or altered by users
 Never erased  Cloud Storage
 Cache  Data stored “in the Cloud” is still stored on
commercial computers called servers
 Smaller form of RAM
 Its purpose is to speed up processing by storing  “Cloud” refers to a distributed system of many
frequently called (used) data and commands in a commercial, networked servers that communicate
small, rapid access memory location through the Internet and work together so closely
that they can essentially function as one large
system. Enormous numbers of servers that store
INPUT DEVICES data are physically located in many warehouse-
 Allow the computer to receive information from the sized buildings
outside world
 The most common input devices are the keyboard and
mouse
 Others commonly seen on nursing workstations include
the touch screen, light pen, microphone, and scanner

Light Pen ECG Electrode Pulse Oximeter

5 MAJOR TYPES OF COMPUTER
OUTPUT DEVICES
 Allow the computer to report its results to the external SUPERCOMPUTERS
world  The largest type of computer
 First developed by Semour Cray in 1972

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 It is a computational-oriented computer specially

designed for scientific applications requiring a gigantic
amount of calculations which, to be useful, must be
processed at superfast speeds
 Designed primarily for analysis of scientific and
engineering problems and for tasks requiring millions or
billions of computational operations and calculations,
they are huge and expensive
 Used primarily in such work as defense and weaponry,
weather forecasting, advanced engineering and physics,
and other mathematically intensive scientific research
applications

MAINFRAMES
 Most common fast, large, and expensive type of
computer used in large businesses (including hospitals
and other large healthcare facilities) for processing,
storing, and retrieving data
 A large multiuser central computer that meets the
computing needs of large- and medium-sized public and
private organizations.

MICROCOMPUTERS (PERSONAL COMPUTER)

 Computers designed to support a single user are
 Much smaller and less powerful than a mainframe
 Designed to be used by one person at a time.
 Hospital nursing departments use PCs to process
specific applications such as patient classification, nurse
staffing and scheduling, and personnel management
applications

HANDHELD COMPUTERS AND PERSONAL

DIGITAL ASSISTANTS (PDAs)
 Smaller in size than laptops and notebook
microcomputers, some have claimed to have the same
functionality and processing capabilities
 PDAs are the smallest handheld computers.
 PDA is a very small special function hand-held computer
that provides calendar, contacts, and note- taking
functions, and may provide word processing, spread
sheet, and a variety of other functions
 Originally sold as isolated devices, today PDAs have
mostly been supplanted by smartphones which combine
limited computing power with telephone functionality
 The processors for most smartphones, tablet computers,
and other small but powerful devices are made by
several companies, such as Apple, Samsung (Exynos),
Qualcomm (Snapdragon), and Huawei
 Two major hardware platforms and operating systems
for smartphones and tablet computers
 Apple Corporation’s iPhone and iPad using the iOS
operating system
 Smartphones and tablets using the Android
operating system (including the Samsung
products)

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NURSING INFORMATICS
LECTURE / WEEK 3
PPT / BOOK

COMPUTER SYSTEMS BASICS- SOFTWARE AND  Antivirus

INFORMATION TECHNOLOGY SYSTEM  Guard against malicious programs inadvertently
APPLICABLE IN NURSING PRACTICE accessed, usually through e-mail or downloads
from the internet
 Firewalls
OUTLINE  Type of security program that makes it much harder
I Software for unauthorized persons or systems to enter the
II The National Ehealth Program computer and hijack or damage programs or data
III Public Health Information System on the computer (encryption software)

