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Introduction to Health
Informatics
10,Feb, 2022
What is Health Informatics? 1
10/14/2023
Introduction to Health Informatics
• Definition
 Origin of term: "Medical Informatics"
 Russian = informatika 1968 by AI Mikhailov, "Oznovy Informatika"
("Foundation of Informatics") structure and properties of scientific
information
 Health informatics is the field concerned with the optimal use
of information often aided by technology to improve individual
health, health care, public health and biomedical research.
(Hersh,2009)
- Is about information, not technology
 Health informatics is a field that combines information
technology with health care concerns.
 This marriage of technology and health care results in solutions
to problems in the medical field---which ultimately help health
care professionals better serve their patients(Charlotte,2009).
10/14/2023 2
The study of how health data, information, and
knowledge are collected, stored, processed,
communicated, and used to support the process
of health care delivery.
The intersection of information science,
computer science, and professional knowledge in
health care.
• It deals with the resources, devices, and methods
required to optimize the acquisition, storage,
retrieval, and use of information in health. Mark
H.
Informatics ≠ IT
10/14/2023 3
Health informatics is the discipline concerned with the
systematic processing of data in the health care
environment with an emphasis on computer processing.
Information technology is hardware &
software.
• IT is to nouns, as informatics is to verbs.
• Informatics helps IT ‘work appropriately.’
10/14/2023 4
Health informatics and Information technology?
• Health Informatics
 Informatics is the collection,
manipulation and use of
information.
 informatics is to verbs
 Informatics helps IT to work
appropriately
• Information
technology
 Information technology is not
Informatics
 IT is the hardware and
software that Informatics uses
 IT is to nouns
10/14/2023 5
Health informatics and Information technology?
 Information technology is not Informatics
 Informatics is the collection, manipulation and use of
information.
 IT is the hardware and software that Informatics uses
 IT is to nouns as informatics is to verbs
 Informatics helps IT work appropriately
10/14/2023 6
Health Informatics Lecture ,
2016
March-31
Why Health Informatics?
 Health Informatics provides information tomake
decisions
Key component to improve higher-quality health care
system
Better information leads to better decisions
 Health care, management, planning and policy all needgood
information
Key Elements of Informatics
Acquisition
 Storage
 Communication
 Manipulation
 Display
10/14/2023 7
Health Informatics Lecture ,
2016
March-31
Health Informatics Principles
Health Informatics Principles
Use drives data
Interoperability using open standards
Incremental development and strengthening of systems
Enterprise Architecture approach
Collaborative Communities
Health Informatics Tools
Health informatics tools include not only computers
but also clinical guidelines, formal medical
terminologies, and information and communication
systems.
10/14/2023 8
Health Informatics Lecture ,
2016
March-31
Key Elements of Informatics
 Acquisition: capture data taking care to strive/attempt/
for quality (accurate, timely, reliable, complete).
 Storage: save data so that it can be retrieved
 Communication: data needs to be moved from point of
collection to storage, for analysis, and finally to point of
use
 Manipulation: data needs to be manipulated , combined
with other data, aggregated, or compared
 Display:
presenting data in ways
that it can be easily understood and
used for actions
10/14/2023 9
Information Management
• Data
– Generate
– Collect
– Organize
– Validate
– Analyze
– Store
– Integrate
• Information
– Disseminate
– Communicate
– Present
– Utilize
– Transmit
– Safeguard
10
10/14/2023
Information System (Technology)
• Interchangeable terms
– Information system
– Information technology
• Automated system
– Computer hardware and software
• Receives data
• Processes data
• Outputs data
11
10/14/2023
Informatics
12
• The science of information
– Information = data with meaning
• Definition based on
– Data
– Information
– Knowledge
10/14/2023
Data, Information, Knowledge,
Wisdom Hierarchy
• Data
– Symbols, facts, measurements
• Information
– Data processed to be useful
– Provides the “who, what, when, where”
• Knowledge
– Application of data and information
– Provides the “how”
• Wisdom
– Evaluated understanding
– Provides the “why”
13
10/14/2023
10/14/2023 14
Application Domains for
Informatics
• Any area of human endeavor supportable
by information technology
– Such as
• Entertainment
• Law and law enforcement
• Health care
• Other fields where computer technology interfaces
with people
15
10/14/2023
Biomedical Informatics
• AMIA(American Medical Informatics Association )
– “Biomedical informatics (BMI) is the interdisciplinary field that
studies and pursues the effective uses of biomedical data,
information, and knowledge for scientific inquiry, problem
solving, and decision making, motivated by efforts to improve
human health.”
• Shortliffe and Blois
– “The scientific field that deals with biomedical information, data,
and knowledge – their storage, retrieval, and optimal use for
problem solving and decision making.”
