NCM 110

Nursing Informatics

WEEK 4
COMPTER SYSTEMS

Gradient
Computer System
A. Computer Software
B. Brief History of computer software
C. Types of software
D. Common software useful to nurses
E. Issues in Informatics
ü Nursing Informatics and Healthcare
Policy
OBJECTIVES
1. Define the difference between computer software and computer hardware
2. Identify the two categories of software and discriminate between the two
for purpose and functionality
3. List the categories of programming languages and identify at least one
example for each
4. Identify key requirements for software designed to support nursing
practice
5. Define the term “system” and describe how the term applies to the field
of computers
6. Identify the five defining attributes of a system and define the meaning of
each
7. List the most common administrative and clinical modules in an HIS
8. Define the term network and describe the two essential components of
network technology.
Software-general term applied to the instructions that direct the
computer’s hardware to perform work.

1. Computers do not directly understand human language,

software is needed to translate instruction created in human
language into machine language. It can only understand only
binary numbers, not English or other human language.
2. Packed or stored software is needed to make the computer and
economical work tool. Users could create their own software
every time they needed to use computer.
3. Computer hardware is merely a collection of printed circuits,
plastics, metals, and wires. Without software, hardware is
nonfunctional.
 History of Computer Software

Youtube video: https://www.youtube.com/watch?v=au-gE-Ohbhg

Charles Babbage-first described the concept of a stored computer
program. He invented ( but never built) a device that he named the
“analytical machine”

Countess Lovelace-the first programmer in computer history. She

theorized the use of automatic repetitious arithmetic steps that the
analytic engine would follow to solve a problem, namely loop
concept.

Rear Admiral Grace Murray Hoppe- the Mother of Computing- work

with the first digital computer
 2 Types of Software: system software &
applications software

1. System Software- “boots up” (start up &

initializes) the computer system, controls input,
output & storage & controls the operations of the
application software

2. Application Software- includes various

programs that users require to perform day-to-
day tasks. They are program that supports the
actual work of the user
Common Software Useful to Nurses
1. Chat Rooms
2. Electronic Bulletin Boards
3. Listservs
Reference:
https://medium.com/@dmitriy.malets/10-most-popular-types-of-healthc
are-software-2019-edition-61129475bbc0
https://www.elpassion.com/blog/most-popular-types-of-healthcare-softw
are
 Issues in Informatics
https://www.usfhealthonline.com/resources/health-inform
atics/current-challenges-in-health-informatics/

Five of these challenges facing health

informatics are:
1. DATA MANAGEMENT TRENDS
Writing for Becker’s Hospital Review, Jackie Drees and Laura Dyrda highlight how
“the pandemic underscored the need for centralized and efficient data management,” as
data-gathering and reporting efforts and the adoption of online cloud storage all
accelerated in 2021.

These needs and expectations for greater data information access, integration and
storage capacity are only going to grow. Imaging has become more precise, creating
larger file sizes and more storage capacity requirements. Artificial intelligence (AI) and
data collected from medical devices must be processed to add insight to diagnoses and
treatments, increasing processing demand.
IT healthcare professionals must be sure systems can adequately handle the data
management needs so these technologies can function as intended. Moving to cloud-
based platforms offers improved data coordination, greater systems integration
potential and more secure data storage.
2. INCREASED CYBERSECURITY
The pandemic proved to be a golden opportunity for cybercriminals, as
more shoppers, workers and business moved online. According to
the FBI Internet Crime Report, a record-breaking 791,790
cybercrime complaints were made in 2020. The figures for 2021 may
top that record.

Hospitals and healthcare systems have found themselves targets in this

rising cybercrime wave, with multiple hospitals often targeted at once
in coordinated ransomware attacks. These kinds of attacks, in which
malware infects a computer and then entire system, slowing the system
or blocking access until a ransom fee is paid, are the leading forms of
cyberattacks, growing tenfold in 2021, according to the latest
Global Threat Landscape Report.
The cost of these attacks on healthcare organizations can be high. Beyond
the ransom to pay, there is often the loss of business, impacts to patient care
if a system is shut down, loss of credibility and trust with patients and
further financial hits from lawsuits. Scripps Health in San Diego is facing
class action suits after a ransomware attack took down its network for
weeks and compromised the data information of over 147,000 patients.

In many ways, the healthcare sector lags behind other industries entrusted
with secure information, such as banking and finance, and some critics
point to the rush to digitize patient records as leading to security gaps.
For 2022, “it won’t be surprising to see more health systems investing in
cybersecurity technology and talent as a top priority,” write
Drees and Dyrda.
The cost of these attacks on healthcare organizations can be high.
Beyond the ransom to pay, there is often the loss of business, impacts
to patient care if a system is shut down, loss of credibility and trust
with patients and further financial hits from lawsuits.
Scripps Health in San Diego is facing class action suits after a
ransomware attack took down its network for weeks and
compromised the data information of over 147,000 patients.
In many ways, the healthcare sector lags behind other industries
entrusted with secure information, such as banking and finance, and
some critics point to the rush to digitize patient records as leading to
security gaps.
For 2022, “it won’t be surprising to see more health systems
investing in cybersecurity technology and talent as a top priority,”
write Drees and Dyrda.
4. APPLICATION OF ARTIFICIAL INTELLIGENCE,
MACHINE LEARNING AND PREDICTIVE ANALYTICS

