NCM 110 - NURSING INFORMATICS

COMPUTER NURSING INFORMATICS MODEL

Cambridge - an electronic machine that is used for storing, Schwirian’s Model (1986)
organizing, and finding words, numbers, and pictures, for doing - Patricia Schwirian – proposed a model intended to stimulate
calculations, and for controlling other machines and guide systematic research in nursing informatics in 1986.
Merriam-Webster - a programmable usually electronic device - The framework that enables identification of significant
that can store, retrieve, and process data. information needs that can foster research.
Britannica - A computer is a machine that can store and process Turley’s Model (1996)
information. Most computers rely on a binary system, which - Nursing informatics is the intersection between the disciple-
uses two variables, 0 and 1, to complete tasks such as storing specific science (nursing) and the area of informatics
data, calculating algorithms, and displaying information. • Core components of informatics
Computers come in many different shapes and sizes, from - Cognitive science
handheld smartphones to supercomputers weighing more than - Information science
300 tons. - Computer science

NURSING Origins of Nursing Information System

- Nursing is the diagnosis and treatment of human responses and 1977 - The first Nursing Information System Conference was
advocacy in the care of individuals, families, groups, held in the United States
communities, and populations in recognition of the connection - Here nurses adapt computer processes to enhance client care,
of all humanity. ANA (2021) education, administration and management, and nursing research
- Nursing encompasses autonomous and collaborative care of October 1995 - The first ANA certification examination in
individuals of all ages, families, groups, and communities, sick Nursing Informatics was given.
or well and in all settings. Nursing includes the promotion of - This creates the Nurse Informaticists – they are responsible for
health, prevention of illness, and the care of ill, disabled and interfacing between the client care and information technology
dying people. Advocacy, promotion of a safe environment, departments and assisting with the development, implementation
research, participation in shaping health policy and in patient and evaluation of initiatives in the clinical information system.
and health systems management, and education are also key 1999 - A study was formed to identify International Standards
nursing roles. for health information and their adaptability in the Philippines
referred to as “Standards of Health Information in the
INFORMATICS Philippines, 1999 ver.
- Combination of the terms information and automatic / 2003 - Master of Science in Health Informatics was proposed to
automation which means automatic information processing. be offered by UP-Manila College of Medicine (major in medical
- A science that combines domain science, computer science, informatics) and the College of Arts and Science (major in
information science and cognitive science. bioinformatics) and was later approved to be offered starting
academic year 2005-2006.
HEALTHCARE INFORMATICS 2006 - Creation of TIGER (Technology Informatics Guiding
- It is the integration of information science, health science, Educational Reform)
computer science, and cognitive science. - HIMSS (Healthcare Information and Management Systems
- It is the derivative of the holistic objective of medical Society)
practitioners, such as nurses, healthcare providers, physicians, - Created to identify knowledge/information management best
and healthcare staff. practices and effective technology capabilities of nurses.
- NI is a specialty that integrates nursing science with multiple 2008 - The Nursing Informatics course in the undergraduate
information management and analytical sciences to identify, curriculum was defined by the Commission on Higher Education
define, manage, and communicate data, information, knowledge, (CHED). Memorandum Order 5 Series of 2008, later revised and
and wisdom in nursing practice. included as a Health Informatics course in CHED Memorandum
- NI supports consumers, patients, nurses, and other healthcare Order 14 Series of 2009, and first implemented in the summer of
professionals in their decision-making in all roles and settings to 2010.
achieve desired outcomes. This support is accomplished through 2009 - Mr. Kristian R. Sumabat and Ms. Mia Alcantara-
the use of information structures, information processes, and Santiago, both nurses and graduate students of Master of Science
information technology. in Health Informatics at the University of the Philippines,
Manila began
Rognehaugh (rown-hoff) - “the use of any computer and drafting plans to create a nursing informatics organization.
information technologies that support any nursing function 2010 - They began recruiting other nursing informatics
carried out by nurses in the performance of their duties” specialists and practitioners to organize a group which later
Hannah (1985) - “use of information technologies in relation to became the Philippine Nursing Informatics, a sub-specialty
those functions, within the purview of nursing that are carried organization of PNA for nursing informatics.
out by nurses when performing their duties” - Philippine Nursing Informatics Association (PNIA)
Graves and Corcoran (1989) - “a combination of computer Framework of Nursing Informatics
science, information science and nursing science designed to - Data – discrete entities that are described objectively without
assist in the management and processing of nursing data, interpretation.
information and knowledge to support the practice of nursing - Information – as data, however is interpreted, organized or
and the delivery of nursing care.” structured.
Hebda (1998) - Defines nursing informatics as “the use of - Knowledge – as information that has been synthesized so that
computer technology to support nursing, including clinical interrelationships are identified and formalized this results to
practice, administration, education, and research. decisions that guides practice.
 NCM 110 - NURSING INFORMATICS

