DE LA SALLE HEALTH SCIENCES INSTITUTE College of Nursing and School of Midwifery Dasmarias City, Cavite

By: Balen, Zhariena Ging De Guzman, Ameline Mae Duhaylungsod, Jade Gonzales, April Joy Sealza, Monnalisa Joy Yoshida, Sayaka BSN31 Mar. 07, 2013 Nursing Informatics in South America Nursing Informatics Development
(JOY) The first applications of computers to medicine and healthcare in Brazil started around 1968, with the installation of the first mainframes in public university hospitals, and the use of programmable calculators in scientific research applications. Minicomputers, such as the IBM 1130 were installed in several universities, and the first applications were developed for them, such as the hospital census in the School of Medicine of Ribeiro Preto and patient master files, in the Hospital das Clnicas da Universidade de So Paulo, respectively at the cities of Ribeiro Preto and So Paulo campi of the University of So Paulo. In the 1970s, several Digital Corporation and Hewlett Packard minicomputers were acquired for public and Armed Forces hospitals, and more intensively used for intensive-care unit, cardiology diagnostics, patient monitoring and other applications. In the early 1980s, with the arrival of cheaper microcomputers, a great upsurge of computer applications in health ensued, and in 1986 the

Brazilian Society of Health Informatics was founded, the first Brazilian Congress of Health Informatics was held, and the first Brazilian Journal of Health Informatics was published. Since 1997, the Buenos Aires Biomedical Informatics Group, a nonprofit group, represents the interests of a broad range of clinical and non-clinical professionals working within the Health Informatics sphere. Its purposes are: Promote the implementation of the computer tool in the healthcare activity, scientific research, health administration and in all areas related to health sciences and biomedical research. Support, promote and disseminate content related activities with the management of health information and tools they used to do under the name of Biomedical informatics. Promote cooperation and exchange of actions generated in the field of biomedical informatics, both in the public and private, national and international level. Interact with all scientists, recognized academic stimulating the creation of new instances that have the same goal and be inspired by the same purpose. To promote, organize, sponsor and participate in events and activities for training in computer and information and disseminating developments in this area that might be useful for team members and health related activities.

(MAE) Technology is transforming not only nursing practice but also nursing training and education models. With the introduction of computers in the healthcare area, nurses became primary users, responsible for data input. To meet educational and training needs, nursing schools and hospitals initiated programs to prepare nurses to use computers. Technology can present a unique instrument to help nurses to face challenges and discover how to use its resources to involve and maybe to design their way taking care of the people (Marin, 1996). Technology plays an important role in facilitating access to the information because for the information to be useful and meaningful, it has to be timely. There is a clear trend in the direction of the computerization of health records: People are able to connect to the internet that is a telecommunication resource with no parallel to fast exchange data information. In result, we can expect to see better-informed health-providers and consumers. Computer applications - in nursing education are also changing nursing education from a passive teaching to an active learning process.

Computers - allow students to work at the time that best meets their specific needs. Usually, the programs are very interactive and easy to use and offer immediate feedback about students performance. The main goal was to characterize how nursing informatics and the use of standards can improve nursing practice and management, taking advantage of resources. The initial motivation to develop computer systems in the healthcare area was driven by financial and administrative concerns. Countries like Brazil, Mexico, Argentina, Colombia, Chile, and Paraguay have clinical information systems in hospitals or health institutes. Latin America and the Caribbean region rank third in information technology expenditure. A study performed by the Pan America Health Organization/World Health Organization (1998) showed that the Information Society Index, based on the use of information, computer, and social infrastructure, is evolving rapidly.

Use of Information Technology in Clinical Practice

(AYA) The Argentinian health system is heterogeneous in its function, and because of that the informatics developments show a heterogeneous stage. Many private Health Care center have developed systems, such as the German Hospital of Buenos Aires, or the Hospital Italiano de Buenos Aires that also has a residence program for health informatics. In Brazil, two universities are pioneers in teaching and research in Medical Informatics, both the University of Sao Paulo and the Federal University of Sao Paulo offer undergraduate programs highly qualified in the area as well as extensive graduate programs (MSc and PhD) SBIS is a nonprofit membership organization of individuals and institutions interested in developing and using information technologies to improve health care in Brazil. Some of SBIS areas of interest are: * Health information systems * Health information management * Electronic patient record * Telemedicine and telehealth

