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Nursing Informatics Definitions

American Nurses Association 1994
"Nursing informatics is the specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, research and the expansion of nursing knowledge."

International Medical Informatics Association - Nursing Informatics (IMIA-NI) - 1998
Nursing Informatics is the integration of nursing, its information, and information management with information processing and communication technology, to support the health of people worldwide.

ANA 2001
Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology. (p. 17)

Canadian Nurses Association 2001
Nursing Informatics (NI) is the application of computer science and information science to nursing. NI promotes the generation, management and processing of relevant data in order to use information and develop knowledge that supports nursing in all practice domains.

Canadian Nurses Association (2003)
Nursing Informatics (NI): integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, and knowledge to support clients, nurses, and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology. The goal of nursing informatics is to improve the health of populations, communities, families, and individuals by optimizing information management and communication. This includes the use of information and technology in the direct provision of care, in establishing effective administrative systems, in managing and delivering educational experiences, in supporting lifelong learning, and in supporting nursing research.

ANA 2008
Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information,knowledge, and wisdom in nursing practice. Nursing informatics facilitates the integration of data, information, knowledge, and wisdom to support patients, nurses, and other providers in their decision-making in all roles and settings. This

News and Info 1. The following resources are links to nursing organizations. and articles detailing the development of this dynamic new field of nursing informatics. and concludes that within 20 years there will not be enough nurses to care for the exponentially growing elderly population. It aims to boost the efficiency of data management and communication in the healthcare field. catalogs of nursing schools. Resources on Nursing Informatics Nursing informatics is the integration of computer science and information systems into the practice of nursing. 2. and in so doing. It proposes a list of recommendations for bringing nursing into the 21 st century through education and collaboration. and information technology. information processes. The author outlines several ways that information technology can address this growing is accomplished through the use of information structures. Preparing the Next Generation of Nurses is an article by The National League for Nursing that outlines the state of the industry in nursing informatics. is revolutionizing the field of nursing. The Nursing Shortage: Can Information Technology help to explores the causes and effects of the much-discussed nursing shortage. .

Their website has links to the many member organizations of the alliance and news items in nursing informatics. consulting services and a continuing education program in informatics.3. Five Emerging Majors The New York Times education blog included nursing informatics in its list of five “emerging areas of study” in higher educational settings. As pagers are replaced by smart phones and wireless internet brings gigabytes of data to your fingertips in the blink of an eye. .com offers articles. Nursingschools. 11. The context page provides a schematic breakdown of the factors involved in the development of informatics. 9. Nurseweek Overview of Nursing Informatics predicts that nursing informatics will be “one of the top 10 fastest-growing professions in the next decade. 10. Technology in Nursing is a brief survey of how information technology has changed the face of nursing. tutorials. 6. Biohealthmatics' 10 Easy Tips on How to Get Started in Nursing Informatics has a few handy directions for getting one's start in this cutting-edge career. Alliance for Nursing Informatics started the TIGER initiative (Technology Informatics Guiding Education Reform) to help prepare practicing nurses and nursing students in using new technology to improve patient care. 7. and networking center at your disposal. 4. Using the TIGER initiative as a model. along with service science. career center. nurses have the means to provide more efficient and knowledgeable service to a wider array of patients. RNs Warming Up to Information Technology describes the often welcoming but occasionally confused response that informatics has received among veteran nurses. and describes how nurses trained in IT can meet those needs. as shaped by competing medical philosophies.” This overview provides an introduction to the field as well as what to expect from a career in nursing's Nursing Informatics outlines the need for information systems in hospitals and other health settings. 5. 8. Nursing-informatics. with hundreds in development across the nation. Biohealthmatics also has a job search engine. The author emphasizes the importance of collaboration between medical and IT experts to facilitate the shift to informatics-driven medicine. the NLN seeks to introduce educational programs in nursing informatics at all levels of higher education and collaborate with industry leaders to support the adoption of informatics technology. and public health. Nursing informatics is gaining speed especially in terms of undergraduate degree programs. sustainability. NLN's Informatics Agenda The NLN (National League for Nursing) released this position statement in May 2008 to establish an agenda for efficiently and effectively incorporating information technology in the health care arena. It also explains the educational requirements and other prerequisites for entering the field of nursing informatics. computational science.

