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Presentations at the AMIA Annual Symposia

AMIA2002

AMIA 2002 -
Bio*Medical Informatics: One Discipline

Workshop 3
Linking Nursing Informatics Scope of Practice, Standards, and Competencies to Nursing Roles
Workshop Leaders: Carole A. Gassert, PhD, RN, Christine Curran, PhD, RN, Columbia University, New York, NY, and Nancy Staggers, PhD, RN, University of Utah, Salt Lake City, UT.

Using presentation and interactive discussion formats, this workshop will expand next steps in informatics competency work. Identifying core NI competencies by nursing roles is needed to be certain nurses are prepared to apply these competencies to practice. With adequate preparation in informatics, nurses will have needed information available to enhance their delivery of health care. This workshop will demonstrate how to translate informatics competencies into a) an operational environment (i.e., Columbia University) and b) will use a specific example of a nursing role to identify pertinent informatics competencies (namely, NPs). Further, additional competencies are proposed, specifically around evidence-based practice and data presentation. This workshop builds upon past informatics competencies research and the new Nursing Informatics scope of practice and standards. Specifically, participants will: 1) discuss highlights of revised nursing informatics (NI) scope of practice and standards, 2) demonstrate how to link NI competencies to roles in nursing, 3) identify barriers to implementing NI competencies, and 4) explore measurement strategies for NI competencies.

Workshop 10
Information Literacy: Essential Tool for Evidence-based Practice Presented by the Interagency Council on Information Resources in Nursing
Workshop Leaders: Annelle Tanner, EdD, MSN, RN, Central LA AHEC, Alexandria, Susan Pierce, EdD, MSN, RN, Northwestern State University of Louisiana, Shreveport, LA, Diane Pravikoff, PhD, RN, and Judy Levy, MLS, Cinahl Information Systems, Glendale, CA.

The exponential growth rate of nursing information and the increasing environmental demand for Evidence-Based Practice (EBP) mandate development and integration of critical Information Literacy skills into educational experiences of nursing students and clinicians. Despite increasing significance of Information Literacy competency to support EBP, little is known by nurses or librarians about how to design instructional strategies for integrating Information Literacy into basic or continuing education programs for nurses. This workshop is sponsored by the Interagency Council on Information Resources for Nursing (ICIRN), a committee of nurses and librarians who promote access to and use of nursing information resources. Facilitators will introduce instructional methods for mentoring students, educators, and clinicians in gaining proficiency in Information Literacy to support EBP. Specifically, the presenters will: (1) provide an overview of the need for Information Literacy (IL) skill development based on three research studies conducted in education and practice settings; (2) identify IL competencies for nurses; (3) link the steps of Information Literacy to the application of EBP; (4) outline instructional strategies to effectively teach Information Literacy to students and peers; and (5) facilitate discussion of this new pedagogical framework as a key element of best practice in nursing education.

Workshop 11
Nursing Informatics: From Novice to Expert
Workshop Leaders: Patricia Button, EdD, Cerner Corporation, Kansas City, MO, Brentwood, TN, Ida Androwich, PhD, RNC, Loyola University Medical Center, Maywood, IL, Connie Delaney, PhD, RN, University of Iowa City, IA, Melissa Dolenga, Bolingbrook, IL, Judy Murphy, RN, Aurora Health Care, Milwaukee, WI, Vicky Elfrink, PhD, RN, Vanderbilt Unviersity, Nashville, TN, Diane J. Skiba, Ph.D, FAAN, FACMI, University of Colorado Health Sciences Center, Denver, CO, and Vicki Elfrink, Athens, OH.

Patricia Benner described the transformational phases of nurses' growth in her 1984 AJN Book of the Year, From Novice to Expert: Excellence and Power in Clinical Nursing Practice. This model can be extrapolated to include the recent growth in career opportunities for those in nursing informatics. Those nurses who are just beginning an informatics career (or wondering how to expand roles in informatics) will have the opportunity to interact with leaders in nursing informatics. This informal workshop will provide a forum for leaders to share their career stories while interacting directly with the participants. Testimonials will reflect the roles of: project management, consultation, education, research, development support, decision support/outcomes management, policy development, change agent, and information brokers. Relevant resources will be discussed including the new Scope and Standards of Nursing Informatics Practice as well as other resources available through the NIWG web page. Participants will leave with a career guide that includes their plans for individual growth and for personal networking.

