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This article does a great job on addressing privacy concerns within healthcare. It also goes on to address and implement privacy controls and practices and how those can be achieved.

Patients must be confident that their privacy rights and the confidentiality of their personal information and personal health information are respected and upheld, and that the information they share is kept confidential and secure. Maintaining high standards that safeguard information privacy and security is an essential aspect of healthcare that should always be TOP PRIORITY.

Health privacy has become increasingly important due to the rapid rate of technology integration in healthcare. New technologies like mobile apps that allow you to view tests results or past medical history. You can now track substantially larger amounts of information about a patient than ever before and put it in an easy to access place such as a cloud-based service.

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1. Understand privacy, security and confidentiality;

2. Define privacy and security requirements;

3. Create privacy and security controls based on risk;

4. Implement a privacy and security management program;

5. Create a culture of privacy; and

6. Be ready for a privacy breach.

Understand Privacy, Security and Confidentiality
Information privacy is about the control of how personal health information is collected, used and disclosed. Information privacy ensures that the Personal Health Information (PHI) is protected when transmitted, processed and stored. This applies to both healthcare organizations and healthcare IT vendors that process and host information on behalf of healthcare organizations.

Secure and timely access to relevant patient PHI is essential to the proper functioning of healthcare practices and to the delivery of appropriate and quality patient care. Patients must be confident that their rights to the privacy and confidentiality of their PHI are respected and upheld, and that the information they share with their healthcare providers is kept safe and secure.

It is important to note that there are differences between privacy and confidentiality. Privacy is concerned with information handling processes of personal and sensitive information. Confidentiality deals with ensuring that this information is not disclosed for any purpose other than for which it was collected without appropriate consent.

The security and protection of information are of prime importance to all healthcare organizations and vendors that provide digital solutions and/or process and store PHI on behalf of these healthcare organizations. For the health sector, there is added emphasis on the requirements for confidentiality, privacy, integrity, and availability.

With increasing electronic exchange of patient health information between healthcare providers, there is a clear need in adopting a privacy and security management program.

Health information is an important asset for healthcare providers and needs to be adequately protected. The primary focus of health information security relates to the protection and safeguarding of patient information and the requirement to protect the privacy of patients/clients. In addition, health providers must ensure that information is accurate and available when required.

Information security involves the preservation of the following:

Confidentiality: information accessible and available only to those authorized to have access.

Integrity: information stored, used, transferred and retrieved in manners such that there is confidence that the information has not been tampered with, or modified, other than as authorized.

Availability: information accessible to authorized individuals when and where required.

Define Privacy and Security Requirements
Finding out which privacy legislations apply to which jurisdiction and entity can be difficult to understand. In countries such as Canada, there are both federal and provincial standards to consider. The federal privacy law in Canada is the Personal Information Protection and Electronic Documents Act (PIPEDA). There are also specific privacy laws regarding healthcare for each individual province in Canada. In the United States of America, the relevant privacy legislation is the Health Insurance Portability and Accountability Act (HIPAA). The Guide to Privacy and Security of Electronic Health Information can assist in understanding the HIPAA and how to comply with it. Understanding which privacy laws apply to your organization can be confusing but it is a necessary step to ensure that all patients, clients and staff are protected.

It is critical to conduct the proper research and understand who is responsible under relevant laws in addition to what must be maintained in order to avoid compromising PHI. Knowing who is accountable is key to understanding associated responsibilities. In a healthcare environment, it can be difficult to determine who is in charge of a patient's privacy. Generally, if PHI is compromised at a private healthcare practice, that organization is at fault. If a specific employee is the reason for the compromise, they are considered equally at fault. When a company collects personal information from a client, they are also responsible for protecting that data and are liable if that data is compromised.

Conducting a privacy impact assessment to understand the risks associated with a product or service offered is a good starting place for many organizations. A privacy impact assessment (PIA) assists organizations by identifying and minimizing privacy risks of new projects or policies. The PIA works to accomplish 3 different goals:

