1. National Forces
1.1. Evidence based practice integration
1.2. Institute of Medicine
1.2.1. Require informatics as a core competency
1.3. Creation of the Presidential information technology advisory committee
2. Nursing Forces
2.1. National Center for Nursing Research
2.1.1. Set goals for informatic research
2.1.1.1. Goals included: Standardization of nursing language, distribution of patient education, improved workstations and systems for charting, creating clinical databases, methods to evaluate nursing information systems
2.2. TIGER (2006): Technology Informatics Guiding Educational Reform
2.2.1. Nursing informatics as a standard competency
2.3. American Nurses Association
2.3.1. Incorporating nursing informatics as part of education curriculum.
2.4. National League for Nurses
2.4.1. Reccomendations for preparation for working with technology
2.4.2. Published Standards of Practice for Nursing Informatics
2.4.3. Published Scope of Practice for Nursing Informatics
2.5. Technology Informatics Guiding Educational Reform
2.6. National Advisory Council on Nurse Education and Practice recommendations
2.6.1. Prepare nursing faculty with specialized skills in informatics.
2.6.2. Educate nursing students and practicing nurses in core informatics content
2.6.3. Use informatic projects to enhance nursing practice and education
2.6.4. Increase collaborative efforts in nursing informatics.
3. Consumer Forces
3.1. Healthcare system costs
3.1.1. Computerized Physician Order Entry reduces errors in medications.
3.2. Compatibility of electronic medical records
3.3. Patient safety (National Quality Forum)
3.3.1. Endorses safe practices
3.4. Increased availability and use of technolgy
3.4.1. Smart phones, internet
3.5. Consumer empowerment
3.5.1. Allows for consumers to be actively involved in treatment and advocacy
3.6. Personal health records
3.7. Desire for engagement by consumer
4. Internal Forces
4.1. Organizational Structure
4.1.1. Culture
4.1.2. Hierarchy