Ebook: Nursing Informatics 2020: Towards Defining Our Own Future

The Korean Society for Medical Informatics (KOSMI), and in particular their Nursing Informatics Specialist Group (KOSMI-NI), not only organized a superb 9th International Congress on Nursing Informatics, NI2006, but were kind and generous hosts to the NI2006 Post Congress Conference.

The NI2006 Post Congress Conference was held at Phoenix Park, Pyung-Chang, Kangwon-do, Korea on June 14–17, 2006. We were only able to invite and accommodate about 35 people, although we know that many more of our colleagues have active interests in the issues that we discussed, and would have liked to have been involved. We hope that these proceedings will compensate, in some small way, those unable to be there, and that after reading them, they will feel encouraged to participate in the necessary ongoing discussions, both within IMIA-NI and more widely in the international nursing and informatics communities.

The NI2006 Post Congress Conference and its proceedings complement the main Proceedings of NI2006. We have included the papers developed by each of the five groups, together with specially written papers setting the context and summarizing the discussions and outcomes. We have additionally included June Clark's NI2006 Congress keynote paper; this was used during the Post Congress Conference discussions, and its inclusion here fills the gap of its absence from the main Proceedings of NI2006.

We would like to warmly thank everyone who assisted in the smooth running of the NI2006 Post Congress Conference, and who have made the production of these proceedings possible. In particular, we acknowledge and thank the NI2006 Organizing Committee, for selecting such a superb and conducive venue for the discussions, and for providing their generous support. We also thank all who, under the leadership of Jeongeun Kim and Hyunkyung Ryu, assisted on a daily basis at Phoenix Park, working hard to ensure the comfort of participants and the success of the event. Finally, we thank the group leaders for their hard work before, during, and after the Post Congress Conference, and all of the participants – our nursing informatics colleagues from around the world – without whose enthusiasm and contributions these proceedings would not have been possible.

Peter J. Murray, Hyeoun-Ae Park, W. Scott Erdley, Jeongeun Kim

Within this paper we describe the background context and discussions that lead to the selection of the theme for the NI2006 Post Congress Conference. The rationale for the choice of the overall theme is introduced, together with the selection of the five main sub-themes, on which the group discussions were based, and that lead to the production of the group papers that form the core of these Proceedings.

Each of the five working groups in the NI2006 Post Congress Conference produced a paper summarizing the discussions within their group. This paper provides a summary of the evolution of the discussions, from inti ital presentations through the final papers. Some of the common themes emerging are presented, including the changing role of the nurse, the impacts of technological and demographic changes, the importance of genomics, and introduces the concept of u-nursing, meaning nursing as practiced within a context of ubiquitous technologies.

Future technology developments as applied to healthcare and particularly nursing were discussed. Emerging technologies such as genetics, small unobtrusive monitoring devices, use of information and communication technologies are as tools to not only facilitate but also promote communication among all parties of the healthcare process. These emerging technologies can be used for ubiquitous healthcare (u-health). The role of nursing in the u-health is fundamental and required for success and growth. Nursing's role will evolve as nurses become 'information-mediators' in a broader-sense than current role. All technologies will ultimately focus on the consumer through 'behind-the-scenes' data collection, which in turn will also allow nurses to analyze these data to improve care. We need to acknowledge an increased presence and or pervasiveness of information technologies as key components of quality healthcare. This sort of acknowledgment will help propel nursing, and healthcare, to increase use of these tools. To develop nurses with these types of skills the nursing education process will require a fundamental change to integrate these technology-sorts of tools as necessary elements for success.

Many societal changes will influence the future nature of nursing, nursing informatics and health. Among these are environmental changes, increasing globalization, industrialization of developing countries, and educational developments. The paper considers these issues, and in particular the 'bold transformation' of nurse education that will be necessary if the profession is to be able to deal with the future. The paper concludes with a series of recommended strategic changes.

Among the key issues facing the nursing profession as we moves towards the year 2020 are politics, policy and practice. This paper addresses these areas, as well as considering legal challenges and the question of whether nursing will exist as we currently know it. Moves away from hospital-based care towards more community-based and preventative care are considered, together with various scenarios describing possible futures.

We may be moving towards an era where nurses may get what they say they have always wanted – totally personalized care. This paper examines four major trends, i.e. the increasing importance of the genome, the informed patient, the rise of the patient-payer, and the 'instant gratification generation'. Each individually, and in combination, will have potential impacts on the future of health and nursing. The implications of these issues, and others are explored, as well as nursing's readiness to deal with the implications of truly and totally personalized care.

While this case study uses an example of a home health team, it is meant to describe a system in which clinicians and healthcare organizations specialize and develop expertise by performing a large volume of specific services, procedures for given medical conditions or diagnoses. We introduce the concept of “consumer as a direct employer” of healthcare services. In this model, nurses may work as independent contractors, or as a member of a team contracting out as a unit, as in our example of the Rhine Home Health Team. Nrses also may work as employees to healthcare organizations as they do today.

This meeting was not the first, nor hopefully the last, of its kind to address a set of issues of very real concern – the future of healthcare, nursing and, in particular, nursing informatics. This summation reviews the purpose of the NI2006 Post Congress Conference, briefly reviews the preparatory work (which resulted in three days of intensive discussions for all participants after spending up to a week involved in a major international conference and associated meetings), the themes of each group and threads evident within the final reports included in these proceedings, observations as to issues not mentioned, and closing with suggestions of possible direction(s) and or course(s) of pre-emptive actions relevant for the international nursing informatics community.