TARLAC STATE UNIVERSITY

BACHELOR OF SCIENCE IN NURSING BATCH 2026

NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

LESSON 1: HISTORICAL PERSPECTIVE OF NURSING b. Processes health information

c. Generates health information
INFORMATICS
NURSING INFORMATICS Computerization affects all aspects of healthcare
delivery including:
1. Evolved from the French word “informatics”
a. Provision and documentation of patient care
2. Referred to the field of applied computer science
b. Education of healthcare providers
3. Concerned with the processing of information such as
nursing information c. Scientific research for advancing healthcare
delivery
❖ FOUNDATION OF KNOWLEDGE MODEL: - research does not only solves problem but advances
CONSIDER THE SCENARIO: humanity
Tom H. is a registered nurse who works in a very busy d. Administration of healthcare delivery services
metropolitan hospital emergency room. He has just e. Reimbursement for patient care
admitted a 79-year-old man whose wife brought him to the f. Legal and ethical implications
hospital because he is having trouble breathing. Tom - written consent
immediately clips a pulse oximeter to the patient's finger g. Safety and quality issues
and performs a very quick assessment of the patient's
other vital signs.
COMPUTERS IN NURSING ARE USED FOR
He discovers a rapid pulse rate and a decreased oxygen a. Managing patient care information
saturation level in addition to the rapid and labored b. Monitoring quality
breathing. Tom determines that the patient is not in c. Evaluating outcomes
immediate danger and that he does not require intubation. d. Communicating data and messaged via the
Tom focuses his initial attention on casing the patients Internet
labored breathing by elevating the head of the bed and e. Accessing resources
imitating oxygen treatment; he then hooks the patient up f. Interacting with patients on the Web
to a heart monitor. Tom continues to assess the patient's g. Documenting and processing real-time plans of
breathing status as he performs a head-to-toe care
assessment of the patient that leads to the nursing h. Supporting nursing research
diagnoses and additional interventions necessary to i. Testing new systems
provide comprehensive care to this patient. j. Designing new knowledge databases
k. k. Developing data warehouses
l. Advancing the role of nursing in the healthcare
industry and nursing science

MAJOR HISTORICAL PERSPECTIVES OF NURSING

AND COMPUTERS
💡 1. Knowledge Acquisition – know the reason
- not only the educators, but the students SEVEN TIME PERIODS
- must have the heart to learn
❖ PRIOR TO THE 1960’S
2. Knowledge Processing – training
● Developed in the late 1930s and early 1940s
3. Knowledge Generation – generate the learnings
● Use in healthcare did not begin until the 1950s and
4. Knowledge Dissemination – disseminate the learnings; you are
knowledgeable
1960s
● A few experts formed a cadre to adapt computers to
* Through feedback may ma-llearn then balik sa knowledge
acquire. Pwede ring hindi by steps. We acquire knowledge healthcare and nursing
● Computers in healthcare were used for administrative
through data. But too much information can damage the
system. Information is important, dapat may tamang and accounting functions
information = HIT.
❖ 1960’S
● Use of computer technology began to be explored
HEALTH INFORMATION TECHNOLOGY (HIT) ● Studies were conducted to determine how computer
▪ HIT is an all-encompassing term technology could be utilized
▪ Refers to technology that: ● The nurses’ station was viewed as the most appropriate
a. Captures health information center for the development of computer applications

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● The mid-1960s presented nurses with new opportunities ● Legislative activity in the mid-1990s paved the way for
for computer use electronic health records through the Health Insurance
● Increased time devoted to documentation and a rise in Portability and Accountability Act (HIPAA) of 1996 (public-
medication errors prompted the investigation of emerging law 104-19)
computer-based information systems ● The complexity of technology, workflow analysis, and
💡 Nurses’ station was viewed as the most app. center for the regulations shaped new roles in nursing
development of comp. applications. ● In 1992, the ANA recognized nursing informatics as a
new nursing specialty separate Scope of Nursing
❖ 1970’S Informatics Practice Standards, and also established a
specific credentialing examination for it.
a) During the late 1960s through the 1970s, hospitals
● The demand for nursing informatics (NI) expertise
began developing computer-based information systems
increased
which initially focused on:
● The ANA developed the Nursing Information and Data
(1) Physician order entry
Set Evaluation Standards (NIDSEC) to evaluate and
(2) Results reporting
recognize nursing technology rapidly changed in
(3) Pharmacy
the 1990s:
(4) Laboratory
(1) PCs became smaller
(5) Radiology reports
(2) Computer notebooks became affordable
(6) Information for financial and managerial purposes
(3) Computers were linked through networks
(7) Physiologic monitoring systems in the intensive care
(4) The Internet became mainstream
units
(5) The World Wide Web (WWW) increased
access to information
b) A few systems started to include
(1) care planning 💡 Philippines accepted informatics (emerging country)
(2) Decision support
(3) Interdisciplinary problem lists ❖ 2000’S
c) Nurses were often involved in implementing systems ● More healthcare information became digitalized and
d) Interest in computers and nursing began to emerge in newer technologies emerged
public and home health and education ● In 2004 an Executive Order 13335:
e) In the 1970s, conferences helped public and home (1) Established the Office of the National
health nurses Coordinator (ONC) for Healthcare Information
(1) Understand the importance of nursing data Technology (HIT)
and their relationship to new Medicare and (2) Issued a recommendation calling for all
Medicaid legislation healthcare providers to adopt interoperable
(2) Provide information on the usefulness of electronic health records (EHRs) by 2014/2015
computers for capturing and aggregating home
health and public health information ● Wireless, point of care, regional database projects,
and increased IT solutions proliferated
f) Hospitals and public health agencies embarked on ● The use of bar coding and radio-frequency identification
investigating computers and nursing (RFID) emerged as a useful technology
💡 Marami ng information na-input sa computer ● Smaller mobile devices with wireless or Internet access

- Emerge in public and home health and education increased access to information for nurses within
hospitals and in the community
- Embarked on investigating
● The development and refinement of voice over Internet
protocol (VoIP) provided voice cost-effective
❖ 1980’S
communication
● The field of nursing informatics exploded and became
● The Internet provided a means for development of
visible in the healthcare and nursing clinical applications
● The nursing profession needed to update its practice
● The nursing informatics research agenda promoted the
standards and determine its data standards, integration of nursing care data in HIT systems that would
vocabularies, and classification schemes that could be also generate data for analysis, reuse, and aggregation
used for the computer-based patient record systems
● Many mainframe healthcare information systems (HISs)
❖ 2010’S
emerged with nursing subsystems
● The impact of the Nursing Minimum Data Set (NMDS)
● These systems documented several aspects of the
demonstrated that continued consensus and effort was
patient record
needed to bring to fruition the vision and implementation
● The microcomputer or personal computer (PC) emerged
of minimum nursing data into clinical practice
during this period
● A new nursing informatics research agenda for 2008–
💡 Informatics exploded because this was the time where 2018 emerged as critical for this specialty
technology exploded ● The new agenda is built on one originally developed and
published by the National Institute for Nursing Research
❖ 1990’S (NINR) in 1993
● Advances in relational databases, client-server ● During 2010, the ONC convened two national
architectures, and new programming methods committees:
● Better application development at lower costs (1) National Committee on Health Policy

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

(2) National Committee on Health Standards supported the integration of computer technology in the
which outlined and designed the focus for the nursing curriculum
“Meaningful Use” (MU) legislation 2. The American Association of Colleges of Nursing
(AACN), revised The Essentials for Doctoral
● Meaningful Use was designed to be implemented in at Education for Advanced Nursing Practice and The
least three stages Essentials of Baccalaureate Education for Professional
● Consists of the regulations which built onto each Nursing Practice to require the use of computers and
other with the ultimate goal of implementing a complete informatics for both baccalaureate and graduate
an interoperable EHR and/or HIT system in all education
US hospitals
● In 2011/2012 MU Stage 1 was initiated focusing
ELECTRONIC HEALTH RECORDS FROM A
primarily on the Computerized Physician Order Entry HISTORICAL PERSPECTIVE
(CPOE) initiative for physicians
● In 2012/2013 MU Stage 2 was introduced focusing ❖ THE INSTITUTE OF MEDICINE (IOM)
primarily on the implementation of Quality Indicators 1. In 1989, the Institute of Medicine (IOM) convened a
● The Quality Indicators are used to guide hospitals in committee and asked the question, “Why is healthcare
patient safety and if not implemented used as indicators still predominantly using paper-based records when so
subject to financial penalties many new computer-based information technologies are
● - It is anticipated that MU Stage 3 will be implemented emerging?”
in 2014/2015 2. Two major conclusions resulted from the committee’s
● The Center for Medicare and Medicaid Services (CMS) deliberations.
plans to increase reimbursement for the implementation a. First, computerized patient record (CPR) is an
of “MU” regulations in their HIT and/or EHR systems essential technology for healthcare and is an
through 2015 integral tool for all professionals
b. Second, the committee after hearing from
numerous stakeholders recognized that there
CONSUMER-CENTRIC HEALTHCARE SYSTEM was no national coordination or champion for
1. There is a shift to a consumer-centric healthcare CPR
system due to escalating costs
2. Consumers are encouraged to be active partners in THE COMPUTER-BASED PATIENT RECORD
their care INSTITUTE
3. A variety of technologies have evolved to enable 1. Created in 1992
consumers to have access to their health information 2. Given the mission to initiate and coordinate the urgently
4. Consumers can choose whether to share this across needed activities to develop, deploy, and routinely use
healthcare providers and settings CPRs to achieve improved outcomes in healthcare
5. Personal health records multiplied as either stand- quality, cost, and access
alone systems or those tethered to EHRs 3. Developed the CPR Project Evaluation Criteria in 1993
6. Consumers are more literate regarding healthcare modeled after the Baldridge Award
information literacy and expect to become more involved a.) These criteria formed the basis of a self-assessment
in managing their own health that could be used by organizations and outside
reviewers to measure and evaluate the
NURSING STANDARDS INITIATIVES accomplishments of CPR projects
b). The four major areas of the initial criteria
1. Nursing practice standards have been developed and (1) Management
recommended by the ANA. (2) Functionality
2. Nursing Scope and Standards of Practice that focused (3) Technology
a. On the organizing principles of clinical nursing (4) Impact
practice c) Provided a framework through which to view an
b. The standards of professional performance implementation of computerized records
3. Nursing Informatics Scope and Standards of Practice d) The criteria which provided the foundation for the
builds on Nicholas E. Davies Award of Excellence Program
a. Clinical practice standards 4. The Davies Program evolved through multiple revisions
b. Outlines further the importance for 5. Under HIMSS management, the Davies Award of
implementing standardized content to Excellence is offered in four categories [HIMSS-
support nursing practice by specialists in nursing Healthcare Information and Management Systems
informatics Society]
💡 Organizing clinical principle standards a. Enterprise (formerly Organizational or Acute
- Continuous evolution Care), first offered in 1995
- Systematic thinking para sa real world, systematic ang b. Ambulatory Care, started in 2003
way of thinking c. Public Health, initiated in 2004
d. Community Health Organizations (CHO), first
presented in 2008
NURSING EDUCATION STANDARDS
1. Since the NLN’s Nursing Forum on Computers in
Healthcare and Nursing was formed in 1985, it has