* Medical image processing * Internet applications in health * Distance education in health The Federation of Medical Informatics for Latin America and the Caribbean, IMIA-LAC, assist in the biomedical informatics in the region. Policies and Trend the Brazilian Journal of Health Informatics (in Portuguese language, Revista Brasileira de Informtica em Sade ) was the first trade journal on health informatics, telemedicine and related subjects, to be published in Brazil. The journal was an official publication of the Center for Biomedical Informatics of the State University of Campinas, located in Campinas, So Paulo state. The journal's creator and editor-in-chief was Dr. Renato M.E. Sabbatini, PhD, also the Center's director. The first issue was published on November 1986 and it was printed regularly every two months for approximately one year and half, when it folded due to loss of advertisement revenues. (AEJAY) National and international software industry became more represented in the South America healthcare market. They provide a broader range of solutions with systems that address patient care documentation. Most of the computer systems implemented are intended to control administrative data. The most frequently implemented and used applications still are the nursing orders. Nurses are becoming even more involved with the design, implementation, and evaluation of clinical information systems. Vendors and developers recognize that the success of a computer system requires nursing input and collaboration. The government of the federal district (GDF) of Brasilia, the capital of Brazil, is modernizing the delivery and administration of healthcare for its population of more than 2.5 million citizens by deploying InterSystems TrakCare. The GDF healthcare delivery network includes 17 hospitals with 4,400 beds, plus 61 health centers, polyclinics, diagnostic laboratories, and pharmacies. InterSystems TrakCare is a unified healthcare information system based on the most advanced technologies. TrakCare creates a complete view of each patient's history, provides secure access to records at every point of care and on any Internet-connected device, integrates easily

with other applications, and delivers real-time active analytics that drive informed actions. This breakthrough system includes clinical, administrative, laboratory, and community care capabilities, unified by a single data repository. Each patient's consolidated history can be shared securely across all care settings. GDF also is distributing to all of its 2.5 million citizens a smart card that holds a unique healthcare system ID plus demographic, registration, and clinical EPR data. The use of TrakCare and the smart card already is increasing our worker productivity, lowering operating costs, and reducing wait times, notes Cludio Freitas, MD, Associate Professor of the College of Medicine of the University of Braslia. ALERT PFH is a comprehensive solution to computerize hospitals, and thus making it possible to document, integrate and review all the information relating to patient care and hospital operations with real time clinical information input. It includes specialized applications per clinical environment and uses a multidisciplinary approach of clinical processes. Advantages: Improve patient and professional satisfaction Provide hospital administration with reliable information for better management Control costs Increase professional performance Improve patient outcome and reduce medical errors ALERT EDIS is the complete solution for Emergency Departments. Advantages: Document, review and integrate all the clinical information from Emergency Department episodes Staff in Emergency Departments can access different levels of information according to their professional responsibilities (physicians, nurses, ancillary staff, administrative clerks, laboratory and imaging technicians,

case managers, information desk clerks) by means of user profiles and biometric identification All the information can be documented immediately and is shared by other users Easier access to the patients history Innovative graphic interface designed specifically for the needs and responsibilities of both professionals and patients in an Emergency Department (ED) setting

Considering trends and tendency in healthcare informatics, and to facilitate the process in South American countries, the Pan American Health Organization (PAHO) has published guidelines and protocols to orient the development and deployment of information and communication technology in Latin America and the Caribbean.

Educational and Distance Learning Efforts

(GING) To meet educational and training needs, nursing schools and hospitals initiated programs to prepare nurses to use computers. In addition to teaching how to use computer applications, course instructors also considered the use of computers to teach nursing content. Formal education programs in nursing informatics, such as a specific nursing informatics specialization and master or doctoral course is also being provided. The Nucleo de Informatica em Enfermagem at the Universidade Federal de Sao Paulo (NIEn/ UNIFESP) was the first center to offer the specialization degree in South America. Since 1989, it also provided the nursing informatics discipline in its graduate and undergraduate nursing programs.

In Brazil, the Brazilian Council of Telemedicine was established in 2002. It is developing several educational programs. The council includes the telenursing group. (JADE) A 4-year grant from the Fogarty International Center of the National Institutes of Health (U.S.A), promoted the establishment of a bilateral consortium of health informatics faculty. A program was designed to enhance training in Brazil by augmenting the teaching resources of local faculty. This training program was based on the experience of the Brazilian faculty and some lessons learned from an existing training program in Boston, U.S.A which involved faculty from Harvard University and its affiliated

hospitals: Massachusetts Institute of Technology (MIT), Boston University, and Tufts University. The program started in October 1999. It has sponsored 10 onsite courses in Brazil. The program started in years 1-2, with activities targeted at faculty from leading universities in southern Brazil, which are better equipped with staff and material resources than universities in other parts of the country. In years 3-4, the training program was responsible for the organization of several scientific meetings in Brazil and continued to promote student and faculty participation in national and international conferences, shortterm courses, and workshops. Computer technology is providing students living in distant regions and having difficulties in accessing the main educational centers the opportunity to improve their personal knowledge base. A contributing factor to the development and success of these programs is the distance between countries and cities due to the geographic characteristics of South America.