What is Informatics?

Chris Curran, PhD, RN

M8120
September 4, 2001
 The modern age has a false
sense of superiority because it
relies on the mass of knowledge
that it can use, but
what is important is the extent to
which knowledge is organized
and mastered.
Goethe, 1810
Terms
Medical Informatics
Healthcare Informatics
Nursing Informatics
Goal of Nursing Informatics
“The goal of nursing informatics is to improve
the health of populations, communities,
families and individuals by optimizing
information management and
communication. This includes the use of
technology in the direct provision of care, in
establishing effective administrative systems
managing and delivering educational
experiences, supporting life-long learning and
supporting nursing research.”

Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of
Practice and Professional Performance for the Informatics Nurse Specialist
First Definition:
Nursing Informatics

“The application of computer technology

to all fields of nursing—nursing service,
nurse education, and nursing research.”
(Scholes and Barber, 1980, p. 70)
Definition: Nursing Informatics

Nursing informatics is a combination of

nursing science, information science,
and computer science to manage and
process nursing data, information and
knowledge to facilitate the delivery of
health care.
(Graves & Corcoran, 1989)
Definition: Nursing Informatics
Nursing Informatics is a specialty that
integrates nursing science, computer science, and
information science to manage and communicate
data, information, and knowledge in nursing practice.
Nursing informatics facilitates the integration of data,
information and knowledge to support patients,
nurses and other providers in their decision-making
in all roles and settings. This support is accomplished
through the use of information structures and
information technology.

Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the Informatics Nurse Specialist
Definition: Medical Informatics
The scientific field that deals with
biomedical information, data and
knowledge-their storage, retrieval, and
optimal use for problem-solving and
decision-making.
(Shortliffe & Perreault, 2001)
The Metastructures, Concepts, and Tools
of Nursing and Nursing Informatics

Nursing Nursing Informatics

Nurses, patients, health, Nursing data, information, and

environment knowledge
Content of information Design, structure and presentation
of information as it impacts nurses’
decision-making

Using information applications Optimizing information structures,

and technology applications and technology for use
in managing and communicating
data, information and knowledge

Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the Informatics Nurse Specialist
What Informatics is Not…

Synonymous with computer technology

Facts
Recognized as a specialty for registered
nurses by the American Nurses
Association in 1992.
Computers can’t…but Humans can…

Perceive data and information

Abstract data and information
Make decisions that involve values and
risk preferences
Scope of Informatics
Data, information, knowledge and
wisdom
Communication and information
management
Types, capabilities, and limitations of
technology
Legal and ethical considerations of
information
Key Concepts
Data Technology
Information Hardware
Knowledge Software
Wisdom Electronic Standards
Knowledge Workers System Architecture
Decision Making Internet / WWW
Informatics Database
Competencies
Workflow
Data, Information and Knowledge
(Blum, 1986)

Data are discrete entities that are

described objectively without
interpretation,
Information is data that are interpreted,
organized, or structured, and
Knowledge is information that is
synthesized so that relationships are
identified and formalized
Wisdom
Wisdom is the appropriate use of data,
information and knowledge in making
decisions and implementing nursing
actions.
Knowledge Workers
Definition: Knowledge work is non-
repetitive, non-routine work consuming
considerable levels of cognitive activity
(Drucker, 1993).
Bring their knowledge, skills, judgment,
and time to the organization
Information Processed:
Quantity vs. Quality (Patel, 1997)

Relevant
Information
Information
Processed

Novice Intermediate Expert

Decision Making
Models
 Information Processing
 Decision Analysis
 Skill Acquisition
Uncertainty
Biases
Decision Making
Process vs Outcome
Critical Thinking vs Decision Making
Workflow
Process Mapping
Low Level vs High Level Processes
Systems Architecture
Integrated
Distributed
Overarching Standards of Practice for the
Informatics Nurse Specialist

1. Incorporates theories, principles and concepts from

appropriate sciences into informatics practice such as
information, systems, and change theories;
implementation methods, organizational culture, and
database structures.
2. Integrates ergonomics and human-computer
interaction principles into informatics solution design,
selection, implementation and evaluation.
3. Systematically determines the social, legal, and
ethical impacts of an informatics solution within
nursing and health care.
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of
Practice and Professional Performance for the Informatics Nurse Specialist
Informatics Nurse Specialist
Standards of Practice

Standard I. Identify the Issue or Problem

Standard II. Identify Alternatives
Standard III. Choose and Develop a
Solution
Standard IV. Implement the Solution
Standard V. Evaluate and Adjust Solutions

Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of
Practice and Professional Performance for the Informatics Nurse Specialist
Informatics Nurse Specialist
Standards of Professional Performance

