The American Nurses Association (ANA) has recognized nursing informatics as a specialty since 1992. Healthcare systems in first-world countries utilize informatics practitioners as part of daily practice. However, fellow nurses in developing countries may still not fully understand what nursing informatics truly is.

For this reason, the graduate students of Central Philippine University conducted a webinar. They collaborated with Qualimed Iloilo. Its purpose was to demystify in a way the application of nursing informatics in Medical-Surgical settings. Additionally, they offered 3.5 continuing professional development (CPD) units for license renewal. Considering my current role, they opted to invite me to speak on the topic.

Here is the video link and the presentation starts at the 37-minute mark:

https://www.facebook.com/100069349868560/videos/1057947328167748/

Defining the Specialty

In part, the ANA states that

Nursing informatics (NI) is the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice.

We highlighted the metastructures of NI which are data, information, knowledge, and wisdom (DIKW). DIKW serves as the foundation of everything concerning NI. We have acknowledged that NI permeates all aspects of healthcare both on the clinical and administrative sides of things.

The Electronic Health Record (EHR)

Former President Bush signed a law in 2004 that all Americans must have EHRs by 2014. Thus, the widespread use in the United States of America. People may be familiar with the term but not to the extent of how it is being currently used.

We mentioned some of the aspects of Meaningful Use and the role of Centers for Medicare and Medicaid Services (CMS) in financial reimbursement for meeting the requirements. We touch-based on the importance of computerized provider order entry (CPOE). Best practice advisories were also discussed in the case of allergies entered or the medication administered, among other things.

One of the things we mentioned was the ability to streamline workflows using the EHR. For one, the navigators literally walk the nurse through the necessary documentation for admission, transfer, and discharge. We talked about the ability of the sections to talk to each other. As far as quality improvement, we have demonstrated the ease and convenience of extracting data and identifying trends.

Challenges for Implementing EHR in Developing Countries

The audience was very upfront in identifying some of the challenges in a developing country. They mentioned such truths as unreliable internet connection, cybersecurity concerns, and hesitance to change. Because of those, they feel that it will be harder to introduce EHR locally. They acknowledge that maybe some aspects of it may be implemented soon, but not in its entirety.

Their interest was piqued when interoperability was mentioned. They were amazed that EHR interoperates with cardiopulmonary monitors and intravenous pumps. However, upon realizing that these cost considerable amount, they considered this as another hurdle!

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Role of the Nurse Informaticist

Nurse informaticists are the catalyst between the end-users or clinicians and the information technology (IT) folks. In a way, these highly skilled nurses interpret the workflow of frontline staff to the IT staff. By doing so, the latter are able to procure devices and build program applications that are beneficial to the end-users. This is from the usability perspective of course.

Furthermore, improvement in workflow through the use of technology promotes better and safer patient care. At the end of the day, this is the most important goal of all:

To provide safe, quality, holistic, and person-centered care.

Another way of achieving this goal is for the informaticists to educate the end-users on how to use the devices and applications in practice. They conduct onboarding classes for clinicians, including nurses, as well as provide onsite support during upgrades or Go-Lives of new innovations.

The Discussion

Considering the fact that more than 500 registrants signed up for the webinar, it was smooth-sailing and well-conducted by the organizers. Participants asked questions via chat, messages to the organizers, and verbally expressed them via Zoom. The questions were insightful and realistic from each of their respective perspectives. Some participants also shared their own experiences in dealing with the EHR, insurance billing, reimbursement, and the like.

Personally, I liked the question:

What is the biggest challenge nursing informatics face today?

There is a myriad of answers to this question. The explosion of using Internet of Things is one. Training of end-users is another. However, I sincerely believe that the greatest challenge in the field today is our inability to keep up with technology in use!

The logic is simple: you buy a phone today; by tomorrow, it is almost obsolete already! The same can be said about healthcare technology. It is therefore important for nursing informatics practitioners to keep up with the advances in technology and to disseminate that information to the stakeholders.

My Personal Reflection on the Experience

I am no stranger to teaching. In fact, I was a clinical instructor at the outset of my nursing career. Also, I have been conducting virtual classes for our new team members. I even presented continuing education topics to my colleagues. Nevertheless, I had never spoken in front of so many nurses before. Well, save for my extemporaneous speaking days back in college, but that is a completely different story.

Upon knowing the number and kind of audience I will be facing, I had to psyche myself up. I brushed up on my knowledge regarding my daily work as an informaticist. Armed with the lessons learned in grad school, I embarked on setting realistic expectations and sharing truthful experiences.

As I stated earlier, we had spirited discussions all throughout the presentation. They asked relevant questions and shared anecdotes about their own ideas and impressions regarding the EHR and informatics.

How the organizers conducted the webinar impressed me a great deal! Despite the power interruption and not so ideal weather in Iloilo, Philippines, they pulled through without missing a beat!

The audience was not only local Ilonggo (people in Iloilo) nurses. They represented different regions of the country.  Some were even from as far as Australia, the Middle East, etc. Putting that experience in a word (or phrase):  Filipino nurses rock!

My Wish for the Future

I started this back in grad school and I am reiterating this again here:

Although unable to come up to par with the technology in the first world countries, I hope that at healthcare organizations in the Philippines are able to implement at least a portion of the EHR. In a nutshell, we need to set the national direction towards the right path – that is introducing technology in healthcare practice!

I sincerely hope that I will be able to see this in my lifetime. Moreover, I can share whatever expertise I may have in the field to get this initiative started and going. Hopefully and after some time, I may be able to say: my work here is done!

Thank you again to the organizers: the Master of Arts in Nursing students as well as Qualimed Iloilo for the privilege and honor to present during your webinar. I am both humbled and proud!

If you attended the webinar, I would love to hear your feedback. Looking forward to your comments below. Thank you for your active participation.