Topic Outline Objectives

At the end of this lesson, the students are expected to:

NURSING INFORMATICS 1. Data Processing  Describe the relationship between data to wisdom
“Information is just bits of data. continuum and database systems
TECHNOLOGY (Part 2) Knowledge is putting them
2. Health Data Standards  Describe the need of Health Data Standards
3. Nursing Terminologies Standards  Describe the impact and features of Standardized
Nursing Terminologies
together. Wisdom is 4. Human Computer Interaction (HCI)  Discuss Human Computer Interaction principles
transcending them.” 5. Safe and Private Healthcare  Explain the relationship among Security, Privacy and
Trust.
NCM 110 (Lesson2) -Ram Dass
F.B. Reyes; E.B. Yaneza; M.R. Jimenez

Data Data Types Data Hierarchy

 Any collection of facts of figures  Computer-Based Data Types 1. Bits 5. Records
 Basic unit of information  A collection of related
 Raw material to be processed by a computer 1. Numeric Data - The data which is represented in data items or fields
the form of numbers is known as Numeric Data. 2. Bytes treated as a unit.
 Observations and recordings are done to obtain  A unit of computing that
This includes 0-9 digits, a decimal point (.), +, /,
Data Processing data
– sign
most commonly consists of
eight bits
6.

Files
Made up of records
 Example:
2. Character Data 3. Characters  A collection of related
 names of students A unit of computing that
information
 String Data - Sequence of characters. Characters 
 sales figures may be English alphabets, numbers or space. corresponds to 1 byte 7. Database
 maps  Alphabetic Data 4. Fields  Collection of files
 pictures  Alphanumeric Data  The data items that make
up a record
 anything that is inputted to the computer for  Graphical Data – Data like pictures, charts and
processing maps.

State of Data Databases Why Do We Need a Database? Data Processing

 Any operation or set of operations performed
 Three states of digital data
 A database is any organized collection of  Keep records of our: upon data, whether or not by automatic means,
1. Data at rest—data on a storage device
related data.  Clients such as collection, recording, organization,
2. Data in use—data that a database program is  Staff storage, adaptation or alteration to convert it into
reading or writing  Some examples of databases you may  Volunteers useful information
3. Data in motion—moving between applications, encounter in your daily life are:  To keep a record of
activities and
 Once data is collected, it is processed to convert
over the network, or over the Internet  a telephone book
interventions; it into useful information. The data is processed
 T.V. Guide
 Keep sales records; again and again until the accurate result is
 airline reservation system achieved. This is called data processing cycle
 motor vehicle registration records  Develop reports;
 papers in your filing cabinet  Perform research
 files on your computer hard drive.  Longitudinal tracking

Types of Processing Data Processing Cycle Data Processing Cycle Data Processing Cycle
1. Manual Data Processing  Data processing activity involves three basic 3. Output - Anything that comes out of a computer after
 Involves human intervention activities: processing. In output, following activities can be
performed:
2. Electronic Data Processing (EDP) 1. Input - It is the process through which collected data is
i. Retrieval
transformed into a form that computer can understand.
 Processing of data by a computer ii. Conversion
In input step, following activities can be performed:
3. Real Time Processing iii. Communication Data
i. Verification DATA
Operation INFORMATION
 A continual input, process and output of data. Data ii. Coding
has to be processed in a small stipulated time period iii. Storing
(real time) 2. Processing - The actual data manipulation. Techniques Processed facts, with
are as follows: shapes and patterns
4. Batch Processing
i. Classification
 An efficient way of processing high volume of Transforming Data into Information
ii. Sorting
data iii. Calculation
iv. Summarizing
Data to Information Information Data/Information to Knowledge Knowledge
 A collection of data which conveys some 1. Data mining - We can refer to the process of  Knowledge is the appropriate collection of
Data warehouses meaningful idea. extracting information and knowledge from information.
a. A large collection of data imported from several  When data is collated or organized into large-scale databases as knowledge  When a student "memorizes" information,
different systems into one database something meaningful, it gains significance. discovery and data mining (KDD) then he/she obtained knowledge.
b. The source of the data includes not only This meaningful organization is information. 2. Benchmarking – Benchmarking is a process  Knowledge is an organization and processing
internal data from the institution but can also where one compares outcome measures
 Relates to description, definition, or to convey understanding, experience, and
include data from external sources
perspective. with industry averages accumulated learning.
 Answers the questions ―what‖, ―who‖, ―when‖, 3. Outcome probabilities - The concept of  Comprises strategy, practice, method, or
―where‖. outcome probability is built on the statistical approach.
concept of probability  Answers the question ―how?‖.