I. SOFTWARE
 It is the general term applied to the instructions that
direct the computer’s hardware to perform work.
 Encryption id a way of scrambling data so that only
 Hardware consists of physical components, whereas
authorized parties can understand the information.
software consists of instructions communicated
It is the process of converting human-readable
electronically to the hardware.
plaintext to incomprehensible text, also known as
 Purpose: (a) needed to translate instructions created in
ciphertext. It requires the use of cryptographic key
human language into machine language; (b) packaged
or set of mathematical values that both the sender
or stored software is needed to make the computer an
and the recipient of an encrypted message agree
economical work tool.
on
 Programs or ”apps”
 Organized instruction set of software
 Package- set of related programs
SYSTEM MANAGEMENT UTILITIES
 Designed to help the user keep the computer system
CATEGORIES OF SOFTWARE running efficiently
 Disk management utilities
SYSTEM SOFTWARE
 Boots up (starts up or initializes) the computer system BACKUP UTILITIES
 Controls input, output, and storage  Help the users back up their data
 Controls the operations of all other software  Different from external drives and cloud storage
 Application programs may be backed up, but usually is
BASIC INPUT/OUTPUT SYSTEM (BIOS) not necessary because legal copies of programs can be
reloaded by the person who bought the license
 First level of system control stored on a read-only
memory (ROM) chip on the motherboard.
 Combination of hardware and software SCREEN SAVERS
 It is a chip with software (firmware) that first to control  Computer programs that either blank the monitor or fill it
function on a computer when turned on with constantly moving images when the user is away
from the computer but does not turn it completely off
OPERATING SYSTEM (OS)
 First level system software
ARCHIVAL SOFTWARE
 Over-all controller of the work of the computer  Compresses information in files to be archived then
 Handles the connection between the CPU and stores them in a compressed form in some long-term
peripherals storage device
 Interface  When files are retrieved, software must be used to
 The connection between the CPU and a peripheral unpack or decompress the data so it can be read
or a user  WinZip and WinRar are well-known archival utilities
 One of the most critical tasks performed by the OS on Windows
involves the management of storage
PROGRAMMING ENVIRONMENT SUPPORT
UTILITY PROGRAM PROGRAMS
 Consists of programs designed to support and optimize  Used by program developers to support their
the functioning of the computer system itself programming work or to run their programs
 Helps maintain the computer system’s speed. Clean  Computers cannot read or understand English or any
unwanted programs, protect the system against virus human language
attacks, access the World Wide Web, and the like
 They do this by adding power to the functioning of the APPLICATION SOFTWARE
system software or supporting the OS or application  Programs that perform the business or personal work
software programs people use the machine to do
 Applications software that includes all various programs
SECURITY SOFTWARE people use to work, process, play games, communicate
 Include anti-virus, firewall, encryption programs, protects with others, and watch videos and multimedia programs
the computer and its data from attacks that can destroy on a computer
programs and data  Nursing application programs are typically part of a
hospital or healthcare organizations. Hospitals usually

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have a large information system called a Hospital or TYPES OF NETWORK

Health Information System (HIS) or Health Information
Technology System (HITS) POINT-TO-POINT
 These systems include most of the business applications
 A very small network in which all parts of the system are
needed, such as billing, payroll, budget management,
inventory control (for the hospital’s Central Supply directly connected via wires or wireless (typically
department), personnel applications, etc. They also provided by a router in a single building)
include clinical and semi-clinical systems, such as
laboratory, pharmacy, admissions and patient locator, LOCAL AREA NETWOK (LAN), WIDE AREA
order entry/results reporting, and the electronic medical NETWORK (WAN), AND METROPOLITAN AREA
record (EMR) or electronic health record (EHR), that NETWORK (MAN)
contain the clinical documentation or hospital charts for  Sequentially larger and given the number of users, they
patients. require communications architecture to ensure all users
on the network are served
COMMON SOFTWARE USEFUL TO NURSES
 Electronic medical record for charting patient care INFORMATION SCIENCE
 Admission-discharge- transfer (ADT) systems that help  Interdisciplinary field primarily concerned with the
with patient tracking analysis, collection, classification, manipulation, storage,
 Medication administration record (MAR) software retrieval, movement, dissemination, and use of
 Laboratory systems that are used to order laboratory information
tests and report the results
 Supplies inventory systems, which nurses change IVs, KEY THEMES
dressings, and other supplies used in patient care
OPTIMALITY
Health
Health Information System in
Information  Varies with the situation, but generally refers to
Public and Primary Health achieving an optimum value for some desired outcome
System in
Facilities  When a nurse wants to obtain information on
Hospitals
outcomes of patients that suffered a complication
Integrated Hospital for the purpose of determining whether they were
eField Health Service Information Management rescued or not, the optimal outcome is that the
System Information search facility in the information system finds all
System patient records for patients who were truly at risk,
and does not miss any. Additionally, the system
Integrated Tuberculosis Information retrieves few if any records of patients who did not
Bizbox, Inc. suffer a high-risk complication
System
 Almost any variable that is measured on a numerical
Unified diseases Registry System scale
 Online National Electronic Injury  Cost, time, workload
Surveillance System
 National Rabies Information Kccl Medsys PERFORMANCE
System  Context of average performance of the information
 National Online Stock Inventory
system over a series of communication instances
System
 Average are better representations of performance than
Philippine Integrated Disease a long lists of single instance performance
Comlogik  The average time it takes for an e-mail to reach the
Surveillance and Response
intended recipient is much more useful than a long
Electronic Medical Records list of each e-mail and its transmission time
 Integrated Clinic Information
System (iClinicSys) (non- COMPLEXITY
functional)
 Community Health Information  Reality with the enormous masses of data and
Tracking System (CHITS) information generated, collected, stored, and retrieved
 Segworks  A typical measure of complexity in informatics is the
 e Health Tablet for Informed amount of time it takes to complete a task
Decision-making (eHATID)
 Secured Health Information STRUCTURE
Network and Exchange (SHINE)  Developing a system for ordering and cataloguing the
 Wireless Access for Health data and information, particularly in a database
(WAH- Electronic Health  Excellent structure serves to reduce the amount of time
Record) required to perform operations on the database, such as
retrieve, update, sort, etc.
COMPUTER SYSTEMS  When data are well structure and catalogued in a
 Consists of organized set of interconnected components database, complexity can actually be reduced because
or factors that function together as a unit to accomplish the system will not have to review all the data to find
results that one part alone could not particular items
 May refer to a single machine and its peripherals and
software that is unconnected to any other computer II. THE NATIONAL EHEALTH PROGRAM
 However, most healthcare professionals use computer
systems consisting of multiple, interconnected PHILIPPINE HEALTHCARE SYSTEM CHALLENGES
computers that function to facilitate the work of groups of
providers and their support people in a system called a ACCESS TO HEALTHCARE SERVICES
network.  Inequity and inequality in healthcare financing for patient
and providers
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 Inadequate and inequitable distribution of health FOUR STRATEGIC PILLARS