- Health and nursing information science - studies how health Informatics Theory Foundations of NI
care data is acquired, communicated, stored, managed, and Core phenomena - Data, information, knowledge, and wisdom
processed into information and knowledge. and the transformations
- This knowledge is useful to nurses in decision- making at the NI models - Representations of some aspect of the real World.
operational, tactical, and strategic planning of levels of health Particular perspectives of a selected aspect and may illustrate
care. relationships Evolve as knowledge, different models reflect
different viewpoints
Computer System Theories Supporting Nursing Informatics Nursing theories-
1. Computer Hardware about nursing practice. NI can utilize the theories in nursing
2. Computer Software System since it involves the individual, groups and communities and can
3. Open Source and Free Software be used accordingly.
4. Data Assessment Computer science- a study of algorithms for solving
5. Personal, Professional and Educational informatics computation problems. An automated solution to problems if
algorithm is identified, then a machine can be built. Like when a
Computer System computer was built as a tool.
• A network of computers, users, programs, and procedures in an Information science- focuses on the gathering, manipulation,
organization – assists the healthcare team with decision-making classification, storage, and retrieval of recorded knowledge.
and communication. Three important branches are information retrieval, human-
Two (2) most common types of Computer Systems: computer interactions, and information handling within a system.
1. Management Information System The Mathematical Theory of Communication (1949)
2. Hospital Information System by Weaver and Shannon- concept of communication channel
Computer Hardware which was sequential to the Classic information theory that
• Hardware is the physical part of the computer and its focuses on a central problem that has been the engineering
associated equipment. Computer hardware can comprise many problem of the transmission of information over a noisy channel.
different parts, these include: Sender (source of information), a transmission medium (with
1. Input devices noise and distortion), and a receiver (whose goal is to reconstruct
2. Output devices the sender’s messages.
3. Central Processing Unit (CPU) Encoding and decoding- if the data exceeds or sent below the
channel capacity, errors are inevitable. Information can be
Read-only memory (ROM) is permanent; it remains when the encoded so that it can be received without errors then the
power is off. A start-up instruction for the computer is an receiver will have to decode the message.
example of ROM. Communication- Bruce I. Blum (1985) presented the central
Random access memory (RAM) is a temporary storage area for concepts of data (raw), information (interpreted, organized, or
program instructions and data that is being processed; it is only structured), and knowledge (synthesis of inter-relationships of
active while the computer is turned on. (Located on the data and information) which are adopted by NI.
motherboard not part of CPU). Systems- the theory that relates to the properties of systems as a
Control Unit: manages instructions to other parts of the whole. The focus are organization and interdependence of
computer, including input and output devices “traffic cop”. relationships within a system. It is constantly changing.
Solid-state drive (SSD) is a solid-state storage device that uses Closed system- does not interact with the surrounding
integrated circuit assemblies to store data persistently, typically environment. Example, human circulatory system because the
using flash memory, and functioning as secondary storage in blood never leaves the system of blood vessels.
the hierarchy of computer storage. Open system- can be influenced by events outside of the actual
Secondary Storage - Provides space to retain data in an area or conceptual boundaries. Example, people.
separate in an area computer’s memory after the computer is
turned off, Six key concepts in understanding system change:
- dynamic homeostasis (preserves the character of a
Issues in informatics system through its growth)
- Like many other disciplines, nursing informatics faces many - entropy (disorder or breaking down into the smallest parts, eg
challenges while in its infancy stage. However, the contents of loss of information)
the curriculum were adapted from international materials which - negentropy (in order, organized)
do not match the local needs. Lack of certification and - Specialization
credentialing programs in post-graduate levels are also absent - reverberation (one part of the system changes, the rest of the
with the scarcity of local nursing informatics experts. This new system are affected)
field has yet to gain acceptance and recognition in the nursing - equifinality (same end, different routes)
community as a sub-specialty.
- Development of training, certification and credentialing Informatics Theory
programs are in the pipeline for the Philippine Nursing Behavioral and social sciences- the process driving actions.
Informatics Association. Future partnerships with local and Although interchangeably used, behavior can include emotions,
international nursing and health informatics organizations have cognition, and motivation while social processes and acts can be
started as well. Other programs are expected to be slowly status, levels of social context, and biosocial interactions (Office
delivered with PNIA's CORE X strategic platform which stands of Behavioral and Social Sciences, 2010.)
for Competency, Organization, Recognition, Experience, and Change- in healthcare and nursing informatics, change often has
Expertise. It is also a major thrust to support the use of health to be dealt with among groups of people and healthcare
organizations. Affects not only structures and ways of doing
