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The Global Impact of Nursing Informatics

February 2012

According to the Healthcare Information and Management Systems Society (HIMSS) 2011 Nursing Informatics Workforce Survey, nursing informatics professionals are advancing as leaders in the growing healthcare IT field. As new technologies continue to emerge, nurses in this field have a unique opportunity to develop new strategies which will ultimately help national and international patient care.

"Telehealth applications, such as mobile communication and videoconferencing, enable nurses to provide health-related services and information to people and areas which, until recently, were out of our reach," said Patricia Abbott, PhD, RN, Associate Professor and Co-Director of the Pan American Health Organization (PAHO)/World Health Organization (WHO) Collaborating Center for Nursing Knowledge, Information Management and Sharing at the Johns Hopkins School of Nursing in Baltimore, Md. Abbott is this year's chair of the 11th International Congress on Nursing Informatics, scheduled for June 23-27 in Montreal.

Telehealth has accelerated international health education and training. Last month, Abbott visited the indigenous community of Santiago Atitlán, which is located in the western mountains of Guatemala. In this community, Abbott and six others from the U.S. and Guatemala are implementing cellular technology (eHealth) for nurse training in hopes of improving the quality of care provided to the region.

While there are different types of healthcare delivery systems in Guatemala, Abbott's focus is on health centers and health posts. Health centers, which are generally staffed with at least one degreed nurse, are located in more densely populated areas. Health centers branch out into rural health posts, each supported almost exclusively by one auxiliary nurse.

According to Abbott, these auxiliary nurses have eighth-grade level educations with approximately six to nine months of health training, which includes only very basic education on first aid, how to give immunizations and standard life-saving techniques. "They have very little training, yet are responsible for an average case load of 1,500 to 2,000 patients," said Abbott.

Abbott and her colleagues will be installing simple apps on cell phones to help these nurses improve care quality and better educate patients on healthier lifestyle options. The apps will also facilitate patient-provider communication, allowing the auxiliary nurses to SMS or "text" their patients. "We are emphasizing the use of cell phones, which gives the auxiliary nurses an opportunity to learn from outside sources and connect with the health center where there is a more experienced nurse," said Abbott.

While telehealth and mobile health services provide far-reaching educational support for nurses, patients are also being given more access and direct control of their health closer to home. To explore this trend, Abbott is currently conducting a telehealth pilot study funded as part of Dr. Miyong Kim's National Institutes of Health P30 Center, which installs electronic health monitoring devices into the homes of African American congestive heart failure (CHF) patients in the city of Baltimore, Md.

"The majority of these patients do not have a primary care provider, so they use the emergency room to receive care. We wanted to conduct a study that would measure whether implementing this telehealth resource in their homes can help them to help themselves," said Abbott. "Research shows that when patients feel connected and empowered, they will often take better care of themselves."

The health monitoring device, known as an Intel® Health Guide, is a comprehensive telehealth solution that enables patients to monitor their conditions, participate in learning modules and communicate with clinicians online. With this technology, patients are able to participate in their own care by monitoring their health status, including blood pressure, blood sugar and weight, under the guidance of a healthcare professional.

"Today, nursing informatics embodies the profession in a way I always envisioned it would. It is extremely humbling and rewarding to work in informatics. We are finding ways to help people maximize the quality of their life – and we're doing that with technology. It's a great time to be a nurse informatician," said Abbott.

For more information about nursing informatics, visit www.discovernursing.com.

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