workforce  Health Financing, Health Service Delivery, Health
 Facility infrastructure and service delivery network Regulation, Good Governance in Health
challenges  Ensure generation and use of evidence in health policy
 Access to healthcare services is not ideal as inequity and development, decision-making, and program planning
inequality pervade our healthcare system in terms of and implementation
financing, distribution of our health workforce, the need  This will in turn aid in the attainment of the National
to catch up with the demand for health facility Health Agenda embodied in the Fourmula Plus One
infrastructure and challenges to the stability of the strategic framework (known as F1 Plus) that sustains
service delivery network particularly at the local level. and further strengthens the achievement of health sector
reform in financing, service delivery, regulation and
ACCESS TO REAL-TIME INFORMATION FOR governance
DECISION-MAKING  The Plus in F1 Plus alludes to the inclusion of an
additional strategic pillar of Performance Accountability
 Weak regulatory powers and implementation of policies
which attempts to monitor the accomplishment of set
 Weak institutional accountabilities, including inadequate
targets as closely as possible to real-time status of
response and feedback mechanisms
program implementation through the continuous
 Delayed submission and poor quality of clinical, monitoring of priority scorecard indicators
administrative, and financial data
 Problematic policy implementation, weak institutional EGOVERNMENT MASTER PLAN FRAMEWORK
accountabilities and an over-all sluggish deployment of
ICT solutions to facilitate submission of quality clinical,
administrative and financial data are seemingly
overwhelming

CHALLENGES OF UTILIZATION OF ICTs FOR

HEALTH

Challenges Examples
Many data or health
information coming from
disparate systems (EMRs)
and locations
mm/dd/yyyy NATIONAL EHEALTH PROGRAM
Different data formats
yyyy/mm/dd  Interagency initiative spearheaded by DOH in
‘F’ Female and ‘M’ Male partnership with Philhealth, DOST, DICT, UP Manila,
Different data codes and key stakeholders from other public and private
1 Female and 2 Male
sectors, otherwise known as the National eHealth
Available data are Governance Committee
Poor data quality
outdated, 3 years late  Aim is to direct and regulate the practice of eHealth in
Lack of terminologies and the country
Sex, gender, lab results
meanings
SPECIFIC AIMS
DOH collets data
Lack of harmonization in  Establish a system of rules and essential components
Philhealth collets the
processes that will:
same data
 Direct and regulate action of providers
 Streamline and make system and services
PHILIPPINE DEVELOPMENT PLAN interoperable
 Ensure patient safety and protection
 Define and guarantee quality of service
 Define and institutionalize governance mechanism
to achieve coherence, cooperation and
complementation
 Avoid duplication among eHealth services and
efforts among government agencies with the
private sector
 Define a budget to finance and sustain it

VISION
 By 2022, an ICT-enabled Philippine Health System
towards better and equitable access to quality health
care services, and easier access to secure real time and
quality health data and information for evidenced-based
 The DOH Information Systems Strategic Plan and decision making
Updated Philippine eHealth Strategic Framework and
Plan MISSION
 These are meant to address the challenges that were  To effectively stimulate and establish the use of
mentioned in order to further strengthen the Philippine harmonized and relevant information and
Health Information System which supports the fulfillment communications technologies to improve healthcare
of the mandate of the DOH as well as the whole health delivery, administration and management, and
sector communicating health to Filipinos