perceptions. Mapping the Literature of Nursing Informatics was a 2005 study undertaken by the Medical Library Association to characterize the growth of medical informatics over the past quarter century. You can apply online or schedule a site visit for any of their hundreds of accredited universities. experience. Schools and Programs 13. Nursing informatics articles were underrepresented compared with general informatics. Weekend Immersion in Nursing Informatics is a monthly nursing informatics continuing education program designed to be a crash course in information technology with a focus on the professional practice. The program's main objective is to prepare students for the comprehensive ANCC Nursing Information Certification Exam. CAHIIM Accredited Programs is a catalogue of undergraduate and masters HIM (Health Information Management) programs. Allied Health World 's Nursing Informatics section provides information about schools and programs for receiving certification in nursing informatics. knowledge” regarding all facets of nursing informatics. delves into the advantages and disadvantages of the move to electronic health records. as well as the pros and cons of a career in nursing informatics as compared with other fields. and/or Masters) and whether they have online courses. American Nurses Credentialing Center 's home page provides all the information you need to get board certification for nursing informatics. 15. . Online Journal of Nursing Informatics was founded so that nurses could share “findings. 16. 19. educational events. Full-text articles are freely available without subscription. along with summaries of the programs they offer (Certificate. Doctorate. 14. You can search by program type or geographic region to find the college that suits your needs. 17. associate professor for the UCSF School of Nursing. 20. Nursing Informatics Online is a massive message board forum with updates on conferences. as well as links to other nursing informatics sources. Once that's taken care of. Their online bookstore has several introductory texts explaining the science and its applications. Forums and Journals 18. 31 Nursing Informatics Graduate Programs lists the top schools in the country with nursing informatics programs. suggesting that nurses may be using sources other than journals to disseminate information. A Look at Nursing Informatics An interview with Suzanne Bakken Henry. and journal articles. they'll help you with job-seeking and career advice as well.12.

Information. 23.CARING is one of the largest nursing informatics sites. ANIA . History of the ANI Founded in 2004 to establish a “unified voice” for nursing informatics. 22. Whether it is an individual. job bank. Its 5. the ANI currently represents over 5. and many other resources. Online Journal of Issues in Nursing is one of the leading medical journals in nursing. Medical and Nursing Training Blog is a guide to medical and nursing training and vocational schools. Weekly blog posts focus on an individual school. Nursing) journal article recounts the story of their founding and lists their current member organizations. Their Getting Started page has nurse testimonials on how to start a career in nursing informatics. with links to their web sites.000 readers share anecdotes and advice about this rapidly developing profession.21.000 nursing informaticists. This CIN ( Nursing Informatics Forum is a blog/forum for the latest news and trends in nursing informatics. computers are must for smooth flow of business and . Allnurse. with a quarterly newsletter. business or service providers. 24. THE USE OF COMPUTERS IN HOSPITALS : The age of Information Technology came about with the invention of computers. giving an in-depth look at their curriculum and environment. it is inconceivable for us to function without one. and today. 25. Its “Nursing Technology” page has an introduction to and several articles on nursing informatics.

Electronic health record(Patient record system): An electronic health record (EHR) (also electronic patient record (EPR) or computerised patient record) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations. In addition.operations. you will realize what medical imaging is all about. including hospitals. sicknesses. by . In fact. has adopted the use of computers in their day to day activities. However. so that they can offer the best care and diagnostic tools to patients. computers are also used for several types of medical examinations and procedures. This usually comes up to a huge amount of data that needs to be preserved. having specialized computer for various medical procedures is expensive and painstaking process. When special gadgets are used to get an image of the bones and organs inside the body. For instance. Here are some of the uses of computers in hospitals: One of the main uses of computers in hospitals is for storing data. it is known as medical imaging. The second use is for medical imaging. CT scan and MRI. so that it can be retrieved any time. it is impossible for a hospital to function with technology and computer. hospitals have realized the immense value and are constantly trying to upgrade their technology. Today. heart rate monitor is used in hospitals where patients with heart ailments come. This data is pertaining to patients' case histories. Nonetheless. Blood glucose monitor is another computer based system where diabetics are monitored. the kind of medication taken by patients and kept in the hospitals and also the billing details for each and every patient. The most common examples of this are ultrasound. prescriptions. If you have ever been scanned. It is a record in digital format that is capable of being shared across different health care settings. even the medical community.

DRG and medical procedures information. but hierarchically ordered and layered. Computerized Physician Order Entry (CPOE)—one component of EHR—increases patient safety by listing instructions for physicians to follow when they prescribe drugs to patients. quality management. laboratory test results. employers. physicians and other health care providers. radiology images.000 adverse drug events and save about $1 billion per year if installed in all hospitals. A personal health record is. Improved usage of EHR is achieved if the presentation on screen or on paper is not just longitudinal. During compilation while hospitalisation or ambulant serving of the patient. and outcomes reporting. It is important to note that an EHR is generated and maintained within an institution.being embedded in network-connected enterprise-wide information systems. easing to get access on details is improved with browser capabilities applied to screen presentations also cross referring to the respective coding concepts ICD. and billing information. although a difference between them can be defined. Information Technology is being used today to automate day-to-day processes. Fast access to medical literature and current best practices in medicine are hypothesised to enable proliferation of ongoing improvements in healthcare efficacy. medical history. CPOE can tremendously decrease medical errors: CPOE could eliminate 200. clinic. or physician office. thus helping to reduce administration costs which then in turn can free up time and money for patient care EHR systems can help reduce medical errors by providing healthcare workers with decision support. and payers or insurers access to a patient's medical records across facilities. in modern parlance. Improve quality of care The implementation of electronic health records (EHR) can help lessen patient sufferance due to medical errors and the inability of analysts to assess quality. generally defined as an EHR that the individual patient controls. EPR and EMR (electronic medical record) are often used interchangeably. including demographics. integrated delivery network. vital signs. Such records may include a whole range of data in comprehensive or summary form. Its purpose can be understood as a complete record of patient encounters that allows the automation and streamlining of the workflow in health care settings and increases safety through evidence-based decision support. The EMR can be defined as the legal patient record created in hospitals and ambulatory environments that is the data source for the EHR. immunization status. • Terminology The terms EHR. to give patients. such as a hospital. personal stats like age and weight. Naturally.[14] . medication and allergies.

