Abstract
Nursing involvement in health informatics, which originated in the 1960s, was driven by pioneers based in North America and Europe. At that time, the complex requirements for safe and efficient clinical practice were beyond the technical capabilities of affordable computers (Hoy and Hyslop, 1995). Nowadays, the use of powerful digital tools to deliver effective patient care is ubiquitous, and electronic health records are found in many hospitals across the globe. The reviewed study from Iran offers important insights into care in a geographical location that is rarely explored in the nursing research literature. It gives us an interesting gaze with which to explore informatics competencies of nurses in Tabriz University hospitals.
Seeking relevant clinical data and managing health information has been a core domain of professional caring from the early days of Florence Nightingale. However, in the 21st century, nurses not only process and safely share many more types of information but also rely much more on access to relevant, timely and credible information, when and where they see their patients. This may include remote consultations using myriad platforms and devices. In order to continue to offer optimal care, nurses must gain the competencies that enable them to master the technology and understand the benefits, as well as the risks of using systems that may not be fit for practice. It is therefore critical, as suggested by the authors, that informatics is embedded in the undergraduate nursing curriculum.
The Holy Grail of an integrated and shared health and care information system is to enable users to record core data once, and use information entered by others, without losing the original meaning and clinical significance. Interoperability relies on agreed minimum datasets or clinical templates, as well as comprehensive nursing terminology that builds on and contributes to the unique body of nursing knowledge. Similarly, in research we should consider using validated tools and recognised frameworks to guide data collection and analysis. By so doing, readers can critique findings and identify whether the research was robust, and conclusions can be drawn through comparison with relevant studies. In the case of nursing informatics competencies, it is surprising that the authors opted to create a new data collection tool to overcome the language barrier, rather than translating into Persian existing frameworks they themselves referenced.
It is nevertheless encouraging to see that the results reported by this study affirm the critical role of informatics competencies on patient outcomes, ‘… [more so] than the information systems themselves’. Indeed, the possibilities harboured in future developments of digital health and care are exciting, but we should not be seduced by the technology itself. A lot of research and development is still needed to ensure the right systems are developed and implemented to deliver a safe and robust tool for all users. Nursing, being the largest segment of the healthcare workforce using clinical systems, should drive current developments and evaluation efforts. This call, as demonstrated in the reviewed study, should now have a global echo.