information standards in the Philippines and to have nursing tasks, but also the performance, expectations, and perceptions of
informatics specialists in every hospital in the country. all involved parties.
 NCM 110 - NURSING INFORMATICS
group to a common goal on a highly efficient and cooperative
The Informatics Nurse Specialist (INS)- primary change agent basis).
in facilitating the implementation of clinical information system
(CIS). Consumer Use of Informatics
Planned-change theory- collection of ideas about modifications Consumer Health Informatics (CHI) - The intersection of health
to an organization or social system that are explicitly designed information technology and patient engagement. It focuses on
and put into place. Change do not happen by chance. empowering patients by providing them with personalized health
Lewin’s basic planned-change model: unfreezing (overcoming information and tools to make informed decisions about their
inertia and dismantling the existing mindset), changing well-being
(behavioral change occurs, a period of confusion), refreezing (a - CHI encompasses any electronic tool or system that interacts
new mindset has formed, returning comfort level). directly with consumers, with or without the presence of a
Diffusion of innovations theory- Everett Rogers, 1962, healthcare professional. These tools provide individualized
“Diffusion of Innovations”. information and assistance to help patients manage their health
or healthcare
Five specific groups of innovation adopters: Objectives - Information Access: CHI aims to make health
 Innovators data and services more accessible to consumers.
 early adopters Self-Care Promotion: It encourages self-care by providing tools
 early majority for monitoring health status (e.g., blood pressure or blood
 late majority glucose).
 laggards. Informed Decision-Making: CHI supports informed decision-
making by offering personalized health information.
Five-stage model for the diffusion of innovation: Healthy Behaviors: It promotes healthy behaviors through
 Knowledge education and lifestyle management assistance.
 Persuasion Peer Support: CHI facilitates peer information exchange and
 adopter makes a decision, social support
 Implementation
 confirmation. Examples of CHI Applications
Self-Management Systems: These platforms monitor health
Informatics Theory metrics (e.g., blood pressure) and provide timely responses to
Characteristics that mostly affect the rate of adoption: users.
relative advantage (degree to which an innovation is perceived Electronic Personal Health Records (PHRs): PHRs contain an
as better than the idea it replaces), compatibility (degree to individual’s health information, allowing patients to manage and
which an innovation is perceived as being consistent with control their data.
existing values, past experiences, and needs of potential Patient Portals: These online platforms enable patients to
adopters), access their health records, communicate with providers, and
complexity (a negative characteristics, degree to which an schedule appointments
innovation is perceived as difficult to understand and use)
trialability (degree to which an innovation may be tried out or Education Application
experimented with) 1. Curriculum Integration: Nursing informatics content is
observability (degree to which the results of an innovation are integrated into nursing programs. Students learn about electronic
visible to others). health records (EHRs), data management, and health information
Learning- two basic elements: pairing and reinforcement. systems
Pairing is a combination of a stimulus and response. 2. Competencies: Nurses develop competencies in:
Reinforcement, the stimulus-response element that has two • Information Literacy: Understanding how to access, evaluate,
pathways- positive and negative. and use health information.
Cognitive learning theory- internal mental processes, • Data Management: Handling patient data securely and
including insight, information processing, memory, and efficiently.
perception. Four steps in learning: information input (the • Technology Use: Proficiency in EHRs, data analytics, and
information is received by the learner), input processing (the emerging technologies
information is either remembered only for a short time or is 3. Evidence-Based Practice: Nurse informaticists help develop
moved to long-term memory where it can be drawn upon as evidence-based policies and procedures for healthcare
needed), output behaviors (that demonstrate if learning has taken organizations, ensuring informed decision making based on data.
place), and the use of feedback to embed the same information The Informatics Nurse Specialist (INS)- primary change agent
more firmly or to correct errors. in facilitating the implementation of clinical information system
Organizational behavior- focused on organizations which are (CIS).
examined, using the methods drawn fromeconomics, sociology, 3. Telehealth and Telemedicine: Research investigates the
political science, anthropology, and psychology. effectiveness of telehealth interventions, remote monitoring, and
Management- management science uses mathematics and other virtual consultations. These technologies enhance access to care
analytical methods to help make better decisions. Uses and improve patient outcomes.
techniques to inform and improve decisions of all kinds. 4. Wearable Technologies: Wearables collect real-time health
Group dynamics- focuses on the nature of groups. Formal and data (e.g., heart rate, activity levels). Researchers study their
informal groups. Tuckman’s model (1965): forming (pretending accuracy, usability, and impact on health management
to get on or get along with others), storming (letting down the
politeness barrier and trying to get down to the issues even if
tempers flare up), norming (getting used to each other and
developing trust and productivity), and performing (working in a
 NCM 110 - NURSING INFORMATICS