After participating in this event, attendees will be able to:
1. describe the scope of practice in nursing informatics
2. select various career trajectories in nursing informatics
3. network with other nurses regarding career options in nursing informatics

Workshop 15
Issues and Challenges in Validation of Terminology Models for Nursing Informatics
Workshop Leaders: Ida M. Androwich, PhD, RNC, Loyola University Chicago, Maywood, IL, Patricia Button, EdD, RN, Cerner Corporation, Kansas City, MO, Carol Correia, MS, RN, Kaiser Permanente, Pasadena, CA, Amy Danko, RN, MBA, McKesson HBOC, Malvern, PA, Susan Matney, RN, MS, Intermountain Health Care, Salt Lake City, UT, and Rosemarie Kennedy, Seimens, Malvern, PA.

This interactive workshop is designed to report and build on the work of the Nursing Intervention Working Group of the Nursing Terminology Summit. The Nursing Terminology Summit is an interdisciplinary, international, invitational conference that has convened annually since 1999. The summit goal, contributing to the development of a reference terminology for nursing, is enacted through on-site group work and by ongoing collaborative efforts by small teams. In this workshop Intervention Working Group members will describe the work they have accomplished as a result of the summits. Specific focus will be given to the work using nursing interventions to validate the HL7-RIM model. The Intervention Working Group's development, refinement, and testing of six use cases for the intervention "Patient Education" and the issues related to this will be discussed. The Nine Step Method (Russler) used to validate the ability of HL7 to provide full representation of the actors and activities described in the use cases will be demonstrated. Outcomes of interaction with the Patient Care Committee at HL7 will be reported. Lessons learned as well as issues and inconsistencies that were identified will be presented. Participants will then have the opportunity to participate in discussions of challenges in this type of modeling and planned future efforts.

Session 67
Technology Transfer Track Plenary Panel: The Nursing Terminology Summit: Conference 2002 - From Reference Terminology Model to Strategic Plan
Authors: Judy G. Ozbolt, PhD, RN Vanderbilt University School of Nursing Vanderbilt University School of Nursing I.M. Androwich, PhD, RN, Loyola University of Chicago, Chicago, IL S. Bakken, RN, DNSc, Columbia University, New York, NY P. Button, EdD, RN, Cerner Corporation, Kansas City, MO C. Mead, MD, MS, CareCentric Solutions, Duluth, GA N.M. Hardiker, PhD, RN, University of Salford, Greater Manchester, UK J.J. Warren, PhD, RN, Kansas University Medical Center, Kansas City, KS C. Zingo, Kaiser Permanente, Pasadena, CA.

The Nursing Terminology Summit Conference 2002 convened at Vanderbilt University June 27-30, 2002, to follow up on work initiated in previous years to develop a reference terminology model for nursing. The participants, representing 5 continents, included developers of nursing vocabularies and experts on terminology and standards. The focus of the 2002 Nursing Terminology Summit was on clarifying a strategic vision for uses of the Reference Terminology for Nursing and on developing a strategic plan for its realization. The plan specifies roles for academic medical centers, professional associations, standards developing organizations, government agencies, industry, and the Summit itself. This panel describes the strategic vision and plan and the process by which they were developed.

AMIA 2001

AMIA 2001 -
A Medical Informatics Odyssey: Visions of the Future and Lessons from the Past

Workshop 4
Issues and Strategies of USA Nursing Minimum Data (NMDS) Articulation with International Nursing Minimum Data Set (I-NMDS) Initiative
Participants: Connie J. Delaney, PhD, RN, FAAN University of Iowa College of Nursing University of Iowa College of Nursing C. Delaney, , The University of Iowa, Iowa City, IA USA N. Lang, , University of Pennsylvania, Philadelphia, PA USA C. Bickford, , American Nurses Association, Washington, DC USA A. Coenen, , International Council for Nurses, Geneva, Switzerland N. Lang, , University of Pennsylvania, Philadelphia, PA USA C. Bickford, , American Nurses Association, Washington, DC USA A. Coenen, , International Council for Nurses, Geneva, Switzerland V. Saba, , International Medical Informatics Association, Arlington, VA USA

The purpose of this day-long tutorial is to provide an overview of the basics of informatics and medical information systems. Through a series of lectures and discussions, participants will learn about the components of clinical computing systems, the major applications found in these systems, and the fundamental ways in which information systems can make an impact on the practice of medical care. Lecturers will provide overviews of major informatics concepts such as standards, confidentiality, expert systems, and knowledge resources. Participants will learn key features of information systems in a variety of healthcare environments, and issues in the implementation of such systems. By the end of the day, participants should be conversant in many of the practical and academic aspects of medical informatics. They will be better able to critically evaluate the advanced informatics concepts presented during the Scientific Program, and to understand the potential of current informatics research to their own environment. They will also be better prepared to make informed decisions concerning specification and use of computing systems in their own organization. Who should attend: Clinicians, administrators, students, and others who are relatively new to the field of medical informatics, who wish to get an overview of the field.

