Nursing Informatics, What It Is and What It Is Not
Nursing Informatics is among the fastest growing specialities within nursing, but what is it, really? According to the American Nurses’ Association (ANA) Scope and Standards of Practice (2015), Nursing Informatics (NI} is the speciality that integrates nursing science with multiple information management and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice. It is the speciality that “cuts across” all other specialities, content areas, domains, roles, functions and jobs in our field.
You have erroneously heard it said that nursing informatics is “you know, like … a computer” and this is not the case. Computerized systems such as the Electronic Health Record (EHR) are, of course, involved, but this is only a portion of the Informatics trajectory. Nursing Informatics is, and always will be, about witnessing the transformation of data to information, information to knowledge, and knowledge to wisdom—otherwise known as the DIKW Model. This model said to be a hierarchy representing the structure and functional relationships between the four entities—data, information, knowledge, wisdom—has an uncertain origin yet has been discussed considerably in the socioeconomic literature since the 1950s.
Beginning in the latter half of the 20th century, this part of our discipline was hindered by the lack of standards for data and language thus limiting the functionality and usefulness of application to nursing practice. The speciality couldn’t grow, yet neither could medical or health informatics as we now know them. The need to document nursing care provided—the nursing care processes—is something practised and written about since the time of Nightingale. Yet this too is only an initial part of the informatics picture. The remainder of that big picture involves the documentation of the multiple influences on the results of the care provided—patient outcomes, the quality of which now form a partial basis for reimbursement to hospitals and healthcare organizations by the federal government.
Today, collaboration across disciplines and across regional, state and national boundaries has led to standards for digital health records that meet the challenges of compatibility and semantic interoperability. As nursing has contributed foundational work to this effort, nursing informatics is and will remain, a vital contributor to the domain and practice in the larger field of health informatics. Eventually, as further solutions to interoperability issues (when various EHRs don’t communicate with each other) are found, all of the healthcare provision, irrespective of environment of care, will conjoin to realize the dream of population health which could be seen as the summation of each health and illness encounter for all persons in a community, a state or a nation.
A number of professional societies are integral to the propagation of the field of nursing, indeed, health informatics. Among these are: the American Nursing Informatics Association (ANIA) (www.ania.org) the American Medical Informatics Association (AMIA) {www.connect.amia.org) and the Health Information Management Systems Society or HIMSS {www.himss.org). Each organization has individual professionals as their constituent members and many belong to more than one organization holding office or serving as volunteers through Task Forces or interest groups.
ANA (2015). ANA Scope and Standards of Practice, 2nd ed. Washington, D. C.: Nursesbooks.org.