ECLIPSE, XYRA ANN M. | 3

 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

LESSON 2: COMPUTER HARDWARE COMPUTER IN NURSING

● Computer hardware advances during the late 1900s and
COMPUTER into the 2000s have made possible many changes to the
health care industry.
● The first work to be modified consisted of special
administrative functions such as finance, payroll, billing,
and nurse staffing and scheduling support
● Later, the computer allowed fantastic changes in the
practice of radiology and imaging, allowing noninvasive
visualization not only of internal structures, but even of
metabolic and movement functioning.
● Computer enhanced surgical instruments enabled
surgeons to insert endoscopy tools that allow for both
visualization and precise removal of diseased tissues,
Computer hardware is defined as all of the physical leaving healthy tissues minimally damaged and the
components of a computer. patient unscarred

A computer is a machine that uses electronic

REQUIRED HARDWARE COMPONENTS OF A
components and instructions to the components to COMPUTER LEAVE
perform:
a. Calculations ❖ THE BOX OF ANY COMPUTER CONTAINS A
b. Repetitive and complex procedures MEMORY
c. Process text ● a. It is a form of permanent storage on the computer
d. Manipulate data and signal ● b. It carries instructions that allow the computer to be

💡 AMD – kilala sa gaming booted (started), and other essential machine instructions
● c. Its programming is stored by the manufacturer and
4M1 - Processor na mahal
cannot be changed by the user
Switched-Mode Power Supply
● d. Data and programs in ROM can only be read by the
computer, and cannot be erased or altered by users
Processors that can be seen in phones: ● e. ROM generally contains the programs, called
Apple – apple a series; for office firmware, used by the
Samsung – exynos control unit of the CPU to oversee computer functions
Huawei – kirin ● f. In microcomputers, this may also include the software
Snapdragon din minsan ang ginagamit; for gaming almost programs used to translate the computer's high-level
May pinagkaiba ba mga to? Meron, kung gaano kabilis to programming languages into machine language (binary
ganun code)

The basic hardware of a computer composes the

computer's architecture, and includes:
a. Electronic circuits
b. Microchips, processors
c. Random Access Memorv (RAM)
- stores permanent data; this modifies data
d. Read-Only Memory (ROM)
e. Graphic and sound cards RAA
💡 check always the CPU

❖ THE MOTHERBOARD
Is a square or rectangular board with circuits into which
are plugged the main electronics of the computer. ❖ THE BOX OF ANY COMPUTER CONTAINS A
- this is where you can see the hdmi, etc. MOTHERBOARD
● a. The motherboard is a thin, flat sheet made of a firm,
Devices that may be inside the computer case but are nonconducting material on which the internal
not part of the architecture include: components— printed circuits, chips, slots, and so on—of
● a. Main storage device which is usually an internal hard the computer are mounted
drive ● b. The motherboard is made of a dielectric or
● b. Cooling system nonconducting plastic material
● C. Modem ● c. Electric conducting lines are etched or soldered onto
● d. Ethernet connectors the bottom of the board
● e. Optical drives ● d. The motherboard has holes or perforations through
● f. Universal Serial Bus (USB) connectors which components can be affixed so they can transmit
● g. multi-format media card readers data across the circuits on the motherboard.

ECLIPSE, XYRA ANN M. | 4

 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

❖ THE BOX OF ANY COMPUTER CONTAINS AN

INPUT DEVICES
● a. These devices allow the computer to receive
information from the outside world
● b. The most common input devices are the keyboard
and mouse
● c. Others commonly seen on nursing workstations
include the touch screen, light pen, voice, and scanner
● d. A touch screen is actually both an input and output
device combined
● e. Electronics allow the computer to "sense" when a
particular part of the screen is pressed or touched
● f. In this way, users input information into the computer
● g. The touchscreen displays information back to the
user, just as does any computer monitor

💡 Motherboard is a circuit board, where RAM, ROM, CPU,

card reader, usb, all the circuits you can see

ROM – permanent storage, kapag binoot mo ung computer

RAM – the memory that processes the openings or software

- kapag ang CPU ay mababa kahit gaano pa kalaki pa ang
RAM, di pa rin mapapatulong

Input devices – enables us to perform 💡 The oximetry device

- voice operator, scanners, can see in nursing input devices In radiology, most machines today input images from the
X-Ray machines to a computer rather than storing them on
❖ THE BOX OF ANY COMPUTER CONTAINS A RAM film. Computerized Axial tomography (CAT)-scans, and
(RANDOM ACCESS MEMORY) Medical Resonance Imaging machines
● a. Refers to working memory used for primary storage
● b. It is used as temporary storage ❖ THE BOX OF ANY COMPUTER CONTAINS AN
● c. Also known as main memory, RAM can be accessed, OUTPUT DEVICES
used, changed, and written on repeatedly ● a. These devices allow the computer to report its results
● d. RAM is the work area available to the CPU for all to the external world
processing applications ● b. Defined as any equipment that translates the
● e. When a user clicks on a program icon, the computer computer information into something readable by people
loads all or part of or other machines
the program into RAM where it can be accessed very ● c. Output can be in the form of text, data files, sound,
quickly graphics, or signals to other devices
● f. It saves work done through the programs until the user ● d. The most obvious output devices are the monitor
formally saves the work on the hard drive or other (display screen), and printer
permanent storage ● e. Other commonly used output devices include storage
devices such as the Universal Serial Bus (USB) drive
(also known as flash or thumb drives) and optical media

ECLIPSE, XYRA ANN M. | 5

 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

💡 Heart monitors are output devices recording and

displaying heart rhythm patterns, and initiating alarms MAJOR TYPES OF COMPUTERS
when certain conditions are met SUPERCOMPUTERS
● Volumetric infusion pumps output includes both images on
● a. The largest type of computer
a screen and fluids infused into the patient’s body
● b. First developed by Seymour Cray in 1972
● The pump delivers a specific volume of IV fluids based on
● c. The early supercomputer research, development, and
commands that the nurse inputs so the ordered fluid volume production was done by Cray Corporation or one of its
will be infused in the correct time period affiliates (Cray, 2014)
● d. A supercomputer is computational-oriented computer

STORAGE MEDIA specially designed for scientific applications requiring a

gigantic number of calculations which, to be useful, must
❖ HARD DRIVE OR HARD DISK be processed at superfast speeds
● a. It is a peripheral that has very high speed and high ● e. supercomputers are used primarily in such work as
density defense and weaponry, weather forecasting, advanced
● b. It is a very fast means of storing and retrieving data engineering and physics, and other mathematically
as well as having a large storage capacity in comparison intensive scientific research applications
with the other types of storage ● f. Provides computing power for the high-performance
● c. The hard drive is the main storage device of a computing and communication (HPCC) environment
computer - dito pumapasok ung mga nakukuhang data like from the
● d. For small computers, it is typically inside the case or internet
box that houses the CPR and other internal hardware
● e. Internal hard drives are not portable; they are plugged
directly into the motherboard
● f. The storage capacity of hard drives has increased and
continues to increase exponentially every few years
● g. In 2014, most personal computers are sold with about
a terabyte of storage

