Question and Answer with Oliver De la Paz
(Fraser Health Authority Health Informatics-Advanced Clinical Systems Coordinator)

 

 

Q: What led to you to working in nursing informatics?

 

Here's a little history of me:

I graduated from the University of Victoria in 2000 and started working in the hospital right away. At the time there were so many vacancies, overtime was the norm and we often covered more patients than usual because a shift couldn't be covered.  I worked orthopaedics for 5 years. 

 

At the time, informatics wasn't something people heard of except for maybe a paragraph in a textbook. That's all I knew of it. Even though I didn't have the formal knowledge of it, I think I naturally understood the concepts behind it as I was always interested in technology as a tool. I always say my opportunity in the field came because I broke my arm.

 

I had a cast from my fingers to my elbow so I couldn't work.  I also didn't have enough sick time to cover the time I needed off and with a new mortgage, unpaid leave was not an option.  I asked my manager (begged is probably more accurate) if there was anything I could do for hours. She got me doing chart audits for a few hours/week. Then she said she was thinking of keeping some patient information on the computer so the nurses wouldn't have to spend so much time rewriting things every day. So created a worksheet for the staff that they updated once/shift. I think it ended up saving every nurse 15 minutes every morning during report. They still use it today.

 

Eventually I went back to work at the bedside but then one day my manager called me into her office and told me about a position she saw posted that was "right up [my] alley."  It was a Clinical Information Specialist to implement an HCIS to our hospital. I changed jobs and never looked back.  Okay, I looked back once but I quickly turned back to my CIS job!  I don't have any formal education in informatics but in order to keep current, I take workshops and attend seminars and conferences. 

 

In 2010, I changed positions. I'm now the coordinator for the Health Informatics-Advanced Clinical Systems department and my team does all the development, education, and maintenance of our HCIS for the direct care clinicians across the entire authority.

 

 

Q: Nursing informatics is a growing speciality in nursing. Have you experienced or anticipate any challenges to its development?

 

The challenges I see are focused mainly on the change in culture of health care professionals and their perception of what technology is in this industry.  With nurses anyway, the concept of technology in a field that really focuses on the human connection with patients is very difficult to sell.  Cold data means nothing to the seasoned nurse that "just knows" when a patient is going downhill. The problem with the growth and development of the field of health informatics is centered around the culture of the industry, and because I end up working with our American vendor, I can see the Canadian perspective around health care almost holds us back.  I think our fundamental belief in universal health care stems from the Canadian culture of community and looking out for your fellow man/woman.  To convince those that have embraced this the most (ie, health care professionals) that a computer system will benefit the health of our patients and communities, well, good luck with that!

 

 

Q: What growth have you seen in the nursing informatics field over the past years? How does this growth affect nursing practice?

 

Health Informatics has matured as a field. I can speak specifically about how it has changed in our authority.  It went from "just the computer stuff" to an integral tool in our emergency departments, inpatient units, and for our physicians.  New clinicians expect to have some form of electronic record or tool to help them in their jobs.  Every other industry utilizes technology and health care is just catching up.  People do their banking, book their own flights, and get entire educations through their computers.  Staff expect that there should be something to provide better information about their patients. Something to help them do their job more effectively and more efficiently.  Nursing is an information-wealthy profession and it's unrealistic to think nurses can learn everything right out of school or on the job. With the sicker patients, the faster turnover, and the need to have information at your disposal, not only is an EHR invaluable, but also necessary is a tool for decision support. Electronic Care plans, realtime patient locators, and up-to-date rounding lists all help support the clinicians' judgments and problem solving skills to provide better care. 

 

 

The best evidence I've seen that informatics is growing faster than I can keep up with, is seeing the expectations of our end users.  It's like paper is archaic and if it's not in the computer, then it damn well should be!