Standard I. Quality of Nursing Informatics Practice

Standard II. Performance Appraisal
Standard III. Education
Standard IV. Collegiality
Standard V. Ethics
Standard VI. Collaboration
Standard VII. Research
Standards VIII. Resource Utilization
Standard IX. Communication
Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards of
Practice and Professional Performance for the Informatics Nurse Specialist
Theoretical Models
Schwirian (1986)
Graves & Corcoran (1989; 1995)
Staggers and Parks (1993)
ANA Scope and Standards Document
(2001)
Schwirian Model (1986)

Goal

Computer

Hardware

Software

Information
NI Activity

User

Context

Source: Schwirian, P. M. (1986). The NI pyramid-A model for research in nursing informatics.
Computers in Nursing, 4(3), 134-136.
Graves and Corcoran Model
(1989; 1995)

Literacy Management

Data Decisions

Information Designs

Knowledge Discoveries

Informatics
(structure and transformation)

Source: Graves, J. R., Amos, L. K., Huether, S., Lange, L., & Thompson, C.B. (1995). Description of a graduate program
in clinical nursing informatics. Computers in Nursing, 13(2), 60-70.
 Staggers and Parks Nurse-Computer
Interaction Framework (1993)

Nursing Informatics Development Trajectory

Nursing Context

Nurse Characteristics

Nurse Behaviors

Initiate

Information Task Exchange

Time

Respond
Computer Interface Options

Computer Characteristics

Source: Staggers, N. & Parks, P. A. (1993). Collaboration between unlikely disciplines in the creation of a conceptual framework for
nurse-computer interactions. In M. E. Frisse, (ed.). Proceedings of the Sixteenth Annual Symposium on Computer Applications in
Medical Care, NY: McGraw Hill, 661-665.
ANA Scope & Standards Model
(2001)

Knowledge

Information

Data

Human Intellect

Fig. 1 Transformation of Data to Knowledge

Source: ANA. (2001, proposed). The Scope of Practice of Nursing Informatics and the Standards
of Practice and Professional Performance for the Informatics Nurse Specialist
Informatics Competencies
Levels of Competency
 Beginning Nurse
 Experienced Nurse
 Informatics Nurse Specialist
 Informatics Innovator
Types
 Computer Skills
 Informatics Knowledge
 Informatics Skills
Informatics Competencies:
Three Areas
Computer Literacy
 a set of skills that allow individuals to use computer
technology to accomplish tasks.
Informatics Knowledge
 a set of cognitive processes that allows the individual to
recognize what, when, and where information is needed and
to locate, evaluate, and use that information appropriately.
Informatics Skills
 the technical ability to use tools and techniques to improve
information and knowledge access, integration, management
and use.
Beginning Nurse:
Informatics Competencies

Has basic computer skills

Uses applications
Uses sources of data
Uses technology for care delivery,
communication, and decision support
Respects and protects patients’ rights to
privacy and confidentiality of
information
Experienced Nurse:
Informatics Competencies
Understands the value of data and
information
Uses technology to trend and aggregate
individual and population-based patient
information for decision support and
communication
Evaluates quality of information sources
Advocates for technology solutions that
improve care delivery
Informatics Nurse Specialist:
Informatics Competencies
Uses advanced systems and tools to manage,
evaluate, integrate, and communicate data,
information and knowledge
Assesses current capabilities and limitations
of technology and their impact on users and
organizations
Manages IT projects across the systems life
cycle
Actively seeks to improve the information and
knowledge available for clinical decision-
making
Informatics Innovator:
Informatics Competencies

Conducts research related to nursing

informatics
Influences top-level decisions and policy
design which impact clinical information
management
Builds theoretical models of NI
Evaluates system level informatics
initiatives
Roles of the Informatics Nurse
Specialist

Project Management
Consultation
Education
Research
System Development
Decision Support/Outcomes Management
Policy Development
Entrepreneur
Information Needs and Tools for Practice

Sound Clinical Decision Making

Evidence Based Practice
Standardized Vocabularies
Clinical Information Systems
Electronic Patient Records:
Development Constraints

Need for standards in clinical

terminology
Concerns about data privacy,
confidentiality and security
Data entry challenges
Integration of records and other
information resources
Research Priorities
Brennan, Zielstorff, Ozbolt, & Strombom, 1998)

Standardized language/vocabularies
Technology development to support practice/ patient care
Data base issues
Patient use of information technologies
Using telecommunications technology for nursing practice
Putting technology into practice
Systems evaluation issues
Information needs of nurses and other clinicians
Nursing intervention innovations for professional practice
Professional practice issues
Assumptions to be Challenged
Organization of electronic systems
 Desktop metaphor
 EMR
 Chronological structure
 Set of processes to be supported by technology