1-1 Discussion: Defining HIT and Assessing Attitudes Toward Its Implementation

Introduction to Information Technology—Role in Nursing and Healthcare

In this module, we begin with an introduction to information technology and the management of information. The readings in this module identify the many areas in healthcare in which information technology is used. The fundamental of healthcare delivery is an important start to our course. Information technology is used in such healthcare facilities as ambulatory care, acute care, and subacute care. The different methods and means each healthcare facility uses and manages information technology is outlined in our readings. Healthcare providers such as direct care providers, clinical allied professionals, and other organizations (i.e., American Medical Association, American Nurses Association) all use technology to guide delivery of care, information, and manage these deliveries for various reasons (McGonigle & Mastrian, 2015). 1-1 Discussion: Defining HIT and Assessing Attitudes Toward Its Implementation

Introduction

As an information-intensive profession, nursing continues to use information technology in healthcare. Nurses use information in applying knowledge to problems, and acting with wisdom forming the basis of the professional of nursing. The availability of this information in caring for patients continues to grow for nurses and allows for increased accessibility, accuracy, and timeliness in caring for patients. The information age is here for nursing and the U.S. healthcare system (McGonigle & Mastrian, 2015). In this module, an introduction to information technology (IT), its role in the professional of nursing, the QSEN Institute and its role in patient safety and quality, and the driving forces leading to its IT advancements in healthcare will be discussed.

Quality and Safety Education for Nurses

What is “QSEN?” QSEN stands for Quality and Safety Education for Nurses. According to McGonigle and Mastrian (2015), as nursing science continues to advance there is a concern that patient safety will be ignored or not improved. Therefore, the Quality and Safety Education for Nurses (QSEN) Institute project was created to address these quality and safety concerns and prepare future nurses with the knowledge, skills, and attitudes (KSAs) needed to improve the quality and safety of the healthcare systems. The goal of QSEN is to focus on addressing gaps in nursing education to include informatics in education that covers all the KSA levels and objectives are outlined. Examples of these are described on pages 14 through 15 of our textbook (McGonigle & Mastrian, 2015).

Strategic Plan for Health Information Technology

The addition of information technology to the U.S. system has taken strategic planning and involved several processes. These processes include informing clinical practice with use of electronic health records (EHR), interconnecting clinicians so that they can exchange health information using advanced and secure electronic communication, and personalizing care with consumer-based health records and better information for consumers (i.e., the patients). In addition, information technology within the health care system has a goal of improving public health through advanced biosurveillance methods and streamlining the collection of data for quality measurement and research (McGonigle & Mastrian, 2015).

Driving Forces

The driving forces leading the charge for information (IT) and management in healthcare are at the national and state levels. In addition, nursing is also influencing advancements in IT in today’s healthcare. At the national level, some of the forces include the creation of the President’s Information Technology Advisory Committee, or PITAC, groups to study standardizing terminology, the Institute of Medicine’s (IOM’s) reports emphasizing informatics as a core competency for all healthcare professionals, and the TIGER Initiative. Additional driving forces include patient safety. This is where QSEN falls into play. Safety databases and barcoding for medical administration are also initiatives. The costs: The Leapfrog Group is one group that is trying to address cost within our healthcare system, and examining the costs of healthcare for the U.S. healthcare system.

State and local influences include legislation. Nursing forces involve the National Center for Nursing Research program goals, the National Informatics Agenda for Education and Practice, the AACN’s list of core competencies, the American Nurses Association, and the impending nursing shortage. Finally, other influencing that are driving changes in healthcare to advance IT include more of a focus on patient safety (i.e., safety databases, barcoding medication, QSEN), and cost containment (i.e., the Leapfrog Group) (McGonigle & Mastrian, 2015).

Information Management Tool: Computers

A brief history of information technology and management begins in the early 1950s and 1960s when computers were introduced to manipulated numeric tasks for financial information and transactions. During this time, a few computers were introduced in patient care applications, but it was not until the late 1960s that early healthcare information systems began. These systems were the pioneers to the information systems we have today. These include the following: problem-oriented medical information systems (PROMIS), leading to the problem- oriented medical record (POMR) and Health Evaluation through Logical Processing (HELP) system. As information technology and management progressed, the process orientation was initially introduced, and then data standards in terminology and protocols began to be added, leading to the systems we have today (McGonigle & Mastrian, 2015).

Benefits of Information Technology to Healthcare in General

The benefits of information technology and management being used in healthcare today is that previously buried data is now usable, provides information about problems, and [has the] ability to show patterns to a problem. There is proven improvement to communication between interdisciplinary teams in healthcare. The healthcare record of clients is easy stored and quickly retrieved when needed. In addition, the added cost savings and time related to recording of tasks performed is demonstrated with use of information technology at the bedside in healthcare (McGonigle & Mastrian, 2015).

As a profession of nursing, the increased use of information technology and management has enhanced nursing practice, encouraged nursing science development, improved documentation of care and time spent with patients, and allowed for the use of data for quality control and research that is complete. The increased use of information technology by nurses has led to the building of evidence-based knowledge for the profession of nursing (McGonigle & Mastrian, 2015).

Standards

As information technology and management advances in our healthcare system, the industry must set and define standards for the exchange of this information. The information exchanged is often valuable patient and medical data between applications that communicate frequently with each other. Therefore, standards assists to ensure data in one database can be understood by another application or database. Vendors must support and adhere to standards in order to facilitate what is known as interoperability of diverse systems that are now seen in today’s healthcare system (McGonigle & Mastrian, 2015).

Interoperability is the ability of two or more systems to pass information and to use the exchanged information. There is adherence to accepted interface and terminology standards. Through the use of a third-party system (i.e., vendors) to seamlessly integrate two systems, three types of interoperability exist and are as follows:

·  Technical: useful transmission and reception

·   Semantic: automatic interpretation and action without human intervention

·   Process: workflow management (McGonigle & Mastrian, 2015)

· Data Elements

· 
Databases or paper records should include standard data elements to make it likely applications will have data similar to other systems, improving interoperability and providing common elements for system-wide reporting. A data set is a list of data elements collected for a particular purpose. 
Examples of this would be patient demographics, insurance information, or an individual’s next of kin. A healthcare data set usually represents the minimum list of data elements that must be collected in order for the system to understand and process information.

· Health Level Seven (HL7)

· Health Level Seven (HL7) is a nonprofit organization that first developed and now maintains the leading messaging standard used to exchange clinical and administrative data between different healthcare computer systems (McGonigle & Mastrian, 2015). This is the most prominent interoperability standard used in healthcare today. Facilities using various types of application software from multiple vendors must use HL7 to maintain interoperability between various applications. CCOW subset helps maintain context while switching between applications (McGonigle & Mastrian, 2015).

· References

· 
Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.

· McGonigle, D., & Mastrian, K. (2015). Nursing informatics and the foundation of knowledge. (3rd ed.). Boston, MA: Jones and Bartlett.

· The Networking and Information Technology Research and Development (NITRD) Program 2012 Strategic Plan. (2012). The Networking and Information Technology Research and Development (NITRD) program. Retrieved from https://www.nitrd.gov/Pubs/strategic_plans/2012_NITRD_Strategic_Plan.pdf