Additional Pioneers

Myrna L. Armstrong Ed.D., RN, FAAN

During the 1981 annual meeting of the Council on Continuing Education, American Nurses Association Dr. Armstrong presented about the potential use of computers in continuing education. After the presentation she met and encouraged a small group of nurses (about 7) using computers to share information about their work and vision on the topic of computer-assisted instruction (CAI) in health care facilities and educational settings. The discussion centered on the attendees’ work with computers, various Patient Care Information Systems under development, and how CAI could be implemented. A CAI Interest Group was then formed to explore what nurses were doing with technology. This group was instrumental in establishing the Council on Computer Applications within the American Nurses Association. Dr. Armstrong also disseminated a quarterly newsletter / mailing list for 4 years to providing information about nurses considering, developing, and facilitating CAI. The group of seven from 1981 grew to over 86 members by 1985. Many of the members also participated in a Delphi study to create computer competencies for nurse educators.

Constance Berg, RN, MBA, FHIMSS

Connie Berg, RN, MBA, FHIMSS, is Principal of CMB Consulting, which focuses on Information Technology [HCIT], Nursing and Healthcare Informatics projects for Hospitals and Vendors. She is an invited member of ACNL’s 2013 Patient Safety and Quality committee and supports the QSEN efforts to standardize the California Nursing Informatics Education Curriculum. Connie serves as an NI lecturer for California State College of Nursing and leads curriculum CE developed NI programs in Northern California. She has written articles for the Healthcare IT News, US Health Care Trade Journals, nursing textbooks and proceedings for NI International programs. The Association of Medical Directors of Information Systems (AMDIS) recognizes her for her contributions, as does the National HIMSS for her dedication and leadership in chapter’s advancement and changes in healthcare information technology through knowledge sharing, advocacy, collaboration, innovation and community affiliations. As a volunteer for California Health and Human Services eHealth committees she assisted with the development of HIE Finance Budget for the State. Among many HCIT engagements she completed ANA’s NIDSEC project which targeted clinical information systems vendors.

Diane M. Billings, EdD, RN, FAAN

My career is focused on the use of information technology to promote teaching and learning. After receiving my EdD in Information Systems Technology I assumed leadership positions at Indiana University School of Nursing in order to acquire information technology and learning resources for student and faculty support and development. My scholarship was directed toward developing and disseminating best practices for teaching and learning using a variety of technologies. Two of my books, Computer Assisted Instruction for Health Professionals (1986) and Conversations in E-Learning (2002) received AJN Book of the Year Awards. I have been on the editorial boards of Computers in Nursing, Journal of Nursing Education, and International Journal of Nursing Education encouraging the dissemination of best practices in using information technology. I served on task forces of several nursing organizations exploring the use of technology and developing software to meet the needs of their respective members. I was also co-chair of Sigma Theta Tau International’s two “Info-Expo” conferences, the first international conferences focusing on using information technology.

Amy Coenen, PHD, RN, FAAN

Dr. Coenen is an Associate Professor at the University of Wisconsin-Milwaukee College of Nursing, USA. Her research is focused on nursing and health care terminology standards for the electronic health record. Dr. Coenen, currently the Director of the International Classification for Nursing Practice (ICNP®) Programme at the International Council of Nurses, in Geneva Switzerland, is also a representative for the International Organization of Standards (ISO) Technical Committee 215- Healthcare Informatics. She serves as a member of the Steering Committee for the Canadian Health Outcomes for Better Information and Care (C-HOBIC) project as well as a member of the World Health Organization (WHO) Advisory Group for ICD-10 Mental Health Diagnosis & Classification.

Dorothy Fishman-Wetstone

Dr. Dorothy Fishman-Wetstone’s initial contribution to nursing informatics began with the development of the first interactive video program for nursing education, her doctoral dissertation. This research was published in the first issue of Computers in Nursing, 1984. Additionally, she was Program Director, Special Projects Grant, Division of Nursing, Bureau of Health Professions, USDHHS, called “Interactive Video in Continuing Nursing Education.” At the University of Connecticut School of Nursing, she inaugurated an interactive video research center. Dr Fishman-Wetston served as Clinical Instructor in Information Systems at Baystate Medical Center, Springfield, MA, integrating physician offices and clinics with the Physicians Office Network and Patient Care Clinical Information System (CIS). Also, she was employed by Southern New England Telecommunications, first identifying and analyzing potential business opportunities in telemedicine, healthcare, and distance learning, and then assuming management of the SNET Health Information Network, including interconnectivity, software and hardware applications, interfaces, security, repositories, master patient index, and enterprise-wide interconnectivity. She managed the SNET Telemedicine Project, which connected Norwalk Hospital and the AmeriCares nurse-run clinic.

Kristine M. Gebbie, DrPH, RN

Dr. Gebbie’s teaching and research has focused on health policy and health services with particular attention to population-based public health services and nursing. Her career includes White House service as National AIDS Policy Coordinator (1993-94), Secretary of the Department of Health for the State of Washington (1989-93), public health administrator for the State of Oregon (1978-89), and coordinator of ambulatory care for St. Louis University Hospitals (1975-78). Her faculty appointments include University of Washington (1989-93), Oregon Health Sciences University (1978-89), University of California at Los Angeles (1968-71), and St. Louis University (1971-78). She currently directs Robert Wood Johnson Foundation-funded research on public health law modernization and HRSA-funded emergency preparedness education for clinicians. While at St. Louis University, Dr. Gebbie was a co-convener of the first national conference on nursing diagnosis (1973) and worked with Mary Ann Lavin and others to develop a nursing taxonomy. Their publications and work led to the establishment of the North American Nursing Diagnosis Association in 1978, providing a platform from which today’s standard nursing diagnosis codes could be developed.