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NATIONAL EHEALTH PROGRAM COMPONENTS and Technology and Information and Communications
Technology.
 A National eHealth Technical Working Group provides
oversight over all components:
 Leadership governance and multi-sector
engagement
 Legislation, policy and compliance
 Strategy and investment
 Standards and operability
 E-Health solutions
 Human Resource

PRIMARY HEALTHCARE FACILITY EMR

ADOPTION MODEL
Specific eHealth solutions were taken from the WHO
framework and recommendations:
 Information sources
 Delivery of services and
 Information flows

EHEALTH ROAD MAP

HIGHLIGHTS OF OUR EMR SYSTEM

DEVELOPMENT AND DEPLOYMENT
 Developed two systems
 One is for the Primary Health Care Facility which
we call the iClinicSys. At present, the capabilities
being enhanced now are patient care
management, the incorporation of other national
health insurance benefit packages and the
PHASE 1: STANDARDIZE AND CONNECT electronic submission or repoets required by the
 2013 – 2014 DOH
 Establish governance  In the coming years, EMR system capabilities will
 Development of policies and standards subsequently consider the portability of patient
data across health facilities and the integration of
PHASE 2: TRANSFORM management and administrative report
 2015 – 2016 submissions and future integration with the PHIE
 EMR/HER validation
 EMR in all health facilities
HOSPITAL EMR ADOPTION MODEL
 Resulted in the initial and subsequent deployment of
electronic medical record systems (EMR)

PHASE 3: MAINTAIN AND MEASURE

 2017 – 2023
 Implement Philippine Health Information Exchange
(PHIE)
 IT enabled health services

GOVERNANCE AND MANAGEMENT STRUCTURE

EMR IMPLEMENTATION STATUS - RHU

 Multi-sectoral
 Expertise-based  The map includes other systems that were developed by
 Governance is through a National eHealth Steering private organizations and academic institutions (CHITS,
Committee chaired by the Secretary of Health and co- WAH, Shine, etc.) but most of the deployed EMR
chaired by the secretaries of the Departments of Science systems were installed by the DOH

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iHOMIS IMPLEMENTATION STATUS – GOVT. III. PUBLIC HEALTH INFORMATION SYSTEM

HOSPITAL WITH iHOMIS/HBSys
THE HEALTH CHALLENGES BASED ON A
SPEECH BY MARGARET CHAN, M.D., WORLD
HEALTH ORGANIZATION (WHO) DIRECTOR-
GENERAL, AT G8 GLOBAL HEALTH FORUM
 Inefficiencies in the delivery of services and good
governance
 Access to care, especially of the poor (protect the poor;
guarantee universal access to basic healthcare)
 Equity and fairness in health-service delivery
 Costs of healthcare pushing people below the poverty
line
 Stagnancy in improving service coverage
 Maternal and child mortality
 High-mortality diseases: tuberculosis, HIV and AIDS,
PHILIPPINE HEALTH INFORMATION EXCHANGE
vaccine-preventable diseases, malaria
(PHIE)
 Inefficient aid: duplication, fragmentation, multiple
 Enable a data subject’s medical or health information to reporting requirements, high transaction costs, and
follow him/her wherever healthcare services are fierce competition for scarce health staff
provided
 Aging population, urbanization, unhealthy lifestyles,
 Enable portability of patient data and health information chronic diseases brings on heavy healthcare costs
 Healthcare providers will be able to exchange data  Shortage of healthcare workers and specialized
subject’s medical or health information securely to caregivers
improve health care delivery and decision making  Financial crisis
 Policies, country leadership’s commitment, and
innovative thinking

FUNCTIONS AND GOALS OF A HEALTH SYSTEM

(2000)

 The framework of the PHIE shows the importance of

integration of health date across various point of care
application systems. Data is meant to be kept and SOURCES OF HEALTH INFORMATION
maintained in registries and shared across facilities.  Population-based data sources
PHIE will seek to aid in complying with national health  Census
data reporting requirements  Surveys
 Civil registration
eHEALTH INFRASTRUCTURE
1. Initialization of the Interconnection of Health Facilities COMPONENTS AND STANDARDS OF A NATIONAL
through the DICT’s iGovernment Philippines and Free HEALTH INFORMATION SYSTEM
Wi-Fi Project
 1,959 (61.41%) out of 3,190 health facilities - i.e.
1748 (67.52%) out of 2,589 RHUs/HCs and 211
(35.11%) out of 601 hospitals – have been
interconnected under the DICT Free Wi-Fi Project
 At 1-5 mbps: 152 hospitals, and 1746 RHUs/HCs.
 At 8-12 mbps: 58 hospitals and 2 RHUs.
 Speed not indicated: 1 hospital
 DOH has been working to strengthen our eHealth
infrastructure by having facilities interconnected
 61.41% of health facilities are now
interconnected
2. Crafting of the Sectoral/DOH ICT Related Policies and
Documentations
 Cloud Computing Policy
 Application Hosting Service Agreement for the PHIE
 Free Wi-Fi Internet Access in Public Places

