GROUP 1, 2BSN4

MABALOT, RHONIDA MACAALAY,

SHEMIAH CHEN

MACARAEG, LIEZL MAE G. MAMORNO, RONEDEL CLAUDINE MANAOIS, ELEANOR REPATO ,

SHANIE LEY

Nursing Informatics in Europe Europe is a continent with over 750 million inhabitants in about 50 countries with many different languages, cultures, social systems and other living condition. Widespread of use of IT in healthcare services is very limited in comparison to other areas of society. The main mission in Europe is to establish a stable infrastructure that improves healthcare quality, facilitates the reduction of errors and delivery of evidenced based and cost effective care. The Europe Union (EU) is a driving force of healthcare informatics development by funding projects that are all cross- cultural involving healthcare professional users, educators, and administrators, always with three or more countries participating. Telemedicine or telehealth, which is the practice of medicine and nursing over a distance where data and documents are transmitted through telecommunication system, is widely disseminated in parts over Europe.

Electronic Patient Record All RN in Sweden are by law, since 1986, obliged to document nursing care (SFS, 1985) Regulations emphasize that RNs have an autonomous responsibility for planning, implementing and evaluating nursing care and that nursing diagnoses in the patient record is a part of that responsibility (SOSFS, 1990).

Nursing Practice in Europe Association for Common European Nursing Diagnoses Intervention and outcomes (ACENDIO), which was established in 1995. The aim of the association is to support the development of standardized classifications, terminologies, and data sets for sharing and comparing nursing data.

ACENDIO Supports the development of nursing informatics by biannual conferences, publications and presentations to advance understanding. Serves as a network for nurses in different European countries so that they can share knowledge about developments. Provides resources such as reference lists and sample Methodologies for developing and evaluating nursing vocabularies and by providing interpretation of international standard for terminologies and classifications.

NURSING INFORMATICS IN THE PACIFIC RIM Trends in Healthcare

New Zealand has seen more collaborative approach resulting in integrated care being seen as a priority. Integrated care is being supported by technology.

The Web environment and the use of powerful integration engines, is now providing contextual views of data that is browser- based and single logon. Placed over multiple hospital information systems this connection provides a single patient view of data across all medical applications. Online technologies provide products

and services that enhance patient care and improve clinical outcomes through evidence-based health information and decision support systems.

Although New Zealand is a small country, it has a surprising number of health IT companies who are producing software that is being used both locally and internationally, the i-Health.

Technology Trends

New Zealand has been embracing changes in technology. No longer is information restricted to individuals and organizations. Higher speed networks including wireless and broadband are enabling information in a variety of formats to be shared. Exploration into telehealth has occurred in a number of fields including teledermatology, teleradiology, telepsychiatry, and telepediatrics (Oakley, 2001).

Improvements in portability are now allowing the use of technology in a greater range of settings. Personal Digital Assistants (PDAs) and tablets are being used in the clinical setting by students and healthcare professionals. Some Australian nurses are using PDAs for point-of-care information and clinical documentation for community and acute hospital nursing, hospital-based infection control and wound management.

Funding for the use of the technologies is probably one of the biggest limitations imposed in embracing new technologies to enhance care delivery.Nurses need to be prepared to work alongside and use technology to best care for clients.

Current National Initiatives

The New Zealand Ministry of Health, in 2001, prepared a 5-year broad strategic directive for information and technology developments, referred to as The WAVE Report. The report was produced by means of collaboration among industry,

clinicians, government and healthcare managers. The report has also formed the foundations for long-term issues such as EHRs.

Following the WAVE report, the drive for collaboration from the bottom-up has consolidated as the district health boards (DHBs) replace their isolated departmental systems with more integrated and dynamic Web-based technologies that support a more connected delivery network. Such arrangements have reduced duplication and contributed to more effective and efficient management of infrastructure. 1993 Establishment of the National Health Data Dictionary. 1999 The first national strategic information action plan, Health Online was initiated. This was followed by a number of projects initiated by the Australian government: HealthConnect, MediConnect,the provision of quality health information for consumers known as HealthInsite, along with more than 360 projects. 2005 It was expected that a strengthened governance model with greater central leadership will be implemented to enable better use of information technologies. The overall aim is to improve health outcomes while containing cost increases driven by advances in medical technologies and an ageing population.

Standards Development and Adoption

The minister of health directed that a WAVE working group, the Ministerial Committee on a Health Information Standards Organization (HISO), be established to investigate the implications of establishing a nonstatutory organization to manage health information standards.

