6.    E-healthcare Education

	Project 1.	Education of Health Professionals in Informatics
	Project 2.	Application Software for Public Health Nursing Practice

A.    Project Proposals

Professional competence can be defined as "having the attributes necessary for performance of a job to the appropriate standards". Competence is viewed as a simultaneous integration of the knowledge, skills, and attitudes required for the performance in a designated role in a particular setting. Competency-based education is specific to the learner's requirements to do a given job, and is currently used by many healthcare facilities to achieve competence in professional roles. Changes in the workplace command corresponding educational processes to facilitate those changes. This is a exceptionally important issue when one considers: (a) the requirements of the processes being implemented in the context of health sector reform in which many developing countries are presently engaged and (b) the development of information-based health functions in the healthcare system of Brazil.

The current generation of students in the health professions are taking advantage of the increasing use of computer technology in the society in general and in their academic environment, but health professionals already working in healthcare settings will have to gain this knowledge through continuing education channels or staff development programs. Those involved in staff development face the challenge of educating staff of various levels of computer and information literacy.

The goal of this Project is to promote and sustain the development of health professionals in the area of Information Systems and Technology in Health. Considering the increasing penetration of information technology in the health sector, the curricula will equip health professionals at all levels and in all roles to become skilled in the use of computer technology in order to support managerial functions, clinical decision making, and delivery of care. The project will have the following activities:

1. Develop training syllabi and courseware materials in the following areas: (a) Basic IT for health professionals, (b) Establishing a Health Informatics Training Program, (c) Leadership and capacity building in the area of IT, (d) Implementation of data-related standards.
2. Produce CD-ROM and Internet-based educational and training materials in collaboration with Brazilian academic institutions.

Nurses are the largest single group of health professionals who directly influence the quality and outcomes of most health services provided. Nurses influence a wide range of healthcare services from clinical care of individual patients to the administration of health services and the management of health problems at all levels of complexity, including public health and community care, occupational and home care, and school health. Nurses depend on accurate and timely access to appropriate information to perform the great variety of professional activities involved in patient and community care. Nursing information integrates technical knowledge, quality control, and the clinical and administrative documentation of services provided. Nurses need information about available resources, science development, and patient needs to facilitate decision making, for program planning, for the operation and supervision of clinical and management interventions, and to evaluate care outcomes.

In developing countries, low priority is given to health records, especially in the area of community health, because incentives such as legal, reimbursement, accreditation, and other regulations that require an appropriately completed health record do not exist or are not enforced. Less-qualified clinical staff, such as nurse assistants and aides, that usually represent the bulk of health professionals in developing countries, receive only a basic level of training. This level of training does not enable them to deliver and document care appropriately and to follow the Nursing Process - a systematic problem-oriented decision making process of organizing and delivering nursing care. These caregivers could profit from and enhance their practice by the availability of even simple knowledge bases and decision-support tools.

In Latin America and the Caribbean these issues are magnified by:

• the high demand for nursing care,
• insufficient number of direct care personnel,
• geographical isolation,
• wide disparity in means, levels, and quality of professional education and performance,
• absence of documentation in standard format precluding data extraction for analysis,
• absence of benchmarking methodologies and tools for measuring quality and cost-effectiveness of nursing care, and
• lack of knowledge and skills relative to information technology.

The goal of this project is to improve the use of information in public health nursing by the introduction of a patient-oriented information technology application. Based on the experience and excellent results obtained in the use of public-domain software (e.g., Epi-Info) in the support of primary care health practice, this project will develop a generic client-server patient-oriented primary care nursing record combined with primary care nursing practice support tools. The products of the project will be focused toward public health and will be available at no cost to users. Deliverables include (a) a multilingual (Portuguese, Spanish, English) stand-alone / networked-ready Public Health Nursing Record Assistant (PHNRA) comprising a set of computer-based tools and applications, and (b) a distribution and training program to promote the use of the PHNRA application.

Activities:

1. Development of specifications (functions, data content, practice tools required) for a primary care nursing record and nursing practice support tools focused toward public health in collaboration with national academic centers and local community health workers and professionals.
2. Identification and contract with a systems developer.
3. Development and laboratory testing of application suite and recoding as needed.
4. Field testing of beta-version of application suite and recoding as needed.
5. Roll-out of distribution version of PHNRA application suite.
6. Survey to evaluate utilization and requirements for eventual future expanded application suite and other correlated projects.
7. Development of systems and user manuals, training modules, and application distribution strategy.

B.    Participating Organization

The Institute for Johns Hopkins Nursing

(WHO Collaborating Center for Information Systems in Nursing Care)

525 North Wolfe Street

Baltimore, MD 21205-2110

USA

C.    Contacts

Roberto J. Rodrigues, MD

Regional Advisor, Health Services Information Technology

Essential Drugs and Technology Program

Division of Health Systems and Services Development

Pan American Health Organization / World Health Organization

525 Twenty-third Street, N.W.

Washington, D.C. 20037-2895

USA

Tel: +1(202)974-3826

Fax: +1(202)974-3610

mailto:rrodrigues@paho.org

Kathleen Hartman Sabatier, MS, RN

Director, The Institute for Johns Hopkins Nursing

(A joint venture between The Johns Hopkins University and the School of Nursing and a WHO Collaborating Center for Information Systems in Nursing Care.)

525 North Wolfe Street #533

Baltimore, MD 21205-2110

USA

Tel: +1 (410) 614 3160

Fax: +1 (410) 614 8972

mailto:ksabatier@son.jhmi.edu

Marion J. Ball, Ed.D.

Vice President, Clinical Solutions

Healthlink, Incorporated

2 Hamill Road

Quadrangle 359 West

Baltimore, MD 21210

USA

Tel: +1 (410) 433 7110

Fax: +1 (410) 433 7419

mailto:marion.ball@healthlinkinc.com

mailto:marionball@earthlink.net

http://www.healthlinkinc.com/

D.    Curricula

Detailed curriculum vitae of the above participants of this projects are available upon request.