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Nursing Informatics

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Introduction to Information, Information Science, and Information Systems
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Page 1: Nursing Informatics

Introduction to Information, Information Science, and Information

Systems

Page 2: Nursing Informatics

Objectives

• Reflect on the progression from data to information to knowledge.

• Describe the term information.• Assess how information is acquired.• Explore the characteristics of quality

information.• Describe an information system.

Page 3: Nursing Informatics

Objectives

• Explore data acquisition or input and processing or retrieval, analysis and synthesis of data.

• Assess output or reports, documents, summaries alerts and outcomes.

• Describe information dissemination and feedback.

Page 4: Nursing Informatics

Objectives

• Define information science.

• Assess how information is processed.

• Explore how knowledge is generated in information science.

Page 5: Nursing Informatics

Key Terms Defined• Acquisition - The act of acquiring, to locate and hold;

We acquire data and information.• Alerts - Warnings or additional information provided

to clinicians to help with decision making; the action of the clinician or system triggers the generation of an alert; an example of when an alert could be generated would be if the patient's serum potassium level is high and they are on potassium chloride, the system would alert the nurse on the screen (soft copy alert) with or without audio and/or by a printed (hard copy alert) warning; also know as triggers.

Page 6: Nursing Informatics

Key Terms Defined

• Analysis - Separating a whole into its elements or component parts; examination of a concept or phenomena, its elements, and their relations.

• Chief Information Officers (CIO) - CIO is involved with the information technology infrastructure and this role is sometimes expanded to Chief Knowledge Officer.

Page 7: Nursing Informatics

Key Terms Defined

• Chief Technical Officers (CTO) or Chief Technology Officers (CTO) -

Is/are focused on organizationally-based scientific and technical issues and responsible for technological research and development as part of the organization’s products and services.

Page 8: Nursing Informatics

Key Terms Defined

• Cognitive Science - The interdisciplinary field that studies the mind, intelligence and behavior from an information processing perspective. According to Wikipedia (2007), “The term cognitive science was coined by Christopher Longuet-Higgins in his 1973 commentary on the Lighthill report, which concerned the then-current state of Artificial Intelligence research” (¶ 1).

Page 9: Nursing Informatics

Key Terms Defined

• Communication Science - Area of concentration or discipline that studies human communication.

• Computer-Based Information System (CBIS) – Information systems used in the professional arena that are computer based.

Page 10: Nursing Informatics

Key Terms Defined• Computer Science - Branch of engineering (application

of science) that studies the theoretical foundations of information and computation and their implementation and application in computer systems; study of storage/memory, conversion and transformation, and transfer or transmission of information in machines, that is computers, through both algorithms and practical implementation problems, algorithms are detailed unambiguous action sequences in the design, efficiency and application and practical implementation problems deal with the software and hardware.

Page 11: Nursing Informatics

Key Terms Defined

• Consolidated Health Informatics (CHI) - A collaborative effort to adopt health information interoperability standards, particularly health vocabulary and messaging standards, for implementation in federal government systems.

• Data - Raw fact; lacks meaning.

Page 12: Nursing Informatics

Key Terms Defined• Dissemination - It is not simply the act of

scattering or spreading but a thoughtful, intentional, goal-oriented communication of specific, useful information or knowledge.

• Document - Represent information that can be printed, saved, emailed or shared, or displayed; communication in the form of written, or text, audio, video, graphic, photographic, pictorial or any blending of these means used to describe some characteristics or elements of an object, system or practice.

Page 13: Nursing Informatics

Key Terms Defined• Electronic Health Record (EHR) - A data

warehouse or repository of information regarding the health status of a client, replacing the former paper-based medical record; it is the systematic documentation of a client’s health status and healthcare in a secured digital format, meaning that it can be processed, stored, transmitted and accessed by authorized interdisciplinary professionals for the purpose of supporting efficient, high quality healthcare across the client’s healthcare continuum;

Page 14: Nursing Informatics

Key Terms Defined• Electronic Health Record (EHR) - cont’d(also known as

an Electronic Medical Record): An electronic health or medical record is a computer-based patient medical record that can be used to collect and look up patient data by physicians or health professionals at various locations such as doctor’s offices or hospitals. The record includes information such as patient problems, medications, allergies, laboratory results, etc. (Certification Commission for Healthcare Information Technology [CCHIT], 2007).also known as electronic medical record (EMR).

