Exploring the Knowledge and Use of Standardised Nursing Terminology Across Australia.

Standardised nursing terminologies (SNTs) support the visibility of nursing work and documentation, enabling data sharing and comparison. An online survey assessed the knowledge and use of SNTs and revealed barriers and enablers to their use by Australian nurses. Just over half of the respondents were familiar with SNTs before the survey, a quarter reported a reasonable understanding of SNTs, just under half reported previous use of a SNT, and less than 14% indicated a current use of a SNT in their workplace.

Representing Nursing Practice in EMR/EHRs.

Objective: Review of the ISO 18104 technical standard for a Nursing Categorial structure to best represent nursing practice in EMR/EHRs and digital health ecosystems.

Methods: Application of ISO standard review guidelines in consultation with ISO member stakeholders.

Results: Comprehensive views of the nursing practice knowledge domain are presented as mindmaps.

Integrating a Categorial Structure for Clinical Practice into EHRs.

A continuing global desire to be using clinical systems within a digital health ecosystem, able to facilitate data flows and information exchange as required to support person-centred, predictive, preventative, participatory and precision (5p) health and medical care can best be supported through the use of the standard categorial structure able to represent not only the clinical nursing practice domain but also other clinical disciplines by the generic labelling of some high-level categories. It is hypothesised that adoption of this generic clinical categorial structure within any electronic health/medical record within a well connected digital health ecosystem, supported by a cloud based openEHR platform, will enable the 5p support to be realized. This presentation provides the results of the latest update of this technical standard based on the 20+ year nursing practice categorial structure development process adopted to achieve this aim and a summary about linking this categorial structure to standard terminologies and to standard EHR/EMR system architectures.

Recommendations of the International Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics: Second Revision.

Background: The purpose of educational recommendations is to assist in establishing courses and programs in a discipline, to further develop existing educational activities in the various nations, and to support international initiatives for collaboration and sharing of courseware. The International Medical Informatics Association (IMIA) has published two versions of its international recommendations in biomedical and health informatics (BMHI) education, initially in 2000 and revised in 2010. Given the recent changes to the science, technology, the needs of the healthcare systems, and the workforce of BMHI, a revision of the recommendations is necessary.

Nursing Informatics Integration into Mainstream Health Informatics.

Nursing Informatics emerged in Australia during the early 1980s and drove the Professional development and acceptance of Health Informatics. Milestones achieved include the development of a national journal, the establishment of the Health Informatics Society of Australia and the Australasian College of Health Informatics (now collectively the Australasian Institute of Digital Health), nursing participation in Health Informatics standards development activities, adoption of the HL7 messaging standard, the delivery of numerous workshops, an annual national health informatics conference since 1993, hosting international conferences, the development and delivery of Health Informatics post graduate programs and establishing a research centre where the first prototype for an archetype repository was developed. This became the openEHR Clinical Knowledge Manager.

Applying the Nursing Ecosystem Concept to Developing Strategic Innovation and Entrepreneurial Leadership for Valued Patient Care.

Research confirms entrepreneurial leadership encourages entrepreneurial behaviour and an entrepreneurial culture supports the development of 'entrepreneurial mindset'. Nurses implementing and optimizing information technology need to work with numerous stakeholders that collectively make up their ecosystem. Indeed, nurses with an entrepreneurial mindset increase their ability to sense opportunities and mobilize the resources and knowledge required to seek' informatics' opportunities to deliver patient centred care across the whole ecosystem.

Technology Informatics Guiding Education Reform - TIGER.

Background: While health informatics recommendations on competencies and education serve as highly desirable corridors for designing curricula and courses, they cannot show how the content should be situated in a specific and local context. Therefore, global and local perspectives need to be reconciled in a common framework.

Objectives: The primary aim of this study is therefore to empirically define and validate a framework of globally accepted core competency areas in health informatics and to enrich this framework with exemplar information derived from local educational settings.

Operationalising the National Nursing Informatics Position Statement.

The need for nurses and midwives to drive the digital transformation of care has been recognised as an important factor in future health care innovation. An Australian Chief Nursing Informatics Officers collaboration is leading the way. They were supported by the three professional organisations who collaboratively developed a National Nursing Informatics position statement.

Connecting PHRs and EHRs for a Sustainable National Health System.

An EHR for integrated care (IEHR) is defined by the International Organization for Standardization (ISO) [1]: "…a repository of information regarding the health status of a subject of care, in computer processable form, stored and transmitted securely, and accessible by multiple authorised users, having a standardized or commonly agreed logical information model that is independent of EHR systems and whose primary purpose is the support of continuing, efficient and quality integrated health care. It contains information which is retrospective, concurrent and prospective." We need to differentiate between EMR/EHR and the lifelong PHR in terms of type of data storage, sharing and use [2-3].

Embedding Nursing Informatics Education into an Australian Undergraduate Nursing Degree.

