This paper examines the careers and contributions of two pioneering nursing informatics leaders — Dr. Patricia Abbott and Dr. Betty L. Chang — drawing on interviews from the American Medical Informatics Association (AMIA) Nursing Informatics History Project. The paper begins by defining nursing informatics and situating it within the broader history of the nursing profession, invoking Florence Nightingale as an early forerunner. It then profiles Dr. Abbott's work in geriatric care and nursing informatics education, and Dr. Chang's development of decision-support systems for clinical nursing diagnosis. Together, their careers illustrate how nursing informatics emerged from direct patient-care concerns and grew into a discipline reshaping healthcare delivery worldwide.
According to the American Medical Informatics Association (AMIA), nursing informatics has been classified as 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" (2013). This emerging field has the potential to dramatically improve the delivery of healthcare services across the board. Just as the intrepid Florence Nightingale paved the way for modern nursing by establishing the first nursing school at St. Thomas' Hospital in 1860 — defining nursing in her famous notes on the profession as "the act of utilizing the environment of the patient to assist him to recovery" (Nightingale, 1860) — the widespread adoption and integration of nursing informatics was made possible by the tireless contributions of several influential pioneers.
As part of their continued efforts to document the history of nursing informatics, the AMIA instituted the Nursing Informatics History Project, with 33 recognized leaders in the field submitting to extensive video-recorded and audio-transcribed interviews to provide their personal stories, glimpses into the early days of nursing informatics theory, and a review of the progress made while implementing the practice within American hospitals and healthcare centers. After viewing a number of these interviews, the careers of Dr. Patricia Abbott and Dr. Betty L. Chang stood out as exemplary. By comparing how the contributions of both women influenced the efficiency and effectiveness of health information technology and nursing practice today, it is possible to gain a greater sense of respect and admiration for the work of these nursing informatics specialists.
Dr. Patricia Abbott, PhD, RN, FAAN, FACMI currently serves as the Co-Director of the Pan American Health Organization (PAHO)/World Health Organization (WHO) Collaborating Center for Nursing, Information Knowledge and Management at the Johns Hopkins School of Nursing. She has been involved in the field of nursing informatics since its beginnings in the 1980s. After listening to her interview with the AMIA Nursing Informatics History Project, it became apparent that Dr. Abbott's commitment to nursing informatics was not simply a pragmatic career choice — her passion for the subject was made evident as she described her personal struggles to improve the quality of care administered to long-term patients.
Dr. Abbott reveals that her initial inspiration to pursue nursing informatics came while working at the Baltimore VA's Geriatric Research and Education Clinical Center (GRECC), where she compared the care provided to elderly and infirm patients with the steady stewardship she had received from her own grandparents, who raised her as a child. After coming to a stark realization that "there were real issues with the quality of care that we were providing to our older generation," Dr. Abbott dedicated herself to utilizing her knowledge of nursing informatics to improve healthcare delivery on a systemic level. In her words, "unless we are able to start counting and quantifying what happens to patients in the entire health care continuum, I really believe that we can't make things better" (AMIA, 2008).
After leaving GRECC to pursue her passion for harnessing the potential of nursing informatics, Dr. Abbott made her most significant contribution to the field by serving as the director of graduate programs in Nursing Informatics at her university, where she quickly steered the program into becoming the largest nursing informatics educational outlet in the world. One critical component of Dr. Abbott's approach to teaching nursing informatics was shaped by her own introduction to the field through an independent, three-credit course. Rather than limiting the role of informatics to one niche of a nurse's overall education, Dr. Abbott advocated for an innovative and inclusive approach, stating that "it should be woven into every single class that we teach, that every basic essential core competency in nursing has a data or an informatics component to it" (AMIA, 2008).
As she stated with characteristic humility in her AMIA interview, "I like to think that I played just a small role in creating this third-, fourth-, fifth generation of nurse informaticians that are now out in practice" (2008). After learning more about Dr. Abbott's work, it is safe to say that her impact on the nursing profession has been profound.
"Chang's decision-support system for nursing diagnoses"
Dr. Chang cites this novel approach to quantifying the efficacy of nursing diagnostics as her most lasting contribution to the field of nursing informatics, telling the AMIA that she is most proud of "drawing attention and awareness of nurses to the use of decision support in making nursing diagnoses and subsequently in selecting nursing interventions, and finally, in the evaluation of care" (2008).
The careers of Dr. Patricia Abbott and Dr. Betty L. Chang demonstrate how nursing informatics grew not from abstract theorizing but from direct observations of inadequate patient care — particularly among elderly populations. Both pioneers channeled their concern for vulnerable patients into systematic, technology-driven solutions that have reshaped the profession. Dr. Abbott broadened nursing informatics education by insisting that data literacy be embedded throughout nursing curricula, while Dr. Chang advanced the use of clinical decision-support systems to standardize and strengthen nursing diagnoses. Together, their contributions illustrate the transformative power of nursing informatics and offer a compelling model for future generations of nurse informaticians committed to improving healthcare delivery.
Abbott, P. (2008, November 19). [Video tape recording]. Nursing informatics pioneer interview. American Medical Informatics Association Nursing Informatics History Project, Bethesda, MD. Retrieved from
Chang, B. (2008, June 07). [Video tape recording]. Nursing informatics pioneer interview. American Medical Informatics Association Nursing Informatics History Project, Bethesda, MD. Retrieved from
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Nightingale, F. (1860). Notes on nursing: What it is and what it is not. New York: D. Appleton and Company.
Travers, D., & Mandelkehr, L. (2008). The emerging field of informatics. North Carolina Medical Journal, 69(2), 127–131. Retrieved from
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