Page 15: Nursing Informatics

Key Terms Defined

• Federal Health Information Exchange (FHIE) - A Federal Information Technology (IT) health care initiative that enables the secure electronic one-way exchange of patient medical information from Department of Defense's legacy health information system, the Composite Health Care System (CHCS), for all separated service members to Veteran Affair's (VA) VistA Computerized Patient Record System (CPRS) - the point of care in Veteran Affairs.

Page 16: Nursing Informatics

Key Terms Defined• Feedback - Input in the form of opinions about or

reactions to something such as shared knowledge; in an ISs, feedback refers to information from the system that is used to make modifications in the input, processing actions or outputs.

• Health Information Exchange (HIE) – an organization charged with preparing and organizing people and resources to manage healthcare information electronically across organizations within a community or region.

Page 17: Nursing Informatics

Key Terms Defined• Health Level Seven (HL7) - Level Seven in HL7’s name

means the “highest level of the International Standards Organization's (ISO) communications model for Open Systems Interconnection (OSI) - the application level. The application level addresses definition of the data to be exchanged, the timing of the interchange, and the communication of certain errors to the application. The seventh level supports such functions as security checks, participant identification, availability checks, exchange mechanism negotiations and, most importantly, data exchange structuring” (¶ 5); HL7 (n.d.) “is one of several American National Standards Institute (ANSI) -accredited Standards Developing Organizations (SDOs) operating in the healthcare arena” ¶ 1).

Page 18: Nursing Informatics

Key Terms Defined• Health Level Seven (HL7) – (cont’d) Their mission

states that “HL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity, and enhance knowledge transfer among all of our stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients” (¶ 5). HL7 was initially associated with HIPAA in 1996 through the creation of a Claims Attachments Special Interest Group charged with standardizing the supplemental information needed to support healthcare insurance and other e-commerce transactions.

Page 19: Nursing Informatics

Key Terms Defined

• Indiana Health Information Exchange (IHIE) – an example of a regionally based health information exchange

• Information - Data that are interpreted, organized, or structured; data that is processed using knowledge or data made functional through the application of knowledge.

Page 20: Nursing Informatics

Key Terms DefinedInformation Science - Can be thought of as the science of

information, studying the application and usage of information and knowledge in organizations and the interfacings or interaction between people, organizations and information systems.

• It is an extensive, interdisciplinary science that integrates features from cognitive science, communication science, computer science, library science and social sciences.

• Information science is primarily concerned with the input, processing, output, and feedback of data and information through technology integration with a focus on comprehending the perspective of the stakeholders involved and then applying information technology as needed. (cont’d)

Page 21: Nursing Informatics

Key Terms DefinedInformation Science – (cont’d)• It is systemically based, dealing with the big picture

rather than individual pieces of technology. • Information science can be related to determinism. It

is a “Response to technological determinism, the belief that technology develops by its own laws, that it realizes its own potential, limited only by the material resources available, and must therefore be regarded as an autonomous system controlling and ultimately permeating all other subsystems of society" (Wikipedia, 2007, ¶ 2; Web Dictionary of Cybernetics and Systems, 2007).

Page 22: Nursing Informatics

Key Terms Defined

• Information System (IS) - "group of components that interact to produce information. The system that uses a computer to produce information is considered automated." (Mastrian, McGonigle & Pavlekovsky, 2007, p. 181); the manual and/or automated components of a system of users or people, recorded data and actions used to process the data into information for a user, group of users or an organization.

Page 23: Nursing Informatics

Key Terms Defined• Information Technology (IT) - use of hardware,

software, services, and supporting infrastructure to manage and deliver information using voice, data, and video or the use of technologies from computing, electronics, and telecommunications to process and distribute information in digital and other forms; anything related to computing technology, such as networking, hardware, software, the Internet, or the people that work with these technologies. Many hospitals have IT departments for managing the computers, networks, and other technical areas of the healthcare industry.