and how many providers use it. EHRs improve quality. In a project initiated by the Office of the National Coordinator for Health Information (ONC). and 33 percent paid more than $6. Also. Disadvantages Critics point out that while EHRs may save the "health system" money. Costs The steep price of EHR and provider uncertainty regarding the value they will derive from adoption in the form of return on investment has a significant influence on EHR adoption. patients are shopping for their procedures. Studies also call into question whether. but not every practice gets that far. national or regional level) so that various systems can easily share information. depending on what's included. Realistically. how robust the system is. Asked what they paid in an online survey. may not benefit financially. those who buy the systems. these benefits may only be realized if the EHR systems are interoperable and wide spread (for example.001 and $6. Many international patients travel to US cities with academic research centers for specialty treatment or to participate in Clinical Trials. physicians. They spend more time entering data into an empty EHR than they used to spend updating a paper chart with a simple dictation.000. 2009 produced several articles raising doubts about EHR benefits.It is also easier to check in their records whether a patient as been admitted to such a medical centre or if they have any allergies since they have been admitted before.. Coordinating these appointments via paper records is a time-consuming procedure. surveyors found that hospital administrators and physicians who had adopted EHR noted that any gains in efficiency were offset by reduced productivity as . Physicians do tend to see at least short-term decreases in productivity as they implement an EHR. to avoid failures that can cause injury to the patient and violations to privacy. in real life. and as workflow in the practice changes. EHR price tags range widely. about a third of respondents paid between $500 and $3.000 per physician for their HER.Promote evidence-based medicine EHRs provide access to unprecedented amounts of clinical data for research that can accelerate the level of knowledge of effective medical practices. A third paid between $3.000 per physician. Such hurdles can be overcome once the software has some data. the best practices in software engineering and medical informatics must be deployed Record keeping and mobility EHR systems have the advantages of being able to connect to many electronic medical record systems. In the current global medical environment. as physicians learn to use templates for data entry.

as well as the need to increase information technology staff to maintain the system Time Often. standardized formatting of data electronically exchanged and federalization of security and privacy practices among the private sector. Some doctors believe that adopting a system with EHRs could reduce clinical productivity. The surge in the per capita number of attorneys and changes in the tort system caused an increase in the cost of every aspect of healthcare. . Within the private sector. Private companies have promised to have “stringent privacy policies and procedures. the private sector know the importance of privacy and the security of the systems and continue to advance well ahead of the federal government with electronic health records. and Germany. the concept of a national centralized server model of healthcare data has been poorly received. This includes two ideas. privacy and legal issues Privacy Concerns In the United States. many companies are moving forward in the development. in the retail industry. Great Britain. Governance. doctors do not want to spend the time to learn a new system. By law. and from government databases. establishment and implementation of medical record banks and health information exchange. and healthcare technology was no exception. have caused concern about storing electronic medical records in a central location.the technology was implemented. So. companies are required to follow all HIPAA standards and adopt the same information-handling practices that have been in effect for the federal government for years. Records that are exchanged over the Internet are subject to the same security concerns as any other type of data transaction over the Internet. in banking and other financial institutions. According to the Los Angeles Times.000 payers. people will not trust the technology nor will they participate in it. Legal issues Liability Legal liability in all aspects of healthcare was an increasing problem in the 1990s and 2000s. Recent revelations of "secure" data breaches at centralized data repositories. roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization.” If protection and security are not part of the systems developed. Issues of privacy and security in such a model have been of concern Privacy concerns in healthcare apply to both paper and electronic records. and 600. providers and other entities that handle providers' billing data have some access also.

(especially when fundamental legal incompatibilities are involved) Exploring these issues is therefore often necessary when implementing cross-border EHR solutions Technical issues Customization Each healthcare environment functions differently. exceptions to the Stark rule were enacted to allow hospitals to furnish software and training to community providers. however. increased overtime. often in significant ways. Many EHR companies employ vendors to provide customization. hospitals attempt to standardize EHR systems by providing discounted versions of the hospital's software to local healthcare providers. which can require radical changes of the technical makeup of the EHR implementation in question. Different countries may have diverging legal requirements for the content or usage of electronic health records. It is difficult to create a "one-size-fits-all" EHR system. Customizing the software when it is released yields the highest benefits because it is adapted for the users and tailored to workflows specific to the institution. .. Legal Interoperability In cross-border use cases of EHR implementations. it's important to recognize that the implementation of electronic health records carries with it significant legal risks. Larger EHR providers (or government-sponsored providers of EHRs) are better able to withstand legal assaults. and missing records when a non-customized EMR system was utilized. In 2006. Some smaller companies may be forced to abandon markets based on the regional liability climate. Similarly. the additional issue of legal interoperability arises. Modularity in an EHR system facilitates this.Failure or damages caused during installation or utilization of an EHR system has been feared as a threat in lawsuits. A challenge to this practice has been raised as being a violation of Stark rules that prohibit hospitals from preferentially assisting community healthcare providers. At the same time they reported negative effects in communication. This customization can often be done so that a physician's input interface closely mimics previously utilized paper forms. This liability concern was of special concern for small EHR system makers. In some communities. An ideal EHR system will have record standardization but interfaces that can be customized to each provider environment. mostly removing this legal obstacle.

