WEEK 13.2: Nursing Informatics in Asia

True

True or False: Asian countries face complex language issues when implementing health informatics programs. China, Japan, and Korea have double byte languages, which make the migration to digital records even more challenging.

True

True or False: Asia’s size and diversity presents many challenges in the development of health informatics in terms of commu- nication, information sharing, standards implementation, and manpower training.

True

True or False: eHealth collaboration in the APEC region started when APEC leaders recognized the digital divide among mem- ber countries and decided to support underprivileged populations within the region in 2000

eHealth Initiatives

At a ministerial meeting in 2005, ministers underscored the importance of the use of ICT to better face threats to health in the region and welcomed the what?

Asia-Pacific Economic Cooperation (APEC) eHealth Seminar and Action Project

In 2006, as part of the eHealth Initiative, an annual what were launched

APEC eHealth Community

Based on the feedback from eHealth Seminars, the what was introduced in 2009 to share information, and to exchange human and material resources through a connection between developed and underdeveloped economies in terms of eHealth.

APEC eHealth Community Forum

• The APEC eHealth Community holds this annual meeting

• Key objectives of this include bridging the gap between APEC member countries through seminars capacity building in information sharing, acknowledging high-value cases related to eHealth, and vitalizing eHealth focused industries within the region.

• The main activities of the eHealth Community Forum consist of

  • technical presentation,

  • exhibition of eHealth products, and

  • poster presentation.

1. Technical Presentation

2. Exhibition of eHealth Products

3. Poster Presentation

3 main activities of the eHealth Community Forum

Asia-Pacific Association for Medical Informatics (APAMI)

• Was established in 1993 as IMIA regional member of IMIA to promote regional cooperation and development of health informatics.

• Has 15 society members, including Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam.

telemedicine

The Asia-Pacific region is a major player in ______ because of the large-sized countries, its low specialist-to-population ratio, affordable cost of technology and telecommunication, and high penetration rate of ICT for equitable distribution of healthcare services.

Asian SARS outbreak of 2003

• China, Hong Kong SAR, Singapore, and Taiwan are especially active in working on public health informatics after this

• Provided an opportunity for APAMI to take on this new challenge through public health informatics

1970s

When were computers first introduced into the health-care sectors of Asian countries?

• Administration

• Billing

• Insurance

The first applications of information technology in healthcare in Asian countries were in what?

1970s; 1980s or 1990s

In most of these countries computers were first used in nursing during the early _____, although the terms health informatics and NI were not introduced until the _____ or early _____.

IMIA

The progress in South Korea and Japan has been expedited by the hosting of the what triannual conferences in 1980 and 1997?

China, Japan, and Korea Medical Informatics Associations

Formed in 1999 helped nurses in these three countries to share and exchange experience

True

True or False: South Korea is the 4th largest economy in the Asia-Pacific Region.

Organization for Economic Co-operation and Development (OECD)

As of 2011, life expectancy in Korea was measured at 81.3, which exceeds the average life expectancy at birth (81.1) across countries measured by the what?

universal health insurance

In 1989, South Korea introduced _____ ______ ______-, covering hospital stays, physician visits, and prescription drugs for the whole population?

Korean Society of Medical Informatics (KOSMI)

In particular, health informatics in South Korea has grown considerably in recent years due to rapid growth of the information technology (IT) sector in Korea and with the help of the professional outreach activities of the what?

1987

The terms health informatics and nursing informatics first introduced in Korea when the KOSMI was founded when?

Nursing Informatics Special Interest Group

• Was organized as one of the five special interest groups in the KOSMI in 1993.

• This has held its own session at the bi- annual conference of the KOSMI.

Journal of the KOSMI

Nursing has been highly visible in the KOSMI through presenting and publishing papers on the use of computers in nursing at these confer- ences and in the what?

True

True or False: Korean nurses have attended and participated in many international conferences of the IMIA and IMIA-NI.

1995

When did Korean nurses represent the country at the IMIA-NI for the first time?