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EXAMPLES OF PHILIPPINE PUBLIC HEALTH TELEMEDICINE

INFORMATION SYSTEM  "Healing at a distance” (1970’s), signifies use of ICT to
 Field Health Service Information Systems (FHSIS) improve patient outcomes
 National Epidemic Sentinel Surveillance System  “The delivery of health care services, where distance is
 Public Health Statistics (in coordination with National a critical factor, by all health care professionals using
Statistics Office) information and communication technologies for the
exchange of valid information for diagnosis, treatment
FIELD HEALTH SERVICE INFORMATION SYSTEM and prevention of disease and injuries, research and
(FHSIS) evaluation, and for the continuing education of health
care providers, all in the interests of advancing the health
 DOH publication that provides data to assess
of individuals and their communities” (WHO)
performance of health care services at the grassroots
level (LGU’s)
 Gathers data from the barangay and bring them to the
TELEMEDICINE AND TELEHEALTH
municipality, provincial office, regional office and then to  Telemedicine - service delivery by physicians only
the national  Telehealth - services provided by health professionals,
including nurses, pharmacists, etc.
OBJECTIVES OF FHSIS  Synonymous and used interchangeably for this lecture
 Provide summary data on health service delivery and
selected program accomplishment indicators FOUR ELEMENTS IF TELEMEDICINE
 Provide data which can be used for program monitoring  Its purpose is to provide clinical support
and evaluating purposes  It is intended to overcome geographical barriers
 Provide a standardized, facility-level database for in-  It involves the use of various types of ICT
depth studies  Its goal is to improve health outcomes
 Ensure data reported are useful and accurate and are
disseminated on time BASIC TYPES OF TELEMEDICINE
 Minimize burden of recording and reporting at the
service delivery level ASYNCHRONOUS/STORE-AND-FORWARD
 Involves the exchange of pre-recorded data between two
NATIONAL EPIDEMIC SENTINEL SURVEILLANCE or more individuals at different times
SYSTEM (NESSS)  Example: e-mail description of medical case sent to
 Part of the Philippine Integrated Disease Surveillance specialist
and Response (PIDSR) System
 Gives weekly Morbidity and Mortality data SYNCHRONOUS/REAL TIME
 Gathers data from major medical institutions – selected  Requires the involved individuals to be simultaneously
government hospitals present for immediate exchange of information
 Surveillance data should be analysed at the local level  Example: videoconferencing
and at the regional level of the health system in the
timeliest fashion possible TYPES OF TELEMEDICINE SERVICE
 Actions include:  Specialist referral services
 Notification, investigation and intervention of
 Direct patient care
epidemics
 Remote patient monitoring
 Program management
 Impact monitoring  Medical education and mentoring
 Problem identification  Consumer medical and health information
 Planning
 Social mobilization DELIVERY MECHANISMS OF TELEMEDICINE
 Networked programs
HEALTHCARE INFORMATION SYSTEM  Point-to-point connections
DEVELOPMENT  Health provider to the home connections
 Direct patient to monitoring center
HOSPITAL MANAGEMENT INFORMATION SYSTEM  Web-based e-health patient service
 A comprehensive software application system that
HOW TO ACCELERATE THE ADOPTATION AND
integrates hospital management systems
DEVELOPMENT IF HEALTH INFORMATION
DOH iCLINICSYS TECHNOLOGY?
 Consumer Empowerment
 Supports functions of a clinic, (barangay health station,
 Chronic Care
rural health unit, or other health care facility) devoted to
 Bio surveillance
providing primary health care service for patients
 Electronic Health Records
VII. TELEHEALTH WITHIN THE PUBLIC HEALTH
AREAS OF COLLABORATION BETWEEN
SECTOR
TELEMEDICINE AND HEALTH INFORMATION
OVERVIEW OF TELE MEDICINE SYSTEM
 Key issues facing health care: access, equity, quality,  Establishing and maintaining networked, organizational
cost-effectiveness relationships
 Potential Areas of Collaboration: Networks already
 Modern ICTs revolutionizes communication with each
established for telemedicine should be used as the
other
initial test beds and role models of mechanisms to
 ICTs have a great potential in addressing global health
exchange health information
problems
 Overcoming Resistance
 Use of ICT for health service delivery