Page 24: Nursing Informatics

Key Terms Defined

• Infrastructure - is generally structural elements that provide the framework supporting an entire structure. The term has diverse meanings in different fields, but is perhaps most widely understood to refer to roads, airports, and utilities. These various elements may collectively be termed civil infrastructure, municipal infrastructure, or simply public works, although they may be developed and operated as private-sector or government enterprises. (cont’d)

Page 25: Nursing Informatics

Key Terms Defined• Infrastructure - (cont’d)In other applications,

infrastructure may refer to information technology, informal and formal channels of communication, software development tools, political and social networks, beliefs held by members of particular groups. Still underlying these more general uses is the concept that infrastructure provides organizing structure and support for the system or organization it serves, whether it is a city, a nation, or a corporation (Wikipedia, 2007, ¶ 1, http://en.wikipedia.org/wiki/Infrastructure)

Page 26: Nursing Informatics

Key Terms Defined• Input - Entering or alterations that are put into a

system; enter or change data and information in a system in order to activate or modify a process; gathering and capturing raw data.

• Interface - Mechanism or a system used by separate things to interact for example, if you want to change a CD in your CD Player, you could use a remote, you are not related to the CD Player but you can interact using the remote control, therefore, the remote control becomes the interface that enables you to tell the CD Player which CD you want to play.

Page 27: Nursing Informatics

Key Terms Defined• Knowledge - The awareness and understanding of a set of

information and ways that information can be made useful to support a specific task or arrive at a decision; abounds with others’ thoughts and information; information that is synthesized so that relationships are identified and formalized; understanding that comes through a process of interaction or experience with world around us ; info that has judgment applied to it or meaning extracted from it; processed information that helps to clarify or explain some portion of our environment or world that we can use as a basis for action or upon which we can act; internal process of thinking or cognition; external process of testing, senses, observation, interacting.

Page 28: Nursing Informatics

Key Terms Defined

• Knowledge Worker - Work with information and generate information and knowledge as a product.

• Library Science - An interdisciplinary science that integrates law, applied science and the humanities, to study issues and topics related to libraries (collection, organization, preservation, archiving and dissemination of information resources).

Page 29: Nursing Informatics

Key Terms Defined

• Massachusetts Health Data Consortium (MAHD) - A consortium of regional healthcare organizations that collect data, publish comparative information, support and promote electronic standards, education and research.

Page 30: Nursing Informatics

Key Terms Defined• National Health Information Infrastructure (NHII) - An

initiative set forth to improve the effectiveness, efficiency and overall quality of health and health care in the United States; a comprehensive knowledge-based network of interoperable systems of clinical, public health, and personal health information that would improve decision-making by making health information available when and where it is needed; the set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health; voluntary and not a centralized database of medical records or a government regulation.

Page 31: Nursing Informatics

Key Terms Defined

• National Health Information Network (NHIN) - Goal is to keep pharmacy prepared to meet healthcare needs and access, safely and conveniently.

• New England Health EDI Network (NEHEN) - Is an example of an implementation model for building RHIOs that are functional, sustainable and growing while reducing administrative costs.

Page 32: Nursing Informatics

Key Terms Defined

• Next Generation Internet (NGI) - A government project to develop new, faster technologies to enhance research and communication.

• Outcome - Changes, results and/or impacts from inputting and processing.

• Output - Changes which exit a system and that can activate or modify processing.

Page 33: Nursing Informatics

Key Terms Defined• Processing - To act on something by taking it

through established procedures in order to convert it from one form to another; for example: information is processed data or we process a credit application to get a loan.

• Rapid Syndromic Validation Project (RSVP) - System where local healthcare professionals report cases such as the influenza via the RSVP system where data is analyzed centrally and the resulting information is shared with appropriate local authorities.

Page 34: Nursing Informatics

Key Terms Defined

• Report - Documents that contain data or information based on a query or investigation designed to yield customized content in relation to a situation and a user, group of users, or an organization; designed to inform, reports may include recommendations or suggestions based on programming and other embedded parameters.

Page 35: Nursing Informatics

Key Terms Defined

• Social Sciences - Collection of academic/scientific fields or disciplines concerned with the study of the human aspects of our world/environment.

• Stakeholders - An individual or group with the responsibility for completing a project, influencing the overall design, and is most impacted by success or failure of the system implementation.

Page 36: Nursing Informatics

Key Terms Defined

• Summaries - Condensed versions of the original designed to highlight the major points.

