Informatics and the Learning Healthcare System

Abstract

SUMMER SCHOOL IS OVER. I have posted my grades. And now I have some think time. One of my immediate concerns is how informatics educators like myself can help faculty incorporate informatics into the nursing curriculum. I was recently on a panel that examined the Institute of Medicine's (IOM) Future of Nursing report (2011) and the role technology will play in facilitating its goals. Naturally, I spoke to the report's emphasis on preparing nurses to use health information technologies as an integral component of nursing practice. is no doubt from this report that informatics must be an essential thread of any nursing curriculum. But, as I talk with faculty, I am beginning to get nervous, fearful that informatics in the nursing curriculum will fall into a quick fix category. In other words, get access to electronic health records (EHRs) and teach students how to push the correct buttons, add a short course into the program, or throw that content in a professional issues course. The question must be, How do we integrate informatics into the nursing curriculum? Before we begin our exploration, it is important to review what is stated in the IOM report: There is perhaps no greater opportunity to transform practice than through technology, and health information technology will fundamentally change the way nurses practice. The National League for Nursing (NLN), the American Academy of Colleges of Nursing (AACN), and Quality and Safety Education for Nurses (QSEN) all state that information management skills are needed to analyze and synthesize information to provide and improve the quality and effectiveness of patient care. As you read this column, you may want to refer to the NLN's Outcomes and Competencies monograph (2010) as well as QSEN (http://qsen.org) or AACN documents (www.aacn.nche.edu/Education/essentials.htm). One possible strategy to integrate technology into the nursing curriculum would be to place informatics, especially information management knowledge and skills, within the context of a healthcare (LHS). As you may recall, an earlier IOM report (2001), Crossing the Quality Chasm, highlighted deficiencies of the current health system and recommended that patients, providers, and policymakers [be engaged] to insure health decisions are guided by timely, accurate and comprehensive real time health information...providing the right to the right person for the right price (Grossman, Powers, & McGuiness, 2011). Five years later, the IOM convened a Roundtable on Evidence-Based Medicine to address two major deficiencies: how to provide clinicians with evidence already available and how to rethink our approach to generate evidence. This roundtable addressed the need for new systems to translate knowledge to improve patient and for a health system that has the capacity to draw on the best evidence to provide the most appropriate to each patient as well as the ability to add to knowledge throughout the delivery of - a healthcare system that learns (Olsen, Aisner, & McGinnis, 2007). Thus, the LHS was born. A key component of the LHS is to generate and apply evidence as a seamless part of the health process. The roundtable's call for action is to create a healthcare system that is designed to generate and apply the best evidence for the collaborative health choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care (Olsen et al., 2007). It is evident that health information technologies and a digital infrastructure are foundational to a learning healthcare system. Here is a sampling of the pressing informatics needs as outlined by Olsen et al. (2007): * Clinical decision support systems that accommodate the pace of information growth * Effective application of EHRs as an essential prerequisite * The notion of clinical data as a public good and a central common resource for advancing knowledge and evidence for effective * Database linkages, mining, and effective use * Forging interoperable patient record platforms to foster more rapid learning The roundtable report by Olsen et al. …