1. To ensure conformance with applicable legal, regulatory and policy requirements for privacy;

2. Determine the risks and effects; and

3. Evaluate protections and alternative processes to mitigate potential privacy risks.[3]

For a deeper understanding of security issues, a threat and risk assessment can be conducted with consideration given to The diagram below details the testing process flow: security awareness training. [ 4]
Create Privacy and Security Controls Based on Risk
The most effective way to control security and privacy is to build it directly into the system or product. Once the PIA and TRA risk assessments have been performed, safeguards and countermeasures should be built to ensure PHI protection. Privacy-Enhancing Technologies refer to methods acting in accordance with the laws of data protection and include anonymizers and related algorithms. However, a more substantial approach must be taken to build security into systems such as the Privacy by Design (PbD) approach. This concept was designed to ensure privacy and gain personal control over one's own information. The 7 Foundational Principles outlined in the tool below can be used to build privacy into the product or system offered from the beginning.
Implement a Privacy and Security Management Program
Privacy management programs are needed if an organization plans to collect, store or manage personal information as part of an offered service. The first step to implementing a privacy management program is to select a privacy officer. A privacy officer is a senior level executive within the organization accountable for keeping personal information safe. A privacy policy should be developed for organizational adherence. Several privacy policies can be created for different purposes. For example, one privacy policy could be created for customers or patients to review while another operational privacy policy could be established for employees to review and follow. People who review sensitive information should also sign a non-disclosure agreement (confidentiality agreement) that outlines principles for keeping PHI confidential.
Create a Culture of Privacy
When every employee in the organization understands that privacy is a core value linked to strategic priorities, they will be more willing to adhere to and protect that privacy. Designing an educational course or webinar to teach members of the organization how to properly follow security and privacy guidelines may be useful. Some tips to create a successful program include:

Train new employees immediately on appropriate security and privacy guidelines;

Provide refresher sessions for existing employees;

Educate employees on why it is important to keep PHI private; and

Sanction employees who violate policies and procedures.

Information covered should include a description of the differences between confidential versus open information; the policies applicable to the organization; and a description of what a data privacy breach is. Other relevant information should be determined by the privacy officer. Finally, understanding if this training needs to be documented under legislation applicable to the organization is critical. For example, HIPAA requires documentation that employees have been properly trained on privacy and security.
Be Ready for a Privacy Breach
Despite being well prepared, many businesses and organizations may still have a privacy breach where PHI is compromised. It is important to implement a privacy breach management protocol where step-by-step procedures and responsibilities are defined for those in charge of managing the privacy breach. This can prevent a privacy breach from becoming even worse.

Privacy and security management is key for the success of any organization, but has particular challenges in healthcare settings when dealing with sensitive information. Focusing on implementing privacy and security measurements from the beginning is key to creating a strong security and privacy system. This can be accomplished by establishing a security management program and appointing a privacy officer. Educating all employees about privacy and security practices, roles and responsibilities is key to this endeavour. Conduct a privacy impact assessment (PIA) to understand the privacy risks associated with new IT solutions or apps being developed or implemented. The PIA will help identify real hotspots where privacy and security countermeasures may be needed. For a deeper dive into security issues, a threat and risk assessment (TRA) may be needed. Having an action plan in place for addressing privacy breaches is also a major component. Need more information? Have some resources to share? Please visit the Healthcare Privacy Community of Practice and ask a question in the discussion space and/or upload files to share with your colleagues.

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Privacy Issues & Technology in Healthcare Organizations

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Patients must be confident that their privacy rights and the confidentiality of their personal information and personal health information are respected and upheld, and that the information they share is kept confidential and secure. Maintaining high standards that safeguard information privacy and security is an essential aspect of asset management for any healthcare provider.

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I would like to say (and hope this applies to all hospitals I've ever worked at) that yes the hospital I am now at is meeting HIPAA requirements. We provide patients their rights upon admission and only discuss their personal health information with themselves or members of the interdisciplinary team. Especially with limited visitors due to covid we have ensured the person receiving updates is the Health Care Proxy so they are allowed to receive information too that way we are not violating HIPAA requirements. One thing I always try to be aware of is WHERE I am discussing patient care or specific information about patients. Some hospitals do things like "No elevator talk", just as a reminder to not in open spaces where people that are not apart of the interdisciplinary team can over hear you.

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This video is a quick and easy watch! This video explains how alert fatigue occurs. Some alerts we see on a day to day basis do not even require any clinical intervention. WHY HAVE THEM? Having these unnecessary pop ups make it extremely difficult to slow down and read a pop up you may actually should because you are so used to clicking out as fast as you can to continue what your previous tasks at hand was. This video brings the dangers to light but shows it needs to be improved on a more technology basis and how it does not fall only on doctors and nurses to fix.

