2. 2003 M.D. (First‐Class Honors) (Ramathibodi)
2009 M.S. in Health Informatics (U of MN)
2011 Ph.D. in Health Informatics (U of MN)
2012 Certified HL7 CDA Specialist
• Deputy Executive Director for Informatics (CIO/CMIO)
Chakri Naruebodindra Medical Institute
• Lecturer, Department of Community Medicine
Faculty of Medicine Ramathibodi Hospital
Mahidol University
nawanan.the@mahidol.ac.th
http://groups.google.com/group/ThaiHealthIT
www.SlideShare.net/Nawanan
Introduction
10. • Life‐or‐Death
• Difficult to automate human decisions
– Nature of business
– Many & varied stakeholders
– Evolving standards of care
• Fragmented, poorly‐coordinated systems
• Large, ever‐growing & changing body of
knowledge
• High volume, low resources, little time
Why Healthcare Isn’t Like
Any Others
13. • Safe
• Timely
• Effective
• Patient-Centered
• Efficient
• Equitable
Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality
chasm: a new health system for the 21st century. Washington, DC: National Academy
Press; 2001. 337 p.
High Quality Care
21. • To Err is Human (IOM, 2000) reported
that:
– 44,000 to 98,000 people die in U.S.
hospitals each year as a result of
preventable medical mistakes
– Mistakes cost U.S. hospitals $17 billion to
$29 billion yearly
– Individual errors are not the main problem
– Faulty systems, processes, and other
conditions lead to preventable errors
Health IT Workforce Curriculum Version
3.0/Spring 2012 Introduction to Healthcare and Public Health in the US: Regulating Healthcare ‐ Lecture d
Patient Safety
22. • Humans are not perfect and are bound to
make errors
• Highlight problems in U.S. health care
system that systematically contributes to
medical errors and poor quality
• Recommends reform
• Health IT plays a role in improving patient
safety
IOM Reports Summary
25. • Cognitive Errors - Example: Decoy Pricing
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Ariely (2008)
16
0
84
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68
32
# of
People
# of
People
To Err Is Human 3: Cognition
26. • It already happens....
(Mamede et al., 2010; Croskerry, 2003; Klein,
2005; Croskerry, 2013)
What If This Happens in
Healthcare?
27. Mamede S, van Gog T, van den Berge K, Rikers RM, van Saase JL, van Guldener C,
Schmidt HG. Effect of availability bias and reflective reasoning on diagnostic accuracy
among internal medicine residents. JAMA. 2010 Sep 15;304(11):1198-203.
Cognitive Biases in Healthcare
28. Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them.
Acad Med. 2003 Aug;78(8):775-80.
Cognitive Biases in Healthcare
39. • “Biomedical informatics (BMI) is the
interdisciplinary field that studies and
pursues the effective uses of biomedical
data, information, and knowledge for
scientific inquiry, problem solving, and
decision making, motivated by efforts to
improve human health.” (AMIA, 2012)
Biomedical Informatics
40. • Provide Patient-Centered Care
• Work in Interdisciplinary Teams
• Employ Evidence-Based Practice
• Apply Quality Improvement
• Utilize Informatics
Core Competencies of
Health Professionals
(IOM, 2003)
46. • Nursing Informatics is the “science and
practice (that) integrates nursing, its
information and knowledge, with
management of information and
communication technologies to promote
the health of people, families, and
communities worldwide.” (IMIA Special
Interest Group on Nursing Informatics
2009).
Nursing Informatics
AMIA Nursing Informatics Working Group
48. • Standards to support evidence-based practice,
research, and education
• Data and communication standards
• Research
• Information presentation and retrieval to support
safe patient centered care
• ICT to address inter-professional workflow needs
across care
• Development, design, and implementation of ICT
• Healthcare policy to advance the public’s health
Core Areas of
Nursing Informatics
AMIA Nursing Informatics Working Group
49. • Nursing Informatics Standards
– Omaha System
Examples of
Nursing Informatics Works
50. • Health IT in Clinical Settings
– Electronic Nursing Records
– e-Kardex
– Careplanning
– Electronic Medication Administration Records
(e-MAR)
– Barcoded Medication Administration
– Other nurse-related workslows
Examples of
Nursing Informatics Works
52. • Health IT for Consumers/Patients
– Personal Health Records
– Telemedicine
– Web Sites for Patient Education & Engagement
– mHealth & Social Media
Examples of
Nursing Informatics Works
Images from HealthVault.com, American Telecare, Inc. & WHO
55. • Information is important & everywhere
in healthcare (and nursing)
• Health IT helps improve quality of care
and reduces errors by health workers
• Informatics is an interdisciplinary field, with
nursing informatics as one key sub-field
• Nursing informatics plays important roles
in today and future’s patient care
Summary