Six Time Periods ✓ Reminders and prompts that appear during documentation
1. Prior to the 1960s: tonsure comprehensive charting
• Computers were first developed in the late 1930s to early Administration: Informatics aids in cost analysis, budget trends,
1940s, but their use in the healthcare industry occurred in the and quality assurance.
1950s and 1960s. ✓ Automated staff scheduling
• These computers utilized punch cards to store data and card ✓ E-mail for improved communication
readers to process information. ✓ Cost analysis and finding trends for budget purposes
2. 1960s - 1970s: ✓ Quality assurance and outcomes analysis
• Computers began to play a more significant role in healthcare. Education: Technology enhances nursing education and training.
• The emergence of mainframe computers allowed for data ✓ Computerized record-keeping
storage and retrieval. ✓ Computerized-assisted instruction
• Basic applications included administrative tasks and financial ✓ Interactive video technology
management ✓ Distance Learning
3. 1980s - 1990s: ✓ Web-based courses and degree programs
• Personal computers (PCs) became accessible. ✓ Internet resources- CEU's and formal nursing courses and
• Nurses started using PCs for documentation, scheduling, and degree programs
communication. ✓ Presentation software for preparing slides and handouts-
• Nursing informatics as a specialty gained recognition PowerPoint and MS Word
4. 2000s: Research: Informatics supports data collection, analysis, and
• Electronic Health Records (EHRs) gained prominence. outcomes assessment
• Nurses adapted to digital charting and integrated technology ✓ Computerized literature searching-CINAHL, Medline, and
into patient care. Web sources.
• Mobile devices and wireless connectivity transformed ✓ The adoption of standardized language related to nursing
workflows. terms- NANDA, etc.
5. 2010s: ✓ The ability to find trends in aggregate data, that is data
• Interoperability and data exchange became priorities. derived from large population groups- Statistical Software, SPSS.
• Nurses collaborated across systems and shared patient
information. Electronic Health Record (EHR)
• Telehealth, wearables, and health apps expanded nursing • An Electronic Health Record (EHR) is a digital format or
practice. documentation of an individual’s medical history that is
6. Present Day: maintained by healthcare providers or health institutions.
• Artificial intelligence (AI), big data, and analytics impact • It includes information on the patient’s demographics progress
nursing. notes, medication problems, vital signs, history, diagnostic
• Nurses engage in telemedicine, remote monitoring, and virtual results, and vaccination.
care. • An electronic record composed of health information regarding
• Nursing informatics continues to evolve, enhancing patient an individual patient that exists as part of a complete system
outcomes. designed to provide access to, and management of, such
information. The EHR is developed and managed by the health
Historical Perspectives of Nursing Informatics: facility or provider. The term Electronic Health Record has
• Time Periods: Nursing informatics has evolved over several largely replaced the older “Electronic Medical Record.”
periods: • It is much more than an electronic replacement of existing
Prior to the 1960s: Early developments in healthcare paper systems. The EHR can start to actively support clinical
technology. care by providing a wide variety of information services.
1960s: Emergence of computers and their potential in healthcare. However, it is hard to understand what information is really
1970s: Introduction of electronic health records (EHRs). important to clinical care and what is simply occasionally
1980s: Growing use of computers in nursing practice.
1990s: Standardization efforts and increased adoption. Electronic Health Record (EHR)
2000s: Integration of informatics into education and research. • The EHR brings uncountable advantages in primary health
2010s: Continued advancements and widespread adoption care detaching such as (1) faster access to information, (2)
updated information, (3) it allows having a clinical process
Four Major Nursing Areas with all the patient clinical information, and (4) easier access
Clinical Practice: Integration of technology at the point of care. to information (ex: allows the simultaneous access from
Examples include monitoring devices recording vital signs different locations).
directly into electronic medical records, computer- generated • Recognizable efforts in the development of EHR are
nursing care plans, and automatic billing for supplies or distinguished by the Nicholas E. Davis Awards of Excellence
procedures. Program whose history describes the improvement of EHR in
✓ Work lists to remind staff of planned nursing interventions different settings.
✓ Computer-generated client documentation
✓ Electronic Medical Record (EMR) and Computer- Based Benefits of EHR
Patient Record (CPR) 1. Medical errors
✓ Monitoring devices that record vital signs and other • EHR enables patients’ safety by eliminating medical errors
measurements directly into the client record (electronic medical through illegible handwriting by physicians.
record). • Medical documentation in EHR appears to be clear and legible
✓ Computer-generated nursing care plans and critical pathways and thus reduces legal implications. Fewer forms to fill out
✓ Automatic billing for supplies or procedures with nursing during a visit.
documentation
 NCM 110 - NURSING INFORMATICS

