Although health informatics has been around for a while it is still considered a very young science wrought with the usual definition inconsistencies, fuzzy boundaries, conflicting priorities, and limited research.
Thus it is no surprise that descriptions of nursing informatics and the relationship of it to health informatics are quite variable.
In response to these conditions our internationally recognized team of nursing informatics researchers led by the University of Illinois Chicago (UIC) College of Nursing has created its own definitions, boundaries, and priorities.
This has allowed us to build and move a powerful research agenda that addresses major priorities systematically in the field of nursing and health informatics.
Health informatics, to us, is the overarching field of the technical and health profession subspecialties whose collective efforts focus on gathering, storing, transmitting, visualizing, and analyzing healthcare information in support of patient care.
Since each health profession possesses a unique domain of knowledge that contributes to a patient’s care, it is natural to expect each to also have unique information needs.
For obvious reasons then, ensuring that information needs of a health profession are properly met must be the primary responsibility of the individual profession. This includes taking leadership in creating effective health informatics technical solutions that affect the work of the health professions such as the Electronic Health Record (EHR).
The practice of delegating this leadership responsibility to those not trained in one’s health profession (e.g., information technology specialists, computer engineers, etc.), as is often the case today, makes little sense and leads to poor information systems.
We therefore define nursing informatics as the subspecialty of nursing that focuses on meeting nursing’s information needs while ultimately connecting our solutions seamlessly to holistic health information solutions.
For nearly two decades the priority of our multidisciplinary nursing informatics research team (currently housed at UIC College of Nursing), is to ensure that EHRs capture and represent key standardized nursing care information at the point of care. This key information includes the
a) nursing issues addressed;
b) outcomes being monitored;
c) interventions delivered: and
d) progress toward goals.
Nurse access to this information that is accurate and in a standardized format is crucial to facilitating information flow that supports the continuity and quality of care across caregivers.
The BHD Initiative
To address this priority, our work has comprised the creation of a method for integrating nursing terminologies systematically into an electronic system (database and user interface) and demonstrating through comprehensive testing its support of nursing practice and ability to generate interoperable data.
Building on the foundational research, we now are demonstrating how the interoperable data collected with our validated method can be used to discover effective nursing practices and improve patient outcomes.
As a result, the entire body of knowledge created by our research agenda, positions nursing to be a significant t player in the new “big health data” (BHD) initiative in this country.
The BHD initiative is specifically focused on developing state of the art tools to extract and analyze data from large healthcare databases for the purpose of quickly uncovering useful patterns, trends and best practices never before possible.
The availability and use of high quality data, however, is a requirement for yielding meaningful discoveries and the good news is that nursing has the capability to generate good data. Thus, following in sequence are two new top priorities for nursing informatics needing attention:
1) wide scale adoption of proven methods for generating interoperable nursing data; and
2) participation of nursing informatics research community in the development of BHD tools that can be used to quickly analyze interoperable nursing data.
Unique Body of Knowledge
In conclusion, we are genuinely excited about the wonderful opportunities created by the field of health informatics that have the enormous potential to dramatically transform the cost and quality of healthcare. The degree of success to be achieved across the entire field, however, will depend on the quality of each subspecialty contribution and the ability to integrate these contributions into the larger whole.
At this juncture, we are proud of our team’s pioneering nursing informatics research and training efforts at the UIC CON. Through our long-term research agenda we have systematically identified, prioritized, and executed the sequential research steps necessary to produce the knowledge needed to achieve nursing’s information goals.
For the patients and healthcare community to benefit from the nursing informatics knowledge generated to date, however, it is imperative that the immediate priorities shift away from reinvention to strategic wide scale adoption and use of the knowledge in practice.
Gail M. Keenan has 11 years of classroom and clinical teaching. Currently, she leads the Nursing Informatics Initiative at UIC. Throughout her career she has conducted numerous seminars and lectured extensively on administrative nursing and nursing informatics.