" Synchronization of records When care is provided at two different facilities. More time must be spent by both the implementation team and the healthcare provider to understand the workflow needs. higher costs involved to implementation of a customized system initially. The field will need to come to consensus on the length of time to store EHRs.Customization can have its disadvantages. edited. timestamps and archive e-signatures. Mandl et al. have noted that “choices about the structure and ownership of these records will have profound impact on the accessibility and privacy of patient information. TNA can store objects in XML-format and prove the integrity of stored data with the help of event records. primary care physicians. Records have the potential to be created. Additionally. methods to ensure the future accessibility and compatibility of archived data with yet-to-be developed retrieval systems. and how to ensure the physical and virtual security of the archives. Ruotsalainen and Manning have found that the typical preservation time of patient data varies between 20 and 100 years. In one example of how an EHR archive might function. There is. and a peer-to-peer file synchronization program (as has been developed for other peer-topeer networks). Development and maintenance of these interfaces and customizations can also lead to higher software implementation and maintenance cost Long-term preservation and storage of records An important consideration in the process of developing electronic health records is to plan for the long-term preservation and storage of these records. considerations about long-term storage of electronic health records are complicated by the possibility that the records might one day be used longitudinally and integrated across sites of care. These entities include. but are not limited to. are only useful once record standardization has occurred. it may be difficult to update records at both locations in a co-ordinated fashion. insurance companies. which are subject to change over time. and viewed by multiple independent entities. Two models have been used to satisfy this problem: a centralized data server solution.” The required length of storage of an individual electronic health record will depend on national and state regulations. of course. . their research "describes a co-operative trusted notary archive (TNA) which receives health data from different EHR-systems. stores data together with associated meta-information for long periods and distributes EHR-data objects. however. used. hospitals. and patients. Synchronization programs for distributed storage models.

RECORDS AND REPORTS INTRODUCTION: Records play an important part in a nursing education programme apart from being necessary for the day-to-day administration of the school or college of nursing. They provide continuity from the time the school/college is established. Records and the system of maintaining them vary from one school to another. . Thus facilitating evaluation of the programme.

11. records should permit some freedom of expression. accuracy and reliability. 8. Items on forms and in registers should be conveniently grouped so as to make their completion as easy as possible. There should be sufficient number of filing cabinets and appropriate equipments to operate filing system which is simple and safe requires the minimum possible time.PRINCIPLES OF MAINTAINING SCHOOL RECORDS: 1. Where appropriate. The following list is intended as a guide to the minimum which should be maintained in the school. 9. Records. instructions to facilitate interpretation should be included. A simple system should be used for keeping records. safe. 10. which are required by the teaching staff should be easily accessible to them. staff and other aspects of the programme as is really necessary for the school programme and for evaluation. 3. which should be clearly understood by those maintaining and using the records. and content kept in regard to students will vary from one school to another. 2. There should be an adequate supply of stationery to permit records to be maintained on the proper forms and in the proper registers at all times. There should be adequate. There should be provision for periodic review of all records to ensure that they keep place with the changing needs of the programme. Persons responsible for maintaining records should be aware of their particular responsibility and every effort should be made to keep records upto date and accurate. Records should contain only such information regarding the student. 1. 5. fireproof. All irrelevant material should be carefully avoided and records should not be duplicated. TYPE OF RECORDS: • • • Student records Staff records Academic and Administrative records. 7. The wording should be easily understood and where doubt is likely to arise. Each record should be for a specific purpose. STUDENT RECORDS: The number. The List of records are. 4. storage arrangements. type. For routine recording which is carried out by non-profession personnel the system should be standardized as much as possible for speed. 6. .