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I constantly battle alert fatigue. I actually notice it hard when I am on three days in a row at work. It is so exhausting sometimes hearing alarms continuously go off that you truly just want to ignore them. I know it is wrong but I am honest and I know anyone who has worked in an acute care setting has suffered from this. I try to handle it by walking off the floor, even if it is for 5 minutes, it gives me a nice break to relax and not hear a bunch of random noises. When I come back I do feel better, I was able to take a breather, and can focus back on my work. In my opinion, I think we need to be better about alarm parameters and setting them to what is appropriate to the patient. It can make a huge difference.

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Awesome review to fully understand GAMIFICATION

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Awesome review to fully understand GAMIFICATION

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I had never heard of gamification prior to this class. This video laid it all out for me in a clear, easy to understand way. When I attempted to play Sea Quest Hero for the Iphone I was unable because they only allow certain users within the research to participate. This app is used in research of Alzheimer's Disease. This app is in place to test those with Alzheimer's navigational skills specifically with a direction with an end goal and a result. A lot of people who used to play it when it was open to the public mentioned that the game actually helped them learn some of their directional and awareness skills even not having dementia. While people can benefit from playing they seem to be upset it is no longer open to the general public. I wonder if this research has moved on to the next phase of data collection possibly? Very interesting to see technology advance in this way.

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How large data collection is NON beneficial...

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How large data collection is NON beneficial...

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Large amounts of data is beneficial to make it "easier" but it may not all be truthful and accurate. A group of 100 people with honest, true, accurate data is better than having 1,000 people's data that may be different or misleading. Taking the time to collect data ensures that the research in place is TRUTHFUL and SAFE and that is how it should remain. Data in medicine needs to be controlled and those researching the data need to have patience in order to keep everyone safe while still changing the lives of others each and everyday!

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This video shows all the benefits for a patient using telehealth. Parents or caregivers of elderly patients are also able to use telehealth to alleviate stress of coming to the office. Telehealth visits also may help patients who need in person appointment to actually get in and be seen. There is not enough doctors to go around these days so it is nice that telehealth is an option for our ever growing healthcare industry.

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Using technology to deliver health care has several advantages!!! These include cost savings, convenience, and the ability to provide care to people with disabilities such as mobility limitations. Telehealth can absolutely benefit those in rural areas who don't have access to a local doctor or clinic. Currently, 76 percent of hospitals in the U.S. connect doctors and patients remotely via telehealth.

Telehealth has also been utilized widely during the coronavirus pandemic. I myself had a couple of telehealth appoints for situations that did not really require an in person visit. This helped prevent spreading and increased exposure while allowing me to be in the comfort of my own home during the visit.

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HIE and how it relates to Patient Safety... 

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HIE and how it relates to Patient Safety... 

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This article has a lot of useful information in regards to how how the health information exchange benefits patient safety. In the article I found an interesting point, did you know roughly around 18% of the patient safety errors and as many as 70% of adverse drug events could be eliminated if the right information about the right patient is available at the right time? Health information exchange makes this possible!! Whether it is between provider to provider. Or patient to provider HIE makes safety a number one priority.

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Abstract

One of the most promising advantages for health information exchange (HIE) is improved patient safety. Up to 18% of the patient safety errors generally and as many as 70% of adverse drug events could be eliminated if the right information about the right patient is available at the right time. Health information exchange makes this possible.

Here we present an overview of six different ways in which HIE can improve patient safety-improved medication information processing, improved laboratory information processing, improved radiology information processing, improved communication among providers, improved communication between patients and providers, and improved public health information processing. Within the area of improved medication information processing we discuss drug-allergy information processing, drug-dose information processing, drug-drug information processing, drug-diagnosis information processing, and drug-gene information processing. We also briefly discuss HIE and decreased patient safety as well as standards and completeness of information for HIE and patient safety.

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Health information exchange and patient safety

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One of the most promising advantages for health information exchange (HIE) is improved patient safety. Up to 18% of the patient safety errors generally and as many as 70% of adverse drug events could be eliminated if the right information about the right patient is available at the right time.

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Some benefits to having a proper HIE:
- Improve patient safety by reducing medication and medical errors
- Increase efficiency by eliminating unnecessary paperwork and handling
- Provide caregivers with clinical decision support tools for more effective care and treatment
- Eliminate redundant or unnecessary testing
- Improve public health reporting and monitoring
- Engage healthcare consumers regarding their own personal health information
- Improve healthcare quality and outcomes
- Reduce health related costs

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This video in a fun and interactive way shows how an EMR benefits literally everyone! Having a complete picture of your medical record is important for managing your health safely from home and having the comfort knowing you can easily interact with your providers from the comfort of your own home if questions arise.

