Module 4:
Use of Nursing
Informatics in Healthcare
Delivery
(Clinical Practice)
Prepared by: Saliha Janine D. Gubaten, RN
Electronic Health Records (HER)
Electronic Health Records (EHRs) are digital versions of
a patient’s medical history, including information about
their diagnoses, treatments, medications, and test
results.
EHRs are designed to improve the quality, safety, and
efficiency of healthcare delivery by providing healthcare
providers with the information they need to make
informed decisions about patient care.
Features
• Patient demographics and medical history
• Electronic prescriptions and medication management
• Clinical decision support tools
• Laboratory and diagnostic test results
• Imaging and other medical records
• Patient portals for secure communication and access to
health information
Advantages
• Fewer lost medical records
• Eliminated transcription costs
• Increased readability/legibility
• Ease of chart access for multiple users
• Chart availability outside of office hours
• Increased access to patient education materials
• Decreased duplication of test orders
• More efficient transfer of records
• More efficient billing processes
• Greatly decreased storage needs
• Accessed from other locations
• Physician’s home
• Satellite offices
• Used in teleconferences
Disadvantages
• Costly
• Staff training requirement
• IT staff may be needed
• Possible damage to system and software and or
required upgrades
Other Features
• Tickler files
• Specialty specific
• Electronic schedulers
• Eligibility verification and referral management
• Billing and coding
• Report generators
• Electronic prescriptions
• Patient access
Issues of EHR’s
• Security and confidentiality
• Access code
• Limits access
• Date and time stamp
• Release of information policy
Telehealth
Telehealth is a broader term encompassing a wide
range of healthcare services delivered remotely. It
includes clinical services like diagnosis and monitoring,
as well as non-clinical services like administrative
meetings and continuing medical education. Telehealth
can involve synchronous (real-time) communication,
such as video conferencing, as well as asynchronous
communication, such as secure messaging or email.
Telemedicine
The delivery of healthcare services, where distance is a
critical factor, by all healthcare professionals using information
and communication technologies for the exchange of valid
information for diagnosis, treatment and prevention of disease
and injuries, research and evaluation, and for the continuing
education of healthcare providers, all in the interests of
advancing the health of individuals and their communities.
Advantages
• Makes expertise available anywhere
• Early institution of appropriate treatment
• Decrease needs for transfers
• Effective utilization of transports
• Saves costs to patient, provider
Benefits to Healthcare Professionals
• Improved diagnosis and better treatment management
• Continuing education and training
• Quick and timely follow-up discharge
• Access to computerized comprehensive data of
patients, both offline and real time.
Benefits to Patients
• Access to specialized health care services to under-
served rural, semiurban and remote areas.
• Early diagnosis and treatment
• Access to expertise of medical specialists
• Reduced physician’s fees and cost of medicine
• Reduced visits to specialty hospitals
• Reduced travel expenses
• Early detection of disease
• Reduced burden of morbidity
2 Types of Telemedicine
Store and Forward
• For non-emergency situations
Two-way interactive television/Real Time
• Video conferencing
• Almost equivalent to a face to face “real time”
consultation
Application
• Medical, surgical, diagnostic
• Emergency care
• Military medicine
• Disaster management
• Homecare
• Rehabilitation
Features of Telemedicine
• Teleconsultation
• Telediagnosis
• Teletreatment
• Telemonitoring
• Telepresence
Clinical Decision Support System
(CDSS)
• ICT solution designed to provide health professionals
with clinical decision support (CDS) such as assistance
with clinical decision-making tasks.
• These systems use data analytics to give nurses real-
time insights into patient care. This can help nurses
make more informed decisions and improve outcomes.
• Clinical Decision Support Systems (CDSS): Integrating
systems that provide nurses with evidence-based
information to support clinical decision-making.
Use of Nursing Informatics in
Healthcare Delivery (Public Health)
Point-of-Care systems and Clinical Information
Systems
• Work lists to remind staff of planned nursing
interventions
• Computer generated client documentation
Informatics on Population Health
The utility of nursing informatics in healthcare communication,
analysis, and care delivery has become increasingly popular. Since
the SARS outbreak in the early 2000s, the global threat of an unknown
virus highlighted the global threat. This was eventually followed by
Ebola, MERS CoV, and Zika. Understanding the value of timely,
accurate, and reliable data has been recognized by the Centers for
Disease Control and their Emergency Operations Center has
collaborated with local, national, and international response partners.
Informatics on Population Health
The work of the surveillance center is to develop and
implement surveillance systems to collect, analyze, and
use data to ensure public health prevention by detecting
the early stages of an outbreak. These systems capitalize
on technology and informatics tools in order to (1) assess
the level of risk, (2) formulate policies, and (3) recommend
population-level appropriate and cost-effective practices.
• Computer–based Management Information System
(MIS) in public health was developed for statistical
purposes.