Workshop 10
Validation of Terminology Models for Nursing Interventions
Participants: Ida M. Androwich, PhD, RN, Loyola University Chicago P. Button, EdD, RN, IDX, Seattle, WA A. Danko, RN, McKesson-HBOC, Malvern, PA R. Haskell, SMS, Malvern, PA R. Kennedy, RN, SMS, Malvern, PA S. Matney, RN, MSN, Intermountain Health Care, Salt Lake City, UT

This interactive workshop is designed to build on the work of the Nursing Intervention Working Group of the Nursing Terminology Summit. The Nursing Terminology Summit is an interdisciplinary, international, invitational conference, hosted by Vanderbilt University, that has been convened in 1999 and 2000 with the goal of contributing to the development of a reference terminology for nursing. Summit Intervention Working Group members will describe the work accomplished at the 2000 summit where nursing interventions from various classifications were used to validate the then current CEN and the HL7-RIM models. The Intervention Working Group developed six use cases for the intervention "Patient Education" that were tested for face/content validity with experts from multiple disciplines and refined accordingly. These use cases were then used to validate the ability of HL7 to provide full representation of the actors and activities described in the use cases. Results reported will include issues and inconsistencies that were identified. Patient Education was selected for use as an example of a broad scale and common intervention that could be used a template. Participants will then have the opportunity to work through other examples of interventions using a similar process.

Workshop 11
Nursing Informatics Education: Building Virtual Collaborations
Workshop Leaders: Deborah A. Lewis, EdD, RN Indiana University Indiana University C. Delaney, PhD, RN, FAAN, University of Iowa, Iowa City, IA P. Brennan, RN, PhD, FAAN, University of Wisconsin-Madison, Madison, WI P. Abbott, PhD, RN, FAAN, University of Maryland, Baltimore, MD D. Skiba, PhD, FAAN, FACMI, FAAN, University of Colorado, Denver, CO D. Billings, EdD, RN, FAAN, Indiana University, Indianapolis, IN

The focus for this workshop is to enhance the understanding of current technologies that will support virtual nursing informatics education, including methodologies for delivery, strategies for evaluation, and organizational issues. A combination of short presentations and demonstrations will be followed by an open discussion and exchange with workshop participants. It is hoped that participants will be able to: verbalize a basic understanding of distance learning technologies and identify strategies and challenges in the implementation of virtual nursing informatics education. Further, that participation in the workshop will foster the development of national and international collaborations to implement virtual nursing informatics education efforts.

Tutorial 35
Evaluating the Impact of Health Care Information Systems
Instructors: J.G. Anderson, PhD, Purdue University, West Lafayette, IN and B. Kaplan, PhD, Boston University Medical Information System Unit and Kaplan Associates, Hamden, CT

Dr. Anderson is a co-editor of Evaluating Health Care Information Systems: Methods and Applications, Sage Publications, 1994. and Use and Impact of Computers in Clinical Medicine, Springer-Verlag, 1987 and co-author of CyberHealthcare: Case Studies in Social and Ethical Issues, Springer-Verlag, in press. Information systems are being marketed to health care organizations to provide management information, control costs, and to facilitate TQM and CQI programs. There is mounting evidence, however that information systems affect the structure and functioning of organizations, the quality of work life of employees within them, and ultimately the cost and quality of the services they provide. Professionals who develop, implement, and evaluate clinical computer systems, however, frequently address only the technical aspects of these systems, while the success of implementation and utilization depends upon integration of the computer system into a complex organizational setting. Without an evaluation strategy that goes beyond the technical aspects of the system, an institution has no means of knowing how well it is actually functioning within the organization and no firm basis for developing specific interventions to enhance system success. Although implementation success depends heavily upon the integration of the computer system into a complex organizational setting, professionals who develop, implement, and evaluate health care computer systems have few guidelines for designing effective evaluation strategies and selecting appropriate methods to examine the outcomes of systems use in health care organizations. Evaluating the impact of computer-based medical information systems requires not only an understanding of computer technology, but also an understanding of the social and behavioral processes that affect and are affected by the introduction of the technology into the practice setting. This tutorial will outline ten questions that can be used as a framework for addressing information system impacts. Each question will be linked to models of change and appropriate evaluation methods. Case studies will be discussed that illustrate a number of these issues and evaluation methods.

