Learning Objectives
By the end of this section, you will be able to:
- Explain the importance of informatics in nursing
- Explain how technology has affected nursing education and practice
- Explain the impact of the Health Insurance Portability and Accountability Act (HIPAA) on delivering care
As technology has evolved in health care, nurses have used these advances to improve patient care in numerous ways. The huge leaps in health-care technology over the past few decades have resulted in invaluable tools. Examples include the use of medical devices and mobile health apps to help monitor patient care, and the use of EHRs to document and track patient’s medications, tests, laboratory results, and orders. These technological advancements, in conjunction with the field of nursing informatics, have promoted the efficiency, effectiveness, and safety of patient care.
Informatics
The specialty that uses information and technology to improve the efficiency of health care and its delivery is called nursing informatics. This field of nursing focuses on methods of storing the three building blocks of communication as well as wisdom in computer programs and software so they can be analyzed and used to support improvements in health care (Nursing informatics, n.d.).
Let’s look at how these four components—data, information, knowledge, and wisdom—breakdown.
- The term data refers to raw, unprocessed facts or observations. In nursing, data can be objective and measurable information collected during patient assessments, such as vital signs (e.g., heart rate, blood pressure, temperature) or laboratory values. Examples include numeric values representing a patient’s blood glucose levels or a list of recorded symptoms (e.g., pain scale scores).
- Information is processed and organized data that provides context and meaning. It transforms raw data into a structured form, facilitating understanding. In nursing, information may involve interpreting and contextualizing data to support decision-making. For example, aggregated vital signs data, over time, enable providers to detect trends and patterns that help identify changes in a patient’s condition.
- Knowledge involves the synthesis and interpretation of information to derive insights and conclusions. It reflects a deeper understanding and application of information in specific contexts. In nursing, knowledge integrates information to guide clinical reasoning and decision-making. For example, a nurse may apply information from a patient’s medical history and about current symptoms and responses to interventions to formulate a comprehensive care plan.
- Wisdom is the ability to make sound judgments and decisions based on a deep understanding of situations. In nursing informatics, wisdom goes beyond knowledge and involves the application of experience and ethical considerations to guide actions and outcomes. An example is making informed decisions about patient care that not only consider clinical data and knowledge but also incorporate ethical principles, patient preferences, and long-term implications for well-rounded and compassionate care.
In nursing informatics, the progression from data to wisdom reflects the evolution of information into actionable insights, ultimately contributing to improved patient outcomes and the overall quality of nursing practice.
The Importance of Informatics
Nursing informatics is essential in helping nurses make informed decisions. Nurses have always used data, information, and knowledge in their daily practice. With the advancement of nursing informatics, however, these components are immediately available for each patient to assist each nurse in making sound decisions about care and effectively communicating these decisions—and their outcomes—with the interdisciplinary team. In addition to developing communication and information technology, nursing informaticists also work as educators, researchers, and software engineers to develop evidence-based policies and procedures for organizational use in the nurse’s clinical practice.
Application to Professional Nursing
Nurses need quick access to each patient’s medical history, medication lists, laboratory values, and imaging results, as well as to notes from physicians and other members of the interdisciplinary team. All this information gives a comprehensive picture of a patient’s clinical status, enabling the nurse to make informed decisions to improve patient outcomes and to effectively communicate with all members of the interdisciplinary team. Communication is, without doubt, one of the most important components of patient safety. Nursing informatics has been instrumental in developing and advancing the capabilities of EHRs (discussed later in this module) and the ability of physicians to immediately input digital orders for patient care. This has effectively reduced medical errors, patient care delays, and health care costs.
Technology in Nursing Education
Throughout one’s nursing education, it’s important to stay abreast of the advancements in technology. This enables nurses to remain in sync with the industry’s expectations for health-care delivery and with patients’ expectations for health outcomes. More fundamentally, technology has come to play a vital role in nursing education, from learning in a classroom (and assessing that learning) to conducting research in the field. Even what counts as a “classroom” has evolved as technological advances have enabled many educational institutions to move to online platforms.
A particularly important advance in technology for nursing education has been the development of high-tech simulation laboratories (“sim labs”) using manikins that closely resemble real people. The manikins are programmed to simulate real-life patients and clinical situations; for example, they can talk and blink, their pupils dilate, and their “heart” beats. This enables nursing students to work in an environment that parallels the real world. After each sim lab experience, students can debrief, talking through what went right and wrong, which further promotes their knowledge and critical thinking skills. Working through simulated scenarios during nursing school better prepares nursing students for their entry into high-pressure clinical situations. After graduation, nurses may still use simulations to renew certification skills such as cardiopulmonary resuscitation.
Technology in Nursing Practice
New medical technologies also make nurses’ lives easier when delivering care and, when used properly, they can also improve patient safety and outcomes. Today, a variety of technologies help nurses complete their daily routines while decreasing human mistakes and errors—especially important when working long hours with a heavy caseload. Technology will never replace the human experience, which is crucial for positive patient outcomes, but with the right balance, it can help ease the demands associated with direct patient care. Examples of technologies that facilitate routine nursing tasks include
- automated intravenous infusion pumps
- centralized command centers
- EHRs
- portable monitors
- smart beds
- telehealth and apps
- wearable devices
Technology has also enabled the use of e-prescribing, enabling a prescriber to electronically send an accurate, error-free, and understandable prescription directly to a pharmacy from the point of care. This has become an important element in improving the quality of patient care.
Electronic Health Records
EHRs provide immediate access to patient information, enabling the nurse to access a patient’s medical history, medications, and laboratory and other test results to promote sound decision-making. EHRs also promote effective communication between the providers within the interdisciplinary teams, minimizing delays in treatment, reducing errors, and improving health-care costs.
In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law. HITECH’s main goal was to encourage the adoption of EHRs by creating a financial incentive for providers to transition from paper to electronic records. In addition, HITECH strengthened existing regulations to ensure electronic data remain secure. As a result, many providers have implemented the use of portals for patients to access and even record or supplement their own health data (US Department of Health and Human Services, 2017; Alder, 2023).
The Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act (HIPAA) became federal law in 1996. It created national standards to protect patient privacy, primarily by prohibiting the disclosure of health information without a patient’s consent or knowledge. It has two components: the HIPAA Privacy Rule and the HIPAA Security Rule.
The HIPAA Privacy Rule provides standards relating to the use and disclosure of an individual’s health information, which is known as “protected health information” (PHI), by “covered entities” that are subject to this rule. The Privacy Rule also provides standards for individuals’ rights to understand and control how their health information is used. The covered entities include health-care providers and practices, health plan providers, health-care clearing houses, and business associates such as billing and claims processors, data analysis providers, and utilization review entities. The primary goal of the Privacy Rule is to protect individuals’ health information while also enabling the flow of the health information needed to provide quality care (Alder, 2023).
The HIPAA Security Rule protects public health information, which is a subset of information covered by the Privacy Rule. This subset includes individually identifiable health information that a covered entity creates, receives, maintains, or transmits in electronic form (known as electronic protected health information [e-PHI]); it does not apply to PHI transmitted orally or in writing. To ensure compliance with the Security Rule, all covered entities must ensure confidentiality, maintain integrity, and provide accessibility to all e-PHI; be aware of and safeguard against anticipated threats to the security of e-PHI; provide protection against any anticipated impermissible uses or disclosure not permitted by the Privacy Rule; and ensure compliance by their employees (Alder, 2023).