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Office of the National Coordinator for Health IT

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Updated: Health IT for You: Giving You Access to Your Medical Records When and Where They're Needed

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I believe EMRs are super useful and user friendly, especially at all the hospitals I have worked at. It is a great tool for all members of the interdispilnary team to work together and see all of the EMR at the same time. Everyone can view the same things and it allows the team to fully understand the patient and their current state of health. Epic that I used at the first hospital I worked at actually allowed us to live chat with other members of the interdisciplinary team. I was able to quickly message doctors who were off the floor at the time and ask a question about the patient I needed to and we could both see all of the assessment data right at our fingertips. I love the use of EMR in the acute care setting. It makes everything happen in a much more time efficient manner.

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How Meaningful Use saves the Hospital $$$

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How Meaningful Use saves the Hospital $$$

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This quick 3 minute video was actually pretty interesting. It breaks down meaningful use into three stages and how each one once implemented and followed actually helps safe the hospital money when followed properly.

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Meaningful Use of an EHR: What Meaningful Use Is & How It Can Save You Money

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An experience I have had with an aspect of meaningful use is using the EMAR to administer medications. The first thing that comes to mind is IV heparin drips, these at my hospital need to be 2 nurse verified. I know some hospitals that do not need a 2 nurse verifier and this shocks me. Both Epic and the Meditech computer systems I have used require this and it truly gives me a sense of safety and security. There is no way to go around this and IV infusions should always require a second set of eyes. Myself and another nurse are able to verify the correct dose is being given or adjusted properly. Safety is key!

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I would actually utilize the DIKW hierarchy in any given healthcare setting.  I remember when I took a travel assignment and the hospital recently switched over to EPIC. The hospital staff was lost! They did not get great education on it so the staff would always ask me how to do certain things on the new system. A new system is a HUGE transition and can be very challenging.

If I was the NIS in this situation I would first address the staff on the new EHR that is going to be implemented. I would reassure the staff that there will be in-service days where they can learn the new system that way they understand they will not just be thrown into it. We will first receive data based off a survey with the staff. I want to get an idea what is important to them and what they want to see with this implementation. I will take this information and have better knowledge of what the staff is requesting and be open to any suggestions they may have to make the EHR the most time manageable compared to paper documentation.

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These initiatives such as TIGER are in place in order to allow hospital staff to provide quality care to patients. HIMSS conducted a cross-sectional study in 2018. Data was collected using the researcher- developed questionnaire.
"The majority of participants (96%) held a bachelor’s degree.  According to the participants views, 66.5% had relatively good familiarity with computers. In terms of frequency of using computers, the vast majority (59%) used computers more than once a day." This goes to show that the quality of patient care can be better ensured by communicating effectively and sharing accurate information. This in turn, will increase the continuity of care. Thorough documentation and knowledge development to support evidence-based practice is imperative to developing nursing informatics knowledge and nursing informatics competencies.

Self-Assessment of Nursing Informatics Competencies in Hospitals | HIMSS

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Abstract

Background: To manage the high volume of generated data and enhance the quality of nursing care in the healthcare system, nurses need informatics competencies including 1) basic computer skills, 2) informatics knowledge and 3) informatics skills.

Objective: The aim of this study was to evaluate the informatics competencies of nurses working in hospitals.

Methods: The present study was conducted in 2018 on 200 nurses working in hospitals. The tool used to collect data was the localized Staggers standard questionnaire.

Results: The results of this study showed that 60.6% of nurses have few capabilities regarding informatics competencies. Also, practicing nurses were more able in the area of informatics knowledge rather than the other two areas of basic computer skills and informatics skills.

Conclusion: Informatics competencies of practicing nurses were not at an adequate level which requires the attention of universities and colleges and educational planning in this field.

Introduction

Today, information technology is a critical part of our health care industry and requires healthcare providers to have basic computer knowledge, as well as informatics competencies, to manage and use technology to deliver care (Pordeli, 2017). In early 2000, the American Institute of Medicine (IOM) suggested that hospitals use electronic solutions to improve the quality of care provided to hospitalized patients (Baker, 2001). Previous studies on the consequences of the use of health information technology suggested that countless positive effects on healthcare system had been realized (Buntin et al., 2011). The use of technology and computer systems can facilitate nursing care and support educational resources for nursing studies (Darvish et al., 2014; Rouleau et al., 2017). In addition, the use of information technology in the workplace enables nurses to spend less time documenting patient care and spend more time delivering quality care to patients (Kelley et al., 2011; Chaudhry et al., 2006). In general, the benefits of using information and communication technology in nursing include improved patient safety and improved efficiency of nursing professionals (Rouleau et al., 2017).