Session 28
Panel: 20 Years of Nursing Informatics at SCAMC/AMIA
Authors: J.G. Ozbolt, PhD, RN, Vanderbilt University, Nashville, TN, and P.F. Brennan, RN, PhD, University of Wisconson, Madison, WI, P.S. Button, EdD, RN, Seattle, WA, C.J. Delaney, PhD, RN, University of Iowa, Iowa City, IA, K.A. McCormick, RN, PhD, SRA International, Rockville, MD, C. Romano, PhD, RNC, National Institutes of Health, Bethesda, MD, and JS Ronald, EdD, RN, University of Buffalo, Buffalo, NY

This panel reviews the evolution of the science and practice of nursing informatics from its first appearance at the Symposium on Computer Applications in Medical Care (SCAMC) in 1981 into the 21st Century. Panelists pay tribute to Dr. Virginia Saba, organizer of the nursing track in the 1981 SCAMC program, for her contributions to the field. The audience has the opportunity to raise questions and to discuss accomplishments, gaps in knowledge, and prospects for the future of the field.

Session 40
Panel: Toward Defining the State-of-the-Science of US Nursing Informatics in 2001
Authors: N. Staggers, PhD, RN University of Utah University of Utah C. Bickford, PhD, American Nurses Association, Washington, DC C. Curran, PhD, RN, School of Nursing, New York, NY C. Gassert, PhD, RN, FAAN, FACMI, Devision of nursing, Bureau of Health Professions, Rockville, MD

This panel will discuss the contributions of two works integral to building the state-of-the science for Nursing Informatics (NI) in the United States in the year 2001: the newly revised national scope and standards of practice for NI and the research-validated informatics competencies required by four levels of nurses (national Delphi study).

Session 58
Panel: The Nursing Terminology Summit Conference 2001 - Resolving Ambiguities at the Intersections of Conceptual Structures
Authors: Judy G. Ozbolt, PhD, RN Vanderbilt University School of Nursing Vanderbilt University School of Nursing I. Androwich, Ph.D., R.N., Loyola University-Chicago, Maywood, IL S. Bakken, Ph.D., R.N., Columbia University, New York, NY P. Button, Ph.D., R.N., IDX Systems Corporation, Seattle, WA C. Mead, M.D., M.S., CareCentric Solutions, Inc., Duluth, GA N. Hardiker, M.S., R.N., The University of Salford, Greater Manchester, UK J. Warren, Ph.D., R.N., University of Nebraska, Omaha, NE C. Zingo, M.S., R.N., Kaiser Permanente, Pasadena, CA

The Nursing Terminology Summit Conference 2001 convened at Vanderbilt University July 7-10, 2001, to follow up on work initiated in previous years to develop a reference terminology model for nursing. Participants included developers of nursing vocabularies recognized or considered by the American Nurses Association, experts on terminology and standards, and representatives of federal agencies, professional associations, health care providers, and the health informatics industry. This panel describes the issues addressed and the outcomes of the working conference. The focus of the 2001 Nursing Terminology Summit was on the ambiguities at the intersections of conceptual structures and on templates as a possible means of resolving them.

AMIA 2000

AMIA 2000 -
Converging Information, Technology, and Health Care

Workshop 12
Evidence-based Nursing Practice, Language and Documentation: IMIA NI
Instructors: E. J.S. Hovenga, Central Queensland University, Rockhampton, Queensland, Australia

To practice nursing based on evidence requires the use of a standardized language and appropriate nursing documentations systems. Nurses need to be able to brig together the best available evidence about nursing diagnoses, interventions and outcomes documented at the point of care with the use of information and communication technology to support the health and decision making about health of people world-wide. This requires the incorporation of a standardized nursing language. It is imperative that nurses begin to understand the relationship between evidence-based practice, quality, nursing concept representation, standards, management and nursing informatics research. IMIA NI together with the ICN has proposed a new work item to the International Standards Organization to develop a reference terminology model for nursing by integrating existing terminologies. Such a standard is needed to support evidence-based practice by means of appropriate nursing documentation systems and is an example of an enabling technology.

AMIA 1999

AMIA 1999 -
Cornerstones for a New Information Management Paradigm

Workshop 1
Developing and Testing of a Nursing Terminology Model
Instructors: I. Androwich, PhD, RNC, Loyola University- Chicago, Maywood, IL, P. Button, EdD, RN, Oceania, Falls Church, VA, S. Bakken, RN, DNSc, University of California, San Francisco, CA, C. Mead, MD, MS, CareCentric Solutions, Duluth, GA, and J.J. Warren, PhD, RN, University of Nebraska Medical Center, Omaha, NE.