The scope of development activities that HISO will be involved with includes standards associated within the following categorization scheme: Records structure and content data formats. Vocabulary codes for medical and other healthcare terms. Messaging standards used for interchange of data. Security and privacy how access to information is managed.

HISO, and supported by the Ministry of Health produced the New Zealand Draft National Health Standards Information Plan (NZHSP) to assist in its role of developing health information standards for the health and disability sector. HISO enhances the New Zealand e- Government Interoperability Framework (e-GIF) direction.

The HZHSP proposes a framework for describing the sector priorities, standards development processes, governance and leadership, and presents a clear statement of the proposed plan. HISOs role is aimed at the acceptance throughout the health and health-related industries of such standards. The availability of detailed and clinically relevant data is essential for clinical care decisions and for oversight groups making decisions related to the quality of that care.

Standardized terminology systems are essential to permit the use and exchange of clinical data across applications and IT systems. Give point-of-care documentation, technology is now available to build electronic health information systems that will efficiently meet a variety of needs. This includes providing immediate feedback to care providers by, for example, exchanging critical patient information in a timely manner across the healthcare continuum, and reducing provider burden associated with current documentation requirements.

Archetypes are constraint-based models of domain entities and were first defined by the Australian-based OpenEHR group, an international not-for-profit foundation working toward interoperable lifelong EHRs. In July 2004, NHIG endorsed L7 as the standard for healthcare messaging in Australia. This represents a small step toward the implementation and an increase in the adoption of available standards.

Research

Health-related information has a number of uses. Apart from the direct use of information in the care of clients, there is a growing awareness of the need for timely and accurate data for research. Two specific areas that are currently gaining more attention within NI are clinical pathways and evidence-based practice. In the New Zealand, this is demonstrated by The Centre for Evidence Based Nursing Aotearoa (CEBNA) and the New Zealand Guidelines Group (NZGG).

CEBNA is a partnership between the Auckland District Health Board and the University of Auckland, School of Nursing. It collaborates with the Joanna Briggs Institute for Evidence Based Nursing and Midwifery, the lead, centre, in an Autralasian-wide collaboration, that includes centers throughout Australia, Hong Kong, and Singapore. These centers are committed to an evidence-based approach to healthcare and to promoting an evidence-based culture in nursing.

NZGG is an informal network of expertise and information on guidelines development and implementation. It is funded by the Ministry of Health and through contracts with other health agencies such as ACC.

HISA organizes an annual conference where between 40 and 60 papers are presented each year. These are indexed in CINAHL and provide a good overview of progress in health informatics in Australia. Health informatics does not exist as a research category for the major government research funding organizations which

makes it difficult to obtain research funds from these organizations. It is anticipated that this will change in the near future as part of the Australian governments health workforce capacity building initiative.

Education

In New Zealand, NI has been recognized as significant by the Ministries of Health and Education since the early 1990s. A national Guidelines for Teaching Nursing Informatics curriculum was introduced into the undergraduate preparation of nurses programs in 1991. Undergraduate nurse education reflects the need for computer literacy. The new nursing student, most commonly from secondary school, enters with increased computer skills than ever before.

Since the mid-1990s nurses registering for practice in New Zealand also complete an undergraduate degree. Furthermore, the changes in health service delivery in New Zealand and the establishment of new roles and career opportunities for nurses are drivers for an increased demand for postgraduate nursing education. Yet there have been barriers to nurses accessing postgraduate education, which is generally based in urban areas. Nurses are found throughout the country and the nature of nursing necessitates shift work. While NI as a postgraduate specialist subject has not been recognized in New Zealand, nurses are favouring the health informatics options. In 1998, the University of Otago offered for the first time a diploma in health informatics. The University of Auckland commenced offering postgraduate programs that include courses in health informatics in 2001. Both tertiary education providers have given nurses the opportunity to study informatics in abroad context alongside other health

professionals.

The first Australian experiences of nurses using computers were compiled into a edited text by Graham MacKay and Anita Griffin in 1989. Informatics education for nurses in Australia varies considerably from one university to another. Most have one

person attempting the impossible, often in environments where fellow nurse academics have little or no knowledge of informatics. In some instances, there is active resistance to its introduction.

Some schools of nursing integrate informatics into their undergraduate nursing program to some extent. Most universities offer one unit of study within their undergraduate nursing pre- and postregistration programs as an elective. This enables all registered nurses either to obtain a double degree or convert their hospitalbased certificate into a Bachelors degree.

