Objectives:
1. to desrcibe the deveopment of nursing
informatics (NI) in selected asian countries.
2. to identify historical milestones, changes,
and trends influencing how nurses embrace informaics, such as goverment
initiatives and nternational collaborations.
3. to discuss NI practice, education, and
research.
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Since computers were first introduced into the
health care sectors of Asian countries in he 1970s, there have been exciting
developments in the healthcare informatics associated with the rapid growth in
information and communication technology. this chapter provides an overview of
the current status of the field of NI in south Korea, Japan, China, Taiwan, and Thailand. It describes the history of NI , the use of informatics in clinical
practice, informatics education, informatics education, informatics research, and
government initiatives and professional outreaches.
KOREA
South korea comprises 8 provinces with 7
metropolitan cities, abd the otal population was about 47 million in 2002. The
population is predominantly in urban areas, with 21% living with in the seoul
metropoltan area. ther arre currently 190,720 licensed midwives and nurses, of
whom 81,478 and practicing and 23,331 of these are situated in the seoul
metropolitan area.
History of nursing informatics in korea
The use of computers in south korean healthcare
bega
n in he late 1970s in hospital finance and administration systems to expedite insurance reimburesments. soon ther after, the national health insurance system expanded to cover the whole population, and computers became necessary equipment in healthcare organizations. The ters health care informatics and NI were first introduced in korea when the KOSMI was founded in 1987.
n in he late 1970s in hospital finance and administration systems to expedite insurance reimburesments. soon ther after, the national health insurance system expanded to cover the whole population, and computers became necessary equipment in healthcare organizations. The ters health care informatics and NI were first introduced in korea when the KOSMI was founded in 1987.
Use of information technology in clinical
practice
According to a report published by the Korean
health industry development institute in 2000, 100% of teaching hospitals 96%
of general hospitals, and 75% of private clinics now have hospital information
systems (Korea health industry development institute,2000). Such a high
inplementation rate is believed to have been initially driven by financial
factors associated with medical insurance claims, with the focus subsequently
shiftng to all areas of patient care when clinicians began to use computers in
theiir practices.
Health informatics education
As information technology has become
indispensable in healthcare and its impact on the daily activities of healh
care professionals has become significant, schools are beginning to realize the
importance of heath informatics education for clinicians. According to a recent
survey on health informatics and compueter education programs in south korean
medical and nursing schools, about 25% of medical schools and 21% of nursing schools offer health informatics
courses, while the remainder offer ntroductory computer courses (park,2002).
Research
Most papers presented at KOSMI conferences and
published in the journal of the KOSMI since 1991 have addresed the application
of commercially available programs, with more recent papers discussing the use
of computers as a tool for nursing education. Distance education using the
nternet has also been described (park, cho, and kim, 1998; cho and park, 1998;
kim et al., 2000).
Standardization Activities
There are current efforts to implement a single,
integrated healthcare and nursing terminology in south korea, the primary
motivation for which is compatibility of data, clinical documentation, and
research outcomes across the country. There are korean representatives actively
involved in several international initiatives toward this end, such as
international organizations for standardization/technicsl committee 215
(ISO/TC215) and health level seven (HL7).
Government Initiatives
The Korean government has contributed to the
development of health informatics by providing funding or other incentives and
guidelines in telemedicine, emergency, medical systems, infectious
diseases reporting systems, and standardization. the Korean government has
contributed to the implementation of a nationwide information highway, with the
ministry of information and communication having funded information highway
projects since the early 1990s.
Summary
The Korean healthcare environment is becoming in
hospitable due to healthcare costs, increasing competitions among healthcare
organizations, decreased funding from the government, and customers with more
sophisticated demands.The introduction of information systems and information
technology can help healthcare organizations to survive under these difficult
conditions.
JAPAN
The population of japan is about 127 million,
which is about twice that of united kingdom and half that of united states.
there are about 10,000 hospitals in japan, of which about 430 have more than
400 beds. About 750,000 nurses work at these hospitals, including about 220,000
nurse aides, and there are about 260,000 medical doctors, 90,000 dentists, and
230,000 pharmacists (Ministry of health, labor and welfare, 2004).
Health informatics in japan
Japan began to pay attention to the use of
computers in healthcare during e late 1970s following the increased use of
computers n other industries.Japan hosted the use of computers in other
industries. Japan hosted IMIA conference MEDIIINFO80 in 1980. The Japanese
association of medical informatics (JAMI) was founded at that time with the aim
of supporting health informatics in japan.
Nursing informatics education
As on April 2004, there were 486 professional
schools, 1 junior colleges, 120 universities, and 45 graduate schools in japan
(Tokyo academy, 2004), compared to 461 professional schools, 74 junior
colleges, and 30 universities in 1994. these comparison illustrates that
nursing education in japan has shifted from professional schools o universities
and postgraduate education during the last 10 years.
Nursing informatics research
The amount of NI research is increasing in japan,
the 2 main purposes o which are improving he quality and standardization of
nursing practice. NI was one of the main subject areas of paper presentations
at a recent annual meeting of the japanese academy of nursing, indicating that
it is becoming one of the major areas in nursing.