MEDINFO98; NI2006

The IMIA conference _______ and the IMIA-NI conference _______ held in Seoul provided excellent opportunities for Korean nurses to become acquainted with nursing informatics at the global level

Korean Science and Engineering Foundations

Further momentum for nursing informatics has been coming from funding for a nursing informatics study group provided by the what since 1998.

picture archiving and communication systems (PACs)

• In addition, about 90.5% of tertiary hospitals, 78.6% of community hospitals, and 22.6% of physician’s offices are equipped with what

• There has been a great deal of interest among healthcare organizations in acquiring these systems since the Korean government announced high reimbursement rates for diagnostic radiology examinations using this in early 2000.

International Classification for Nursing Practice

A standardized nursing terminology based on the what was integrated into the electronic nursing record (ENR) system and introduced at Seoul National University Hospital in Korea in 2003.

Seoul National University Hospital

A standardized nursing terminology based on the ICNP was integrated into the electronic nursing record (ENR) system and introduced at where in Korea in 2003.

Seoul National University College of Nursing

This is the university with the only graduate program specializing in nursing informatics in Korea

• Journal of Korean Academy of Nursing

• Korean Journal of Nursing Query

• Journal of Korean Academy of Adult Nursing

Korean Nursing Journals

1. clinical practice

2. teaching and learning

3. decision support

4. public and consumer health informatics

5. patient-centered healthcare such as telemedicine and ubiquitous healthcare

6. standardization activities

7. use of IT for nursing research

7 areas of NI research in Korea

True

True or False: The number of NI-related papers published in Korea has increased dramatically over the past 20 years.

Health Informatics Standards Committee

• The Korean Ministry of Health introduced this in 2004 in an attempt to develop a single, integrated healthcare terminology in Korea as part of the National Health Information Infrastructure

• This committee is in charge of developing, disseminating, and maintaining healthcare terminologies.

• There are 14 sub-committees working on healthcare terminologies in 14 different areas, such as medicine, dentistry, public health, and nursing

National Health Information Infrastructure

The Korean government initiated information systems planning for the public health sector and the what in 2005.

Center for Interoperable EHR (CiEHR)

• As part of Korean government initiatives, they established this in 2005

• Role is to develop core technologies necessary to implement a lifetime electronic health record (EHR), which enables the public to securely access and use their own medical record anytime and anywhere, as necessary, from the cradle to the grave

• Korean Medical Association

• Korean Nurses Association

2 Professional organizations that have also played significant roles by including health informatics in their continuing education programs

Health Informatics Standardization Committee

Another healthcare informatics expert group, the what, serving as the South Korean technical advisory group of the ISO Technical Committee 215, has held open forums and published health information standards.

IMIA

The what has contributed significantly to furthering the knowledge of South Korean healthcare professionals about worldwide trends in health informatics?

wireless LAN

Although personal digital assistants (PDAs), tablet PCs, and note- books are all suitable mobile computing platforms, users favor notebook computers with _____ ____ connections because of their large screen size and easier-to-use interface

• Telecare Center of Seoul National University Hospital

• Telemedicine Center of Gil Hospital

2 Examples of telecare at home

Ubiquitous computing in healthcare

• Another technical trend in Korean healthcare

• defined as the environment where healthcare is available to everyone, everywhere without any dependence on time and location and where the technologies enabling this healthcare will be assimilated flawlessly in our daily lives such that the technologies become invisible

• being considered an alternative to traditional face-to-face healthcare services in Korea

1. Smart Digital Home, Health Management, and Health Promotion projects

2. Ubiquitous Home Healthcare project

3. u-City progect

3 Pilot projects that promote ubiquitous computing in healthcare

Smart Digital Home, Health Management, and Health Promotion projects

Pilot project that promotes ubiquitous computing in healthcare

• use ubiquitous IT for underprivileged populations

Ubiquitous Home Healthcare project

Pilot project that promotes ubiquitous computing in healthcare

• for the elderly

1. B2C ubiquitous healthcare model

2. B2B model

2 examples of ubiquitous computing in healthcare in the private sector

B2C ubiquitous healthcare model

Example of ubiquitous computing in healthcare in the private sector

• was developed to help manage chronic diseases (e.g., diabetes and hypertension),

• promote health in the general population (e.g., exercise, diet, and life style management), and

• support disease prevention in the private sector.

B2B model

Example of ubiquitous computing in healthcare in the private sector

• where medical information solutions companies collaborate with healthcare organizations and insurance companies to provide ubiquitous healthcare services

SK Telecom; LG Electronics

For example, a consortium of healthcare organizations with life insurance companies, medical information solutions companies, and local governments led by ____ ______ and ______ _____ is developing ubiquitous healthcare models for private clinics and major healthcare organizations.