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 Potential Areas of Collaboration: New alliances

should be made between such leaders from health
technology, clinical medicine and public health
 Surmounting the Absence of Standards and Guidelines
 Potential Areas of Collaboration: Specific areas of
collaboration should focus on mutually needed
technical benchmarks and high quality
communication networks that assure
interoperability on several levels
 Financial Sustainability
 Potential areas of collaboration: Development of
unified business models that specify cost-benefit
factors and identify appropriate technical, clinical
and administrative pathways that should be
followed

LUZON HEALTH FACILITIES TELEMEDICINE

INITIATIVES

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NURSING INFORMATICS
LECTURE / WEEK 4
PPT / BOOK

THEORIES AND MODELS FOR NURSING  Their model placed data, information, and knowledge in
INFORMATICS sequential boxes with one-way arrows pointing from data
to information to knowledge

OUTLINE

I Models of Nursing Informatics

NURSING INFORMATICS
 Nursing informatics (NI) is a specialty that integrates
nursing science with multiple information management
and analytical sciences to identify, define, manage, and
communicate data, information, knowledge, and wisdom
in nursing practice
 Supports nurses, consumers, patients, the
interprofessional healthcare team, and other
stakeholders in their decision-making in all roles and
settings to achieve desired outcomes
 This support is accomplished through the use of
information structures, information processes, and
information technology (ANA) PATRICIA SCHWIRIAN'S MODEL
 In 1986, Patricia Schwirian proposed a model of nursing
I. MODELS OF NURSING INFORMATICS informatics intended to stimulate and guide systematic
 The foundations of nursing informatics are the core research in this specialty
phenomena and nursing-informatics models  Identifying significant information needs, which, in turn,
 The core phenomena are data, information, knowledge, can foster research
and wisdom and the transformations that each of these  In this model, there were four primary elements arranged
undergo in a pyramid with a triangular base
 Models are representations of some aspect of the real  The raw material (nursing-related information)
world, show perspectives of a selected aspect, and may  The technology (a computing system comprised of
illustrate relationships hardware and software)
 Models evolve as knowledge about the selected aspect  The users surrounded by context, and the goal (or
changes and are dependent on the worldview of those objective) toward which the preceding elements
developing the model were directed
 It is important to remember that different models reflect  The goal element was placed at the apex of the
different viewpoints and are not necessarily competitive; pyramid to show its importance
that is, there is no one, right model  Similarly, all interactions between the three base
elements and the goal were represented by bidirectional
CLINICAL INFORMATION SYSTEM arrows
 Information system designed specifically for use in the
critical care environment
 Computer-based system
 Gather, store, and alter clinical data on patients

Computer

Nursing related
information

TURLEY'S MODEL
 Nursing science was a larger circle that completely
encompassed the intersecting circles
 Nursing informatics was the intersection between the
GRAVES AND CORCORAN'S SEMINAL WORK discipline-specific science (nursing) and the area of
MODEL informatics
 Cognitive science - study of thought
 The model is a direct depiction of their definition of  Information science - data storage and retrieve
nursing informatics data
 Necessity of using a multidisciplinary approach to fully  Computer science - study of computers
utilize the potential of the computer in nursing

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THEORY AND OTHER MODELS SUPPORTING

NURSING INFORMATICS

THEORY
 Scholarly, organized view of some aspect of the world
(reality)
 Can describe, explain, predict, or prescribe selected
phenomena within this reality
 The concepts within a theory are interrelated
 Testing of these relationships through research is how
theories gain or lose supporting evidence
 A profession needs theories to build evidence for the
existence of a unique body of knowledge

Turley’s Model GRAND THEORIES

 Broad in scope and the most complex of the three
MCGONIGLE AND MASTRIAN (FOUNDATION OF classifications
KNOWLEDGE MODEL)
 The base of this model showed data and information PRACTICE THEORIES
distributed randomly  The most specific of the three and usually provide
 Foundation of knowledge is data and information prescriptions or directions for practitioners.
for critical thinking
 The upward cones represented acquisition, generation, MIDDLE-RANGE THEORIES
and dissemination of knowledge  Somewhere in the middle of these two ends—they are
 Knowledge processing was represented by the more specific than grand theories but not as prescriptive
intersections of these three cones as practice theories
 Feedback circled and connected all of the cones
 The cones and feedback circle were dynamic in nature DIFFERENCE BETWEEN LAW AND THEORY
 Predicts the results of certain initial
Law conditions
 Predicts what happens

 Tries to provide the most logical information

about why things happen as they do
 Proposes why
Theory  Will never grow up into a law
 Development of one often triggers progress
on the other
 Flexible as it can adapt to any challenge
 Can be challenge in a certain time