This workshop built on previous Nursing Informatics Working Group (NI-WG) - sponsored educational activities. The overall purpose of the workshop was to introduce participants to the knowledge and skills needed to evaluate the validity of proposed nursing terminology models and to provide an opportunity to apply these skills to an evolving model. A nursing terminology model developed by a small group of domain experts, assisted by an expert modeler, will be presented and described to participants. The workshop instructors will lead participants in a validation exercise on this model. The basic process of modeling, where few build the model and domain experts test/validate the model, will be presented, with the cyclic and iterative nature of the process emphasized. At the end of this workshop participants will be able to understand relevant aspects of modeling related to nursing terminology models; describe components of a specific terminology model for nursing interventions; participate in a validation exercise designed to demonstrate the cyclic, iterative learning process of model testing and validation; practice using use cases with specific identified models, and identify resources/examples for additional self-study.

Workshop 11
The ABCs of Data Mining: A Primer for Health Care Professionals
Instructors: P.Abbott, PhD, RNC, University of Maryland, Baltimore, MD, L. Goodwin, PhD, RN, Duke University, Durham, NC, P. Cullen, MS, RN, Loyola University, Chicago, IL, and C. Delaney, PhD, RN, University of Iowa, Iowa City, IA

Improved data and information handling capabilities have contributed to the rapid development of new opportunities for knowledge discovery. Interdisciplinary research on knowledge discovery. Interdisciplinary research on knowledge discovery in databases (KDD) has emerged in this decade. In health care, pattern recognition has long been linked with expertise. Data mining, as automated pattern recognition, is a set of methods applied to KDD that attempts to uncover patterns that are difficult to detect with traditional statistical methods. Patterns are evaluated for how well they hold on unseen cases. Databases, data warehouses, and data repositories are becoming ubiquitous, but the knowledge and skills required to capitalize on these collections of data are not yet widespread. The use of traditional verification-based approaches to analysis is difficult when the data is massive, highly dimensional, distributed, and uncertain. Innovative discovery-based approaches to health care data analysis warrant further attention. This workshop will provide an overview of data mining methods and their application to health care. This will include open discussion of methods, constraints, fears, and challenges as well as consideration of the opportunities data mining may provide for improved prediction, explanation, and discovery of casual structure related to health and health care delivery.

Session 11
Panel: The 1999 Nursing Vocabulary Summit Conference: Process and Outcomes
Instructors: J.G. Ozbolt, PhD, RN, Vanderbilt University, Nashville, TN
Participants: J.G. Ozbolt, PhD, RN, Vanderbilt University, Nashville, TN, P. Button, EdD, RN, Oceania, Palo Alto, CA, M. Beyers, PhD, RN, American Organization of Nurse Executives, Chicago, IL, S. Bakken, RN, DNSc, University of California-San Francisco, San Francisco, CA, R. Simpson, RN, McKessonHBOC, Atlanta, GA, J. Warren, PhD, RN, University of Nebraska Medical Center, Omaha, NE, and C. Zingo, MS, Kaiser Permanente, Pasadena, CA.

The Nursing Vocabulary Summit Conference convened at Vanderbilt University June 10-13, 1999 to develop recommendations for further development of nursing vocabulary standards for representing data in electronic records. Participants included developers of nursing vocabularies recognized or considered by the American Nurses Association, experts on terminology and standards, and representatives of federal agencies, professional associations, health care providers, and the health informatics industry. This panel, consisting of the Planning Committee for the conference, describes the processes and outcomes of the working conference.

Session 35
Panel: Informatics Competencies and Curricula for Registered Nurses
Session Chair: C.A. Gassert, PhD, RN, HRSA, Rockville, MD, N. Staggers, PhD, RN, University of Utah, Salt Lake City, UT, and E.J.S. Hovenga, PhD, RN, Central Queensland University, Rockhampton, Australia.

This panel will present the outcomes from an expert panel on nursing informatics competencies and from an international working conference on nursing informatics curricula sponsored by the International Center of Nursing Informatics at the College of Nursing, University of South Florida, and the AMIA Nursing Informatics Working Group. The conference, convened in April 1999, is the first in a series of conferences with the overall goal of defining and developing core curricula for health informatics education for practitioners from all health care disciplines. This first conference focused on providing feedback to the US expert panel on nursing informatics competencies and to the European Nightingale project; on developing standards and a common framework for teaching nursing informatics across all levels of nurses (e.g., beginner, advanced, informatics practitioner, informatics visionary); and on developing strategies for dissemination and adoption of the competencies and standards, and for continuing informatics research.

Nursing Presentations at AMIA's Fall Symposium - 1999 (© by each author and AMIA-NIWG. Use is permitted; proper citations are expected.)