• Fewer repetitive questions – regarding past medical history Confidentiality and Security Standards
alert system ensure proper dosage and drugs are administered. • Increasing access through the electronic capture and exchange
2. Improves patient’s quality of life of information raised concerns about the privacy and security of
• EHR assists in better disease management and client education. personal healthcare information (PHI). Provisions for
• It also enhances communication among healthcare providers. strengthening the original HIPAA legislation were included in
• When patient are educated and healthcare providers work the 2009 HITECH Act (Gallagher, 2010). Greater emphasis was
collaboratively better patient outcome is achieved. placed on patient consent, more organizations handling PHI
3. Reduces cost of healthcare were included in the legislation, and penalties were increased for
• HER reduces transcription, re-filling, and storage costs. It security breaches
saves time and cost by eliminating redundant diagnostic testing,
and paper charting and decreasing storage and retrieval costs.
This digital format enables healthcare professionals to
communicate and track data for specific patients
4. EHR maintains patient privacy
• HIPAA law protects: any information that your doctors, nurses,
or other health care providers put in the medical record
conversations between doctors and others about your family’s
care or treatment information about your family in the health
insurance carriers’ computer system billing information

Nursing Practice Standards

• Nursing Practice Standards have been developed and
recommended by the ANA, the official professional nursing
organization. The ANA published Nursing: Scope and Standards
of Practice (ANA, 2008) that focused not only on the organizing
principles of clinical nursing practice but also on the standards
of professional performance.
• The six standards/phases of the nursing process serve as the
conceptual framework for the documentation of nursing practice.
The updated Nursing Informatics: Scope and Standards of
Practice (ANA, 2010) builds on clinical practice standards,
outlining further the importance of implementing standardized
content to support nursing practice by specialists in NI.
• The National League for Nursing (NLN) has been the primary
professional organization that accredits undergraduate nursing
programs. Since the NLN’s Nursing Forum on Computers in
Healthcare and Nursing (NFCHN) was formed in 1985, it has
supported the integration of computer technology into the
nursing curriculum.
• The American Association of Colleges of Nursing (AACN),
which also accredits nursing education programs, revised The
Essentials for Doctoral Education for Advanced Nursing
Practice (AACN, 2006) and The Essentials of Baccalaureate
Education for Professional Nursing Practice (AACN, 2011) to
require the use of computers and informatics for both
baccalaureate and graduate education. These new requirements
for informatics competencies prepare nurses to use HITs
successfully and to contribute to the ongoing design of
technologies that support the cognitive work of nurses (AACN,
2011).

Nursing Content Standards

1859- Florence Nightingale’s Six Cannons in her “Notes on
Nursing”
1893- Standardization of healthcare data began for the reporting
of morbidity cases worldwide.
1955- Virginia Henderson published her 14 Daily Patterns of
Living as the list of activities and conditions that became the
beginning of nursing practice standards in this country.
1970- The American Nurses Association (ANA) accepted the
Nursing Process as the professional standard for nursing
practice
1973- standardization of nursing content— data elements.
several nursing organizations, educational institutions, and
vendors developed nursing data sets, classifications, or
terminologies for the documentation of nursing practice.
 NCM 110 - NURSING INFORMATICS

Nicholas Davies Award • The Public Health Davies Award is part of the Nicholas E.
• The Nicholas E. Davies Award of Excellence is presented by Davies Award of Excellence, which recognizes outstanding
the Healthcare Information and Management Systems Society achievements in the use of health information technology (HIT)
(HIMSS). to improve public health outcomes.
• This award recognizes healthcare organizations that • In nursing informatics, these awards highlight organizations
demonstrate innovative and effective use of health information that have successfully integrated HIT into primary care practices
technology to improve patient outcomes and population health to enhance care delivery and patient safety.

