The Intersection of ICT and Health Informatics Research

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Theera-Ampornpunt N. The intersection of ICT and health informatics research. Presented at: Faculty of ICT, Mahidol University; 2012 Feb 24; Bangkok, Thailand.

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The Intersection of ICT and Health Informatics Research

  1. 1. The Intersection of ICT and Health Informatics Research February 24, 2012Nawanan Theera-Ampornpunt, MD, PhD
  2. 2. A Few Words About Me...2003 Doctor of Medicine (1st-Class Honors) Ramathibodi2009 M.S. (Health Informatics) University of Minnesota2012 Ph.D. (Health Informatics) University of MinnesotaCurrently• Medical Systems Analyst, Health Informatics Division,Faculty of Medicine Ramathibodi Hospital• Chair-Elect, Student Working Groups, American MedicalInformatics Association SlideShare.net/Nawanan www.tc.umn.edu/~theer002 groups.google.com/group/ThaiHealthIT
  3. 3. Outline• What Is Informatics?• Informatics vs. ICT• Some Research Areas in Informatics• The Road Ahead
  4. 4. Biomedical & Health Informatics• “[T]he field that is concerned with the optimal use of information, often aided by the use of technology, to improve individual health, health care, public health, and biomedical research” (Hersh, 2009)• “[T]he application of the science of information as data plus meaning to problems of biomedical interest” (Bernstam et al, 2010)
  5. 5. DIKW Pyramid Wisdom Knowledge Information Data
  6. 6. DIKW Pyramid Wisdom KnowledgeKnowledge ManagementInformation Informatics Data ICT
  7. 7. Task-Oriented View of Informatics Collection Processing Utilization Communication Storage /Dissemination/ Presentation
  8. 8. Informatics As A Field Shortliffe (2002)
  9. 9. Public Health Informatics Hersh (2009)
  10. 10. Informatics and Other Fields Social Sciences Statistics & (Psychology, Sociology, Research Linguistics, Methods Cognitive & Law & Ethics) Medical Decision Sciences & Science Public Health Engineering Management LibraryComputer & Biomedical/ Science,Information Health Information Science Informatics Retrieval, KM And More!
  11. 11. Why Informatics ≠ ICT People Techno- Process logy
  12. 12. Why Informatics ≠ ICTInformaticsInformation & Communications T echnology
  13. 13. Why We Need Informatics in Health Care?
  14. 14. Why We Need Informatics in Health Care?#1. Because information iseverywhere in health care
  15. 15. Manufacturing Source: Guardian.co.uk
  16. 16. Banking Source: Cablephet.com
  17. 17. Health care Source: nj.com
  18. 18. Why Healthcare Isn’t Like Any Others? • Life-or-Death • Many & varied stakeholders • Strong professional values • Evolving standards of care • Fragmented, poorly-coordinated systems • Large, ever-growing & changing body of knowledge • High volume, low resources, little time Source: nj.com
  19. 19. Why Healthcare Isn’t Like Any Others?• Large variations & contextual dependence Input Process Output Patient Decision- Biological Presentation Making Responses Source: nj.com
  20. 20. Why We Need Informatics in Health Care?#2. Because health care is complex and difficult to automate
  21. 21. Why Adopting Health IT?“Go paperless” “Computerize” “Get a HIS” “Digital Hospital”“Have EMRs” “Modernize” “Share data”
  22. 22. Some Quotes• “Don’t implement technology just for technology’s sake.”• “Don’t make use of excellent technology. Make excellent use of technology.” (Tangwongsan, Supachai. Personal communication, 2005.)• “Health care IT is not a panacea for all that ails medicine.” (Hersh, 2004)• “We worry, however, that [electronic records] are being touted as a panacea for nearly all the ills of modern medicine.” (Hartzband & Groopman, 2008)
  23. 23. Health IT: What’s In A Word?Health  GoalInformation Value-AddTechnology Tools
  24. 24. Why We Need Informatics in Health Care? #3. Because unlike other industries, the goal is HEALTH
  25. 25. To Err Is Human• Perception errors Source: interaction-dynamics.com
  26. 26. To Err Is Human• Lack of Attention Source: aafp.org
  27. 27. To Err Is Human• Cognitive Errors - Example: Decoy Pricing # ofThe Economist Purchase Options People• Economist.com subscription $59 16• Print subscription $125 0• Print & web subscription $125 84 # ofThe Economist Purchase Options People• Economist.com subscription $59 68 32 Ariely (2008)• Print & web subscription $125
  28. 28. Clinical Decision Support Systems (CDSSs) PATIENT Perception CLINICIAN Attention Long Term Memory External Memory Working Memory Knowledge Data Knowledge Data Inference DECISION From a teaching slide by Don Connelly, 2006
