Health Informatics

History of Informatics and Areas of Practice
Informatics is a term that refers to the integration of nursing, its information and information management with information and communication technology (ICT) to promote the health and wellbeing of people across the globe (Elsayed, El-Nagger & Mohamed, 2016). Informatics has emerged as an important component in modern healthcare systems given the increased adoption of technology in this industry. Elsayed, El-Nagger & Mohamed (2016) state that the nature and extent of use of information and communication technology in healthcare has experienced dramatic changes across the globe over the past two decades. Given the significance of nursing informatics, this paper provides an overview of the history of informatics. The overview includes a discussion on three informatics groups or specialty areas that have had significant impacts on informatics based on their rank, preference, and importance.
History of Informatics
Informatics in the healthcare field is a discipline that incorporates a wide range of products, theories, activities, and research. The origin of health informatics can be traced back to evolution and adoption of information technology in medicine. According to Rendon (2014), informatics in healthcare emerged from 1949 when Dr. Gustav Wagner established the German Society for Medical Documentation, Computer Science, and Statistics. This organization was the first professional organization for informatics worldwide and paved the way for the development of informatics to become an integral part of modern healthcare. In 1952, the first computer used in clinical practice was McBee manual punch card at the American Society for Clinical Pathology. This was followed by research in integrating technology in healthcare such as the publication by Ledley & Lusted in 1959 on how to integrate computers in healthcare to automate the work of clinicians and lessen errors.
Over the years, various stakeholders within and outside the healthcare field have undertaken measures that are geared toward promoting digitalization of healthcare processes. The development and use of digital computer has had significant implications in the growth and practice of clinical medicine. The development of informatics in healthcare has been supported by various informatics groups or specialty areas. Nursing, Finance, and Software/medical device vendors are the three specialty areas that have had the greatest impact on informatics in the field of healthcare.
Role and Ranking of Specialty Areas in History of Informatics
As previously indicated, nursing, finance and software/medical device vendors are specialty areas that have significantly impacted the growth and development of healthcare informatics. While each of these specialty areas is different, they have the same objective of enhancing healthcare. Nursing has played a critical role in the development of informatics in healthcare through providing a premise for enhancing healthcare processes and services (Cashin & Cook, 2010). The nursing profession incorporate four major areas i.e. research, education, clinical and administrative areas. These four different areas are intertwined and centered on delivery of evidence-based practice in healthcare. In this regard, nursing has shaped informatics by ensuring that information and communication technologies adopted in healthcare focus on enhancing care through evidence-based practice. Therefore, these technologies are adopted to enhance clinical decision-making toward better healthcare processes and services.
The second specialty areas that has played a critical role in the history of informatics is finance. Finance in healthcare relates to affordability and accessibility of healthcare services to different patient populations in relation to their healthcare needs and demands. As technology is increasingly adopted in healthcare for improved health information management, the cost of care remains a major concern. This is primarily because of the huge number of uninsured and underinsured patient populations. In this regard, finance has influenced the history and development of informatics through emphasis on establishment of affordable medical equipment and processes to patients. Through finance, health information management systems focus on ensuring the cost of care is cheap or affordable to patient populations. This implies that finance has influenced informatics by promoting development of technological medical devices and equipment that improve healthcare accessibility and affordability.
Software/medical device vendors have also influenced the development of informatics in healthcare. Software/medical device vendors help to ensure the available of technological devices that are used in the healthcare field. While developers create these devices, their availability in the market is partly a responsibility of device vendors. The role of software or medical device vendors in the history of informatics entails ensuring the availability of latest medical equipment. Through this, these vendors have propelled the growth and availability of health information management systems as well as medical equipment, which in turn promotes the growth of healthcare informatics.
Nursing informatics is ranked number one in its impact on and importance in healthcare informatics since nursing is the frontline of care. Nurses usually maintain ongoing contact with patients within and outside the clinical setting, which implies that they play a leading role in shaping health informatics. The second in rank is finance given that affordability of healthcare services is important toward health promotion and disease prevention in communities (Elsayed, El-Nagger & Mohamed, 2016). The next in ranking is software/medical device vendors since they help to promote the availability of medical devices that can be used in the clinical setting for improved patient outcomes.
Area of Interest
An important area of interest of healthcare informatics is nursing informatics, which entails application of information and computer technology to all nursing fields (Thede, 2012). Nursing informatics is a key healthcare informatics area since it’s used to enhance the health and wellbeing of individuals, families, communities, and populations through optimizing information management and communication (Elsayed, El-Nagger & Mohamed, 2016). Currently, nursing informatics continues to experience tremendous changes that are fueled by changes in general technology over the past decade. Nursing informatics is currently characterized by improvements in nursing informaticist education. This is primarily because many nursing students are increasingly attracted to informaticist education. In addition, employment of nursing informaticists has increased, especially in hospitals. Hospitals currently employ 58% of nursing informaticists, which represents 10% increase (Thew, 2014).
However, some of the current challenges facing nursing informatics include decline in the number of informaticists employed in corporate offices and those working for vendors. Additionally, many nursing informaticists are not encouraged to engage in direct clinical care despite their many years of clinical experience. The decrease in the number of nursing informaticists working in corporate offices and for vendors is a trend expected to continue in the future. The other probable future trend in nursing informatics is requiring nursing informaticists to engage in direct clinical care given the worsening nursing shortage. It is also expected that security of health information management systems will improve in nursing informatics since better management of health information is as important as patient care.
In conclusion, nursing, finance and software/medical device vendors will continue to propel the future of health informatics and the overall healthcare sector. As shown in this analysis, these specialty areas have continued to play a critical role in the development and application of informatics in healthcare. These specialty areas will continue to shape the future of health informatics since they all focus on enhancing healthcare. However, nursing informatics will continue to be the leading specialty area in health informatics since it is the frontline of patient care. The increased adoption of technology in nursing is expected to enhance patient care while lessening errors or mistakes.



References
Cashin, A. & Cook, R. (2010). Evidence-based practice in nursing informatics: concepts and applications. Hershey, PA: IGI Global.
Elsayed, J.A., El-Nagger, N.S. & Mohamed, H.A.A. (2016). Evolution of Nursing Informatics: A Key to Improving Nursing Practice. Research Journal of Medicine and Medical Sciences, 11(1), 1-7.
Rendon, F.X. (2014, May 5). The Long Road to Digitization: A History of Healthcare Informatics. Retrieved February 27, 2019, from https://www.healthworkscollective.com/long-road-digitization-history-healthcare-informatics/
Thede, L. (2012, January 23). Informatics: Where Is It? The Online Journal of Issues in Nursing, 17(1). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Informatics-Where-Is-It.html
Thew, J. (2014, March 25). The State of Nursing Informatics. Retrieved February 27, 2019, from http://healthstandards.com/blog/2014/03/25/the-state-of-nursing-informatics/