This work can advance nursing practice to move beyond "on-the-job informatics training" to a more competency-based model of nursing informatics education and practice.

The results of CFA and SEM provide additional evidence for the construct and predictive validity of Health-ITUES. The customizability of Health-ITUES has the potential to support comparisons at the construct level, while allowing variation at the item level. We also illustrate application of Health-ITUES across stages of system development.

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Inpatient portals may be an effective tool to improve the patient experience in the hospital. Moreover, making this technology available to inpatients may help to foster ongoing use of technology across the care continuum. However, deriving the benefits from the technology requires appropriate support. We identified multiple opportunities for hospital management to intervene. In particular, teaching patients to use the application by making a variety of instructional materials available could help to reduce several identified barriers to use. Additionally, hospitals should be prepared to manage patient anxiety and increased questioning arising from the availability of information in the inpatient portal application.

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