  29. 29. Clinical Decision Support Systems (CDSSs) PATIENT Perception CLINICIAN Abnormal Attention lab highlights Long Term Memory External Memory Working Memory Knowledge Data Knowledge Data Inference DECISION
  30. 30. Clinical Decision Support Systems (CDSSs) PATIENT Perception CLINICIAN Drug- Attention Allergy Checks Long Term Memory External Memory Working Memory Knowledge Data Knowledge Data Inference DECISION
  31. 31. Clinical Decision Support Systems (CDSSs) PATIENT Drug-Drug Perception Interaction CLINICIAN Checks Attention Long Term Memory External Memory Working Memory Knowledge Data Knowledge Data Inference DECISION
  32. 32. Clinical Decision Support Systems (CDSSs)• CDSS as a replacement or supplement of clinicians? – The demise of the “Greek Oracle” model (Miller & Masarie, 1990) The “Greek Oracle” Model The “Fundamental Theorem” Friedman (2009)
  33. 33. Why We Need Informatics in Health Care?#4. Because health care iserror-prone and technology can help
  34. 34. Some Research Areas in Informatics
  35. 35. Research Agenda for Thailand’s Informatics http://www.slideshare.net/nawanan/research- topics-for-informatics-in-the-context-of-thailand
  36. 36. Health IT Adoption & Use:Underlying Assumption ICT’s Focus Informatics FocusSystemsAnalysis, Adoption Use OutcomesDesign & Coding
  37. 37. Underlying Assumption • Better clinical outcomes • Improved patient satisfaction Individual • More provider productivity/satisfaction Adoption & use • Improved operational efficiency • More patients Organizational • Reduced costs/increased revenues Adoption & Use • Better individual health/quality of life • Better population health Societal • Long-term cost savings Adoption & Use
  38. 38. Areas of IT Adoption Research Adoption Use Outcomes• Describe the state of • Describe the state of • Determine if/when IT adoption in a specific health IT use in a adoption & use will lead setting specific setting to better outcomes (+ what outcomes?)• Compare adoption in 2 • Compare use in 2 settings settings • Compare impacts of same health IT in• Identify facilitators and • Identify facilitators and different settings barriers of IT adoption barriers of IT use • Reveal • Determine if/when mechanisms/pathways adoption will lead to use that translate adoption & use to outcomes
  39. 39. Example of Health IT Adoption Studies
  40. 40. Adoption Studies: Descriptive Aspect Unpublished contents on this slide were removed. Please contact the speaker at ranta@mahidol.ac.th for more information.
  41. 41. Adoption Studies: Theoretical Aspect Unpublished contents on this slide were removed. Please contact the speaker at ranta@mahidol.ac.th for more information.
  42. 42. Evaluation Studies of Health IT: Benefits of Health IT Kaushal et al. (2003)
  43. 43. Risks of Health IT• Alert fatigue
  44. 44. Workarounds
  45. 45. Evaluation Studies of Health IT: Risks of Health IT Koppel et al. (2005)
  46. 46. Evaluation Studies of Health IT: Risks of Health IT Han et al. (2005)
  47. 47. Evaluation Studies of Health IT: Risks of Health IT Ash et al. (2004)
  48. 48. Public Health Informatics Yasnoff et al. (2001)
  49. 49. Consumer Health Informatics Kaelber et al. (2008)
  50. 50. The Road Ahead for ICT & Informatics
  51. 51. IBM’s Watson Image Source: socialmediab2b.com
  52. 52. Rise of the Machines? Image Source: englishmoviez.com
  53. 53. Data Mining in Health Care Image Source: Dr. Kumar @ UMN
  54. 54. mHealth & Social Media
  55. 55. ICT in Emergencies & Disasters http://www.kromchol.com/
  56. 56. ICT in Emergencies & Disasters http://dds.bangkok.go.th/Canal/
  57. 57. ICT in Emergencies & Disasters http://www.thaiflood.com
  58. 58. ICT in Emergencies & Disasters http://www.youtube.com/user/roosuflood
  59. 59. ICT in Emergencies & Disasters https://www.facebook.com/groups/mophwarroomcoordination/
  60. 60. Biosurveillance
  61. 61. Google Flu Trends (Biosurveillance) Source: Google.org/FluTrends
  62. 62. Other Intersecting Areas• Natural Language Processing (NLP)• Knowledge Representation & Semantics• Standards, Vocabularies, Ontologies• Bioinformatics• Telemedicine/Telehealth, Bio-sensing• Information Retrieval• Ethical, Legal & Social Issues (ELSI) Image Source: Dr. Kumar @ UMN
  63. 63. What Will The Future Be for Health Care? HAL 9000 Data David NS-5 Intelligent & Machines with a Machines that Dangerous helpful human touch replace humanskiller machines machines
  64. 64. Let’s Shape the Future Together!
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