EMPOWERMENT INFORMATICS FRAMEWORK

 Knight and Shea
 Provides a framework where nurses use technology to:
 Guide chronic illness interventions through the
integration of patient self-management and nursing
informatics
 Focus on self-management research
 Promote ethical technology use by practicing
nurses

 The model is used to guide intervention design as well

as evaluation and support nurses’ ethical use of
technology to guide nursing practice using technology
that prioritizes patient needs

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THE IMPLEMENTATION OF ELECTRONIC  Use of computerized system to electronically document

CLINICAL DOCUMENTATION USING LEWIN’S patient information
CHANGE MANAGEMENT THEORY  The informatics nurse maintain the change by providing
the staff with ongoing education and support
UNFREEZE  Ensure that resources are put in place to support the
staff once they have withdrawn from the project
 Recognize the need for change and prepare for the
 Presence of technical staff: information technologists,
change to occur.
clinicians and clinical educators
 Evokes a change in the behaviors among individuals
 Policies must be available assist staff in the
 Analyze driving force versus restraining force documentation process
 Ongoing evaluation is also essential to determine if this
EVIDENCE OF NEED AND DRIVING FORCE system of documentation meets personal, professional,
 Long-time spending on paper works (30-60min) and organizational standards, or if additional changes
 Transition from paper to electronic documentation need to be made to further improve this method of
reduces the overall time that nurses spend documenting clinical documentation
patient information
 Provision of more legible and comprehensive patient
records
 Minimize the potential of lost or damaged information
that occur with paper-based writing
 Improve the accuracy of patient information which assist
nurses in meeting regulatory and legal documentation
requirements
 Facilitates better communication between nurses and
other health care professionals
 New computerized documentation systems generate
work lists and alerts features that offer nurses an
“electronic helping hand,” and assist them in prioritizing
and managing their care
 Reduce documentation redundancies and promote
quicker retrieval of clinical data

RESTRAINING FORCE
 Perception and attitude of nurses towards clinical
information system
 Age and computer literacy (younger nurses and
experienced computer users had a more positive attitude
 Nurses regularly resist new technological advancements
based on the assumption that it will disrupt their normal
way of performing routine activities
 Cost of selecting and implementing electronic systems
 Lack of infrastructure to support computerized
documentation
 Acceptance of new technology
 Time to adequately train and provide ongoing technical
support for employees
 Problems with computer equipment

CHANGE
 Also known as “moving”
 Change management strategies geared towards
strengthening driving forces or weakening restraining
forces

STRATEGIES
 The informatics nurse continue to communicate with the
nursing staff and acknowledge their suggestions and
opinions
 The informatics nurse help the staff to recognize the
benefits of electronic documentation
 End-user involvement in the planning and
implementation process
 Continuous monitoring for changes in staff attitude and
behavior

REFREEZE
 Equilibrium has been successfully reached
 Change are incorporated into routine procedures and
practices within the organization.
 Continuously maintain and re-evaluate the change