Due to extensive integration of health information technology in healthcare, competencies and capabilities in information and communication technology are essential for nursing professionals as healthcare providers (Honey, 2017; Nagle, 2013). In the study conducted by Yang et al. (2014), it was found that nursing managers' informatics competencies were at a medium level (77.6). Choi and De Martinis (2013) showed that nursing students had the required capabilities in the field of informatics.

Nursing informatics competencies can be defined as adequate knowledge, skills and abilities to perform specific informatics tasks (Hunter et al., 2013). Informatics competencies include three features: basic computer skills, informatics knowledge and informatics skills. Basic computer skills refer to the knowledge and ability to use a computer and related technologies (Goldhammer et al., 2013). Informatics knowledge refers to the knowledge to use computer technologies to deploy information sciences. In addition, informatics skills can be defined as the skills to implement instructions, tools and specific methods in informatics (Staggers et al., 2002).

Since the appearance of computer and information technologies in healthcare, the assessment of nursing informatics competencies has become a favorite subject for researchers (Darvish et al., 2014). To meet these increasing needs, a scale for self-assessment of nursing informatics competencies was developed to evaluate informatics competencies in nursing students and practicing nurses. Generally, an instrument's validity and reliability scores depend on the characteristics and specifications of the sample under investigation. The Staggers list of valid competencies is a standardized instrument. However, it has been developed and tested more in communities with a high level of computer knowledge and skills (Sunmoo and Po-Yin, 2009); therefore, this scale must be evaluated in a variety of societies based on development and growth patterns of informatics competencies and according to different backgrounds and cultural contexts (Chang et al., 2011). This study aimed to assess nursing informatics competencies within healthcare organizations.

Methods

This cross-sectional study was conducted in 2018. Data were collected using the researcher- developedquestionnaire. A review of previous studies and evaluation of existing tools and scientific resources associated with nursing informatics competencies was done initially. Based on the study done by Staggers et al. (2001), primary items were extracted with 74 points regarding competencies in three areas including basic computer skills, informatics knowledge and informatics skills. Next, the questionnaire was reviewed by eight nursing experts holding a master's degree or faculty members with at least five years of work experience with hospital information systems and by four information technology professionals holding a bachelor's degree and a minimum of five years of work experience with hospital information systems. Experts assessed the importance of each point using a 5-point Likert scale ranging from "strongly disagree" to "strongly agree."

Questionnaire validity was assessed by experts using a content validity index (CVI) and content validity ratio (CVR) (Farzandipour et al, 2017). The test-retest method was used to assess questionnaire validity and to ensure reproducibility. For this purpose, a validated version of the questionnaire was given to 20 nurses. After a period of two weeks, the participating nurses were asked to fill out the questionnaire again. Cronbach's alpha was used to assess data reliability. Data reliability was calculated as 0.97. A sample of 200 individuals participated in the study. Simple, random sampling was done using a list of nurses with a bachelor's degree or higher and three years of work experience in educational and medical hospitals. Questionnaires distributed among the nurses were composed of two parts: the first part included demographic characteristics including age, sex, marital status, employment, education, work experience, familiarity with computers, frequency of using computers, and interactions with the hospital information system (HIS); the second part included questions related to informatics competencies subscales in a scale of 48 questions. Questionnaire items were rated using a 4-point Likert scale ranging from "completely" to "very low." Data analysis was performed using SPSS software version 20 including descriptive and analytical statistics.

Ethical Considerations

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed and approved by the Ethics Committee of the Institutional Review Board.

Results

Out of 200 questionnaires distributed among nurses, 197 were returned with 98.5% of items answered. Regarding occupational status, the majority of participants (77%) were ward nurses and 11.5 % were directors of nursing. Also, 11.5% were matrons and supervisors. The majority were females (75.5%), 68.5% of whom were married.

The majority of participants (96%) held a bachelor's degree. In terms of years of service, the majority (56.3%) had three to 11 years of work experience. Also, according to respondents' views, 66.5% had relatively good familiarity with computers. In terms of frequency of using computers, the vast majority (59%) used computers more than once a day. In addition, regarding interaction with HIS, the majority (59%) spent less than an hour per shift interacting with the system.