💡 What is the issue of hard disk? In terms of saving files it

is maganda, but since it is optical and gumagamit ng cd,
nahihirapan na magbasa ang kanyang cd. Since umiikot at
loading, mabagal lang sya. Pero in terms of corrupt, hindi
sya madaling makukuha since naka-cd sya. Pwede parin MAINFRAMES
ma-retrieved. ● a. The most common fast, large, and expensive type of
computer used in large businesses (including hospitals
Solid state drive – maganda dahil hindi na sya nagbabasa and other large healthcare facilities) for processing,
ng cd dahil chips na sila. Ang pag-save ng data ay nasa storing, and retrieving data
microchips, mabilis na sya mag-work. However, if corrupted ● b. It is a large multiuser central computer that meets the

ay pwede paba makuha? Magkaroon ng back-up like icloud computing needs large and medium sized public and
private organizations
or naka hybrid ang computer
Virtually all large and medium sized hospitals (300 beds
and up) have a mainframe computer to handle their
business office operations. They may have the hospital's
electronic medical record (EMR) on that computer as well,
or they may subcontract mainframe computing from a
professional computer system support vendor

● c. Mainframes are used for processing the large amount

of repetitive calculations involved in handling billing,
payroll, inventory control, and business operations
computing

💡 Mainframes – ginagamit lang sa mga business, more like

mas maliit lang ang nakukuhang data compared sa
supercomputers

ECLIPSE, XYRA ANN M. | 6

 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

COMPUTER POWER
1. BITS AND BYTES
● a. A bit (binary digit) is a unit of data in the binary
numbering system
● b. Binary means two, so a bit can assume one of two
positions
● c. A bit is an ON/OFF switch—ON equals the value of 1
and OFF equals 0
● d. Bits are grouped into collections of 8, which then
function as a unit
● e. That unit describes a single character in the computer,
such as the letter A or the number 3, and is called a byte.

CONNECTIVITY, COMPATIBILITY, AND 2. MAIN MEMORY, WHICH INCLUDES THE ROM ON

INCOMPATIBILITY ISSUES THE MOTHERBOARD IN TODAY’S COMPUTERS, IS
❖ 1. COMMUNICATION AMONG VARIOUS VERY LARGE AS COMPARED WITH THAT OF JUST A
HARDWARE DEVICES CANNOT BE ASSUMED. FEW YEARS AGO, AND CONTINUES TO INCREASE
● a. Given that departments within a single organization EVERY YEAR WITH NEW COMPUTERS
have often bought small systems designed to support ● a. The size of memory is an important factor in the
their work, a single hospital may have literally hundreds of amount of work a computer can handle
different computers and applications on those computers ● b. Large main memory is another key measure in the
● b. Simply wiring incompatible machines so that power power of a computer
can flow between them accomplishes nothing ● c. In the mid-1970s, the PCs on the market were
● c. Often, computers cannot transfer data meaningfully typically sold with a main memory of between 48 and 64
among themselves K
● d. This makes it difficult to create a comprehensive ● d. By 2014, the size of main memory in computers sold
medical record for individual patients to the public had risen exponentially
● e. Information stored somewhere in the facility may not ● e. Most computers in 2014 are advertised with between
be available when needed to the providers who need the 5 and 16 GB of main memory and computers with 20 GB
information to make good patient care decisions or more of main memory are available

❖ 2. DIFFERENT COMPUTERS HAVE DIFFERENT COMPUTER SPEED

ARCHITECTURES, HARDWARE The basic operations of the CPU are called cycles
CONFIGURATIONS, AND DIFFERENT STORAGE
● a. The four types of cycles, or operations of a CPU,
SCHEMES
include:
● a. Software must be specifically designed to
(1) Fetch
communicate with another program for the two to
(2) Decode
communicate
(3) Execute
● b. Systems not designed specifically to work together
(4) Store
cannot communicate information and processes to each
● b. It takes time for the computer to perform each of these
other without the addition of complex translation programs functions or cycles c. The CPU speed is measured in
(that usually don't exist); that is, they are not interoperable
cycles per second, which is called the clock speed of the
computer
❖ 3. AS A RESULT OF THE INTEROPERABILITY
PROBLEMS, IT CAN BE ECONOMICALLY
Clock speeds, like most other components, have greatly
INFEASIBLE TO MOVE DATA ACROSS
DIFFERENT COMPUTERS AND PROGRAMS. improved over time
● a. For example, the original IBM PC introduced in 1981
● a. The interoperability problem limits the nurses' ability
had a clock speed of 4.77 MHz (4.77 million cycles per
to obtain, combine and analyze data the need to provide
second)
high quality, safe patient care
● b. In 2010, home computers commonly had speed of 1.8
● b. Organization progress and performance is hampered
to 3 GHz. In 2014, advertised computers in the $1000
when data and information are not available to perform
range have clock speeds of 2.5 to 3 GHz
the analysis required to identify problems, opportunities
● c. The higher the clock speed possessed by the CPU,
for improvement, safety risks, and to make projections
the faster and (in one dimension) the more powerful the
about future needs
computer
● c. Interoperability is necessary to meet the requirements
of the Medicare and Medicaid HR Incentive Programs
(which provide financial incentives for the "meaningful NETWORK HARDWARE
use" of certified EHR technology) as part of the HITECH 1. A network is a set of cooperative interconnected
Act of 2009 computers for the purpose of information interchange
2. The networks of greatest interest include local area
networks (LANs), wide
area networks (WANs), and the Internet, which is a
network of networks

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

a. A LAN usually supports the interconnected computer LESSON 3: ADVANCED HARDWARE AND MHEALTH
needs of a single company or agency
b. The computers are physically located close to each
other, and generally, only members of the company or WIRELESS COMMUNICATION
agency have legitimate access to the information on the 1. The ability of a mobile device to connect with networks
network in multiple ways are the foundation of mobile computing
c. WANs support geographically dispersed facilities, such and mhealth.
as the individual grocery stores in a national chain
d. A subset of WANs includes the metropolitan area 2. Technology used to wirelessly communicate with a
mobile device includes:
networks (MANs) that support and connect the many
a. Mobile telecommunications technology
buildings of local governmental agencies or university
b. Wi-fi
campuses.
c. Bluetooth
d. Radio-frequency identification (rfid)

3. Fourth generation (4g) networks

a. Are replacing 3g networks
b. Support all internet protocol (ip) communication
c. Use new technology to transfer data at very high bit
rates
d. The international telecommunications union-radio
communications sector (itu-r) sets the standards for
international mobile telecommunications advanced (imt-
advanced) technology.

4. Wi-fi
a. Intended for general local network access
b. Called a wireless local area network
c. Bluetooth is intended for a wireless personal are
network (WPAN)
d. Wi-Fi and Bluetooth are complementary
e. Wi-Fi is access point-centered
f. Bluetooth is used for symmetrical communication
g. Protocols covering wireless devices include

1. Wireless Application Environment (WAE),

which specifies an application framework
2. Wireless Application Protocol (WAP), which is
an open standard, providing mobile devices
access to telephony and information services

5. Bluetooth
a. Is a wireless technology standard for control of and
communication between devices, allowing exchange of
data over short distances
b. Bluetooth is used to wirelessly connect
1. Keyboards
2. Mice
3. Light-pens
4. Pedometers
5. Sleep monitors
6. Pulse oximeters

6. Radio-frequency identification (rfid)

a. Uses radio-frequency electromagnetic fields to
transfer data,
b. using tags that contain electronically stored
information
c. RFID is used for equipment tracking and inventory
control
d. Tags contain an integrated circuit for:
- storing and processing information
- modulating and demodulating a radio frequency
e. Tags contain an antenna for receiving and
transmitting the signal