Wisdom Wisdom Wisdom The Nelson Data to Wisdom Continuum

 Is seen as the possession of knowledge such  Knowledge application - A proposed theory of
 Expert support/systems –  The Nelson data to wisdom continuum moves
that one is able not only to observe patterns of nursing knowledge/wisdom uses the formula
information within data and make intelligent  Expert systems represent the present and future from data to information to knowledge to
NKW (IB) = P, where:
connections between different patterns, but vanguard of nursing informatics wisdom with constant interaction within and
 NK is nursing knowledge
also to feel the principles which underlie the  These systems aim to help make the nurse ―more across these concepts as well as the
 W is wisdom intelligent‖ in providing quality care based on
patterns themselves. environment
 ―IB is the individual nurses integration and evidence
 It is uniquely a human state and computers do synthesis of nursing knowledge through cognitive,  Data are raw, uninterrupted facts without meaning
 Expert systems use artificial intelligence (AI) to
not have, and will never have the ability to psychomotor, and affective/spiritual domain of model the decisions an expert nurse would make  Information is facts with meaning
posses wisdom. self‖
 Knowledge is understanding the information
 It embodies principle, insight and moral.  P represents the breadth and depth of practice
 Wisdom is knowledge used to make appropriate
 It answers the question ―why?‖.
decisions and acting on those decisions

The Nelson Data to Wisdom Continuum The Nelson Data to Wisdom Continuum Why is There a Need for Health Data
Standards?
 The ability to communicate in a way that
ensures the message is received and the
Health Data Standards content is understood is dependent on
standards.
 Data standards are intended to reduce
ambiguity in communication so that the
actions taken based on data are consistent
with the actual meaning of that data.

Why is There a Need for Health Data Standards Development Process and Standards Development Process and Current Health Data Standards
Standards? Related Organizations Related Organizations Initiatives
 The Health Information Technology for  These emerging organizations are involved in 3. Health IT Standards Committee - By the American  Health Information Exchange and Interoperability
Economic and Clinical Health (HITECH) Act standards development, coordination, and Recovery and Reinvestment Act (ARRA)  Formal entities are emerging to provide both the
is driving U.S. efforts to transform healthcare harmonization in all sectors of the economy. 4. Integrating the Healthcare Enterprise (IHE) structure and the function for health information
International Organization for Standardization exchange efforts at independent and governmental or
through the meaningful use of health data.  Some of the major national and international 5.
regional/state levels.
(ISO)
 The term health data standards are generally organizations are:  These organizations, called Health Information
6. Object Management Group -While the
used to describe those standards having to 1. American National Standards Institute (ANSI) organizations described thus far are made up of
Exchanges (HIEs), are geographically defined entities
do with the structure and content of health that develop and manage a set of contractual
2. European Technical Committee for volunteer-based SDOs, the Object Management conventions and terms, and arrange for the
information. Standardization -In 1990, TC 251 on medical Group (OMG) governance and means of electronic exchange of
informatics was established by the European 7. Public Health Data Standards Consortium information.
Committee for Standardization (CEN) (PHDSC)
The Business Value of Health Data Standardized Nursing Terminology The Impact of Terminologies
Standard on Nursing
 Defining information exchange  A standardized nursing terminology
requirements will enhance the ability to consists of nursing concepts that In 1992, the Council
automate interaction with external Nursing Terminologies represent the domain of nursing. developed the
partners, which in turn will improve criteria for a nursing

efficiency and decrease costs by using

Standards  A nursing terminology must include terminology (see
standardized nursing data that represent Table 8.1 for
data standards to develop emergency the essential building blocks for nursing proposed updated
department data collection system thus criteria)
practice.
generated a positive return on investment

The Impact of Terminologies The Impact of Terminologies Features of Advanced Nursing Features of Advanced Nursing
on Nursing on Nursing Terminology Systems Terminology Systems
 Advanced terminology systems such as ICNP  ICNP - International Classification For
In 1992, the Council ANA recognized12 and SNOMED-CT are a focus of today’s Nursing Practice
developed the nursing terminologies harmonizing efforts.  SNOMED-CT - Systematic Nomenclature of
criteria for a nursing as appropriate for the  Both terminologies facilitate two important Medicine—Clinical Terms
terminology documentation of
nursing practice
facets of knowledge representation for HIT  EHR - electronic Health record (eHr) Systems
(see Table 8.1 for
proposed updated (see Table 8.2 for and EHR systems that support clinical care:  HIT - Healthcare information Technology
criteria) listing).  describing concepts and (HiT)
 manipulating and reasoning about those
concepts using computer-based tools