As evident in Table 1 showing the combined scores for questions related to basic computer skills, informatics knowledge and informatics skills, 39.2% of respondents indicated having a high level of knowledge and competence. In the area of informatics skills, 37.4% of respondents reported a high level of competence; this score was lower than that of those who reported high competence in basic computer skills (39.6%) or the percentage of those who reported high competence in informatics knowledge (41%).

Table 1: Distribution of nurses' comments on informatics competencies (number of responses, total %)

Most participants aged 40 and higher had lower computer familiarity skills (P<0.02). Thus, a significant relationship was observed between age and familiarity with computers and basic computer skills (Table 2).

Table 2: Distribution of nurses' comments on the potential in the area of basic computer skills (number of responses, total %)

With regard to informatics knowledge, there was a significant relationship between marriage, familiarity with computers and interaction with the HIS, and nursing informatics knowledge (P<0.02). To be more specific, most single individuals, those familiar with computers, and those who had more HIS interaction had higher informatics knowledge (Table 3 and 4).

Table 3: Distribution of nurses' comments on the potential in the area of informatics knowledge (number of responses, total %)

Table 4: Distribution of nurses' comments on the potential in the area of informatics skills (number of responses, total %)

Discussion

The findings of this study showed that more than half of the nurses participating in the present study seem to have little ability or skills in the area of informatics competencies. In addition, findings indicate that practicing nurses had higher capabilities in the area of informatics knowledge rather than the other two areas of basic computer skills and informatics skills. Furthermore, they had the least ability in the area of informatics skills. Similarly, Yang et al. (2014) examined current informatics levels of nurse managers. Their findings indicated that informatics competency of these nurse managers was at a moderate range and their computer and informatics skills were lower than informatics knowledge. They suggested that low scores in computers skills and informatics skills be increased through education or training.

Nurses' informatics competencies in Yang et al.'s study (2014) were higher than those of the present study. This could be attributed to the population in Yang et al.'s study having a different level of education, nursing management experience and informatics education compared with the present study, which could influence nurses' informatics competencies. However, similar to the present study, Yang et al. found that the level of informatics competencies of nurse managers is not ideal and, by identifying influential factors, recommended the evaluation of these factors and obstacles.

Results showed that nurses may have higher ability in basic computer skills such as using the Internet and search tools on the Internet and using Windows operating systems and Microsoft Office applications. However, they might be less adept in areas such as backing up files and systems, using antivirus software programs, solving common errors on the computer, changing the default printer, and using computer systems safely. Findings of several studies (Gilmour et al., 2016; González et al., 2017; Saeidi et al., 2014) showed that nurses had the highest skills in working with the Internet, computers, word processors and operating systems. However, the lowest level of ability was observed in the field of documenting care plans, skills and knowledge in informatics, and qualification associated with data entry (Fetter, 2009). As can be observed, the findings mentioned correspond with those of the present study. It seems that practicing nurses need more training on basic computer skills. Hence, to empower nurses in the dynamic healthcare environment, reduce time-consuming paper documentation, improve clinical decisions, reduce errors, reduce duplication and allow nurses to focus on providing patient care, their basic computer skills need to be strengthened.

According to the findings of this study, in informatics knowledge competency the nurses had better understanding and capability in searching for key information on concepts related to the nursing profession. Nevertheless, they had lower capabilities in other areas such as knowledge of file management function in the operating system, recognizing the limitations of computer programs, and analysis of patients' information needs. Other studies show a direct relationship between nurses' knowledge and their skills (Kerie et al., 2018; Munezero et al., 2018). Informatics knowledge is a conceptual and theoretical base for each specialty, without which informatics skills will not be properly obtained. Therefore, it can be concluded that informatics knowledge is the infrastructure for acquiring informatics skills. Thus, as the first step, the level of knowledge and information literacy of nurses needs to be increased through training and appropriate orientation.

Based on the findings of this study, nurses seem to have little ability in terms of informatics skills. Regarding this, results showed that more than half of the nurses participating in the present study had the ability to use HIS to store, retrieve and transmit patient data and the ability to collect data and information related to clinical care. However, they were not proficient in functions such as participation in selection, design, implementation and evaluation of systems; correcting defects when working with the system; or the use of information technology for patient education. Due to the fact that nurses are required to use HIS on a daily basis in the workplace and apply it to patient care, they manifested more competencein this regard. Nonetheless, it seems that since nurses were not involved in the other fields of informatics and had no need to learn these skills, the level of their informatics skills was low.