Like so many facets of healthcare, the application of artificial

intelligence (AI) and machine learning (ML) took an abrupt shift
due to the COVID-19 pandemic.
While long used on the finance and operations sides of
healthcare, the pandemic proved the true potential of AI and ML
for predictive medicine in diagnosing illness and advising
treatment plans, with a number of research institutions and health
systems using it to estimate the risk of their COVID-19 patients
developing severe symptoms.
Access and application of AI- and ML- derived predictive analytics has the
potential to take patient care from reactive to preventative “precision
medicine.” This means the potential for warning care teams of signs of
patient deterioration far before a provider would normally be alerted. It
may keep hospital patients out of the ICU or at-risk patients out of the
hospital altogether.

All this requires the effective gathering and use of data. For example,
taking collected data and “layering in” the needed data analytics tools, such
as AI and ML, makes the patient data “warehouse” a source of ongoing
data insights for precision medicine. These AI and ML systems will
improve their “learning” with the more data they’re exposed to,
underscoring the importance of data analysis from both current and future
data sources—everything from patient wearables (think smart watches) to
integrated biomedical devices and monitoring systems.
Healthcare’s investment in the needed
technologies and analytics capabilities to
integrate these diverse data sources is expected
to increase. In an annual report from
PwC’s Health Research Institute, nearly 75%
of surveyed healthcare executives said their
organizations invested more in predictive
analytics and modeling for 2021, and most
likely, this will be an ongoing investment.
5. ADVANCES IN ELECTRONIC HEALTH
RECORDS CAPABILITIES

It can be argued that electronic health records (EHR) are the

starting point of healthcare digitization when the
“meaningful use” mandate required the adoption of EHR.
The COVID-19 pandemic exacerbated EHR system
usability and interoperability issues, speeding up the
U.S. Department of Health and Human Services
implementation of interoperability rules and standardization,
giving patients free, secure access to their EHR.
What’s next for EHR usage, access and compliance? With
the new rules, interoperability has increased between
providers, payers and health tech developers, with new tools
and interoperability platforms being integrated into EHR
systems. Big tech players, such as Google, Amazon and
Microsoft, have entered the fray as more hospitals and health
systems transition to cloud platforms for hosting their EHR
systems, as these offer more real-time data insights, more
storage solutions and enhanced privacy and security.
Health informatics professionals will continue to lead
these interoperability initiatives, learning these new
tools and systems and ensuring the systems can “talk”
to each other, while complying with standards for
patient access and ensuring that EHRs are usable and
intuitive to the clinicians treating patients. To please all
parties involved and ensure these disparate systems
operate in sync may be the biggest challenge of all.
 Nursing Informatics and Healthcare Policy
Reference:
http://karlrufosumatra.blogspot.com/2011/05/nursing-informatics-and-healthcare.html

Healthcare Policy Impact on Nursing Informatics Practice

Nursing Shortage and Nursing Informatics

Ø Nursing has experienced a number of shortages in recent history.
• An older nursing workforce
• A higher ratio of older associate degree graduates
• The availability of more attractive career opportunities for women
• Decreased interest in nursing as a career difficult work environments.
Ø Unless something is done the shortage will rise from 6% in 2000 to 29% in
2020 or more than 800,000 nurses short of the number needed.
Ø The Bureau of Labor Statistics As Phase 2 of the AAN technology project
began, staff nurses from three hospitals in Virginia and California were asked
to identify or verify the most difficult aspects of their practice and how
technology would improve those tasks.
Ø As the project continues, systems will be designed, implemented, and tested to
determine their effect on nurses’ work.
Ø It is up to NI specialists to help design and implement IT systems that will finally
assists nurses in their practice and to validate the results thru research.
Ø (BLS) is predicting registered nurse positions will increase more than 600,000
between 2002 and 2012. To cover these new positions and replace retiring nurses 1.1
million more nurses are needed by 2012.
Ø Although these numbers differ it is clear that without intervention the healthcare
industry is headed for a major crisis in the nursing workplace.
Ø Schools and colleges of nursing have shortened program lengths and instituted
accelerated program for those who already hold a baccalaureate degree in an attempt
to increase nursing workforce numbers.
Ø Nursing organizations have been actively advocating for increased federal funding
to expand programs and increase loans, scholarships, and incentives.
Ø In 2002 the AAN Commission on Workforce launched a multiphase
project to develop IT that will help support nurses in their day to day
work.
Ø In Phase 1, interdisciplinary, creative thinkers were assembled to
determine how technology could be use to facilitate nurses’ work.
Ø Bradley (2003) indicated that technology solutions should improve
existing care processes and outcomes, increase access thru the use of
portable handheld devices, incorporate Internet capability to overcome
distance barriers of care and improve access to knowledge acquisition.
Ø These authors also advocate for using bar-coding of medications, use
of speech recognition, and fine tuning the user interface of systems to
support nurses.
Thank You :)