LATEST NEWS ABOUT INFORMATICS IN EUROPE

Innovations in E-Health & Informatics Europe Monday, 16 May 2011 20 22 September 2011, London, UK. Healthcare providers across the continent are looking forward to the day when EU-wide eHealth collaboration is a reality, when data can flow freely yet securely across institutional and international boundaries, thus increasing efficiency and improving patient outcomes - and healthcare IT and informatics personnel are working toward this goal by the careful selection, implementation and improvement of informatics. Through attending Innovations in EHealth and Informatics Europe you will hear aspirational and instructional case studies from best-of-breed organisations, learn about both mistakes and best practices, meet face-to-face with healthcare IT experts and walk away with practical ideas and solutions you can implement in your home institution. The expert speaker faculty will show you how to:

Practice advanced interoperability and seamless information management by aligning your ICT to existing and emerging standards with Bernd Blobel of the eHealth Competence Center, University Hospital Regensburg Implement the latest innovations: hear about pilot projects run by Claus Duedal Pedersen at Odense University Hospital, Alberto Sanna at Scientific Institute San Raffaele, Otto Larsen at NSI and more in 5 best-of-breed case studies Institute the best techniques for information security, disaster management, data recovery and patient privacy: Catherine Chronaki of HL7 and FORTH and Neal Mullen of St. Vincent's Healthcare Group show you how Effectively align your informatics with your EHR: benchmark your deployment with Uwe Buddrus of HIMSS Analytics Europe Get the budget and support you need for your informatics deployment from both upper management and clinicians with the help of University College London Hospitals NHS Foundation Trust's Simon Mortimore

These are just some of the most pressing issues currently affecting healthcare IT professionals; join Innovations in E-Health & Informatics Europe conference to investigate how to solve present challenges and position your organisation to achieve future eHealth goals.

First HYDMedia Systems in France Will Support the 'Zero-Paper' Hospital and Regional Hospital Networks Friday, 20 May 2011 Agfa HealthCare announces that the Centre Hospitalier Als-Cvennes (CH Als) and the Centre Hospitalier Jean Monnet in Epinal (CH Jean Monnet), both in France, are extending their existing Agfa HealthCare solutions with an electronic archiving solution. Amongst other advantages, CH Als was particularly attracted by the ability to collect all types of documents to create and share complete archived medical records within the hospital and with other regional healthcare providers, while CH Jean Monnet cites how the solution will support its drive for a paperless environment. Implementation will begin in Q3 of 2011 and is expected to be completed in Q1 2012. Share archived medical records regionally CH Als is a 724-bed hospital, with 16 associated healthcare facilities. To address the needs of its various activities, it uses a mix of different vendors' IT solutions - including Agfa HealthCare's hospital information system (HIS) and laboratory information system (LIS)[1]. CH Als is very active in leading innovative projects as part of a regional hospital network (Communaut Hospitalire de Territoire - CHT), which includes other hospitals of the Gard dpartement. "The HYDMedia solution is 'CHT-ready'," explains Mr. Gil, Deputy Director Finance and IT of CH Als. "It will support us in sharing medical archive records with other regional hospitals within the framework of the CHT. That, combined with our excellent relationship with Agfa HealthCare, was a key factor in our decision to implement HYDMedia." Reduce costs and eliminate paper The CH Jean Monnet in Epinal, together with the Centre Hospitalier Intercommunal de Golbey (CHI Golbey), counts some 696 beds. It is expanding its existing Agfa HealthCare ORBIS hospital information system / clinical information system (HIS/CIS) with HYDMedia, as part of its efforts towards a full electronic hospital and zero-paper environment. "HYDMedia offers us the opportunity to reduce our costs while also creating a paper-free hospital," comments Mr. Gebel, Director of CH Jean Monnet. "With it, we can collect all types of information from all sources in a single archived medical record - and share the information, as well."

HYDMedia1: electronic archiving for healthcare facilities of all sizes HYDMedia enables hospitals and care facilities of all sizes to create a complete electronic archived of patient records, combining their paper-based and electronic documentation - such as diagnoses, modality print-outs, microfilms and clinical and administrative records - while making it available across the organization. In this way it partially reduces the need for physical archiving space and time, cuts down retrieval time for information and reduces associated costs significantly. HYDMedia has been specially developed for healthcare environments and is fully integratable with existing hospital IT solutions and workflows. Improved productivity, with fast access to archived records "We are very pleased to implement these first HYDMedia solutions in France with our long-term customers CH Als and CH Jean Monnet," comments Philippe Blanco, Managing Director of Agfa HealthCare France. "With the move towards the CHT framework, supported by the French health ministry, and the increasing demand for paper-free hospitals, HYDMedia clearly meets a growing market demand. Furthermore, it not only helps reduce costs but it increases productivity as well, by making archived medical records quickly available in different places at the same time."