ECLIPSE, XYRA ANN M. | 8

 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

STANDARDS AND PROTOCOLS 1. Under the Affordable Care Act (ACA), innovative
technology is seen as an integral component of an
❖ NETWORK STANDARDS integrated, accessible, outcome-driven healthcare
● Use of well-established standards and best practices system
allows global and easy access to networks and networked 2. Mobile technology may be key to more effective
information.
preventative care, improved patient outcomes,
● The networking model and communications protocols
used for the Internet are commonly known as:
improving access to specialized medical services,
i. Transmission Control Protocol (TCP) and driving system-wide cost reduction
ii. Internet Protocol (IP) or TCP/IP 3. mHealth
a. The National Institutes of Health defines
● Thissuite of standards provides end-to-end connectivity mHealth as “the use of mobile and wireless
specifying how data are: devices to improve health outcomes,
1. Formatted healthcare services, and health research”
2. Addressed b. A major component of mHealth includes
3. Transmitted timely access to clinical information such as
4. Routed the data contained in electronic health
5. Received at the destination records (EHRs), personal health records
(PHRs), and patient portals
● The Internet Engineering Task Force (IETF) maintains c. This information should be securely
the standards for the TCP/IP Internet protocol suite.
accessible by clinicians, patients, and
● Some of the most used protocols for Internet user
interface services and support services include:
consumers over various wireless mediums
1. Simple Mail Transfer Protocol (SMTP) both inside and outside the traditional
2. File Transfer Protocol (FTP) boundaries of a hospital, clinic, or practice
3. HyperText Transfer Protocol (HTTP) d. The iPhone and Android operating
systems have accelerated the proliferation of
● Encryption provides mobile data use.
1. Confidentiality e. In 2000, the Federal Communications
2. Integrity for data sent over the Internet Commission (FCC) dedicated a portion of the
radio spectrum to wireless medical telemetry
MOBILE HEALTHCARE systems (WMTS), which was widely adopted
DRIVERS OF MOBILE HEALTHCARE for remote monitoring of a patient’s health
1. The 2012 documentary Escape Fire: The Fight to f. Nurses soon became familiar with
Rescue Healthcare is an urgent call to think Computers on Wheels (COWs)
differently about healthcare g. Evolved to workstations on wheels
2. Clinicians shifting from a focus on disease (WOWs)
management to a focus on ending lifestyle disease h. More wireless devices were integrated into
may leverage the use of mobile platforms networks and greater emphasis was placed
3. According to the mHIMSS Roadmap, “patients on error detection and prevention,
and providers are leveraging mobile devices to seek medication administration safety, and
care, participate in, and deliver care. Mobile computerized provider order entry (CPOE).
devices represent the opportunity to interact and i. Nurses now have immediate access to
provide this care beyond the office walls” patient data at the bedside
4. Advancements in technology, federal healthcare
policy, and commitment to deliver high-quality care 4. Infrastructure
in a cost-efficient manner have led to new a. mHealth is a wide variety of use cases that
approaches range from continuous clinical data access to
5. The Affordable Care Act (ACA) leverages remote diagnosis as well as guest Internet
innovative technology to bring about “a stronger, access
better integrated, and more accessible healthcare b. The role of video in healthcare is evolving
system as quickly as the standards
6. The current healthcare focus is on preventive and c. Hospital systems and ambulatory
primary care to reduce hospital admissions and practices have started using products like
emergency department utilization FaceTime, Skype, Google Hangouts, and
7. Engaging patients with the management of their other consumer-oriented video-telephony
chronic diseases helps them maintain their and voice over Internet Protocol (VOIP)
independence and achieve a high quality of life software applications for patient consults,
8. Patients may make use of collaborative tools such follow-up, and care coordination
as Secure Messaging to communicate with their d. Overlay networks for medical devices are
healthcare team, and may find support through becoming obsolete as hospitals seek
social interactions on a blog economies of scale by utilizing their existing
Wi-Fi infrastructure
TECHNOLOGY IN MOBILE HEALTH CARE e. This places a heavy dependency on the
Information Technology department (IT)

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

5. Real-time location services (RTLS) 3. Sensors can now measure heart rate, pulse,
a. Dates back to the 1990s oxygen saturation levels, speed, and distance for
b. Can be used for asset location tracking, exercise regimens.
including medical equipment 4. Devices are emerging for daily blood tests,
c. Can show the status of equipment automated weight tracking, and sleep monitoring
5. EKGs can be registered and transmitted through
MOBILE DEVICES a device no larger than a Band-Aid
1. Smartphones and tablets are ubiquitous in the 6. The concept of home health has been a driving
healthcare setting. factor in the proliferation of remote monitoring
2. Mobile device performance has improved. devices (HIMSS, 2012b)
3. Battery technology has improved
4. Many devices have high-resolution touch PRIVACY AND SECURITY
screens
5. Clinical information systems are designed to 1. The cornerstone of trust in healthcare is privacy
display well on smartphones and tablets and security.
6. Smart devices will emerge as the primary 2. mHealth data presents a greater challenge to
computing device for all users. security and data integrity because this data is in a
7. These devices already support text messaging, mobile environment.
voice, and video 3. The data are not collected in stored access
facilities and stored behind firewalls.
TELEHEALTH
4. Many of the same rules apply to mHealth as well
as the physical hospital environment.
1. A trend in healthcare IT
5. mHealth must comply with all Health Insurance
2. Users do not want multiple communication
Portability and Accountability Act (HIPAA)
devices
mandates, Food and Drug Administration (FDA)
3. Users often prefer their own device
regulations, Office of Civil Rights (OCR)
4. Mobile Device Management products provide
enforcements, and requirements from other
policy enforcement, remote wipe capability, and
governing agencies.
endpoint integrity
6. In a large number of security breaches, the thief
5. Device owners must be willing to abide by the
simply carried the equipment out the door or
hospital’s mobile device policy
removed it from a car.
7. Size does not play a role in protecting the data.
FUTURE OF MHEALTH INSIDE HEALTHCARE
8. An organization is responsible for securing and
FACILITIES
verifying security.
CONSIDERATION FOR MHEALTH PLANNING 9. An organization is responsible for testing to locate
1. The role of cellular networks in video and voice vulnerabilities in systems.
applications is expanding
2. Advances in 4G technologies are beginning to
provide the bandwidth necessary for video
conferencing and Video Remote Interpreting (VRI)
3. Remote monitoring of patients is increasingly
viewed as essential for mHealth planning.
4. By 2020, the majority of computing will be edge
computing.
5. Healthcare will become more patient-centered,
and mobile and health visits will occur in the home,
school, and office (mHIMSS, 2014d)
6. Data from home monitoring devices to fitness
apps raise questions about which kinds of data will
be aggregated.
7. There will be questions about conventions for
meta-tagging the source of that data.
8. Ethical, legal, privacy, and security questions
must be addressed

SETTING THE STAGE FOR MHEALTH ADOPTION

1. Smartphones and tablets offer a new engagement
model for patients, family members, and healthcare
providers
2. Peripheral devices are becoming smartphone
ready LESSON 4: COMPUTER SOFTWARE

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● Designed to help the user keep hard disk space clean

CATEGORIES OF SOFTWARE
and efficient
There are three basic types of software: ● Accomplished by analyzing the use of disk space,
defragmenting the drive, and deleting duplicate files if the
❖ SYSTEM SOFTWARE user so command
● “Boots up” (starts up and initializes) the computer ● Many programs and Internet sites temporarily store
system a. It controls input, output, and storage information on the hard drive as part of their operations,
❖ UTILITY PROGRAMS but when those operations are finished, they don’t clean
● Consists of programs designed to support and optimize the temporary files
the functioning of the computer system itself ● Other disk management utilities include diagnostic
❖ APPLICATIONS SOFTWARE programs designed to find problems with programs or the
operating system so that they can be fixed
● Includes the various programs which users require to
perform day-to-day tasks
❖ BACKUP UTILITIES
● Serve to help the users back up their data
SYSTEM SOFTWARE
● Applications programs may be backed up, but usually
a. Basic Input/Output System (BIOS): The first level
that isn’t necessary because legal copies of programs can
of system control is handled by the BIOS stored
be reloaded by the person who bought the license
on a ROM chip on the motherboard
● Illegal (or pirate) programs are a different issue
b. b. The software on the BIOS chip is the first part ● The computer owner may not have a backup copy of
of the computer to function when the system is illegally downloaded programs
turned on
● Any computer component can fail
c. c. It first searches for an Operating System (OS)
● It is very important for users to back up any data they
and loads it into the RAM
have saved that they don’t want to lose permanently
d. d. The BIOS consists of a set of instructions ● Back up one’s data to an external (removable) hard
permanently burned onto a computer chip, it is a drive or an online backup location
combination of hardware and software
e. e. Programs on chips are often called firmware,
❖ SCREEN SAVERS
because they straddle the line between hardware
and software ● Computer programs that either blank the monitor screen
or fill it with constantly moving images when the user is
away from the computer
UTILITY SOFTWARE
● Does not turn it (and the monitor) completely off
a. Utility programs includes programs designed to ● Originally developed for old technology screens that
keep the computer system operating efficiently 2 would be damaged by having the same image on the
b. They do this by: screen for a long period of time
● Adding power to the functioning of the system ● Modern computer screens have different technology
software and don’t suffer that risk
● Supporting the operating system or applications ● Screen savers are often entertaining or beautiful to look
software programs at
c. Utility programs are sort of between system ● Do provide a small measure of privacy as they hide
software and applications software whatever the user is working on when the user steps away
d. Many writers identify this software as part of the from the computer
system software category ● Unless linked with a program that requires the user to
e. Six types of utility software can describe the sign back in to access the regular screen, they don’t
majority of utility programs, although there is no provide security because a passing person could also tap
formal categorization system for such programs a key to get back to the regular screen

SIX TYPES OF UTILITY SOFTWARE: THE APPLICATIONS SOFTWARE

CATEGORIES INCLUDE AT LEAST ● Includes all the various programs people use to
❖ SECURITY SOFTWARE a. Do the work
● Includes primarily antivirus, firewall, and encryption b. Process data
programs c. Play games
● Antivirus utilities serve primarily to guard against d. Communicate with others
malicious programs inadvertently accessed e. Watch videos and multimedia
● Firewalls are a type of security program that makes it programs
much harder for unauthorized persons or systems to enter ● Written for system users to make use of the computer
the computer and hijack or damage programs or data on ● Application programs are written in a particular
the computer programming language then the program is “compiled” (or
● Firewalls can include both additional hardware and translated) into machine language so the computer can
utility software understand the instructions and execute the program
● The encryption software encodes the data so that it ● By far the most commonly used set of programs are the
cannot be read until it is decoded programs in an office package
● The HTTPS letters on a Web page address indicate that
the site encrypts data sent through that site PROGRAMMING LANGUAGE
● A means of communicating with the computer
● The only language a CPU can understand is binary or
❖ DISK MANAGEMENT UTILITIES machine language
● Binary:

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

a. Some highly sensitive defense applications are (2) Admission-discharge-transfer (ADT) systems
still written in machine language (3) Medication administration record (MAR)
b. The language is tedious and inefficient use of software
human resources (4) Supplies inventory systems
c. Its programs are virtually impossible to (5) Laboratory systems
update and debug (6) Radiology system
● Users have longed for a machine that could accept (7) Computerized patient acuity system
instructions in everyday human language (8) E-mail system
● Although that goal largely eludes programmers
● Applications such as office support programs have ● Nurses are finding that they are able to build regional,
become much easier to use with graphical user interface- national, and international networks with their nursing
based command colleagues with the use of
a. Chat rooms
GENERATION AND LEVELS OF PROGRAMMING b. Bulletin boards
LANGUAGES c. Conferencing systems
d. Disserves on the Internet
❖ MACHINE LANGUAGE
a. Machine language is the true language of the computer ● Nurses may download any of thousands of software
b. Any program must be translated into machine language applications (apps) onto their personal digital assistant
before the computer can execute it (PDA) to assist them with patient care
c. The machine language a. Most are very low cost, and some are free
(1) Consists only of the binary numbers 1 b. Such programs include:
and 0
(1) Drug guides
(2) Representing one ON and OFF
“switch” controlled by electrical impulses (2) Medical dictionaries
d. Single switch is called a binary digit, and for short (3) Consult guides for a variety of patient populations
named a “bit” e. All data are represented by and clinical problems
combinations of binary digits
OPEN SOURCE AND FREE SOFTWARE
❖ 2. ASSEMBLY LANGUAGE 1. Open-source software is any software satisfying the
a. Assembly language is more like the English language open software initiative’s definition
b. It is still very close to machine language 2. The open-source concept is said
c. It is extremely obscure to the nonprogrammer a. To promote software reliability and quality by
d. Assembly language instructions have a one-to-one supporting independent peer review
correspondence with a machine language instruction b. Rapid evolution of source code
e. Assembly language is still used by system c. As well as making the source code of software
programmers freely available
f. Used to manipulate functions at the machine level 3. Provides free access to the programmer’s instructions
to the computer in the programming language in which
COMMON SOFTWARE PACKAGES FOR they were written
MICROCOMPUTERS 4. Many versions of open-source licenses allow anyone to
modify and redistribute the software
❖ THE MOST COMMON PACKAGE SOLD WITH 5. The open-source initiative (OSI) has created a
COMPUTERS IS A STANDARD OFFICE PACKAGE certification mark, “OSI certified”
a. The standard office package includes a
(1) Word processing program FREE SOFTWARE
(2) Spreadsheet program 1. Free software is defined by the FSF in terms of four
(3) Presentation graphics program freedoms for software users
a. To have the freedom to use
b. The upgraded or professional versions usually add b. Study
(1) Some form of database management system c. Redistribute
(2) An e-mail system d. Improve the software
(3) A “publisher” program 2. A program is only free software, in terms of the FSF
definition, if users have all of these freedoms
3. The FSF believes that users should be free to
c. The two most commonly used programs are the
redistribute copies a. Either with or without modifications
(1) E-mail system
b. Either gratis or through charging a fee for distribution,
(2) Word processor to anyone, anywhere without a need to ask or pay for
permission to do so.
COMMON SOFTWARE USEFUL TO NURSES
OPEN SOFTWARE
● In most hospitals, most software systems used by
1. Open-source software is any software satisfying the
nurses are based in a HIS
open software initiative’s definition
2. The open-source concept is said
a. The HIS is a multipurpose program, designed to
a. To promote software reliability and quality by
support many applications in hospitals and their
supporting independent peer review
associated clinics
b. Rapid evolution of source code
b. The components nurses use most include
c. As well as making the source code of software
(1) The electronic medical record
freely available

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

3. Provides free access to the programmer’s instructions IV. A significant motive for supporting the use of
to the computer in the programming language in which OSS/FS and open standards in healthcare is that
they were written interoperability of health information systems
4. Many versions of open-source licenses allow anyone to requires the consistent implementation of open
modify and redistribute the software standard
5. The open-source initiative (OSI) has created a
certification mark, “OSI certified” b. A key element of the process is that, by being open,
6. In order to be OSI certified, the software must be there is less risk of being dominated by any single interest
distributed under a license that guarantees the right to: group
a. Read b. Redistribute I. Bowen et al. summarize a few advantages that
c. Modify d. Use the software freely open-source software offers when compared with
proprietary software, including, but not limited to,
OSS/FS DEVELOPMENT MODELS AND SYSTEMS the following:
● Ease of modification and or customization
● OSS/FS has existed as a model for developing
computer applications and software since the 1950s ● The large developer community and its benefits
● At that time, software was often provided free (gratis), ● Increased compliance with open standards
and freely, when buying hardware ● Enhanced security
● The freedoms embodied within OSS/FS were ● Increased likelihood of source code availability in the
understood as routine until the early 1980s with the rise of event of the demise of the vendor or company
proprietary software ● Easier to adapt for use by healthcare students
● It was in the 1980s that the term free software as we
● And the flexibility of source code to adapt to research
recognize them today, came into existence to distinguish
efforts
it from the proprietary models
● In the 1990s the term open-source software, as we
recognize it today, came into existence to distinguish it
from the proprietary model
● The development models of OSS/FS are said to
contribute to their distinctions from proprietary software

CHOOSING OSS/FS OR NOT

❖ PROPOSED BENEFITS OF OSS/FS
a. OSS/FS has been described as the electronic
equivalent of generic drugs
b. In the same way as the formulas for generic
drugs are made public, so OSS/FS source code
is accessible to the user.
c. Any person can see how the software works
and can make changes to the functionality
d. It is suggested by many that there are
significant similarities between the open-source
ethos and the traditional scientific method
approach
e. As this latter method is based on
(1) Openness
(2) Free sharing of information
(3) Improvement of the end result

SS/FS HEALTHCARE APPLICATIONS

Overview
a. It is suggested that in healthcare, as in many other
areas, the development of OSS/FS may provide much-
needed competition to the relatively closed market of
commercial, proprietary software and thus encourage
innovation
I. This could lead to lower cost and higher quality
systems that are more responsive to changing
clinical needs
II. OSS/FS could also solve many of the problems
health information systems currently face
including lack of interoperability and vendor lock-
in, cost, difficulty of record and system
maintenance given the rate of change and size of
the information needs of the health domain, and
lack of support for security, privacy, and consent
III. This is because OSS/FS more closely
LESSON 5: OPEN SOURCE AND FREE SOFTWARE
conforms to standards and its source code open Freeware – open source software’s, these are
to inspection and adaptation applications used for computer to function

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● The open-source concept is said

OSS/FSS – THE THEORY OSS/FS a. To promote software reliability and quality by
Examples of application software: supporting independent peer review
Skype b. rapid evolution of source code
Netflix c. As well as making the source code of software
freely available
Facebook
● In order to be open-source initiative (OSI) certified, the
software must be distributed under a license that
But if system software: guarantees the right to:
iOS a. Read
Window b. Redistribute
Mac OS open source
c. Modify
d. Use the software freely
💡 readily and easy to get

OSS/FS DEVELOPMENT MODELS AND SYSTEMS

1. OSS/FS draws much of its strength from the
collaborative efforts of people.
a. Who works to improve, modify, or customize programs.
💡 Example: During the book era, when my mom forces me
to study. If kaharap ang book, it’s just book. Because of that
force, sir elgeene became educated. But, the problem with
cellphones, merong ibang applications that are installed to
it which makes you to choose what to do. The problem with
technology today, it makes us to choose. It was made because
it is modernized and we want wellness.
b. Believing, they must give back to the OSS/FS
community so others can benefit from their work.

2. The OSS/FS development model is unique

a. It bears strong similarities to the openness of the
scientific method.
b. It is facilitated by the communication capabilities of the
Internet that allows collaboration and rapid sharing of
developments.
The term open source (and the acronym OSS/FS) in this c. Such that new versions of software can often be made
chapter is used loosely (and, some would argue, available on a daily basis.
incorrectly) to cover several concepts, including
● Open-source software
3. This is only one of several benefits proposed for
● Free software
OSS/FS, with further benefits:
● GNU/Linux
(1) Including lack of the proprietary lock-in that
can often freeze out innovation, e.g: flappy bird
There are 2 major philosophies in the OSS/FS world, (2) With OSS/FS projects supporting open
a. the free software foundation (FF) philosophy standards and providing a level playing field
b. the open source initiative (OSI) philosophy, (3) Expanding the market by giving software
c. today they are often seen as separate movements with consumers greater choice
different views and goals.
4. There are many other reasons why public and private
organizations are adopting OSS/FS, including:
● Security
● Reliability and stability
● Developing local software capacity

ISSUES IN OSS/FS
❖ THE ISSUES INCLUDE
(1) Licensing
(2) Copyright and intellectual property
(3) Total cost of ownership (TCO)
OPEN SOURCE SOFTWARE DEFINITION (4) Support and migration
● Open-source software is any software satisfying the (5) Business models
open software initiative's definition. (6) Security and stability

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

❖ TOTAL COST OF OWNERSHIP

(1) TCO is the sum of all the expenses directly related to
the ownership and use of a product over a given period of
time
(2) The popular myth surrounding OSS/FS is that it is
always free as in free of charge