• Synthesis - Assimilation or integration of two or more pre-existing elements resulting in a new concept or creation; task of putting together pieces or parts to form a new whole (Wikipedia, 2007).

Page 37: Nursing Informatics

Key Terms Defined

• Telecommunications - Broadcasting or transmitting signals over a distance from one person to another person or from one location to another location for the purpose of communication.

Page 38: Nursing Informatics

Introduction

• In this chapter you will be exploring information, information systems and information science.

• As healthcare professionals, we are knowledge workers and deal with information on a daily basis.

• With the gauntlet of an Electronic Health Record (EHR) being set, public and private sector stakeholders have been collaborating on a wide-ranging variety of healthcare information solutions.

Page 39: Nursing Informatics

Information

• Information is processed data that has meaning.

• There are many types of data that we must deal with such as alpha, numeric, audio, image and video data.

• Some of the alphanumeric data that we are concerned with is in the form of our patient’s name, ID or medical record numbers.

Page 40: Nursing Informatics

Information

• Image data would include graphics and pictures such as graphic monitor displays or recorded Electrocardiograms, X-rays, MRIs and CT scans to name a few.

• Video data refers to animations, moving pictures or moving graphics.

• Data integrity can be compromised through human error, viruses, worms, or other bugs, hardware failures or crashes, transmission errors, and/or hackers entering the system.

Page 41: Nursing Informatics

Information

• Information technologies can help to decrease these errors by putting safeguards in place such as backing up files on a routine basis, error detection for transmissions and developing user interfaces that help people enter the data correctly.

• It is imperative that we have clean data if we want quality information.

Page 42: Nursing Informatics

Information

• Quality of information is necessary for it to be valuable.

• There are several characteristics of valuable, quality information such as accessibility, secure, timely, accurate, relevant, complete, flexible, reliable, objective, has utility, transparency, verifiable and reproducible.

Page 43: Nursing Informatics

Information

• The two ways that we acquire information are either by actively looking for it or having it conveyed to us by our environment.

• Currently, we receive information from our computers (output), through our vision, hearing or touch (input), and we respond (output), to the computer (input), and this is how we interface with technology.

Page 44: Nursing Informatics

Information Science• Information science can be thought of as the science of

information, studying the application and usage of information and knowledge in organizations and the interfacings or interaction between people, organizations and information systems.

• Information science is primarily concerned with the input, processing, output, and feedback of data and information through technology integration with a focus on comprehending the perspective of the stakeholders involved and then applying information technology as needed.

Page 45: Nursing Informatics

Information Science

• Information science can be related to determinism.

• Our society is dominated by the need for information and knowledge and information science focuses on systems as well as individual users fostering user-centered approaches that enhance society’s information capabilities by effectively and efficiently linking people, information and technology.

Page 46: Nursing Informatics

Information Processing• Information science enables the processing of

information. • Humans are organic information systems

constantly acquiring, processing and generating information or knowledge both in our professional and personal lives.

• Information is data that is processed using knowledge. In order for information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable and secure.

Page 47: Nursing Informatics

Information Processing• Knowledge is the awareness and understanding

of a set of information and ways that information can be made useful to support a specific task or arrive at a decision.

• Knowledge must be viable. • Knowledge viability refers to applications that

offer easily accessible, accurate and timely information obtained from a variety of resources and methods and presented in a manner as to provide us with the necessary elements to generate knowledge.

Page 48: Nursing Informatics

Information Processing• Information science and computational tools are

extremely important in enabling the processing of data, information and knowledge in healthcare.

• The links between information processing and scientific discovery are paramount.

• Knowledge and wisdom are not synonymous since knowledge abounds with others’ thoughts and information while wisdom is focused on our own minds and the synthesis of our experience, insight, understanding and knowledge.

Page 49: Nursing Informatics

Information Science and The Foundation of Knowledge

• Information science is a multidisciplinary science that involves aspects from computer science, cognitive science, social science, communication science and library science to deal with obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing, disposing of, distributing or broadcasting information.

• Information science studies everything that deals with information and can be defined as the study of information systems.

Page 50: Nursing Informatics

Information Science and The Foundation of Knowledge

• This science originated as a sub-discipline of computer science, in an attempt to understand and rationalize the management of technology within organizations.

• Information science impacts information interfacing, influencing how we interact with information, and subsequently develop and use knowledge.