Nursing informatics practice
Becoming a specialist in NI is useful when
hospital information systems and electronic health records are introduce.
however, the accreditation program of the japan nursing association does not
recognize the training for such specialist. Instead the training of
informatics nurses mainly occurs in hospital settings. In each hospital, nurses
working on medical information are active in committes and working groups.
CHINA
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According to the fifth national census reported
by the national bureau of statistics, the population of china was almost 1.3
billion in 2000. the population is aging fast, with those 65 yrs old and older
representing 6.96% of population in 2000,
compared to 5.57% in the 1990 census. There were 17,764 hospitals,
5,275,000 healthcare professionals, and
1,226,000 registered nurses in china in 2003. This translates into
approximately 1 nurses per 1,000 people.
Nursing information system in china
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The development of nursing information management
system began in china in late 1970 and they were first used in 1987. The first software implementation was a computer assisted primary nursing care system. Te
development of information management systems for nursing in chinese
traditional medicine began in 1994. Many hospitals in china now use nursing
information systems, although there are no official statistics available.
History of nursing informatics in china
The nursing informatics special interest group
with 20 hospital nurses was founded as a branch of the CMIA in 1991. A year
later an expert group for nursing information technology was founded by the
nursing department of the Chinese ministry of health, its mission being to
establish criteria for nursing information management .
Nursing Informatics education
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Higher nursing education was introduced in 1983,
and by 2001 there 120 schools with 3 year diploma programs, 62 schools offering
a baccalaureate, and 11 schools with masters programs. atleast one computer
course is required at the baccalaureate level, and nursing students can select
other computer courses a elective courses.
Nursing Informatics research
NI research is at its infancy in china, with only
30 research articles published in domestic nursing journals from 1994 to 2004
(with key words related to the use of computers in nursing and nursing
information with the research areas of nursing practice, nursing management,
and nursing education).
Nursing Informatics practice
The use of NI in clinical practice in china
includes nursing quality management, staff management, nursing information
management, and training clinical skills
for staff nurses. several expert systems for nursing diagnoses, nursing care
plan, and nursing assessment have been reported.
Thailand
Thailand is located in southeast Asia with Burma, Cambodia, Laos, and Malaysia as neighboring countries. The country has a
population of about 65 million living in 76 provinces, The life expectancy for
males and females is 71.6 and 74.7 years, respectively. 95% of the population
is Buddhist and 3.8% is Muslim. There were 92 regional/general hospitals, 707
community hospitals, and 9,559 health centers across Thailand in 2004.
The development of a health information system
In 1997, the thai MOPH began to implement a
national health information system, which included the development of a nursing
component. Funding was received from the world health organization in 1999 as a
result of collaborative effort between the center for nursing research at the
department of nursing, the faculty of medicine, ramathibodi hospital. Mahidol
university, and the MOPH nursing division to develop the ideal nursing minimum data set (NMDS) and a preliminary nursing classification system.
Summary
The heath care environment in asian countries is becoming in hospital due to high healthcare costs, increasing competition among health care organizations, decreased funding from governments, and costumers with mire sophisticated demands. The introduction of information systems and information technology can help health care organizations to survive under these difficult conditions.
Health care informatics and the use of information technology has proceeded rapidly in asian countries, with exciting developments in the areas of clinical practice, informatics research, and informatics education over the past decade. All of the developments have improved either directly or indirectly the productivity of health care professionals, the efficiency of health care industry, and also the education of health care professionals.
It is clear ta professional organizations play a major role in raising awareness, education, and dissemination of knowledge in health informatics. This is becoming increasingly complex with the proliferation of government initiatives spanning multiple government departments, which is a reflection of the multidisciplinary nature of health informatics . Nurses, as the largest group of health professionals, have a major role to play. A sound knowledge of the many stakeholders will ensure that nurses can coordinate their efforts to ultimately benefit the health care consumer (our patients), communities, and society as a whole.
Summary
The heath care environment in asian countries is becoming in hospital due to high healthcare costs, increasing competition among health care organizations, decreased funding from governments, and costumers with mire sophisticated demands. The introduction of information systems and information technology can help health care organizations to survive under these difficult conditions.
Health care informatics and the use of information technology has proceeded rapidly in asian countries, with exciting developments in the areas of clinical practice, informatics research, and informatics education over the past decade. All of the developments have improved either directly or indirectly the productivity of health care professionals, the efficiency of health care industry, and also the education of health care professionals.
It is clear ta professional organizations play a major role in raising awareness, education, and dissemination of knowledge in health informatics. This is becoming increasingly complex with the proliferation of government initiatives spanning multiple government departments, which is a reflection of the multidisciplinary nature of health informatics . Nurses, as the largest group of health professionals, have a major role to play. A sound knowledge of the many stakeholders will ensure that nurses can coordinate their efforts to ultimately benefit the health care consumer (our patients), communities, and society as a whole.