Davies Award Public Davies Award

• The four major areas of the initial criteria— (a) management, Innovation in HIT: The award recognizes organizations that
(b) functionality, (c) technology, and (d) impact—provided a have implemented innovative health information technologies,
framework through which to view an implementation of such as electronic health records (EHRs), clinical decision
computerized records. support systems (CDSS), and telehealth solutions, to improve
• The criteria, which provided the foundation for the Nicholas E. nursing practice and patient care.
Davies Award of Excellence Program, reflect the nation’s Improved Patient Outcomes: Recipients of the award
journey from paper based to electronic capture of health data. demonstrate measurable improvements in patient outcomes, such
• The Davies Award of Excellence Program evolved through as reduced hospital readmissions, improved patient safety, and
multiple revisions and its terminology updated from the enhanced care coordination
computerized patient record, to the electronic medical record
(EMR), and more recently to the electronic health record (EHR). Organizational Davies Award
• Today, under HIMSS management, the Davies Award of Best Practices and Lessons Learned: Awardees share their
Excellence Program is offered in four categories: best practices and lessons learned with the broader healthcare
• Enterprise (formerly Organizational or Acute Care), first community, contributing to the advancement of nursing
offered in 1995; informatics and HIT.
• Ambulatory Care, started in 2003; Leadership and Collaboration: The award highlights the role
• Public Health, initiated in 2004; and of nursing informatics leaders in driving organizational change
• Community Health Organizations (CHO), first presented in and fostering collaboration among healthcare providers, IT
2008 professionals, and other stakeholders
• Since its inception in 1994, the award has honored Sustainability and Scalability: Successful organizations show
achievements in the implementation and use of Electronic that their HIT initiatives are sustainable and scalable, ensuring
Health Records (EHR) and other health IT solutions across long-term benefits and the potential for broader adoption
various healthcare settings, including hospitals, private across the healthcare industry.
practices, and community health organizations
• The Nicholas E. Davies Award of Excellence has been Electronic Health Record (EHR)
awarded to numerous healthcare organizations over the years for • An Electronic Health Record (EHR) is a digital version of a
their innovative use of health information technology. patient’s paper chart. It is a real- time, patient-centered record
Here are that makes information available instantly and securely to
a few notable recipients: authorized users
• An EHR contains comprehensive data about a
Davies Award patient’s medical history, including:
Stanford Medicine Children’s Health (2017) -  Patient demographics
Recognized for their use of technology to improve patient  Medical histories
outcomes, including reducing nephrotoxin exposure rates and  Vital signs
medication errors.  Medication histories
Northern Ohio Medical Specialists - Awarded the Ambulatory  Immunization records
Award for their achievements in health IT.  Lab test results
Advocate Healthcare - Honored for their enterprise-wide  Radiology images
implementation of health IT solutions  Progress notes
The Cleveland Clinic - Recognized for their comprehensive use
of electronic health records and other technologies to enhance The process of using an EHR involves several steps:
patient care. Data Entry: Healthcare providers input patient data into the
Henry Ford Health System - Awarded for their innovative EHR system.
approaches to integrating health IT into clinical workflows Storage: The data is securely stored either locally or in cloud-
Nebraska Medicine - Recognized for their significant based systems.
improvements in clinical care outcomes through the use of Access: Authorized users can access the data in real-time from
health IT. These organizations have demonstrated exceptional different locations.
commitment to leveraging technology to improve healthcare Sharing: EHRs are designed to be shareable across various
delivery and patient outcomes healthcare settings, allowing for coordinated care among
• The Organizational Davies Award is part of the Nicholas E. different providers.
Davies Award of Excellence, which recognizes outstanding Analysis: The data can be analyzed to improve patient care,
achievements in the implementation and use of health identify trends, and support clinical decisions
information technology (HIT) to improve patient outcomes.
• The Primary Care Davies Award is part of the Nicholas E.
Davies Award of Excellence, which recognizes outstanding
achievements in the use of health information technology (HIT)
to improve.
 NCM 110 - NURSING INFORMATICS
\
Electronic Health Record (EHR) develop, deploy, and routinely use CPRs to achieve improved
Software - EHR software systems are designed to securely outcomes in healthcare quality, cost, and access.
document, store, retrieve, share, and analyze patient care
information. Some popular EHR software Computerized Patient Record (CPR)
includes: 4 Major areas of the initial criteria
Epic: Known for its comprehensive features and widespread use • Management
in large healthcare systems. • Functionality
Cerner: Offers robust solutions for hospitals and clinics. • Technology
Allscripts: Provides flexible and customizable HER solutions. • Impact
Athenahealth: Known for its cloud-based EHR and practice
management solutions • Provided as the foundations of the Davies Award, reflecting
the nation’s journey from paper-based to electronic capture of
Computerized Patient Record (CPR) health data. The awards evolved through multiple revisions and
• Computerized Patient Record (CPR) is an essential technology its terminology updates (ex. EHR).
for healthcare and is an integral tool for all professionals. • Functionality: Assess whether the system meets the clinical
• Computer-Based Patient Record Institute (CPRI), 1992, and administrative needs of the healthcare facility. This includes
was given the mission to initiate and coordinate the urgently features like patient data entry, retrieval, and reporting
needed activities to develop, deploy, and routinely use CPRs to capabilities.
achieve improved outcomes in healthcare quality, cost, and • Usability: Evaluate the user interface and experience. The
access. system should be intuitive and easy to use for healthcare
• 4 Major areas of the initial criteria providers, minimizing the learning curve and reducing errors.
• Management CPR Project Evaluation Criteria
• Functionality • Interoperability: Check if the system can integrate with other
• Technology existing systems, such as laboratory information systems,
• Impact radiology systems, and other electronic health records
(EHRs). This ensures seamless data exchange and continuity of
• Provided as the foundations of the Davies Award, reflecting care.
the nation’s journey from paper-based to electronic capture of • Security and Privacy: Ensure that the system complies with
health data. The awards evolved through multiple revisions and relevant regulations and standards for data security and patient
its terminology updates (ex. EHR). privacy, such as HIPAA in the United States.
• Functionality: Assess whether the system meets the clinical
and administrative needs of the healthcare facility. This includes CPR Project Evaluation Criteria
features like patient data entry, retrieval, and reporting • Scalability: Determine if the system can handle an increasing
capabilities. amount of data and users without compromising performance.
• Usability: Evaluate the user interface and experience. The This is crucial for growing healthcare facilities.
system should be intuitive and easy to use for healthcare • Support and Training: Evaluate the availability of vendor
providers, minimizing the learning curve and reducing errors. support and the quality of training provided to the staff.
Adequate support and training are essential for successful
CPR Project Evaluation Criteria implementation and ongoing use.
• Interoperability: Check if the system can integrate with other • Cost: Consider the total cost of ownership, including initial
existing systems, such as laboratory information systems, setup costs, ongoing maintenance, and any additional costs for
radiology systems, and other electronic health records (EHRs). upgrades or expansions.
This ensures seamless data exchange and continuity of care. • Ethical and Organizational Impact: Assess the ethical
• Security and Privacy: Ensure that the system complies with implications and the impact on organizational workflows and
relevant regulations and standards for data security and patient culture. This includes evaluating how the system affects
privacy,such as HIPAA in the United States. patient care and staff satisfaction
• Scalability: Determine if the system can handle an increasing
amount of data and users without compromising performance.
This is crucial for growing healthcare facilities.
• Support and Training: Evaluate the availability of vendor
support and the quality of training provided to the staff.
Adequate support and training are essential for successful
implementation and ongoing use.
• Cost: Consider the total cost of ownership, including initial
setup costs, ongoing maintenance, and any additional costs for
upgrades or expansions.
• Ethical and Organizational Impact: Assess the ethical
implications and the impact on organizational workflows and
culture. This includes evaluating how the system affects
patient care and staff satisfaction
• Computerized Patient Record (CPR) is an essential
technology for healthcare and is an integral tool for all
professionals.
• Computer-Based Patient Record Institute (CPRI), 1992, was
given the mission to initiate and coordinate the urgently needed
activities to
 NCM 110 - NURSING INFORMATICS