Page 51: Nursing Informatics

Information Science and The Foundation of Knowledge

• Healthcare organizations have been profoundly affected by the evolution of and rely on information science to enhance the recording and processing of routine and intimate information while facilitating human-to-human and human-to-systems communications, delivery of healthcare products, dissemination of information and enhancing the organization’s business transactions.

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Information Science and The Foundation of Knowledge

• Information science has had a tremendous impact on society and will expand its sphere of influence as it continues to evolve and innovate human activities at all levels, especially the nature of our work.

Page 53: Nursing Informatics

Introduction to Information Systems

• Information and information technology have become major resources for organizations and healthcare is no exception.

• Information technologies help to shape the healthcare organization, in conjunction with the personnel or people, money, materials and equipment.

Page 54: Nursing Informatics

Introduction to Information Systems

• In healthcare, information systems must be able to handle the volume of data and information necessary to generate the needed information and knowledge for best practices, the basis of our actions, since our goal is to provide the highest quality of patient care.

Page 55: Nursing Informatics

Information System

• Information systems can be manually-based but for the purposes of this text, we are referring to computer-based information systems.

• ISs are designed for specific purposes within organizations.

• The IS’s capability to disseminate, provide feedback and adjust the data and information based on these dynamic processes are what sets them apart from other computer systems.

Page 56: Nursing Informatics

Information System

• Processing, the retrieval, analysis and/or synthesis of data, refers to the alteration and transformation of the data into helpful or useful information and outputs.

• The processing of data can range from storing it for future use to comparing the data, making calculations or applying formulas, to taking selective actions.

Page 57: Nursing Informatics

Information System

• Output or dissemination produces helpful or useful information that can be in the form of reports, documents, summaries, alerts or outcomes.

• Documents represent information that can be printed, saved, emailed or shared, or displayed.

Page 58: Nursing Informatics

Information System

• Outcomes are the expected results of input and processing.

• Output devices are combinations of hardware, software and telecommunications and include sound and speech synthesis outputs, printers and monitors.

• The IS must also be able to generate payment either electronically or by generating a bill, and storing the transactional record for future use.

Page 59: Nursing Informatics

Information System

• Feedback or responses are reactions to the inputting, processing and outputs.

• In ISs, feedback refers to information from the system that is used to make modifications in the input, processing actions or outputs.

Page 60: Nursing Informatics

Thought Provoking Questions

• How do you acquire information? Choose two hours out of your busy day and try to take note of all of the information that you receive from your environment. Keep a diary denoting where the information came from and how you knew it was information and not data.

Page 61: Nursing Informatics

Thought Provoking Questions

• Reflect on an information system that you are familiar with such as the automatic banking machine. How does this IS function? What are the advantages of using this system i.e., in the banking machine example, why not use a bank teller instead? What are the disadvantages? Are there enhancements that you would add to this system?

Page 62: Nursing Informatics

Thought Provoking Questions

• In healthcare, think about a typical day of practice and describe the setting, how many times does the nurse interact with ISs? What are the IS that we interact with and how do we access them? Are they at the bedside, handheld or station-based? How does their location and ease of access impact nursing care?

Page 63: Nursing Informatics

Thought Provoking Questions• Since our society is dominated by the need for

information and knowledge and information science focuses on systems as well as individual users fostering user-centered approaches that enhance society’s information capabilities by effectively and efficiently linking people, information and technology. Briefly describe an organization and discuss how this impacts the configuration and mix of organizations and influences the nature of work or how knowledge workers interact with and produce information and knowledge in this setting.

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Thought Provoking Questions• Information systems support and facilitate the

functioning of people to enhance and evolve nursing practice by generating knowledge. This knowledge represents five rights: the right information, accessible by the right people in the right settings, applied the right way at the right time. It is also the struggle to integrate new knowledge and old knowledge to enhance wisdom. (cont’d)

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Thought Provoking Questions• (cont’d) If clinicians are inundated with data

without the ability to process it, this yields too little wisdom. That is why it is crucial that clinicians have viable information systems at their fingertips to facilitate the acquisition, sharing and utilization of knowledge while maturing wisdom; it is a process of empowerment. If you could only meet 4 of the Rights, which one would you omit and why? Also, provide your rationale for each Right you chose to meet.


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