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Morning Keynote NI2009 07.01.09 (0800-0845) July 1, 2009

Posted by Scott Erdley in conference, health informatics, IMIA, Keynote, NI2009, nursing informatics, speaker.
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Evelyn Hovenga titled “Milestones of the IMIA-NI History and Future”. As this is closing day, as well as the session moved up 1/2 hour, the number of attendees is a bit sparse. Evelyn’s presenting style is to expound on the slide content. Opening setting reviewed is ‘having a vision’ begun in 1987 in Stockholm – nursing competencies. Key activities cited include reference term model, with ICN, begun in ’99 among others. Key facets of ’09 vision of IMIA-NI include EHR (using & informing nursing knowledge), clinical data standards dev’t, decision support & ebc options among others. Reviewed what IMIA-NI promotes (I’m guessing what she showed is from the website (http://www.imiani.org/). She discusses a national e-health record using a graphic (spoke-wheel design) with phr as the hub. Next up is discussion of integrated ehr (see ISO TR 20514:2002 Health Informatics – EHR Scope, Definition and Practice). EHR needs to be perceived as foundation of sustainable health system infrastructure, therefore requiring adoption of a set of HI standards along with comprehensive governance infrastructure. A description of ehr architecture is drawn from the open ehr foundation’s content. The bottom line is discrepancy between model (nicely structured) and proprietary systems with different reference models. Graphic of ehr structure is available at open ehr website (http://www.openehr.org/home.html). Clinical knowledge manager is next up and again seems to be also a component of the open ehr website (see ckm (clinical knowledge maanger) at site in previously mentioned link). Clinical content models, and the need for such, outlined at this point and the need for said models to relate to the structure (then dictates how data is used). Clarity is necessary for functionality – key point stressed by Evelyn.

Clinical knowledge repositories discussed with national examples cited (Singapore & Sweden with federated approach); need for repository hierarchy versus ‘flat set’ (need for interoperable for sharing via silo without sharing).  Terminology needs to be in context and should have national governance.  Future directions of IMIA-NI includes leadership for dev’t of standards of nursing clinical content knowledge. Collaboration with ICN needed to move forward with mindmaps of content, documentation of nursing processes, clinical templates (see Derek Hoy’s work in Scotland) and global nursing knowledge governance infrastructure. Other items needed to move forward range from national mtgs, recruitment of expert nurses and sharing / participating via technology and in-person. That’s all for now.

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