• The box of any computer contains a motherboard. The • These devices allow the computer to receive information from
motherboard is a thin, flat sheet made of a firm, nonconducting the outside world. Example, keyboard and mouse.
material on which the internal components - printed circuits,
chips, slots, and so on - of the computer are mounted. Output Devices
• The motherboard is made of a dielectric or nonconducting • These devices allow the computer to report its results to the
plastic material. The specific design of the components on the external world. Output devices are defines as any equipment that
motherboard - especially the CPU and other microprocessors - translates the computer information into something readable by
composes the foundation of the computer's architecture. people or other machines.
Example, monitor and printer.

Memory

Input and Output Devices

Input Devices
 NCM 110 - NURSING INFORMATICS

computational operations and calculations, they are huge and

expensive.
Location: Oak Ridge National Laboratory —Tennessee, U.S.
Performance: 1,194 petaFLOPS (1.2 exaFLOPS)
Components: AMD EPYC 64-core CPUs and AMD Instinct
MI250X GPUs
First online: August 2022
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. It is a large multiuser central computer that meets the
computing needs of large- and medium-sized public and private
organization.
• Microcomputers (Personal Computers or PCs) – single user,
one person at a time kind of use. They are available as portable
or laptop computers, and as notebook, tablet, and handheld
computers.

