Nursing informatics in Canada
The Canadian Nurses Association (CNA) has taken the
position that registered nurses and other stakeholders in health care delivery
require information on nursing practice and its relationship to client
outcomes. A coordinated system to collect, store and retrieve nursing data in
It is clear priority for nursing in Canada is the
inclusion in electronic health records and national health data sets of the
nursing components of health information that have been identified, those
essential nursing data elements that must be collected stored and retrieved
from a national health information data bas. Nursing leaders must respond to
the challenge to identify those data essential for the management of patient
care and patient care units. The nursing components of health information have
the potential to provide nurses with the data required to build information for
use in reshaping nursing, as a profession prepared to respond to the health
needs of Canadians in the twenty-first century. However, the window of
opportunity have nursing data elements included in a national data set is
narrowing. We must ensure that the vision of nursing components in our national
health information mission becomes a reality for nursing in Canada
Canadian Institute for Health
Information
The establishment of the National Health Information Council in the late 1980s lead to the National Task Force on Health Information, also known as the Wilk Task Force, which presented comprehensive goals and strong vision for a nationwide health information system(National Task Force on Health Information, 1990).
In Canada nurses are in the fortunate position of recognizing theneed for nursing data elements at the time when the national healthinfostructure is under development. The challenge for nurses is tocapitalize on this timing and speak with one voice to promote theinclusion in the CIHI DAD and the Infoway EHR of those dataelements required by nurses in Canada. To prevent nurses inCanada from losing control of nursing data, nurses must take aproactive stance and mobilize resources to ensure the developmentand implementation of a national health data base and a panCanadian EHR that is congruent with the needs of nurses in allpractice settings in Canada. Some initiatives intended to promotethe vision, of nursing dateintegrated into the pan-Canadian EHRand national health data base, are in progress. Building on work of our U.S. colleagues on the NMDS, and inresponse to contextual factors influencing nursing in Canada,nurses in Canada have recognized the importance of the collectionand storage of essential data elements (Canadian NursesAssociation, 1990, June). Under the leadership of the CanadianNurses Association, nurses have more than 15 year of experience ininitiatives directed at building awareness and consensus regarding the definition and coding of these essential nursing components of health information (Canadian Nurses Association, 1990, June).Nurses built consensus (Canadian Nurses Association, 1993a,
1993b, 2001, April, 2001, November)on the five essential nursingcomponents of health information:
• Client status is broadly defined as a label for the set ofindicators that reflect the phenomena for which nursesprovide care, relative to the health status of clients (McGee,1993). Although client status is similar to nursingdiagnosis, the term client status was preferred because it
represents a broader spectrum of health and illness. Thecommon label “client status” is inclusive of input from alldisciplines. The summative statements referring to thephenomena for which nurses provide care (i.e. nursingdiagnosis) are merely one aspect of client status at a pointin time, in the same way as medical diagnosis.
• Nursing interventions refer to purposeful and deliberatehealth affecting interventions (direct and indirect), basedon assessment of client status, which are designed to bringabout results which benefit clients (Alberta Association ofRegistered Nurses (AARN), 1994).
• Client outcome is defined as a “clients’ status at a definedpoint(s) following health care [affecting]intervention”(Marek & Lang, 1993). It is influenced tovarying degrees by the interventions of all care providers.
• Nursing intensity “refers to the amount and type of nursingresource used to [provide] care” (O’Brien-Pallas &Giovannetti, 1993)
• Primary Nurse identifier is a single unique lifetimeidentification number for each individual nurse. Thisidentifier is independent of geographic location (provinceor territory), practice sector (e.g. acute care, communitycare, public health) or employer.
It is essential in Canada that the nursing data elements constituteone component of fully integrated health information data, e.g. theCIHI DAD (Canadian Institute for Health Information, 2002) or anEHR such as that being developed under the leadership of Infoway.Therefore, the five nursing data elements were identifiedcollectively as the Nursing Components of Health Information(Health Information:Nursing Components, HI: NC) (CanadianNurses Association, 1993b). Identifying those data elements that represent the most importantaspects of nursing care is only the first step. In Canada, nurses facedan immediate challenge to determine the most effective and efficient means to collect and code data elements that reflect nursing practice. To collect the data reflecting nursing contributions within the larger health information system, “there is a need for consistent data collection using standardized languagesto aggregate and compare data” (Canadian Nurses Association,1998).
Obstacles to effective nursing management
of information in Canada
In Canadian health care delivery organizations, like hospitals and health care agencies. In other countries, the major obstacles to more effective nursing management of information are: the sheer volume of information, the lack of access to modern information handling techniques and equipment, and the inadequate information infrastructure.
