Puzzle Pieces The Omaha System: Solving the Clinical Data-Information Puzzle
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Omaha System Overview


  • Consists of three relational, reliable, and valid components designed to be used together:
  • Is a research-based, comprehensive, standardized taxonomy or classification that exists in the public domain. It is designed to enhance practice, documentation, and information management. It is intended for use across the continuum of care for individuals, families, and communities who represent all ages, geographic locations, medical diagnoses, socio-economic ranges, spiritual beliefs, ethnicity, and cultural values.
  • Has terms that are arranged in a hierarchy (i.e. from general to specific), and are intended to be easily understood by health care professionals and the general public. It provides a structure to document client needs and strengths, describe multidisciplinary practitioner interventions, and measure client outcomes in a simple and user-friendly, yet comprehensive, manner.
  • Enables collection, aggregation, and analysis of clinical data. It supports quality improvement, critical thinking, and communication. It fosters research involving best practices/evidence-based practice. It links clinical data to demographic, financial, administrative, and staffing data. It is a middle range theory that supports other established health care theories. Examples include Donabedian’s structure, process, and outcome approach and the Neuman Systems Model.
  • Is based on rigorous and extensive research. Initial developmental, reliability, validity, and usability research was conducted during 4 federally-funded projects between 1975 and 1993 (Chapter 1). Following the initial research, 48 additional unique Omaha System studies were conducted and are summarized in Chapter 5. Numerous studies have been conducted since then. It is estimated that 25 or more master’s theses and doctoral dissertations are in progress and/or have been completed in addition to the 14 studies listed in Chapter 5.
  • Has a literature base that is expanding dramatically. Four Omaha System books have been published. The correct reference for the current book is: Martin KS. (2005). The Omaha System: A Key to Practice, Documentation, and Information Management (Reprinted 2nd ed.). Omaha, NE: Health Connections Press. The current book (list price $59.95) replaces the two 1992 books which have been out of print since 2005. In addition, 4 federal grant reports and 6 Omaha System International Conference books of handouts have been completed. More than 300 additional publications are listed in References.
  • Provides a framework for integrating and sharing clinical data. It meets Medicare/Medicaid, Joint Commission, and CHAP guidelines and regulations. It has been recognized by American Nurses Association since 1992, and passed the Healthcare Information Technology Standards Panel (HITSP) Tier 2 selection criteria for Use Cases in 2007. It is integrated into the National Library of Medicine’s Metathesaurus; CINAHL; ABC Codes; NIDSEC; Logical Observation Identifiers, Names, and Codes (LOINC®); and SNOMED CT®. It is registered (recognized) by Health Level Seven (HL7®), and is congruent with the reference terminology model for the International Organization for Standardization (ISO).
  • Was designed to be computer-compatible from the onset. It facilitates interoperability among users and computer software vendors, and has the potential for use in personal health records. Examples of integration and partnerships are listed in Links.


  • Current users are nurses, physical therapists, occupational therapists, speech and language pathologists, social workers/counselors, physicians, registered dieticians, recreational therapists, chaplains, pharmacists, community health workers, chiropractors, and other health care providers. Users also include nursing educators, researchers, and students enrolled in associate degree to doctoral programs, and educators and students from other health-related disciplines.
  • Current users and their sites now include the continuum of care: home care, public health, and school health practice settings, nurse-managed center staff, hospital-based and managed care case managers, educators and students, occupational health nurses, faith community staff, acute care and rehabilitation hospital/long-term care staff, researchers, members of various disciplines, and computer software vendors. The majority of Omaha System users are located in the United States.
  • Initial users included multidisciplinary staff members employed in home care, public health, and school health practice settings, as well as some educators in the United States.
  • Approximately 22,000 practitioners now use point-of-care Omaha System software to document the services they provide nationally and internationally. A small percent of the total use paper-and-pen records.
  • The number and types of international users are increasing; some are using software and others are using paper-and-pen records. The Omaha System was translated into Danish about 1985. Since then, translations include Czech, Dutch, Japanese, Chinese, Swedish, Korean, Slovene, Spanish, Turkish, German, Estonian, and Thai.
  • Users are described in diverse publications as well as on other sections of this Web site including Case Studies, Links, and Conferences.


  • Work on the Omaha System began in the 1970s when Visiting Nurse Association (VNA) of Omaha (Nebraska) staff began revising their home health and public health client records and adopting a problem-oriented approach. The goal was to provide a useful guide for practice, a method for documentation, and a framework for information management. From the beginning, DeLanne Simmons, VNA of Omaha Chief Executive Officer, envisioned a computerized management information system that incorporated an integrated, valid and reliable clinical information system organized around clients who received services, not the multidisciplinary practitioners who provided services.
  • The Omaha System is based on rigorous developmental research. Between 1975 and 1986, three research projects were funded by the Division of Nursing, US DHHS to develop and refine the Omaha System. Further research designed to establish reliability, validity, and usability was conducted between 1989 and 1993, and funded by a National Institute of Nursing Research, NIH RO-1 grant. Practitioners employed at the VNA of Omaha and 7 diverse test sites located throughout the USA participated in the four empirical, inductive studies. Practitioners submitted data based on actual client services they were providing, not on retrospective record review.
  • During the early years, information was disseminated through workshops and speeches. The first Omaha System article was published in 1981, the first books in 1992, and the current book in 2005. The Omaha System is not held under copyright, but needs to be used as published and accompanied by a reliable source such as the 2005 book or this Web site.

For more details about the Omaha System, refer to the 2005 book and other publications.