WOW – workstation-on-wheels
COW – computer-on-wheels

Analog

Storage Media
 Hard Drive
 A peripheral
 device that has
 very high speed
 and high
 density.

USB Flash Drive

• It is a form of a small, removable hard drive that is inserted
into the USB port of the computer. It is also known as pen drive,
jump drive, thistle drive, pocket drive, and so forth.

Optical Media
• It includes CDs, DVDs, and Blu Ray. CD-ROMs and DVDs
are rigid disks that hold a higher density of information and have Digital
higher speed. CD-RWs are compact disc read-write Blu-ray
discs hold up to 27 GB of information Double Blu-ray discs can
store 54 GB or 4.5h of high-definition motion picture media.

Cloud Storage
• An extension of the online storage service offered by
individual vendors. Data stored "in the cloud" are still stored on
commercial computers called servers.
• "Cloud" refers to a distributed system of many commercial,
networked servers that communicate through the Internet, and
work together so closely that they can essentially function as one
large system.
• Data centers - data storage sites.

Major Types of Computers

Supercomputers – first developed by Seymour Crey in 1972. It
is a computational-oriented computer specially designed for
scientific applications requiring gigantic amount of calculations
that, 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
 NCM 110 - NURSING INFORMATICS

Hybrid Security Software

• Anti-virus - utilities serve primarily to guard against malicious
programs inadvertently accessed, usually through e-mail or
downloads from the Internet.
• Firewall - type of security program that makes it much harder
for unauthorized persons or systems to enter the computer and
hijack or damage programs or data on the computer
• Encryption programs – encodes the data so that it cannot be
read until it is decoded.

Disk Management Utilities

• Disk management utilities are essential for managing hard
drives, creating, resizing, or deleting partitions, and optimizing
storage.
• Disk management utilities are software tools designed to
manage storage devices (such as hard drives, SSDs, and external
drives) on a computer system. They allow users to perform
various tasks related to disk partitions, file systems, and storage
optimization.

Backup Utility
• This utility software helps to back up the files, folders,
Handheld databases, or complete disks. Moreover, backup refers to
• Computers/Personal Digital Assistants duplicating the disk information so that the data can be restored
• Smaller than a laptop but have the same functionality and if any data loss happens.
processing abilities but limited in their expansion possibilities,
their ability to serve as full participants in the office network, Screensavers
and the peripherals they can support. • Screensavers prevent phosphor burn-in on CRT and plasma
computer monitors.
Computer Software • A computer program that can be set to turn on after a period of
Categories of Software user inactivity (when you leave your computer). It was first used
• System Software – boots up the computer system; controls to prevent damage to older monitors but is now used as a way to
input, output, and storage; and controls the operations of the prevent viewing of desktop contents while the user is away.
application software
• Utility Programs – consists of programs designed to support Archival Assistance Software
and optimize the functioning of the computer system itself • Archivers output a stream or a single file when provided with a
• Applications Software – includes the various programs that directory or a set of files. Archive suites may include
users require to perform day-to-day tasks. compression and encryption capabilities. Some archive utilities
• System Software - Consists of variety of programs that control have a separate un-archive utility for the reverse operation. One
the individual computer and make the user’s application nearly universal type of archive file format is the zip file.
programs work well with the hardware.
• Basic Input/Output System (BIOS) Programming Environment Support Programs
• First line that searches for an operating system (OS) and loads • These utility software are used to manage files of the computer
it into the RAM. system. Since files are an important part of the system as all the
Operating System - It is the overall controller of the work of data is stored in the files. Therefore, this utility software help to
the computer. The OS software is loaded from the hard drive browse, search, arrange, find information, and quickly preview
into the RAM as soon as the computer is turned on. the files of the system.
-Can be changed or upgraded The connection between the CPU
and a peripheral or a user is called an interface. Managing the Types of Applicatuin software
storage is a critical tasks. [Link] browsers
• Utility Software - Include programs designed to keep the [Link] software
computer system operating efficiently by adding power to the [Link] software
functioning of the system software or supporting the OS or [Link] software
applications software programs. [Link] processors
[Link] software
*Six types of utility software [Link] software
 Security programs [Link] software
 disk management utilities [Link] software
 backup for the user’s data [Link] access software
 screen savers
 archival assistance software Open source software (OSS)
 programming • Open source software (OSS) is software that is distributed with
 environment support programs its source code, making it available for use, modification, and
distribution with its original rights. Open source software is code
that is designed to be publicly accessible—anyone can see,
modify, and distribute the code as they see fit.