❖ NO TRUE OSS/FS APPLICATION CHARGES A

LICENSING FEE FOR USAGE, THUS ON A
LICENSING COST BASIS OSS/FS APPLICATIONS
OSS/FS APPLICATIONS
ARE ALMOST ALWAYS CHEAPER THAN
PROPRIETARY SOFTWARE ● Many OSS/FS alternatives exist to more commonly
known applications
● These are likely to include the following:
SUPPORT AND MIGRATION OF OSS/ FS a. Operating system
● Making an organization-wide change from proprietary b. Web browser
software can be costly 💡 e.g. tsu portal c. E-mail client
● Sometimes the costs will outweigh the benefits d. Word processing or integrated office suite
● Some OSS/FS packages do not have the same level of e. Presentation tools
documentation, training, and support resources as their
common proprietary equivalents WEB BROWSER AND SERVER: FIREFOX AND
● May not fully interface with other proprietary software APACHE
being used by other organizations with which an ● An OSS/FS application, the Apache HTTP server,
organization may work (e.g., patient data exchange developed for Unix, Windows NT, and other platforms, is
between different healthcare provider systems currently the top Web server
● Migrating from one platform to another should be a. Apache has dominated the public Internet Web
handled using a careful and phased approach server market ever since it grew to become the
number | Web server in 1996
SECURITY AND STABILITY OF OSS/FS b. Apache began development in early 1995
c. Is an example of an OSS/FS project that is
● There is no perfectly secure operating system or maintained by a formal structure, the Apache
platform Software Foundation
● Factors such as development method, program ● Firefox (technically Mozilla Firefox) is an OSS/FS
architecture, and target market can greatly affect the graphical Web browser, designed for standards
security of a system and consequently make it easier or compliance, and with a large number of browser features
more difficult to breach a. It derives from the Mozilla Application Suite
● There are some indications that OSS/FS systems are b. Aims to continue Netscape Communicator as
superior to proprietary systems in this respect an open project
● The security aspect has already encouraged many
public organizations to switch or to consider switching to
WORD PROCESSING OR INTEGRATED OFFICE
OSS/FS solutions
SUITE: OPENOFFICE (OFFICE PRODUCTIVITY
● Among reasons often cited for the better security record SUITE)
in OSS/FS is the availability of the source code (making it
● While OSS/FS products have been strong on the server
easier for vulnerabilities to be discovered and fixed)
side, OSS/FS desktop applications are relatively new and
few
OPEN-SOURCE LICENSING ● OpenOffice (strictly OpenOffice.org), which is based on
Types of OSS/FS licenses the source code of the formerly proprietary StarOffice, is
a. A large and growing number of OSS/FS licenses exist an OSS/ FS equivalent of Microsoft Office, with most of its
b. The OSI Web site currently lists over 60 features
c. The two main licenses are the GNU GPL and the ● It supports the ISO/IC standard OpenDocument Format
Berkeley system distribution (BSD)-style license (ODF) for data interchange as its default file format, as
d. It is estimated that about 75 percent of OSS/FS well as Microsoft Office formats among others
products use the GNU GPL GNU – General public license ● As of November 2009, OpenOffice supports over 110
(1) This license is designed to ensure that user languages 5. It includes:
freedoms a. A fully featured word processor
under the license are protected in perpetuity b. Spreadsheet
(2) Users are allowed to do almost anything they c. Presentation software
want to a GPL program
(3) The conditions of the license primarily affect
the user when it is distributed to another user. SOME OTHER OSS/FS APPLICATIONS
❖ BIND

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● The Berkeley Internet Name Domain (BIND) is a domain 1. This could lead to lower cost and higher quality systems
name system (DNS) server, or in other words, an Internet that are more responsive to changing clinical needs
naming system 2. OSS/FS could also solve many of the problems health
● Internet addresses, such as www.google.com or www. information systems currently face including lack of
openoffice.org, would not function without DNS interoperability and vendor lock-in, cost, difficulty of
● These servers take these human-friendly names and record and system maintenance given the rate of change
convert them into computer-friendly numeric and size of the information needs of the health domain,
Internet protocol (IP) addresses and vice versa and lack of support for security, privacy, and consent
3. This is because OSS/FS more closely conforms to
standards and its source code open to inspection and
adaptation
4. A significant motive for supporting the use of OSS/FS
and open standards in healthcare is that
interoperability of health information systems requires the
consistent implementation of open standard
5. Open standards, as described by the International
Telecommunications Union (ITU), are made available to
the general public and developed, approved, and
maintained via a collaborative and consensus-driven
process.
❖ PERL
Bowen et al. summarize a number of advantages that
● Practical Extraction and Reporting Language (Perl) is a open-source software offers when compared with
high-level programming language that is frequently used proprietary software, including, but not limited to, the
for creating CGI (common gateway interface) following:
programs
● Ease of modification and or customization
● Started in 1987, and now developed as an OSS/FS
● The large developer community and its benefits
project
● It was designed for processing text and derives from the ● Increased compliance with open standards
C programming language and many other tools and ● Enhanced security
languages ● Increased likelihood of source code availability in the
event of the demise of the vendor or company
❖ PHP ● Easier to adapt for use by healthcare students
● PHP stands for PHP Hypertext Preprocessor ● And the flexibility of source code to adapt to research
● The name is an example of a recursive acronym (the effort
first word of the acronym is also the acronym), a common
practice in the OSS/FS community for naming
applications OSS/FS HEALTHCARE SOFTWARE
● PHP is a server-side, HTML-embedded scripting INDIVO
language used to quickly create dynamically generated
a. Is the original personal health platform
Web page
b. Enable an individual to own and manage a complete,
secure, digital copy of their health and wellness
❖ LAMP
information
● The Linux, Apache, MySQL, PHP/Perl/Python (LAMP)
c. Integrates health information across sites of care and
architecture has become very popular as a way of
over time
affordably deploying reliable, scalable, and secure Web
d. Is free
applications
e. Open-source
● The “P” in LAMP can also stand for either PHP or Perl
f. Uses open, unencumbered standards and
or Python c. MySQL is a multithreaded, multiuser, SQL
g. Includes those of the SMART Platform project
(Structured Query Language) relational database server,
h. Is actively deployed in diverse settings
using the GNU GPL
1. Integrates health information across sites of care and
over time
j. Is actively deployed in diverse settings

INDIVO
a. Is the original personal health platform
b. Enable an individual to own and manage a complete,
secure, digital copy of their health and wellness
information
OSS/FS HEALTHCARE APPLICATION
c. Integrates health information across sites of care and
It is suggested that in healthcare, as in many other areas,
over time
the development of OSS/FS may provide much needed
d. Is free
competition to the relatively closed market of commercial,
e. Open-source
proprietary software and thus encourage innovation:
f. Uses open, unencumbered standards and

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

g. Includes those of the SMART Platform project a. Is developing a range of electronic personal and
h. Is actively deployed in diverse settings clinician health record applications
i. Integrates health information across sites of care and b. Uses open source software
over time c. Uses health industry standards including
j. Is actively deployed in diverse settings (1) Unified Medical Language Systems (2) Health Level 7

SMART PLATFORMS PROJECT SMARTIE

a. The project is a. Sought to offer a comprehensive collection, or suite
(1) An open source (1) Selected medical software decision tools
(2)Developer-friendly application programming interface (2) Ranging from clinical calculators (i.e., risk factor
(3) Is an extensible medical data representation scoring) tools (i.e., acute abdominal pain diagnosis)
(4) Standards-based clinical vocabularies
b. Allows healthcare clients to make their own OPENECG
customizations a. Sought to consolidate interoperability efforts in
c. These apps can then be licensed to run across the computerized electrocardiography at the European and
installed base international levels
b. Encourages the use of standards
GNUMED c. The project aimed to promote the consistent use of
format and communications standards for
a. Builds free, liberated open source Electronic Medical
computerized ECGs
Record software in multiple languages to assist and
d. Pave the way toward developing similar standards
improve longitudinal care (specifically in ambulatory
for
settings, i.e., multiprofessional practices and clinics)
(1) Stress ECG (2) Holter ECG (3) Real-time monitoring
b. It is made available at no charge
c. Is capable of running on
(1) GNU/Linux (2) Windows (3) Mac OS
It is developed by a handful of medical doctors and
programmers from all over the world

OPENMRS
a. OpenMRS® is a community-developed, open source
enterprise EMR system platform
b. Of particular interest to this project is supporting efforts
to actively build and/or manage health systems
in the developing world to address
(1) AIDS (2) Tuberculosis (3) Malaria
c. Their mission is to foster self-sustaining health IT
implementations in these environments through peer
mentorship
PICNIC
d. Proactive collaboration, and a code base equaling or
surpassing any proprietary equivalent a. From Minoru Development
b. Was designed to help regional health care providers to
develop and implement the next generation of
DISTRICT HEALTH INFORMATION SYSTEM
(1) Secure
a. The District Health Information System (HIS) provides (2) User-friendly regional healthcare networks
for data entry, report generation, and analysis. (3) To support new ways of providing health and
b. It is part of a larger initiative for healthcare data in social care
developing countries, called the Health Information
System Program (HISP)
FREE/LIBRE/OPEN SOURCE SOFTWARE: POLICY
SUPPORT (FLOSSPOLS)
OPENEHR
a. Aim to work on three specific tracks
a. The Foundation is an international, not-for-profit (1) Government policy toward OSS/FS
organization working toward the development of (2) Gender issues in open source
interoperable, lifelong EHRs (3) The efficiency of open source as a system for
b. It is also looking to reconceptualize the problems of collaborative problem solving
health records through an understanding of the b. It should be noted that many of these are R&D projects
(I) Social (2) Clinical (3) Technical challenges of electronic only
records c. Not guaranteed to have any lasting effect or uptake
beyond the lifespan of the project
TOLVEN