16
10/14/2023
Health Informatics
• Informatics applied to health care
• Includes
– Management and use of data and information
in health care
• Involves
– Information technology
• Requires
– Standards
17
10/14/2023
Biomedical Informatics
18
Figure 1.2 Biomedical Informatics: Modified by Dr. Jiajie Zhang, The University of Texas at Houston, School of
Biomedical Informatics from Shortliffe & Blois, 2001
10/14/2023
Current Drivers
• American Recovery and Reinvestment Act
(ARRA)
– Health Information Technology for Economic
and Clinical Health (HITECH) Programs
• Meaningful use of interoperable health information
technology and qualified EHRs
19
10/14/2023
Current Trends in Health
Informatics
• eHealth
• Electronic medical records
• Electronic health records
• Health information exchange
20
10/14/2023
eHealth
• WHO’s definition
– Use of information and communication
technologies for health for different purposes
• HIMSS’s definition
– Application of the Internet/other technologies
to health care for various goals and objectives
21
10/14/2023
Electronic Medical Record (EMR)
• Electronic record of health-related
information on an individual
– Within one health care organization
22
10/14/2023
Electronic Health Record (EHR)
• Electronic record of health-related
information on an individual
– Across more than one health care
organization
23
10/14/2023
Health Information Exchange
(HIE)
• Electronic movement of health-related
information among organizations
• Involves networks
• Local, state, and national HIE initiatives
24
10/14/2023
What is the Practice of
Informatics?
• The practice requires
– A set of skills and methodological tools
– Knowledge, experience, and activity
25
10/14/2023
Skills/Tools of Health
Informaticians
• Derived from knowledge of
– Computer Science (hardware/software)
– Clinical Science
– Basic Biomedical Science
– Cognitive Science
– Bioengineering
– Management Science
– Epidemiology & Statistics
26
10/14/2023
Application Domains
• Examples
– Cognitive/human factors and interfaces
– Data structures
– Database design
– Information retrieval
– Knowledge representation
– Networking/architecture
– Ontology/vocabulary
– Software engineering
27
10/14/2023
Health Informatics Team
• Informaticians with different backgrounds,
experience, and education
– Skills, roles, and responsibilities depend on
• Levels of education
• Stages of career progression
28
10/14/2023
Bioinformaticians
• Develop and apply computational tools
and approaches for expanding the use of
biological data
29
10/14/2023
Health Informaticians
• Required training
– Processes associated with
• Acquisition
• Storage
• Retrieval
• Privacy and security
• Presentation and
• Use of information
30
10/14/2023
Health Informaticians
• Varied assortment of responsibilities such as
– Help design software for patient care
– Build and maintain research systems for clinical research
– Purchase and implement information systems
– Provide training and assistance to health care providers in using
health information technology
– Conduct analyses of large health datasets
– Conduct research and development
31
10/14/2023
Environments Where Health
Informaticians Work
• Academic
• Research
• Health care delivery
• Health care related industries such as
government, medical software firms,
medical information services, insurance or
medical device companies
32
10/14/2023
Academic Role
• Professors
– Focus
• Teaching and research
– Responsibilities
• Educate those interested in the field of health
informatics
• Conduct research to improve the acquisition,
storage, retrieval, representation, and use of
information in health and biomedicine
33
10/14/2023
Research Role
• Researchers
– Focus
• Informatics applications in clinical and translational
research
– Responsibilities
• Advancement of medical science and public health
• Advancement of informatics science
34
10/14/2023
Health Care Delivery Role
• Clinical personnel
– Physicians, Nurses, Pharmacists, Dentists
• Focus
– Patient care
• Responsibilities
– Manage and process clinical data, information, and
knowledge to support clinical practice
35
10/14/2023
Clinical Informaticians
• Assess information and knowledge needs
• Characterize, evaluate, and refine clinical
processes
• Develop, implement, and refine clinical
decision support systems
• Lead or participate in the various facets of
clinical information systems
36
10/14/2023
Health Care Delivery Role
• Health information professionals
– Health information management professionals, health
information exchange specialists, programmers and
software engineers, privacy and security specialists
– Focus
• Clinical information resources, workflow, end-user
support, and connectivity
– Responsibilities
• Varies by individual
– Example: creating health networks that allow doctors and nurses to
share knowledge and best practices
37
10/14/2023
Application Domains
• Health care/clinical informatics
• Bioinformatics and/or computational
biology
• Clinical research and translational
informatics
• Public health informatics
38
10/14/2023
Health Informaticians
• Possess cognitive skills in logical and analytical thinking
• Have a technical understanding of the computing
environment
• Possess an awareness of privacy and security policies
around health informatics
• Have different backgrounds, experience, and education
• Varied assortment of responsibilities
• Transform data into information and information into
knowledge
39
10/14/2023

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1. Health Informatics.ppt

  • 1. Introduction to Health Informatics 10,Feb, 2022 What is Health Informatics? 1 10/14/2023