ACTIVITIES

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NURSING INFORMATICS
LECTURE / WEEK 5
PPT / BOOK

POLICY GUIDELINES AND LAWS IN NURSING REPUBLIC ACT NO. 10173

INFORMATICS  Data Privacy Act of 2012
 Approved into law in August 15, 2012
 They safeguard the fundamental human right of every
OUTLINE
I Laws Related to Nursing Informatics
individual to privacy while ensuring free flow of
information for innovation, growth, and national
development
I. LAWS RELATED TO NURSING INFORMATICS  Recognize the vital role of information and
communications technology in nation-building and
BILL OF RIGHTS, PHILIPPINE CONSTITUTION 1987 enforce the State’s inherent obligation to ensure that
 Article 3, Section 3 personal data in information and communications
 The privacy of communication and correspondence shall systems in the government and in the private sector are
be inviolable except upon lawful order of the court, or secured and protected
when public safety or order requires otherwise, as
prescribed by law. SCOPE OF APPLICATION
 The Act and these Rules apply to the processing of
REPUBLIC ACT 10175: CYBERCRIME PREVENTION personal data by any natural and juridical person in the
ACT OF 2012 government or private sector
 Offenses against the confidentiality, integrity and  The natural or juridical person involved in the
availability of computer data and systems. (illegal processing of personal data is found or established
access, illegal interception, data interference) in the Philippines
 The act, practice or processing relates to personal
data about a Philippine citizen or Philippine
THE MAGNA CARTA OF PATIENT’S BILL OF
resident
RIGHTS AND OBLIGATIONS  The processing of personal data is being done in
 Right to Privacy and Confidentiality the Philippines
 The patient has the right to privacy and protection  The act, practice or processing of personal data is
from unwarranted publicity done or engaged in by an entity with links to the
 The right to privacy shall include the patient’s right Philippines, with due consideration to international
not to be subjected to exposure, private or public, law and comity
either by photography, publications, video-taping,  RA 11332 Section 6. Mandatory Reporting of Notifiable
discussion, or by any other means that would Diseases and Health Events of Public Concern
otherwise tend to reveal his person and identity and  (d) Data collection, analysis, and the dissemination
the circumstances under which he was, he is, or he of information from official disease surveillance and
will be, under medical or surgical care or treatment response systems can only be done by authorized
 All identifiable information about a patient’s health personnel from the DOH and its local counterparts
status, medical condition, diagnosis, prognosis and and may only be used for public health concern
treatment, and all other information of a personal purposes only; thus, should be exempted in the
kind, must be kept confidential even after death. provision of Data Privacy Act on accessibility of
Provided, That descendants may have a right of data
access to information that will inform them of their
health risks NATIONAL PRIVACY COMMISSION
 All identifiable Patient data must also be protected  Rule 3: National Privacy Commission
 The protection of the data must be appropriate as  Section 8. Mandate. The National Privacy
to the manner of its storage Commission is an independent body mandated to
 Human substance from which identifiable data can administer and implement the Act, and to monitor
be derived must be likewise protected and ensure compliance of the country with
 Confidential information can be disclosed in the international standards set for personal data
following cases protection.
o When the patient’s medical or physical  Functions:
condition is in controversy in a court litigation  Rule Making
and the court, in its discretion, orders the  Advisory
patient to submit to physical or mental  Public education
examination of a physician  Compliance and monitoring
o When public health or safety so demands  Complaints and investigation
o When the Patient, or in his incapacity, his/her  Enforcement
legal representative, expressly gives the
consent
OFFENSES
o When the patient’s medical or surgical
 Unauthorized processing (sec. 25)
condition is discussed in a medical or
scientific forum for expert discussion for  Negligence (sec. 26)
his/her benefit or for the advancement of  Improper disposal (sec. 27)
science and medicine, provided however, that  Unauthorized purposes (sec. 28)
the identity of the Patient should not be  Unauthorized access or intentional breach (sec. 29)
revealed  Concealment of security breaches (sec. 30)
o When it is otherwise required by law  Malicious (sec.31) and unauthorized disclosure (sec. 32)

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NURSING INFORMATICS
LECTURE / WEEK 6
PPT / BOOK

INFORMATION COMMUNICATION TECHNOLOGY

IN EDUCATION

OUTLINE
II Information and Communication Technologies

I. INFORMATION AND COMMUNICATION

TECHNOLOGIES (ICT)
 It refers to technologies that provide access to
information through telecommunication. It is similar to
Information Technology (IT) but focuses primarily on
communication technologies.
 Diverse set of technological tools and resources used to
transmit, store, create, share or exchange information.
These technological tools and resources include
computers, the Internet (websites, blogs and emails),
live broadcasting technologies (radio, television and
webcasting), recorded broadcasting technologies
(podcasting, audio and video players and storage
devices) and telephony (fixed or mobile, satellite,
visio/video-conferencing, etc.). (UNESCO)

FLEXIBLE LEARNING
 Pedagogical approach allowing flexibility of time, place,
audience, including, but not solely on the use of
technology
 Commonly uses the delivery methods of distance
education and facilities of education technology, this
may vary depending on the levels of technology,
availability of devices, internet connectivity, level of
digital literacy, and approaches

BLENDED LEARNING
 Mode of educational delivery that combines distance
education, including online, with traditional classroom-
based education

DISTANCE EDUCATION
 Mode of education delivery whereby teacher and learner
are geographically-separated and instruction is
delivered through materials and methods using
communication technologies and supported by
organizational and administrative structures
arrangements. The delivery medium is typically online
but can be by print-based modules or by mobile phones

E LEARNING
 It is a learning program that makes use of an information
network- such as the internet, an intranet (LAN) or
extranet (WAN) whether wholly or in part, for course
delivery, interaction and/or facilitation
 Web-based learning is a subset of e learning and refers
to learning using an internet browser such as the model,
blackboard or internet explorer
 Also known as online learning. E–learning encompasses
learning at all levels both formal and non-formal that
uses an information network– the Internet, an intranet
(LAN) or extranet (WAN). The components include e-
portfolios, cyber infrastructures, digital libraries and
online learning object repositories. All the above
components create a digital identity of the user and
connect all the stakeholders in the education. It also
facilitates inter disciplinary research

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