student rotation Internal assessment register. previous experience. purposes and curriculum of the school. participation in seminars. Application (where applicable) b. c. i. Copy of school brochure . Course content and course plan record for each subject c. g. g. e. Record of academic requirements d. k. Admission register A cumulative health records Class attendance and leave records Clinical and field experience. Grant in aid record if any i. conferences etc. 2. Written policies of the school l. Record of committees in the school f. certificates and results of written test and interview at the time of selection. concerning selection and admission such as references. Record of the staff member’s educational qualification. STAFF RECORDS: In the personal file of each staff these should be a. Affiliation records h. e. ACADEMIC/ ADMINISTRATIVE RECORDS FOR SCHOOL: a. h. marks. medical reports. 3. Statement of budget proposal and allotments m. including mark lists. Application forms and other reports. Rotation plans for each academic year e. f. Record of the stocks in the school g. Minutes of staff meeting n. d. updated every years. holding office in organizations. Records of educational programmes organized for teaching faculty and students j. student details. rank/class for each students. b. Leave record. l. practical experience. Periodic evaluation or progress report. Copy of letter of appointment and any subsequent letter showing change in status.a. b. examination and results. Permanent cumulative student record. j. Health record. f. any short term educational course attended. Student evaluation: internal practical and theory. Membership in professional societies and activities of articles to journals. Annual reports k. c. midwifery records book. theory hours. Job description/ functions d. Philosophy.both theory and practical Mark list ( state council/ board results) Records of extra – curricular activities Grade records for every year Practical record book-procedure book.

The type of information commonly required in an annual report. Recommendations. Course content record ( per each subject) The record for each academic year Rotation plans for each academic year Record of committees in the school Record of the stock in the school . 2. Admission record Health record Class attendance record Clinical and field experience record Internal assessment record of both theory and practical Work lists (State council or Board). Leave record Practical record books – Procedure book. 3. 3. p. Minimal records to be maintained as per INC recommendations: A. staff. midwifery record book. For Students: 1. 4. Factual data relating to students. B. 3. 7. physical facilities. For each academic year for each class. 1. Proposal and plans for future development and problems encountered. REPORTS: The number and nature of report will depend on requirement of controlling body and nursing council. clinical facilities. Records of extra curricular activities of students (Both in school as well as outside). For the School: 1. Inspection/ accreditation records Minute of administrative committee meetings Photographs/ videos/ paper cuttings of important events Computerized records (floppies/ computer discs). 4. r. 5.o. administration and the curriculum. q. 4. The preparation should be done accurately because the data they provide is frequently used for planning and evaluation at state or national level. Cumulative record a. 6. b. 10. It is important that such reports are sent promptly and accurately as they may be required by the authority for a more comprehensive report. 5. 2. Development in the school programme since the last report. 8. 2. For each student ( permanent record). 9.

New Delhi. if any 8. enlarging the system scope and meeting the varying information needs. 72-75. .6. PP No. both in the school as well as outside. So these records and reports protect us in all the ways as a legal document. Grant in aid record. the size of the system. So each of us should know about these records and reports to run a institute as per our INC requirements. School of Nursing should possess detailed and upto date record of each activity in the school. the user understands of the system and the complexity and its interface with other systems. CONCLUSION: Records and reports are very important legal documents which helps the person to know about the detail functioning levels of school. Affiliation record 7. WHO guide for school of Nursing. MANAGEMENT INFORMATION SYSTEM : Implementation of MIS The choice of the system or the sub-system depends on its position in the total MIS plan. PP No. Guide for school of nursing in India. prepared by Indian Nursing council. Records of educational programmes organized for teaching faculty and students. 9. Kotla Road. Tempel Lane. 2. The designer first develops systems independently and starts integrating them with other systems. Annual reports ( Records of achievements of the school prepared annually) The above list of the records are only the bare minimum. It help us to know the strength and weakness of the school for further development. BIBLIOGRAPHY: 1. These records and reports help us to know about the individuals performances either staff or a students. 2002.

The new system does no replace the existing system. This approach becomes useful when these factors are considered. means the implementation of a system in the Organization on a piece-meal basis. MIS is generally used by medium and larger scale organizations. parallel. • Direct Approach Direct installation of the new system with immediate discontinuance of the old existing system is reffered as “cold turnkey” approach. decision making and the understanding of the overall business activity. greater is the stabilization of the rules. The design of the new system is inexpensive with more advantages and less risk involved. 1. and each other’s need are clearly understood and respected mutually. The development becomes a methodical approach with certainty in input-process and outputs. modular or phase in. The real problem in the degree of structure. This method is expensive because of duplicating facilities and personal to maintain both the systems. Implementation of MIS can be achieved by using any of the methods such as direct. Here. Old system is regarded absolutely of no value 3. the procedures. • Modular Approach This is generally recognized as “Pilot approach”. In this approach a target date must be fixed when the operations of old system cease and new one will operate on its own. small organizations are yet to understand its application. 4. 2. and formalization in the system and procedures which determine the timing and duration of development of the system. Higher the degree of structured ness and formalization. However. This has few advantages / merits . it is observed that the user’s and the designer interaction are smooth.Determining the position of the system in the MIS is easy. • Parallel Approach The selected new system is installed and operated with current system. There is dire need to build up computer culture by properly disseminating information about computer applications and its benefits. New system is compact and simple.