Short message service (SMS)

Nurses, in return, deliver nursing care to home care clients using these systems or phones.

False; Japan

True or False: In Korea, the insurance fee is deducted from the monthly salary and pooled by each insurance union.

National Health Insurance

In Japan, the hospital receives reimbursement for the balance from the what system?

70,000 yen

The Japanese government will contribute a maximum of ______ yen to the medical treatment of a person during a one-month hospital stay

True

True or False: The total health expenditure of Japan remains lower than that in some other advanced nations, which is partially attributable to healthier dietary habits.

MEDINFO80

Japan hosted what IMIA conference

Japanese Association of Medical Informatics (JAMI)

• was founded in 1980 with the aim of supporting health informatics in Japan

• has held 24 annual and bi-annual academic conferences, and these conferences have contributed considerably to the progress of health informatics in Japan

True

True or False: In Japan, each organization has been developing its own hospital information systems for its own applications to clinical practice, education, and research…has hindered standardization in many healthcare fields.

False; did not result in immediate progress in Japanese nursing informatics education, due to schools being vocationally oriented

True or False: After MEDINFO80, this resulted in immediate progress in Japanese nursing informatics education.

Late 1990s

When did nursing education in Japan rapidly shifted to a more academic orientation?

Annual Meeting for Nursing Information Systems

• was established as a task force of the JAMI also supports clinical practice, and most of its members are clinical nurses

Nursing Division of the JAMI

• was established in 2000 and is managed by a team of clinical nurses and academic researchers.

Japanese Nurses Association

• prepared a course on nursing information management as the first step toward a continuing education curriculum for ward managers

True

True or False: However, the accreditation program of the Japan Nursing Association does not recognize the training for such specialists. Instead, the training of informatics nurses mainly occurs in hospital settings.

True

True or False: In Japan, there are still very few universities with separate nursing informatics programs.

1. There are few researchers and educators in nursing informatics

2. There is little development of educational tools

3. The cost of improving the network and computer environments is high

3 Barriers to Development of Nursing Informatics in Japan

Japanese Academy of Nursing

• Nursing informatics was one of the main subject areas of paper presentations at a recent annual meeting of the what, indicating that it is becoming one of the major areas in nurs- ing

eJapan strategy

• An ____ strategy encompassing all Japanese minis- tries and related agencies is progressing now in Japan

• The adoption of EHR is one of the main themes in the healthcare sector.

1. electronic health records will be introduced into 60% of hospitals with more than 400 beds, and into 60% of clinics

2. the electronic health expenditure payment system will be introduced into 70% of all hospitals

The Ministry of Health, Labor, and Welfare announced a grand design for healthcare, and set the following 2 achievement goals for 2006

Ministry of Health, Labor, and Welfare

In Japan, who announced the 2 achievement goals for 2006?

Noted :))

Note the ff:

In Japan the following 5 standards have already been completed:

1. 581 facilities now perform medical diagnoses using the ICD-10

2. 330 facilities have surgical and medical treatment standards

3. 5700 clinical tests have been registered in the clinical laboratory test standard

4. about 38,000 drug names have been registered by 203 enterprises

5. about 210,000 medical supplies have been registered by 336 enterprises

Taiwan Nursing Informatics Association (TNIA)

• Was established in 2006; since then NI has become an important nursing professional specialty in Taiwan

• Has taken many strategic steps to get supports; its members have learned from international organizations, such as IMIA NI SIG, AMIA NIWG, ANI, TIGER

• Has held many international and local conference workshops to inspire many nurses to gain an interest in NI every year

True

True or False: In Taiwan, all medical centers and many hospitals in Taiwan have set up NI specialist positions and formed a NIS multi-professional development task force.

NI2014

TNIA held which 12th international congress on nursing informatics?

True

True or False: Taiwan' submitted papers and posters, covering various topics, outnumbered those from other countries, including the United States

Dr. Ying Wu of Capital Medical University

• Successfully organized the first China National Nursing Informatics Conference in Beijing in October of 2013

• Current president of APAMI

National Institute of Hospital Administration (NIHA)

• Is the main governmental organization in China.