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BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

LESSON 6: DATA AND DATA PROCESSING - FINALS (7) Logic data are limited for example Yes or No, True or
False, 1 or 2, and On or Of
THE NELSON DATA TO WISDOM CONTINUUM
DATABASE MANAGEMENT SYSTEM (DBMS)
● The Nelson data to wisdom continuum moves from data
DBMSs are computer programs that are used to:
to information to knowledge to wisdom with constant
(1) Input
interaction within and across these concepts as well as
the environment. (2) Store
● Data are raw, uninterrupted facts without meaning (3) Modify
● Information is facts with meaning (4) Process
● Knowledge is understanding the information (5) Access data in a database
● Wisdom is knowledge used to make appropriate
decisions and acting on those decisions A functioning DBMS consists of three interacting parts
● The data
COMMON APPROACHES TO ORGANIZING DATA ● The designed database
INCLUDE ● The query language that you use to access the data

a. Sorting
b. Classifying ADVANTAGES OF AN AUTOMATED DBMS INCLUDE
c. Summarizing ● Decreased data redundancy
d. Calculating ● Increased data consistency
● Improved access to all data
DATA STATES
a. Three states of digital data
● Data at rest—data on a storage device DBMS FUNCTION—STORE, UPDATE, RETRIEVE,
REPORT
● Data in use—data that a database program is reading or
(1) Store the data
writing
(2) Update the records
● Data in motion—moving between applications, over the
(3) Provide easy retrieval of the data
network, or over the Internet
(4) Permit report generation
DATABASES
a. An organized collection of related data In 1987, John Zachman described database models
b. The possibility of finding databases depends on the four through the framework of information architecture
important factors Hay identified six views
(1) The data naming (indexing) and organizational ● Ballpark
schemes ● Owner’s
(2) The size and complexity of the database ● Designer’s
(3) The type of data within the database ● Builder’s
(4) The database search methodology ● Out-of-context
● Actual system
TYPES OF DATA
Data are classified in terms of how the users will use these THE FOLLOWING DESCRIBES THREE PRIMARY
data: VIEWS OR MODELS
● This is the conceptual view of the data ❖ CONCEPTUAL MODEL
● Conceptual data classifications may include financial ● Identifies the entities and the relationship between the
data, patient data, or human resource data entities.
● The conceptual view of the data has a major impact on ❖ LOGICAL MODEL
how the designer indexes the data ● Defines the structure of the whole database in terms of
the attributes of the entities, their relationships, as well as
❖ DATA ARE CLASSIFIED BY THEIR a primary key for each entity.
COMPUTERIZED DATA TYPE
❖ PHYSICAL MODEL
(1) Data can be numbers or letters, or a combination of
● Includes each of the data elements and the relationship
both
between the data elements, as they will be physically
(2) The designer uses this classification to build the
stored on the computer.
physical database within the computer system
(3) It identifies the number of spaces necessary to capture
DATA TO INFORMATION
each data element and the specific functions that the
system can perform on these data Common database operations
(4) Alphanumeric data include letters and numbers in any ❖ DATA INPUT OPERATIONS
combination ● Input new data
(5) Numeric data can be used to perform numeric ● Update data
functions including addition, subtraction, multiplication, ● Change or modify data
and division
(6) Date and time are special types of numeric data ❖ DATA PROCESSING PROCESSES

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● The purpose is to extract information ● Data stewardship is the aspect of data governance that
● Discover new meanings focuses on providing the appropriate access to users,
● Reorder data helping users to understand the data, and taking
ownership of data quality
❖ DATA OUTPUT OPERATIONS ● Without appropriate stewardship, even the best
● Online and written reports infrastructures become underutilized and poorly
● Processed data as charts and graphs understood by knowledge workers who could be
generating value with the data every day”
❖ DATA WAREHOUSES ● A data steward does not own the data but ensures its
● A large collection of data imported from several different quality
systems into one database ● The data steward is the “keeper of the data,” not the
● The source of the data includes not only internal data “owner of the data”
from the institution
● Can also include data from external sources The National Committee on Vital and Health Statistics
● Smaller collections of data are data marts (NCVHS) under the authorship of Kanaan and Carr
(1) One might develop a data mart with the issued a primer titled “Health Data Stewardship:
historical data of a department or a small What, Why, Who, How: An NCVHS Primer”
group of departments In this primer four key principles were identified with
(2) One might also develop a data mart by implications for nurses:
exporting a subset of the data from the data ● Individual rights to access and to correct their own
warehouse
data. This includes building trust by making the
data transparent and by requiring consent for this
● Purposes of a data warehouse
(1) Spares users from the need to learn several data use
different applications ● A data steward with responsibilities for data quality,
(2) Makes it possible to separate the analytical for identifying the purpose in using specific data,
and operational processing application of good statistical practices, and so forth
(3) Provides an architectural design for the data ● Appropriate safeguards and controls to ensure
warehouse that supports decisional information confidentiality, integrity, and protection of the data
needs from unauthorized access, use, or disclosure
(4) The user can slice and dice the data from
● Policies for appropriate use and accountability for
different angles and at different levels of detail
those using the data
● Functions of a data warehouse
(1) Must be able to extract data from the various DATA/INFORMATION TO KNOWLEDGE (KDD)
computer systems and import those data into the ● Traditional methods of retrieving information from
data warehouse databases no longer work with the sheer amount of data
(2) Must function as a database able to store and that the healthcare industry is producing
process the data in the database ● One can generate, and store data far faster than one
(3) Must be able to deliver the data in the can analyze and understand it
warehouse back to the users in the form ● We can refer to the process of extracting information
of information. and knowledge from large-scale databases as knowledge
discovery and data mining (KDD)
DATA ANALYSIS AND PRESENTATION ● The purpose of data mining is to find previously
❖ ANALYTICS unknown patterns and trends that will assist in providing
● The process one uses to make realistic, quality quality care, predicting best treatment choices, and
decisions using the available data utilizing health resources in a cost-effective manner
● This means that data and its analysis guides the
decision-making process A TRADITIONAL APPROACH TO THE KDD
● Analysis involves a systematic examination and DEVELOPMENT INCLUDES A SEVEN-STEP
evaluation of data to uncover interrelationships within PROCESS
the data, thereby producing new insights and information a. (1) Task analysis
● The process usually involves breaking the data into b. (2) Data selection
smaller parts to better understand the area of concern c. (3) Data cleaning
● The term business intelligence (BI) when the data d. (4) Data transformation
includes administrative data that relates to the e. (5) Data mining
day-to-day operation of the institution, as well as strategic f. (6) Pattern interpretation and evaluation
or long-range planning data. g. (7) Deployment

❖ DATA QUALITY A traditional approach to the KDD development

The concept of a data steward is appropriate when includes a seven-step process
thinking about who is responsible for the data in a data Bagga and Singh propose a three-step process
warehouse (1) Pre-processing
(2) Data mining

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

(3) Post processing LESSON 7: STANDARDIZED NURSING

TERMINOLOGIES
WISDOM
● A standardized nursing terminology consists of nursing
❖ KNOWLEDGE APPLICATION
concepts that represent the domain of nursing. A nursing
● Decision support systems produce knowledge from
terminology must include standardized nursing data that
information
represent the essential building blocks for nursing
● Expert systems use that knowledge base and transform
practice. Such nursing data are critical to the development
it to produce wisdom
of data sets that can be used for analysis and integrated
● With the emergence of supercomputers in the 1990s
with the data of other healthcare disciplines. The
nursing had a unique opportunity to further nursing’s standardized nursing data sets might also serve as
knowledge and practice research data to advance the science of nursing practice.