The planning stage should invariably include the following: 1. System exhibits certain disadvantages such as limited applicability. • Phase-in-Implementation This approach is similar to modular method but it differs because of segmentation of system. testing the system and evaluating and maintenance of the system. 3. Identification of tasks of Implementation Planning the implementation activities. The major problem can be easily identified and corrected before further implementation. The risk of systems failure is localized 2. Operating personal can be trained before system is installed in a location. more costs incurred to develop interface with old system and a feeling in the Organization that system is never completed. 4. Relationship establishment among the activity Network diagram must be prepared to correlate concurrent and sequential activities. Procedure Development This is an important stop for implementation of the system including various activities . 2. Implementation Procedures • Planning the Implementation After designing the MIS it is essential that the organization should plan carefully for implementation.1. Establishing of MIS For monitoring the progress of implementation and for proper control of activities. Acquisition of Facilities For installation of new system or to replace current system the manager should prepare a proposal for approval from the management by considering space requirement movement of personal and location for utility outlets and controls. generating files and forms. procedures development. It has advantages that the rate of changes in a given Organization can be totally minimized and the data processing resource can be acquired gradually over a period of time. however. efficient information system should be developed. not the organization. 5. acquisition of facilities. 3.

Reduction in Maintenance Costs Several organizations having MIS generally go in for reducing maintenance costs Evaluation Methods Evaluation of the MIS in an organization is integral part of the control processes. format date storage forms and other remarks in data base. There are several evaluation approaches such as quality assurance review compliance of audits budget performance review computer personal productivity assessment computer performance evaluation service level monitoring user audit survey post installation review and cost benefit analysis. Types of Maintenance The maintenance of system are classified into corrective/adaptive/perfective. Adaptive maintenance means changing the programming function whereas perfective maintenance deals with enhancing the performance or modifying the program. Programming library should be maintained. purchase or development of software. • Evaluation and maintenance of system The performance should e evaluated in order to find out cost effectiveness and efficacy of the system with minimum errors due to designs environmental changes or services.such as evaluation selection of hardware. Testing of the System Test should be performed in accordance with the specifications at the implementation stage consisting of component test sub system test and total system test. Primary Activities of a Maintenance Procedure Documentation is major part of maintenance in system development. Corrective maintenance means repairing process or performance failures. Generating Files and Forms The MIS manager should generate files and formats for storing actual date. The relationship between effectiveness and efficiency is that the format is . 6. 7. Evaluation performance measurement can be classified into two classes as effectiveness and efficiency. This requires checklist data. Maintenance staff receives requests from the authorized user. testing and implementation strategies.

or as complex as using satellite technology and videoconferencing equipment to conduct a real-time consultation between medical specialists in two different countries.K. Care at a distance (also called in absentia care).a measure of goodness of out put and the latter is a measure of the resources required to achieve the output. administration. and Europe. has evolved into what we know as modern telemedicine. particularly in the U. Dermatology (cf: teledermatology). and other components of health IT. electronic medical records. Telemedicine Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting. radiology. • Types of telemedicine Telemedicine can be broken into three main categories: store-and-forward. biosignals etc) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. The terms eHealth and telehealth are at times incorrectly interchanged with telemedicine. A properly structured . It does not require the presence of both parties at the same time. Like the terms "medicine" and "health care". an old practice which was often conducted via post. There has been a long and successful history of in absentia health care which. Store-and-forward telemedicine involves acquiring medical data (like medical images. telemedicine often refers only to the provision of clinical services while the term telehealth can refer to clinical and nonclinical services such as medical education. Telemedicine generally refers to the use of communications and information technologies for the delivery of clinical care. The term eHealth is often. and sometimes remote medical procedures or examinations. Telemedicine may be as simple as two health professionals discussing a case over the telephone. used as an umbrella term that includes telehealth. thanks to modern communication technology. remote monitoring and interactive services. and research. and pathology are common specialties that are conducive to asynchronous telemedicine.

A key difference between traditional in-person patient meetings and telemedicine encounters is the omission of an actual physical examination and history. reduced travel times." Several studies have documented increase patient satisfaction of telemedicine over past fifteen years. to include phone conversations.. Telemedicine can be used as a teaching tool. or asthma. Patients who live in such areas can be seen by a doctor or specialist. by which experienced medical staff can observe. who can provide an accurate and complete examination.shared health professional staffing. etc. such as heart disease. In addition.medical record preferably in electronic form should be a component of this transfer. Many activities such as history review. while the patient may not have to travel or wait the normal distances or times like those from conventional hospital or GP visits. more effective or faster examination techniques. telemedicine as applied by radiologists is called 'teleradiology'. The 'store-andforward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination. online communication and home visits.. "Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases. and fewer or shorter hospital stays. physical examination. operating over standard telephone lines. Telemedicine is also useful as a communication tool between a general practitioner and a specialist available at a remote location. also known as self-monitoring or testing. The first interactive telemedicine system. enables medical professionals to monitor a patient remotely using various technological devices. Similarly telemedicine as applied by cardiologists is termed as 'telecardiology'. show and instruct medical staff in another location. for remotely diagnosing and treating patients requiring cardiac resuscitation (defibrillation) was developed and marketed by MedPhone Corporation Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as . Interactive telemedicine services provide real-time interactions between patient and provider. for example. These services can provide comparable health outcomes to traditional in-person patient encounters. supply greater satisfaction to patients. It improved access to healthcare for patients in remote locations. psychiatric evaluations and ophthalmology assessments can be conducted comparably to those done in traditional face-to-face visits. Specialties that use telemedicine often use a 'tele-' prefix. and may be cost-effective. Remote monitoring. This method is primarily used for managing chronic diseases or specific conditions. “clinician-interactive” telemedicine services may be less costly than in-person clinical visit Benefits and uses Telemedicine can be extremely beneficial for people living in isolated communities and remote regions and is currently being applied in virtually all medical domains. diabetes mellitus.