• Has the largest mobilization and impact in the formation of national as well as local policy of developing hospital information systems, including nursing information systems.

1. China Hospital Information Management Association (CHIMA)

2. Chinese Hospital Information Networking Conference (CHINC)

The NIHA is working with the (1) ______________ to hold their national conferences, called the (2) _______________-.

China Hospital Information Management Association (CHIMA)

• Organized the largest nursing team to promote nursing informatics in China,

• Under the leadership of Dr. Baoluo Li and Dr. Yu-Xiu Gong, who are currently editing the first nursing informatics textbook in China

1. Dr. Baoluo Li

2. Dr. Yu-Xiu Gong

Leaders of CHIMA that are currently editing the first nursing informatics textbook in China

True

True or False: TNIA also invited leaders from China to attend the conference in Taiwan to exchange insights and build connections.

NURSINFO (HK)

• Hong Kong hospitals have a well-established Clinical Management and numerous other associated systems widely used by nurses.

• Hong Kong nurses established this in 1991

• this organization has enjoyed a consistent increase in membership

Nursing Informatics for Excellence in Patient Care

Motto of NURSINFO (HK)

1. Hong Kong Society of Medical Informatics

2. Hong Kong Computer Society

NURSINFO (HK) is actively involved with these 2 societies

Hong Kong Hospital Authority

• Responsible for over 40 hospitals and over 50 specialist clinics that are part of a large multi-site, multi-protocol intelligent data network to provide seamless data communications throughout Hong Kong

• system has been widely accepted as part of the hospital infrastructure.

Dr. Eric Chan

Leader of Hong Kong Hospital Authority

True

True or False: The Hong Kong Hospital Authority’s (HKHA) Health Informatics Web site has not been updated since 2007.

Care Information Council

• was initiated in some hospitals’ Departments of Nursing (DON) to develop and integrate the hospital information systems into the relevant nursing processes, including electronic medical record and care planning systems.

• The learning platform provides nurses with self-designed educational tools, and demonstrates how the nursing information system can apply to clinical and health education.

Chang Gung Memorial Hospital Linkou Branch

• In 2005, this hospital established an RFID operational care system in order to make the operations processes easier.

• The system includes functions to ensure patient data such as auto-checking, proof of action, and other applications

Taichung Veterans General Hospital

• was the first hos- pital to combine CPOE and RFID into a barcode manage- ment administration (BCMA) system.

Taiwan Nursing Information Council

• part of the TNIA,

• has invited 18 hospitals to set up a clinical nursing terminology and share experiences using the platform in an effort to promote nursing information sys- tems and enhance clinical nursing information environ- ments in Taiwan.

National Yang-Ming University

• This nursing school led by Drs. Shu Yu, I-Ju Chen, Polun Chang and supported by Dr. Connie Delaney, the Dean of School of Nursing at the University of Minnesota (USA), launched its formal NI graduate program in 2013.

• one of the largest and best NI programs in Asia

Centre of Excellence

In 2013, the Nanyang Polytechnic (NYP), Singapore, and the Healthcare Information and Management Systems Society (HIMSS) have established this to provide their students with hands-on training on innovative systems equipping them with skills and honing their abilities to adopt IT solutions

1. Nanyang Polytechnic (NYP), Singapore

2. Healthcare Information and Management Systems Society (HIMSS)

In 2013 Singapore, what 2 bodies established a Centre of Excellence?

Assumption University

• One of nine learning objectives of the Nursing Science program at the First International University in Thailand, _____ ______ indicates that its nurse graduates need to: “Have ability and skills in nursing informatics, numerical and statistics analysis.”

Rangsit University

• Thai university with Four-Year Bachelor of Nursing Science with Nursing Informatics as one of its foundation subjects

8

In Taiwan, at least __ graduate programs in health or biomedical/medical informatics provide informatics training at the master’s level for students with a nursing background.

Joint Conference of Medical Informatics in Taiwan (JCMIT)

TNIA organized an international symposium and joined this to conduct an annual national NI academic conference, in addition to conducting bi-annual NI congresses, seminars, and workshops

Nursing Informatics (NI) Roundtable Alliance

• Initiated by the TNIA to discuss NI issues and share experiences and knowledge among institutions

True

True or False: TNIA has included nursing informatics as a required course for any continuing education programs that were accredited and offered by the TWNA in 2005.