Edward J. Halloran, RN, MPH, PhD, FAAN

In 1970 Dr. Halloran saw his first computer at Winsted [CT] Memorial Hospital. As an MPH student at Yale he observed researchers use the computerized data from Connecticut hospitals to form the diagnosis related groups (DRGs). Dr Halloran tested the assumption that nurses are prescribed by physicians, as part of his dissertation research, and found that variability in length of hospital stay could be explained by patients' dependence on nurses rather than by DRGs. Dr. Halloran and other nurses held a conference supported by the National Center for Health Services Research that served as a prelude to Nursing Minimum Data Set work by Dr. Harriet Werley. This group developed a nursing diagnosis-based patient classification system. Sigma Theta Tau awarded this project with their 1988 Information Resources Technology award. In a series of publications, results have been published on several topics:

  • Regarding the development, analysis and testing of severity of illness measures
  • Examined the end results of hospital care in heterogeneous and homogeneous diagnosis related groups
  • Examined the outcomes of hospital care in relation to selected patient, symptoms, problems and needs
  • Measured the significance of symptoms, problems and needs in dying persons
  • Most recently investigated the assignments of nurses to patients.

Barbara Happ, PhD, RN

We bought our first home computer about thirty years ago. At the same time I went back to school for my BSN. To my great surprise there was little written about the value of computers in nursing. This became the focus of research and the topic for many of my papers. Dr. Ronnie Feeg encouraged me to publish. It was the cover article of Nursing Management 1983. With the support and encouragement of Dr. Susan Newbold I began working with information system companies, IT organizations as well as continuing my education. Point-of-care systems, my dissertation topic, are now everywhere. As I continue to teach I hear many of the same NI challenges of years past.

William L. Holzemer, RN, PhD, FAAN

Bill Holzemer is Professor, School of Nursing, University of California, San Francisco. His program of research examines quality of nursing education, quality of nursing care, outcomes research, variation in practice, self-care symptom management, and quality of life, with special emphasis on living well with HIV infection. He was an early innovator in the application of microcomputers and instructional software to nursing education. Dr. Holzemer is an elected member of the Institute of Medicine, Fellow of the American Academy of Nursing, and a member of the Japan Academy of Nursing. He is a former Fulbright Scholar (Egypt), a Project HOPE Fellow (USA-Mexico Border), and a Visiting Professor at St. Luke’s College of Nursing, Tokyo, Japan. He is an elected member of the Board of Directors (2005-2009) of the International Council of Nurses, Geneva, Switzerland.

Kathleen M. Hunter, PhD, RN-BC

Dr. Hunter became acquainted with computers at the Maryland Institute for Emergency Medical Services System (MIEMSS) where she saw the potential benefits of computers for collecting and managing patient data. During her doctoral studies at the School of Nursing, University of Maryland, she wrote a number of articles about databases, clinical information systems, and nursing implications of these systems. She left MIEMSS and joined Quantitative Medicine, Inc. (QMI) where she designed applications, built individualized datasets, taught implementation classes, and conducted evaluation studies. Subsequently she joined the American Nurses Association (ANA) as a senior policy fellow for research and databases. Her primary focus was supporting the work of the Steering Committee on Databases to Support Clinical Nursing Practice. Dr. Hunter also composed the document that led to the ANA establishing nursing informatics as a nursing specialty (1992). Dr. Hunter was a member of the task force that developed not only the scope of practice for nursing informatics but also coordinated the publishing of the Scope of Practice for Nursing Informatics (1994). Another task force followed, which lead to the book, Nursing Informatics Standards of Practice (1995). The American Nurses Credentialing Center used these publications to develop the first nursing informatics certification examination. In 1997 she accepted the first endowed chair in nursing informatics at the University of South Florida, Tampa, Florida. In 1999 Dr. Hunter began an independent practice in informatics. Dr. Hunter’s latest venture was in January 2007 when she consulted for Walden University on the design and development of the graduate nursing informatics curriculum for their school of nursing.

Ramona Nelson, PhD, BC-RN, FAAN, ANEF

Dr. Ramona Nelson is Professor of Nursing and Chair of the Department of Nursing at Slippery Rock University. Her past publications include textbooks, monographs, book chapters, journal articles, WWW publications, abstracts and newsletters. Recent publications (2009) are two chapters and the fifth edition of her book, Introduction to Computers for Health Professionals. Because of her pioneering work in informatics she was also invited to participate in the publication of the Scope and Standards of Nursing Informatics produced by the American Nurses Association (ANA). The Scope and Standards of Practice (2008) incorporates the Nelson Data to Wisdom Continuum as a framework for describing the relationship of data, information, knowledge and wisdom. Her primary area of research is nursing informatics with a focus on theoretical concepts in nursing informatics, consumer informatics, and distance education.