Telemonitoring is capable of providing information about any vital signs. and hemoglobin. whereby a doctor uses devices to remotely examine and treat a patient. blood glucose. This system enabled wireless transmission of ECG from the moving ICU van or the patients home to the central station in ICU of the department of Medicine. This was because the hospital did not allow him to move patients outside the hospital to his laboratory for testing of his new device. or electrocardiographs. the MDphone. a patient will have a number of monitoring devices at home. as long as the patient has the necessary monitoring equipment at his or her location. S. In developing countries a new way of practicing telemedicine is emerging better known as Primary Remote Diagnostic Visits. These remote monitoring solutions have a focus on current high morbidity chronic diseases and are mainly deployed for the First World.S. served as receiving and treatment centers.Eric Wachtel. in for instance. and the results of these devices will be transmitted via telephone to the health care provider. most telemonitoring programs include subjective questioning regarding the patient's health and comfort. the inventor of the ECG. Twelve hospitals in the U. Cardiac MonitorRemote Patient MonitoringVital Signs MonitorTelemedicine SystemPortable Heart MonitorHolter MonitorPortable Ekg Monitor in 1989 under the leadership of its president and founder. Monitoring a patient at home using known devices like blood pressure monitors and transferring the information to a caregiver is a fast growing emerging service. A year later the company introduced a mobile cellular version. or telemonitoring software can help keep the patient in touch with the health care provider. the provider may check these statistics on a daily or weekly basis to determine the best course of treatment. This questioning can take place automatically over the phone. heart rate. Depending on the severity of the patient's condition. because Primary Remote Diagnostic Consultations not only monitors an already diagnosed chronic disease. Teletransmission of ECG using indigenous methods. Willem Einthoven. Telemonitoring is a convenient way for patients to avoid travel and to perform some of the more basic work of healthcare for themselves. Transmission using wireless was done using frequency modulation which . In general. Telecardiology ECGs. Some of the more common things that telemonitoring devices keep track of include blood pressure. weight.the health care provider. can be transmitted using telephone and wireless. but has the promise to diagnose and manage the diseases a patient will typically visit a general practitioner for. In addition to objective technological monitoring. actually did tests with transmission of ECG via telephone lines. This new technology and principle of practicing medicine holds significant promise of improving on major health care delivery problems. The provider can then make decisions about the patient's treatment based on a combination of subjective and objective information similar to what would be revealed during an on-site appointment. Southern Africa.

The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. and a receiving-image review station. For this process to be implemented. The ECG output was connected to the telephone input using a modulator which converted ECG into high frequency sound. US. No particular software is necessary on the PC and the images can be reached from wherever in the world. which is helpful for purposes of telecardiology. The most typical implementation are two computers connected via the Internet. At the other end a demodulator reconverted the sound into ECG with a good gain accuracy. Sometimes the receiving computer will have a printer so that images can be printed for convenience. an image sending station. Teleradiology Teleradiology is the ability to send radiographic images (x-rays. CT. The teleradiology process begins at the image sending station. SPECT/CT.. PET/CT. The ECG was converted to sound waves with a frequency varying from 500 Hz to 2500 Hz with 1500 Hz at baseline. MR. three essential components are required. MG. Today's high-speed broadband based Internet enables the use of new technologies for teleradiology : the image reviewer can now have access to distant servers in order to view an exam. Teleradiology is the most popular use for telemedicine and accounts for at least 50% of all telemedicine usage. Therefore.) from one location to another. Electronic stethoscopes can be used as recording devices. This technique helped medical aid reach in remote areas.. a standard Personal Computer (PC) and Digital Subscriber Line (DSL) connection is enough to reach keosys central server.eliminated noise. . This system was also used to monitor patients with pacemakers in remote areas. In addition. The central control unit at the ICU was able to correctly interpret arrhythmia. The radiographic image and a modem or other connection are required for this first step. a transmission network. Transmission was also done through telephone lines. they do not need particular workstations to view the images . The image is scanned and then sent via the network connection to the receiving computer.

