Dr. Shirley E. Maranan
Management and Processing
Some barriers are:
Initial cost of acquisition
Privacy and security
Clinician resistance
Integration of legacy systems: this possess a
stiff challenge to many organizations
Some of the benefits are:
• Easy access of patient data
• Structured information
• Improved drug prescription and patient safety:
Clinical Information Systems improved drug
dosing and this leads to the reduction of
adverse drug interactions while promoting
more appropriate pharmaceutical utilization.
Major historical perspectives of
nursing and computers
Six time periods
Four major nursing areas
Standard initiatives
Significant land mark events (chart)
Nursing Practice
• Computer systems, patient care data and
NPC’s are integrated to Electronic Health
• Need for HER was perceived
• New Nursing terminologies were recognized.
Nursing Administration
• Computers linked department together.
• Hospitals data are accessed through
• Hospitals process goes online
• Internet was utiilized.
Nursing Education
• Most nursing schools offered computer
enhanced coursed.
• Campus-wide computer systems became
• Computer technology integrated into teaching
• World Wide Web facilitates student-centered
instructional settings.
Nursing Research
• Provides an avenue for analyzing data
• Softwares are available for processing
qualitative and quantitative data
• Research databases emerged
• Online access
Standard Initiative
• Nursing practice
• Nursing data
• Health care data standards
Nursing practice standard
• American Nurses Association (ANA) – considered
an official nursing organization that contributes in
the development and recommendation of
standards of nursing practice worldwide.
• Joint Commission on Accreditation of Hospital
Organizations (JCAHO) – focuses on the need for
adequate records on patient in hospital and
practice of standards in documentation of care.
Nursing data standard
• Emerged as a new requirements for EHR
• 13 nursing terminologies that has been
recognized by ANA
• Critical care classification system
• Nursing information classification
Health care data standards
• It is a critical review for the standard
organizations that have emerged to either
develop or recommend health care data
standards that should be recommended to the
federal government as required health care
data standards.
Significant Landmark of Event
• 1961 – Healthcare Information and Management
Systems Society was founded.
• 1965 – Development of one of the first hospital
information system in California.
• 1973 – First Conference on Management Information
• 1977 - First research: state-of-the-art conference on
Nursing Information Systems (NIS) held in Chicago 1979
First military conference on computers in nursing in
Washington DC 1980 First workshop on computer
usage in healthcare sponsored by the University of
Akron Ohio Significant Landmark Event YEAREVENT
• 1981 – First National Conference on Computer
Technology held in Bethesda becoming an annual
event, held in Newark, New Jersey First
international meeting: Working Conference on
Nursing Uses and Computers in Nursing held in
London First workshop on computers in nursing
held in Boston.
• 1984 – First Nursing Computer Journal is
• 1989 – Graduate program in Nursing Informatics
was introduced in Maryland University
• 1991 International Classification of Nursing Practice
(ICNP) was initiated First Doctoral Specialty in Nursing
Informatics sponsored by Maryland University
• 1992 American Nursing Informatics Association is
initiated at California, has since become international
ANA recognizes taxonomies: HHCC, OMAHA, NANDA,
NIC ANA recognizes Nursing Informatics as a specialty
by delineating the scope of practice
• 1993 – first International Nursing Informatics
Teleconference held in Australia.
• 1996 First Harriet Werley Award for best
nursing informatics paper Online Journal of
Nursing Informatics (OJNI) first published
• 1997 Nursing Information and Data Set
Evaluation Center (NIDSEC) standards and
scoring guidelines published to address
documentation of nursing care
• 1999 Nursing Vocabulary Summit Conference
• 2002 – JCAHO identified clinical information
system as a way to improve safety and
recommends that hospitals adopt technology.
• 2003 – Health Insurance Portability and
Accountability Act
• 2004 – Establishment of the National Health
Information Coordinator.
• An electronic record composed of health
information regarding an individual patient
that exists as part of a complete system
designed to provide access to, and
management of, such information. The EHR is
developed and managed by the health facility
or provider. The term Electronic Health Record
has largely replaced the older “Electronic
Medical Record.”
• It is much more than an electronic
replacement of existing paper systems. The
EHR can start to actively support clinical care
by providing a wide variety of information
services. However, it is hard to understand
what information is really important to clinical
care and what is simply occasionally desirable.
• The EHR bring uncountable advantages in
primary health care detaching such as the
faster access to information, the updated
information, it allows having a clinical process
with all the patient clinical information and an
easier access to information (ex: allows the
simultaneous access from different locations).
• Recognizable efforts in the development of
EHR are distinguished by the Nicholas E. Davis
Awards of Excellence Program whose history
describes the improvement of EHR in different
The Nicholas E. Davies Awards of
Excellence Program
• The Computer-Based Patient Record Institute
(CPRI), founded in 1992, was an organization
representing all the stakeholders in healthcare,
focusing on the clinical applications of
information technology. It was among the first
nationally based organizations to initiate and
coordinate activities to facilitate and promote the
routine use of Computer-Based Patient Records
(CPRs) throughout healthcare. The Nicholas E.
Davies Awards of Excellence Program
• The CPRI group on CPR Systems Evaluation
developed the CPR project evaluation criteria in
1993 which became the basis in assessing
accomplishments of CPR projects and provided
the Foundation of Nicholas E. Davies Awards
Excellence Program
• The Program was named after Dr. Nicholas E.
Davis, an Atlanta-based physician, president elect
of the American College of Physicians, and
member of Institute of Medicine (IOM)
committee in improving patient records. He was
killed in a plane crash just as the IOM report on
CPRs was being released
Differences of Nicholas E. Davis
Excellence Awardees
• On the other hand, Nicholas E. Davis
Excellence awardees shows differences that
make one distinct from the other Variable
years spent in EHR program development.
Different external agenda and societal
challenges. Application of new technologies
and techniques. Differences of Nicholas E.
Davis Excellence Awardees
• The HIMSS Nicholas E. Davies Awards of
Excellence recognize excellence in the
implementation and use of health information
technology, specifically EHRs, for healthcare
organizations, private practices and public
health systems
• Nowadays the Nicholas E. Davies Awards
Excellence Program is managed by the
Healthcare Information Management Systems
Society , and has the following program.
• Promote the vision of EHR systems through
concrete examples Understand and share
documented value of EHR systems
• Provide visibility and recognition for high impact
EHR system
• Share successful EHR implementation strategies
• Encourages and recognizes excellence in the
Implementation, Strategy, Planning, Project
The Healthcare Information
Management Systems Society
• The Healthcare Information and Management
Systems Society (HIMSS) is the healthcare
exclusively focused on providing global
leadership for the optimal use of healthcare
information technology (IT) and management
systems for the betterment of healthcare.
HIMMS Vision
• Advancing the best use of information and
management systems for the betterment of
health care HIMMS Mission - To lead change
knowledge sharing, advocacy, collaboration,
innovation, and community affiliations HIMMS
Four Criteria
• Management - the organizational aspects of EHR
implementation; strategy, planning, project
management and governance
• Functionality - delivered by the EHR to meet the
organizational objectives and the needs of
patients and end-users
• Technology - technical design and architecture
that enable the EHR to deliver the required
functionality and performance
• Value - concrete return on investment as well as
intrinsic value derived from the implementation
of the EHR