Alongside the rapid rise in the adoption of electronic health records and the use of technology to support nursing processes, there is a requirement for nursing students, new graduate nurses, and nursing educators to embrace nursing informatics. Whilst nursing informatics has been taught at post graduate levels for many years, the integration of it into undergraduate studies for entry level nurses has been slow. This is made more complex by the lack of explicit nursing informatics competencies in many countries.

Learning, Training and Teaching of Health Informatics and its Evidence for Informaticians and Clinical Practice.

A globally agreed well structured framework representing the health informatics discipline's body of knowledge is yet to emerge. Considerable progress has been made towards describing this over the fifty or so years of the discipline's evolution. This contribution explains the need for such a structured body of knowledge from an educational and workforce capacity building perspective.

An Information Paradigm Shift is Required to Realize EHR Benefits.

The use of EHRs and the benefits from them are significant for healthcare and health informatics. Data form the basis for any EHR and its potential to realize these benefits. This paper considers the housing of information and knowledge management in an EHR system.

Health workforce competencies needed for a digital world.

The health workforce constitutes a very significant health system building block. As such it needs to have the capacity to influence how health data are captured, processed and used at all levels of decision making. This requires a national strategy that ensures all new health professional graduates are adequately prepared and that the existing workforce is developed to make the best possible use of all available digital technologies.

Health information systems.

Health information provides the foundation for all decision making in healthcare whether clinical at the bed side, or at a national government level. This information is generally collected as part of systems which support administrative or clinical workflow and practice. This chapter describes the many and varied features of systems such as electronic health records (EHRs), how they fit with health information systems and how they collectively manage information flow.

Our health language and data collections.

All communication within the health industry is dependent upon the use of our health language consisting of a very extensive and complex vocabulary. Converting this language into computable formats is necessary in a digital environment with a strong reliance on data, information and knowledge sharing. This chapter describes our health language, what terminologies and ontologies are, their use and relationships with natural language, indexing, data standards, data collections and the need for data governance.

Health data and data governance.

Health is a knowledge industry, based on data collected to support care, service planning, financing and knowledge advancement. Increasingly there is a need to collect, retrieve and use health record information in an electronic format to provide greater flexibility, as this enables retrieval and display of data in multiple locations and formats irrespective of where the data were collected. Electronically maintained records require greater structure and consistency to achieve this.

Impact of data governance on a nation's healthcare system building blocks.

This chapter gives an overview of a nation's healthcare system, particularly for those who are familiar with IT but not healthcare or for those working in one area of healthcare who may not be familiar with the system and data requirements across the care continuum. The structure of this chapter uses the World Health Organisation's (WHO) Health systems framework with a focus on the need for data and information governance to achieve a sustainable health system delivering improved health for all, responsively and equitably meeting genuine demands for health services, with social and financial risk protection and overall improved efficiency. It is argued that there is a need to gather the right data and to process these data in a manner that provides good information in order to more fully understand how the health system is working and where and when it isn't working well.

National healthcare systems and the need for health information governance.

This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

Developing a common reference model for the health informatics discipline.

This study reports on an examination of the IT industry's Skills Framework for the Information Age (SFIA) to determine if such a process and/or the use of this tool is suitable to be applied to the health informatics discipline. During this process, four sets of known and agreed-upon Health Informatics skill and knowledge domain statements and competencies were mapped to SFIA. The results showed that all high level SFIA skills apply to the health informatics discipline but that these need to be contextualized to suit the health industry and additional health industry specific skills and knowledge domains need to be included to truly reflect the necessary health informatics skill set from which competency statements can be developed.

Health informatics competencies - underpinning e-health.

There is a widespread consensus that we have an urgent need to improve our workforce capacity in all aspects associated with the skills and knowledge required for successful e-health and health informatics developments, associated change management and systems implementation strategies. Such activities aim to support various health reform policy initiatives. This paper considers the work being undertaken by many researchers around the globe to define the range of skills and knowledge requirements to suit this purpose.

Foundations for a nursing services reference model.

The Nursing Services Reference Model (NSRM) is presented as a theoretical position and discussion paper. The aims are to describe the components of the NSRM concept, to explain why such a model needs to be developed and to explore methodological issues in the development of a NSRM. The concept is important to address as it may illuminate a most pressing problem faced by the Australian health care industry where the content and activity of nursing practice is not embedded as computer processable data in health information system structures.

Resource, quality and safety management.

This chapter gives an educational overview of: * Resource management relative to sustainability and the use casemix systems * Types of resources and their information system needs to support their optimal management * Quality, performance measurement options and associated information needs * Casemix systems' characteristics, usage and need for enterprise systems.

National standards in health informatics.

This chapter gives an educational overview of: * The relationship between standards and a national e-health strategy * National and international standards development processes * The Development of a national HI standards roadmap * The benefits of standards adoption.

Sustainable clinical knowledge management: an archetype development life cycle.

This chapter gives an educational overview of: 1. The significance of having a formal ontology of health care data 2. How openEHR has used an ontological approach to designing an electronic health record 3.