The results of the study conducted by Jebraeili et al. (2010) confirmed the fact that preparation of human resources for implementation of electronic health records, which is one of the objectives of the Ministry of Health and Medical Education in Iran, was not required. To achieve an acceptable level of preparation, factors which can increase nurses' preparation need to be considered more seriously and nurses need to be trained so that their computer skills and knowledge can be strengthened.

The U.S. National Advisory Council on Nurse Education Practice (NACNEP, 2009) recommended preparing nurses with the aim of adopting intelligent and quality-based information technology use in patient care by implementing five strategies: providing core informatics courses to nursing schools, educating nurses specialized in informatics skills who are able to solve related issues, offering more powerful nursing care through the implication of telecommunication projects, preparing more nursing faculties in the informatics field to facilitate students' skills enhancement, and enhancing collaboration to advance informatics.

In their study on informatics courses, Elahi et al. (2018) included a plan for designing a curriculum of nursing and medical informatics experts. Most experts considered designing a nursing informatics curriculum as necessary and expressed their positive views on nursing informatics as a missing link in the application of knowledge and information that can prove beneficial in nursing, has the potential for innovation and promotion of health and is the basis of professional knowledge development. The curriculum was designed as 12 units of compensatory courses, 16 units of compulsory courses, 14 optional units, 4 units of thesis, and required workshops.

Conclusion

The quality of patient care can be better ensured by communicating effectively and sharing accurate information. This increases the continuity of care, enabling higher quality of care for patients (Casey & Wallis, 2011). Thorough documentation and knowledge development to support evidence-based practice, developing nursing informatics knowledge and nursing informatics competencies seem to be urgently required in Iran since nurses require proper and sufficient information knowledge and communication technology skills for better information management. The teaching of informatics in nursing faculties in Iran is at the level of basic computer skills in a single semester and almost nothing has been done regarding knowledge and skills in informatics. Therefore, a policy based on careful planning and expert review should be adopted in the country and by the Ministry of Health to further nursing informatics lessons in the curriculum of nursing students to raise knowledge, skills and the inclination of nursing students towards informatics in their professions. Therefore, as the basis of nurses' professional skills is shaped through the academic training courses they take ( Alberto et al., 20 05), inclusion of informatics lessons in university curricula may lead to improvement of their informatics skills (Elahi, et al., 2018).

In this regard, in addition to required and specialized courses, it is suggested that nursing informatics curricula include courses of data base management, clinical information systems, informatics theories and issues, system analysis and design, health data security, information technology project management, and clinical-nursing informatics practicum (University of Pittsburgh, 2018; University of South Alabama, 2017; Vanderbilt University, 2018) to improve nurses' informatics competencies. Despite significant advances in medical science, a lot needs to be done in Iran so that the country can develop in terms of nursing informatics. Hence, it seems necessary to develop this field to enhance nursing in educational, research, clinical and management areas by utilizing the services provided by specialists in this field.

The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.

Online Journal of Nursing Informatics

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Author Bios
Mehrdad Farzandipour is a full professor and head of the Health Information Management Research Center and a faculty member in the Department of Health Information Management and Technology, Kashan University of Medical Sciences, Kashan, IR. Iran.

Hashem Mohamadian is an assistant professor and member of the Research Centre for Social Determinants of Health and a faculty member in the Department of Health Education and Promotion, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR. Iran.

Hossein Akbari is an assistant professor and member of the Clinical Research Center and a faculty member in the Department of Biostatistics and Public Health, Kashan University of Medical Sciences, Kashan, IR. Iran.

Samira Safari, MSc, is a member of the Department of Health Information Management and Technology, Kashan University of Medical Sciences, Kashan, IR. Iran.

Monireh Sadeqi Jabali, Ph.D. student, is a member of the Department of Health Information Management and Technology, Kashan University of Medical Sciences, Kashan, IR. Iran.

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Self-Assessment of Nursing Informatics Competencies in Hospitals

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The aim of this study was to evaluate the informatics competencies of nurses working in hospitals.

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Once I reviewed that video below I looked more into the Nursing Informatics Specialist position. While working in this role post graduate nurses will be expected to:

Support evidence-based education, practice, and research through concept representation and standards

Develop data and communication standards to build a national data infrastructure

Distribute new knowledge into practice using research methods

Defining healthcare policy

It is estimated that there will be a 7% increase for NIS now and until 2029.

Nursing Informatics Career Guide | NurseJournal

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Interoperability in Healthcare and challenges that remain...

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Interoperability in Healthcare and challenges that remain...