A proposed theory of nursing knowledge/wisdom uses the

formula NKW (IB) = P, where BACKGROUND
(1) NK is nursing knowledge ❖ 1. HISTORICAL EVENTS
(2) W is wisdom ● Terminological work within the nursing professions has
(3) “IB is the individual nurses integration and been ongoing for many years.
synthesis of nursing knowledge through ● As early as 1859, Florence Nightingale named her six
cognitive, psychomotor, and affective/spiritual canons of care as “what nurses do” in her text Notes
domain of self” on Nursing
(4) P represents the breadth and depth of practice (1) She considered the six canons to be
measures of “good standards” essential for
the practice of nursing
❖ EXPERT SUPPORT/SYSTEM
Expert systems represent the present and future In 1970 the American Nurses Association (ANA)
vanguard of nursing informatics approved the nursing process as the standard of
professional nursing practice
Some of the advantages of expert systems include: Yura and Walsh identified the nursing process as
(1) Provide a solution more quickly than humans representing an orderly, systematic orientation to
(2) Reduce waste and cut costs addressing a client's condition
(3) Improve patient care by sharing the (1) They described the nursing process as providing
knowledge and wisdom of human experts the framework for gathering patient care data
(2) Beginning with the assessment phase which also
Expert systems have four main components: identified the client’s conditions, which they referred
● Natural language to as nursing diagnoses, through goal designations
● Knowledge base and the planning of nursing activities, and ending with
● A database evaluation
● An inference engine as well as a means of capturing (3) Also identified their “34 Human Needs
expert knowledge and an explanation to the end Assessment” which they outlined with the “
user as to the rationale behind the recommendation Proposed Nursing Diagnoses”

❖ EVIDENCE-BASED PRACTICE HEALTH TERMINOLOGIES

a. The concept of evidence-based practice is
● During this same time period in the United States
widely accepted across each of the healthcare
computer technology was being introduced in hospitals,
disciplines
albeit primarily for administrative applications.
b. The reality of providing evidence-based care at
the point of care is often an elusive goal
● The International Classification of Diseases (ICD)
c. With the advent of big data and data analytics
(1) Was being used internationally for the reporting
techniques along with expert systems capable of
of mortality and morbidity statistics.
analyzing unstructured data and using natural
(2) Was also being used by the U.S. federal
language to present the resulting conclusions,
government for payment of healthcare services.
real time evidence-based practice is a potential
reality
Other hospital specialty departments initiated different
d. But for nursing to achieve this potential reality
terminologies for payment of their specific services
nursing data, information, knowledge, and
such as:
wisdom must consistently be included in building
● Physician’s Current Procedural Terminology (CPT) for
automated healthcare information system
surgical procedures
● Logical Observation Identifiers Names and Codes
(LOINC) for laboratory tests
During this period, however, nursing did not have any
recognized terminologies to:
(1) Characterize their patients

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

(2) Describe nursing interventions Additional criteria applying to concepts themselves

(3) Support documentation include being:
(1) Atomic-level (single concept coded as a single
Subsequent nursing terminology development was data element)
motivated by a number of factors (2) Non-redundancy (unique identifier)
(1) The need to quantify nursing resources (3) Non-ambiguity (explicit definition)
(2) The introduction of the electronic health record in (4) Concept permanence (cannot be duplicated)
healthcare facilities (5) Compositionality (ability to combine concepts to
(3) The development of knowledge bases and growth form new unique concepts)
of evidence-based nursing practice (6) Synonymy (a single concept supports multiple
terms or synonyms)
ADVANCED TERMINOLOGY SYSTEMS IN NURSING
❖ NURSING REQUIREMENTS CONCEPT ORIENTATION
● The HIT and EHR systems that support functionality In order to appreciate the significance of concept-oriented
such as decision support may require more granular (i.e., approaches, it is important to a
less abstract) data than may be found in today’s (1) First understand the definitions of and
interface terminologies. relationships among things in the world (objects)
● More advanced terminology systems are needed that (2) Our thoughts about things in the world (concepts)
allow for much greater granularity through controlled (3) The labels we use to represent and communicate
composition while avoiding a combinatorial explosion of our thoughts about things in the world (terms)
precoordinated terms. (4) The coded data elements needed to represent and
be processed by computer

FORMAL TERMINOLOGIES The International Organization for Standardization

● Advanced terminology systems such as ICNP and (ISO) International Standard ISO 1087-1:2000
SNOMED CT are a focus of today’s harmonizing efforts. provides definitions for elements that correspond to
● Both terminologies facilitate two important facets of each vertex of the triangle
knowledge representation for HIT and EHR systems that ❖ CONCEPT
support clinical care: (i.e., thought or reference): Unit of knowledge created by
(1) Describing concepts a unique combination of characteristics—a characteristic is
(2) Manipulating and reasoning about those an abstraction of a property of an object or of a set of
concepts using computer-based tools objects
❖ OBJECT
Advantages resulting from the first facet—describing (i.e., referent): Anything perceivable or conceivable
concepts—include: ❖ TERM
● Non-ambiguous representation of concepts (i.e., symbol): Verbal designation of a general concept in
● Facilitation of data abstraction or de-abstraction a specific subject field—a general concept corresponds to
without loss of original meaning (i.e., “loss-less” data two or more objects which form a group by reason of
transformation) common properties.
● Non-ambiguous mapping among terminologies
MODEL STRUCTURES
● Data reuse in different contexts
● A terminology model is a concept-based representation
● Data interoperability across settings
of a collection of domain-specific terms (data elements)
that is optimized for the management of terminological
CHARACTERISTICS OF ADVANCED definitions
TERMINOLOGIES ● It encompasses both “schemata” and “type
● Healthcare terminologies suitable for implementation in definitions”. Schemata incorporate domain-specific
HIT systems have been studied by numerous experts who knowledge about:
have provided an evolving framework that enumerates (1) The typical constellations of entities
the recommended criteria. (2) Attributes
(3) Events in the real world
● The characteristics apply to any terminology being used
in the healthcare industry as well as for a nursing REFERENCE TERMINOLOGY MODELS FOR
terminology NURSING
It is clear that such terminologies
● In 2003, the ISO which is responsible for identifying
● Must be concept-oriented (with explicit semantics) international standards for Health Informatics passed ISO
● Rather than based on surface linguistics 18104:2003 Integration of a Reference Terminology
Model for Nursing which covers two Reference
Other recommended criteria for terminologies include Terminology Models
● Domain completeness (1) One for Nursing Diagnoses
● A polyhierarchical organization (2) One for Nursing Actions

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

● The standard was developed by a group of experts ● Their properties (also referred to as relations, slots,
within ISO Technical Committee 215 (Health Informatics) roles, or attributes) such as Web Ontology
Working Group 3 (Semantic Content), including Language (OWL)
representatives of
(1) The International Medical Informatics ICNP AS A TERMINOLOGY
Association– Nursing Informatics Working Group ● The ICNP is a major product of the International Council
(IMIA-NI) of Nurses (ICN), Geneva, Switzerland
(2) The International Council of Nurses (ICN) ● It is a formal terminology for nursing practice and is used
to represent
DEVELOPMENT OF ISO 18104:2003(HEALTH (1) Nursing diagnosis (2) Outcomes (3)
INFORMATICS) Intervention
● The primary motivation for an international nursing
● The standard was developed by a group of experts terminology involves sharing and comparing nursing data
within ISO Technical Committee 215 (Health Informatics) across
Working Group 3 (Semantic Content), including (1) Settings (2) Countries (3) Languages
representatives of
(1) The International Medical Informatics These data can be used to:
Association– Nursing Informatics Working Group (1) Support clinical decision making
(IMIA-NI) (2) Evaluate nursing care and patient outcomes
(2) The International Council of Nurses (ICN) (3) Develop health policy
(4) Generate knowledge through research
● The development of ISO 18104:2003 was motivated in
part by a desire to harmonize the plethora of nursing
terminologies in use around the world. NURSING MINIMUM DATA SET (NMDS)
● The development of ISO 18104:2003 was intended to ❖ NURSING MINIMUM MANAGEMENT DATA SET
be “consistent with the goals and objectives of other a. NMDSs such as the U.S. NMDS often address “
specific health terminology models in order to provide a intensity”
more unified reference health model” b. No current NMDS addresses the essential breadth of
contextual variable
● Potential uses identified for the terminology models c. The 18 NMMDS elements are organized into 3
included to: categories:
(1) Facilitate the representation of nursing diagnosis and (1) Environment
nursing action concepts and their relationships in a (2) Nursing care resources
manner suitable for computer processing (3) Financial resources
(2) Provide a framework for the generation of
compositional expressions from atomic concepts within a ❖ THESE DATA, IN COMBINATION WITH ACTUAL
reference terminology PATIENT DATA IDENTIFIED IN THE NMDS,
(3) Facilitate the mapping among nursing diagnosis and SUPPORT
nursing action concepts from various terminologies (1) Clinical decision making
(4) Enable the systematic evaluation of terminologies and (2) Management decisions regarding the
associated terminology models for purposes of quantity, quality, and satisfaction of personnel
harmonization (3) Costs of patient care
(5) Provide a language to describe the structure of nursing (4) Clinical outcomes
diagnosis and nursing action concepts in order to enable (5) Internal and external benchmarking
appropriate integration with information models
SUMMARY AND IMPLICATIONS FOR NURSING
❖ IT IS INTENDED TO BE OF USE TO THOSE WHO
DEVELOP ● The majority of nursing terminologies that exist today
were developed originally many years ago and were
● Coding systems
primarily designed for the manual documentation of
● Terminologies
nursing practice.
● Terminology models for other domains ● However, with the heavy emphasis on automation, the
● Health information models emergence of HIT and EHR systems, and the entrance of
● Information systems the federal government mandating technological
● Software for natural language processing regulations, the configuration of hospitals’ HIT and EHR
● Markup standards for representation of healthcare systems have changed to a more business model.
documents ● The developers of nursing and healthcare terminologies
and informatics scientists have made significant progress
● From decades of nursing language research, there
ONTOLOGIES
exists an extensive set of terms:
Terminology models may be formulated and elucidated in
◦ Describing patient problems
an ontology language which represents
◦ Nursing interventions and actions
● Classes (also referred to as concepts, categories,
◦ Nursing-sensitive patient outcomes
or types)

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 TARLAC STATE UNIVERSITY
BACHELOR OF SCIENCE IN NURSING BATCH 2026
NCM 110 - NURSING INFORMATICS LAB
ELGEENE E. DIZON, RN, LPT, MAED-PHYSCI

◦ Robust information models, such as the NMDS, to guide

the collection of those terms

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