Links for several sites related to telemedicine. In addition. A notable telepharmacy program in the United States conducted at a federally qualified community health center. refill authorization. 1. monitoring formulary compliance with the aid of teleconferencing or videoconferencing. such as consultation between the psychiatrists. diagnosis and assessment. medication therapy management.Telepsychiatry Telepsychiatry.” The remote site dispensing and patient education process was described as follows: once the prescription is sent from the remote clinics to the base pharmacy. Telepharmacy Telepharmacy is another growing trend for providing pharmaceutical care to the patients at remote locations where they may not have physical contact with pharmacists. also utilizes videoconferencing for patients residing in underserved areas to access psychiatric services. The following are some of the model programs and projects which are undergoing for implementation of telepsychiatry in rural areas in the US. Walter Reed Army Medical Center. Telemental Health Treatment for American Indian Veterans with Posttraumatic Stress Disorder (PTSD) 2. Washington under the telepharmacy program at CHAS. telepsychiatry policy. prior authorization. This program utilized videotelephony for dispensing medication and patient counseling at six urban and rural clinics. patient counseling. “The base pharmacy provided traditional pharmacy study to the clients at Valley clinic and served as the hub pharmacy for the other remote clinics. The Center for Native American Telehealth and Tele-education (CNATT) and b. educational clinical program. etc. It offers wide range of services to the patients and providers. The label is also generated simultaneously. such as providing education. Military Psychiatry. training. When the label queue appears on the . and performing several management functions. Community Health Association of Spokane (CHAS) in 2001. There were one base pharmacy and five remote clinics in several areas of Spokane. and networking are available at the website for the American Psychiatric Association. the pharmacist verifies the hard copy and enters the order. video-conferencing is vastly utilized in pharmacy for other purposes. It encompasses drug therapy monitoring. guidelines. another aspect of telemedicine. and the label queue is transmitted to the remote site. which allowed the low cost medication dispensing under federal government’s program. University of Colorado Health Sciences Center (UCHSC) supports two programs for American Indian and Alaskan Native populations a.

telemonitoring. Even if the practitioner never practices medicine face-to-face with a patient in another state. states with restrictive licensure laws also have several exceptions (varying from state to state) that may release an out-of-state practitioner from the additional burden of obtaining such a license. such as telediagnosis. or between any number of nurses. etc.medication dispensing cabinet known as ADDS. Telenursing Telenursing refers to the use of telecommunications and information technology for providing nursing services in health care whenever a large physical distance exists between patient and nurse. the remote site personnel are connected to the pharmacist at base pharmacy via videoconferencing for medication verification and patient counseling. and the printing and scanning of labels. Licensing. he/she still must meet a variety of other individual state requirements. Typically. teleconsultation. obtaining this license in each state could be an expensive and time-consuming proposition. and has many points of contacts with other medical and non-medical applications. Once those steps are done. regulatory issues & telemedicine Restrictive licensure laws in the United States require a practitioner to obtain a full license to deliver telemedicine care across state lines. As a field it is part of telehealth. passing additional oral and written examinations. the authorized person can access the medicine from ADDS followed by medication barcode scanning. including paying substantial licensure fees. and traveling for interviews. an increase in the number of . Telenursing is achieving a large rate of growth in many countries. Physicians who will be prescribing over the Internet to patients should mandate strict controls on their practice to insure that they stay compliant with the various State Medical Board Regulations concerning Internet Prescribing. due to several factors: the preoccupation in driving down the costs of health care. A number of States require practitioners who seek compensation to frequently deliver interstate care to acquire a full license. Regulations concerning the practice of Telemedicine vary from state to state. If a practitioner serves several states.

videophone. such as neural degenerative diseases (Parkinson's disease. A greater degree of job satisfaction has been registered among telenurses. . handicapped individuals. congestive heart disease. etc. ostomies. and the increase in coverage of health care to distant. [Needs source] A common application of telenursing is also used by call centers operated by managed care organizations. Legal. rural. etc. or disabilitating diseases.aging and chronically ill population.. to reduce distances and save travel time. • Applications One of the most distinctive telenursing applications is home care. or live in remote or difficult to reach places. citizens who have chronic ailments. one nurse can “visit” 12-16 patients in the same amount of time. Using telenursing. ALS). which are staffed by registered nurses who act as case managers or perform patient triage. patients who are immobilized. small or sparsely populated regions. are also still largely unsolved and difficult to address. the care of wounds. Legal issues such as accountability and malpractice. In addition. there are many considerations related to patient confidentiality and safety of clinical data. telenursing may help solve increasing shortages of nurses. interstate and intercountry practice of telenursing is forbidden (the attending nurse must have a license both in her state/country of residence and in the state/country where the patient receiving telecare is located). Still other applications of home care are the care of patients in immediate post-surgical situations. ethical and regulatory issues Telenursing is fraught with legal. may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing. such as chronic obstructive pulmonary disease. nursing teleconsultations. information and counseling as a means of regulating patient access and flow and decrease the use of emergency rooms. Telenursing can also involve other activities such as patient education. internet. and assistance to physicians in the implementation of medical treatment protocols. Alzheimer's disease. diabetes. In normal home health care. ethical and regulatory issues. etc. as it happens with telehealth as a whole. examination of results of medical tests and exams. For example. and to keep patients out of hospital. one nurse is able to visit up to 5-7 patients per day. In many countries. Among its many benefits. etc.