Another major issue is that nursing is frequently under represented in the decision making related to health information systems and EHRs in Canada. Regrettably, even when the opportunity is available, many senior nurse managers fail to recognize the importance of this activity and opt out of the process. They then complain when the systems do not meet the needs of nursing.Canadian senior nursing executives must recognize the importance of allocating staff and money to participate in the strategic planning process and policy making for information systems and EHRs in their organizations, provinces and national organizations. Leaders in provincial and federal EHR and health information systems initiatives must also recognize the importance of nursing input into the strategic planning process and decision/policy making related to such initiatives. In any Canadian health care delivery organization, nurses are the single largest group of professionals using a patient care information system or EHR and nursing represents the largest part of the budget. Nursing, therefore,represents the single largest stakeholder group in Canada related to either patient care information systems or EHRs.
It is clear that a priority for nursing in Canada is the inclusion in electronic health records and national health data sets of the nursing components of health information that have been identified, those essential nursing data elements that must be collected, stored and retrieved from a national health information data base. Nursing leaders must respond to the challenge to identify those data essential for the management of patient care and patient care units. The nursing components of health information have the potential to provide nurses with the data required to build information for use in reshaping nursing, as a profession prepared to respond to the health needs of Canadians in the twenty-first century. However, the window of opportunity to have nursing data elements included in a national data set is narrowing. We must ensure that the vision of nursing components in our national health information system becomes a reality for nursing in Canada.
Nursing informatics in Asia
In Asia , the regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1994 and now
consists of more than 15 member regions in the Asia Pacific Region.<div style="width:425px" id="__ss_3246750"> <strong style="display:block;margin:12px 0 4px"><a href="http://www.slideshare.net/sibermedik/health-informatics-in-asia-gunadarma-ujoko" title="Health Informatics In Asia (Gunadarma U)Joko" target="_blank">Health Informatics In Asia (Gunadarma U)Joko</a></strong> <iframe src="http://www.slideshare.net/slideshow/embed_code/3246750" width="425" height="355" frameborder="0" marginwidth="0" marginheight="0" scrolling="no"></iframe> <div style="padding:5px 0 12px"> View more <a href="http://www.slideshare.net/" target="_blank">presentations</a> from <a href="http://www.slideshare.net/sibermedik" target="_blank">PM Herlambang</a> </div> </div>
China
Health informatics in China
is about the Health informatics or Medical informatics or Healthcare
information system/technology in China.
The main review and assessment of health informatics in China for the WHO-Health Metrics Network was conducted in 2006 which details
Provincial assessments, developing strategic plan outline, improving community
health monitoring system, household surveys, routine health statistics system.
Due to the Health Informatization Development Plan, all hospitals are required to
increase investment in building digitized hospitals. This requirement is
expected to accelerate the growth of China 's
HIT market by about 25 to 30% a year during 2006-2010.
By the end of 2006, China ’s
investment in its healthcare
information systems (HIS) had
increased by nearly 16 percent to RMB 5.8 billion, year-on-year. This amount
accounts for approximately 0.5% of the country’s total healthcare expenditures
of RMB 866 billion during the same period.
The market size is expected to expand to approximately RMB 15 billion in
2010. The development of China ’s
HIT industry is generally considered to be at a preliminary stage, resembling
that of western countries 20 years ago. However, as China
learns more about available and emerging technologies, it now has the
opportunity to leapfrog ahead.
In Hong Kong a
computerized patient record system called the Clinical
Management System (CMS) has
been developed by the Hospital Authority since 1994. This system has been
deployed at all the sites of the Authority (40 hospitals and 120 clinics), and
is used by all 30,000 clinical staff on a daily basis, with a daily transaction
of up to 2 millions. The comprehensive records of 7 million patients are
available on-line in the Electronic
Patient Record (ePR), with
data integrated from all sites. Since 2004 radiology image viewing has been
added to the ePR, with radiography images from any HA site being available as
part of the ePR.
The Hong
Kong Hospital Authority placed
particular attention to the governance of
clinical systems development, with input from hundreds of clinicians being
incorporated through a structured process. The Health
Informatics Section in Hong
Kong Hospital Authority has close
relationship with Information Technology Department and clinicians to develop
healthcare systems for the organization to support the service to all public
hospitals and clinics in the region.
The Hong
Kong Society of Medical Informatics (HKSMI)
was established in 1987 to promote the use of information technology in
healthcare. The eHealth Consortium has been formed to bring together clinicians
from both the private and public sectors, medical informatics professionals and
the IT industry to further promote IT in healthcare in Hong Kong .
The Saudi Association for Health Information (SAHI) was established in 2006 to work under direct supervision of King
Saud Bin Abdulaziz
University
