Canadian Nursing Informatics Association

Dr. Elizabeth Borycki

15 Sep 2018 11:32 AM | Chris McCreery (Administrator)

How and why did you become interested in nursing informatics?

I became interested in nursing informatics when I began working at one of the most highly digitalized hospitals in Toronto, Ontario. I was there working on a project where I implemented Registered Nurses Association of Ontario wound and skin care best practice guidelines. During the implementation I learned about the importance of electronic health records in providing nurses with point of care support in the form of clinical documentation, decision support tools, online educational resources and tools in supporting nurses’ and other health professionals’ work as well as data analytics. As part of this initiative, I had the opportunity to re-design and modernize components of the electronic health record to support nursing wound and skin care activities.

As my interest in designing and implementing health information technology grew, I sought out opportunities to be more actively involved in the implementation of clinical information systems. I moved into a clinical informatics specialist role where I had the opportunity to work on implementing and testing health information systems in another highly digitalized acute care hospital. I found the work interesting and enjoyed learning about and implementing cutting edge technologies that could improve the quality of health care processes and patient outcomes.

It was during these two experiences: working as a user of electronic health records and then as a designer/implementer that I became interested in nursing and health informatics research surrounding the design and implementation of technologies and their effects on health professionals’ cognitive and workflow processes. It was at this point in my career that I decided to pursue doctoral studies in the Department of Health Policy, Management and Evaluation with a research focus on management and health information technology systems.

Shortly, before completing my PhD, I took a faculty position at one of the oldest and largest health informatics schools in Canada – the School of Health Information Science at the University of Victoria in Victoria, British Columbia, Canada. Over the past few years I have been involved in teaching, consulting and research with a focus on studying and improving the quality and safety of health information systems, mobile health care software applications and social media applications to improve the quality and safety of clinical, patient and citizen health care. As a result of this interest I founded a new international working group devoted to healthcare safety through health information technology as part of the International Medical Informatics Association (IMIA) – the Health Informatics for Patient Safety Working Group.

I have also been honoured with the opportunity to serve as an Academic Representative for Canada on behalf of COACH – Canada’s Health Informatics Association (2007-2013) and as Vice President representing North America (2010-2013) on the Board of Directors of IMIA. In both these roles I was fortunate to be able to represent Canada, travel internationally and observe the best practices that could be brought back to Canada and integrated into my classroom teaching.

Describe what your current role involves?

I am currently an Associate Professor at the School of Health Information Science at the University of Victoria. I teach health informatics courses to undergraduate and graduate students in the School of Health Information Science. As part of this work I have had the opportunity to co-design the first nursing informatics graduate degree program in Canada (i.e. a joint, online program between the School of Nursing and Health Information Science), and I currently supervise students in this program. I am also involved in developing health informatics undergraduate and graduate curricula in the School of Health Information Science. In addition to teaching and curriculum development, in my role I am heavily involved in research and community outreach activities focusing on health informatics competency development for clinicians and health informatics/information technology professionals.

Which areas of nursing informatics do you find most interesting?

Over the last few years, I have been involved in developing several streams of research. I have been conducting research in the area of technology safety focusing on identifying technology-induced errors and methods for improving the safety of health information technology. I published one of the first articles about technology-induced errors and the relation of user interface design features, functions and workflows to technology-induced errors. Since then I have been working on developing methods that can be used to improve the safety of health information technology by studying how safety heuristics, usability testing, clinical simulations and techno-anthropologic approaches can be used to identify the root causes of technology-induced errors and the technological factors that can lead to their occurrence.

I have also been involved in research studying and evaluating the design and implementation of clinical documentation systems, medication administration systems, medication reconciliation systems, bar coding technologies, clinician order entry systems, telehealth and mobile eHealth applications.

In addition to this work I have spearheaded educational research focusing on developing clinical and health informatics competencies in nurses, physicians and health informatics professionals. Much of this research has been focused on introducing electronic health records into undergraduate and graduate curricula. Lastly, I have been spearheading research in the area of clinical informatics, evaluating the impact of health information technology on patient outcomes and how technology can be improved to support health professionals’ work in hospital, home care, public health and community settings.

What advice do you have for others who are interested in nursing informatics?

If you have an interest developing a career in nursing informatics, consider pursuing formal nursing informatics education. Over the past several years there have been many changes in the educational landscape of nursing informatics programs. There are currently graduate programs in nursing and health informatics in both online and on-campus formats. Seek out opportunities to extend your knowledge around the design, development, implementation and maintenance of health information technologies. There is a significant need to advance nursing and health informatics knowledge and there is a need for nurses to contribute their expertise to this growing field of study and practice.

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