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This article had a ton of useful information in regards to what challenges interoperability still faces in healthcare. It gets into lack of standardization, consent, security, and professional burdens. I have personally seen issues in regards to cyber security in my own place of work. Our system can often be attacked through emails. Every hospital I have worked at has had a short in-service with some modules to become familiar with what emails to be aware of and what to do if you feel as though you have been under attack.

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Interoperability in healthcare refers to the secure access and integration of electronic health data so it can be used to optimize health outcomes.

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The DIKW hierarchy is a method used in knowledge management. It is used to explain the ways we move from data, to information, knowledge, and wisdom with parts of action and decisions.

It appears as though it is a chain like the Maslow Hierarchy of Needs where you start at the base and you cannot have one without the other, so you work your way up. Data is a measurement or facts that through context provides information. With information that is organized and structured it forms meaning resulting in knowledge that through learning forms insight allowing full insight and understanding through wisdom. DIKW is always used in public health through the use for new policies and skill sets brought out, especially in nursing. Health informatics can help develop digital documentation and improve parts of it through frequent use.

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Me trying to figure out someone's made up abbreviation as I am trying to catch up on the physician's latest report...lol. 

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Ever been in that situation where you're trying your hardest to figure out someone's made up abbreviation? I know I have! It can be super frustrating as you are trying to figure it out and in certain cases this could lead to medical errors if you interpret it for something it is not. Interoperability is in place to try and elevate some of this.

Interoperability is the ability of two or more systems to exchange health information and use the information once it is received (ex. transferring someone to a different hospital). The data get transferred in a standardized way that is safe to share. Two systems can recognize terminology and medication symbols without human intervention. This allows for the patient's information to be safely transferred without information getting lost or misconstrued.

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TIGER which stands for Technology Informatics Guiding Education Reform Initiative was designed to address skills that all nurses will need in the healthcare setting now and in the future. It is expected that all nurses are going to have to be at least competent in informatics, from basic computer skills to advanced-level information technology and literacy expertise. During the week I realized how this is considered so important. Our world and healthcare system is controlled on a widely electronical basis. I see why it is critical that nurses have a solid foundation in informatics so that they are safely documenting according to the standards of nursing practice.

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The HIMSS TIGER (Technology Informatics Guiding Education Reform) Initiative's Global Informatics Definitions define core health informatics terminology. The carefully selected definitions provide context to the TIGER interprofessional community for consideration when terms are referred to in TIGER resources, in official documents and within the TIGER Virtual Learning Environment.

This document seeks to be inclusive of global terminology needs within the informatics field. As the TIGER community and healthcare workforce continue to grow and expand on a global scale, it is important to include definitions relating to informatics that extend beyond geographic borders and regions. Therefore, it is necessary to include varying terms referenced for similar concepts applied locally, regionally and nationally to maximize the integration of informatics into seamless practice, education, research and resource development on a global level.

This document was last updated in July 2020 by the TIGER International Task Force, who reviewed the previous version, infused new definitions and concepts, reconfirmed sources, and verified the currency of the definitions. We acknowledge that as the field of informatics continues to mature, so will the terms defined within this document. As the field evolves, our intention is to have this resource mirror those changes to serve as a helpful reference tool for those learning about both informatics and informatics competencies.

Healthcare, medicine, computer science and informatics continue to develop and evolve, requiring the thoughtful reflection of if and how the discipline has changed and the evaluation of its tools and scope. Today, healthcare has embraced artificial intelligence, virtual reality, augmented reality, blockchain, clinical decision support, robotics, digital health and more. It is from this vantage point that the definitions of the various health informatics disciplines were reviewed-and will continue to be reviewed as the intersection of science, technology and the healing arts continues to evolve.

If you have a term you think should be included in the HIMSS TIGER Global Informatics Definitions, please email us with your suggestions.
Originally published October 28, 2019; updated October 18, 2021

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HIMSS TIGER Global Informatics Definitions

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The HIMSS TIGER (Technology Informatics Guiding Education Reform) Initiative's Global Informatics Definitions define core health informatics terminology. The carefully selected definitions provide context to the TIGER interprofessional community for consideration when terms are referred to in TIGER resources, in official documents and within the TIGER Virtual Learning Environment.

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I loved this video! The presenter kept it super fun and easy to watch. This video explains very well how Nursing can have their won key role when it comes to informatics. This week I learned how essential our online documentation systems are in regards to keeping things running quickly and efficiently.

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Nursing Informatics vs. Health Informatics