Features of Advanced Nursing Theoretical Underpinnings for Theoretical Underpinnings for Human
Terminology Systems Human and Computer Interaction and Computer Interaction
 Other research is focusing on examining how  Human-computer interaction (HCI) is used
terminology models and advanced
 HCI, concerned with interactions between
by health informaticists to understand
people and computers, is an area of study
terminology systems relate to other types of Human Computer Interaction concentrated on by human factors expert
major elements of usability projects and
models that support semantic interoperability, testing. These projects and tests help
such as  HCI is defined as the study of how people health informaticists design applications
 The Health Level 7 Reference Information Model design, implement, and evaluate that are effective, efficient, and user
(RIM) interactive computer systems in the friendly
 The open EHR Archetypes context of users’ tasks and work.
 The Detailed Clinical Models and
 The ontology for document naming

Theoretical Underpinnings for Human–Computer Interaction Human–Computer Interaction How the Application of HCI Principles
Human and Computer Interaction Principles Principles Improve Nurse and Patient Outcomes
Fig. 9.1 is the
in Healthcare
 The goal of a human factors approach in  HCI emerged in the 1980s as an 
framework that has  Traditional outcomes associated with HCI
nurse-led systems is to optimize the interdisciplinary field incorporating ideals been modified to methods are
interactions between nurses and the tools of computer science, cognitive science, explore HCI in the
context of nurse and  efficiency,
they use to perform their jobs, minimize and human factors engineering
patient trajectories as  effectiveness, and
error, and maximize efficiency, optimize professionals, but since has grown into a technology is  satisfaction
well-being, and improve quality of life. science incorporating concepts and integrated into nurse-
approaches from many other disciplines. led systems
 Critical Role that “Trustworthiness” Critical Role that “Trustworthiness” Critical Role that “Trustworthiness”
Plays in Healthcare Quality and Safety Plays in Healthcare Quality and Safety Plays in Healthcare Quality and Safety
 When computers, networks, and software fail  Building trustworthiness in HIT always begins  physical, operational, architectural, and
in such a way that critical services and data with technological safeguards to mitigate and manage

Safe and Private Healthcare are not available when they are needed, or  objective risk assessment,
risks to
 patient safety,
confidential information is disclosed, or health  a continuous process that serves as the basis for  individual privacy,
data are corrupted, personal privacy and developing and implementing a sound information  care quality,
safety are imperiled. assurance policy and  financial stability, and
 Trustworthiness is an attribute of each  public trust
system component and of integrated
enterprise systems as a whole

Relationship among Security, Privacy, Relationship among Security, Privacy, Relationship among Security, Privacy, Relationship among Security, Privacy,
and Trust and Trust and Trust and Trust
 Privacy is more than security, and security is  Security mechanisms and assurance  Trustworthiness can never be achieved by  This trust framework does not dictate a physical
more than privacy methods are used to protect implementing a few policies and procedures, architecture
The confidentiality and authenticity of information and some security technology.  The trust framework may be implemented within a
 Whereas privacy has to do with individual 
single or across multiple sites, and may comprise
rights, security deals with protection  The integrity of data, and the availability of  TRUST requires a complete HIT trust enterprise, mobile, and cloud components
information and services framework
 Provide an accurate record of activities and  This trust framework comprises seven layers of
access to information protection
 Each of which is dependent upon the layers below
it

Fair Information Practices Principles Fair Information Practices Principles Trust Framework Comprising Seven
as Essential to Privacy and Trust as Essential to Privacy and Trust Layers of Protection
Trust
 Essential for establishing and maintaining
 These principles essentially articulate the
trust in a healthcare enterprise
Framework
―rights‖ of individuals to openness, Comprising
transparency, fairness, and choice in the  Many of the safeguards included in the
collection and use of their health information trust framework have been codified in Seven Layers
Health Insurance Portability and of Protection
Accountability Act (HIPAA) standards and
implementation specifications

Trust Framework –
The 7 Layers of Protection
 Layer 1: Risk Management
 Layer 2: Information Assurance Policy
 Layer 3: Physical Safeguards End of Presentation
 Layer 4: Operational Safeguards
 Layer 5: Architectural Safeguards
 Layer 6: Security Technology Safeguards
 Layer 7: Usability Features