  • 2. Introduction to Health Informatics • Definition  Origin of term: "Medical Informatics"  Russian = informatika 1968 by AI Mikhailov, "Oznovy Informatika" ("Foundation of Informatics") structure and properties of scientific information  Health informatics is the field concerned with the optimal use of information often aided by technology to improve individual health, health care, public health and biomedical research. (Hersh,2009) - Is about information, not technology  Health informatics is a field that combines information technology with health care concerns.  This marriage of technology and health care results in solutions to problems in the medical field---which ultimately help health care professionals better serve their patients(Charlotte,2009). 10/14/2023 2
  • 3. The study of how health data, information, and knowledge are collected, stored, processed, communicated, and used to support the process of health care delivery. The intersection of information science, computer science, and professional knowledge in health care. • It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health. Mark H. Informatics ≠ IT 10/14/2023 3
  • 4. Health informatics is the discipline concerned with the systematic processing of data in the health care environment with an emphasis on computer processing. Information technology is hardware & software. • IT is to nouns, as informatics is to verbs. • Informatics helps IT ‘work appropriately.’ 10/14/2023 4
  • 5. Health informatics and Information technology? • Health Informatics  Informatics is the collection, manipulation and use of information.  informatics is to verbs  Informatics helps IT to work appropriately • Information technology  Information technology is not Informatics  IT is the hardware and software that Informatics uses  IT is to nouns 10/14/2023 5
  • 6. Health informatics and Information technology?  Information technology is not Informatics  Informatics is the collection, manipulation and use of information.  IT is the hardware and software that Informatics uses  IT is to nouns as informatics is to verbs  Informatics helps IT work appropriately 10/14/2023 6
  • 7. Health Informatics Lecture , 2016 March-31 Why Health Informatics?  Health Informatics provides information tomake decisions Key component to improve higher-quality health care system Better information leads to better decisions  Health care, management, planning and policy all needgood information Key Elements of Informatics Acquisition  Storage  Communication  Manipulation  Display 10/14/2023 7
  • 8. Health Informatics Lecture , 2016 March-31 Health Informatics Principles Health Informatics Principles Use drives data Interoperability using open standards Incremental development and strengthening of systems Enterprise Architecture approach Collaborative Communities Health Informatics Tools Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. 10/14/2023 8
  • 9. Health Informatics Lecture , 2016 March-31 Key Elements of Informatics  Acquisition: capture data taking care to strive/attempt/ for quality (accurate, timely, reliable, complete).  Storage: save data so that it can be retrieved  Communication: data needs to be moved from point of collection to storage, for analysis, and finally to point of use  Manipulation: data needs to be manipulated , combined with other data, aggregated, or compared  Display: presenting data in ways that it can be easily understood and used for actions 10/14/2023 9
  • 10. Information Management • Data – Generate – Collect – Organize – Validate – Analyze – Store – Integrate • Information – Disseminate – Communicate – Present – Utilize – Transmit – Safeguard 10 10/14/2023
  • 11. Information System (Technology) • Interchangeable terms – Information system – Information technology • Automated system – Computer hardware and software • Receives data • Processes data • Outputs data 11 10/14/2023
  • 12. Informatics 12 • The science of information – Information = data with meaning • Definition based on – Data – Information – Knowledge 10/14/2023
  • 13. Data, Information, Knowledge, Wisdom Hierarchy • Data – Symbols, facts, measurements • Information – Data processed to be useful – Provides the “who, what, when, where” • Knowledge – Application of data and information – Provides the “how” • Wisdom – Evaluated understanding – Provides the “why” 13 10/14/2023
  • 15. Application Domains for Informatics • Any area of human endeavor supportable by information technology – Such as • Entertainment • Law and law enforcement • Health care • Other fields where computer technology interfaces with people 15 10/14/2023
  • 16. Biomedical Informatics • AMIA(American Medical Informatics Association ) – “Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health.” • Shortliffe and Blois – “The scientific field that deals with biomedical information, data, and knowledge – their storage, retrieval, and optimal use for problem solving and decision making.” 16 10/14/2023
  • 17. Health Informatics • Informatics applied to health care • Includes – Management and use of data and information in health care • Involves – Information technology • Requires – Standards 17 10/14/2023
  • 18. Biomedical Informatics 18 Figure 1.2 Biomedical Informatics: Modified by Dr. Jiajie Zhang, The University of Texas at Houston, School of Biomedical Informatics from Shortliffe & Blois, 2001 10/14/2023
  • 19. Current Drivers • American Recovery and Reinvestment Act (ARRA) – Health Information Technology for Economic and Clinical Health (HITECH) Programs • Meaningful use of interoperable health information technology and qualified EHRs 19 10/14/2023
  • 20. Current Trends in Health Informatics • eHealth • Electronic medical records • Electronic health records • Health information exchange 20 10/14/2023
  • 21. eHealth • WHO’s definition – Use of information and communication technologies for health for different purposes • HIMSS’s definition – Application of the Internet/other technologies to health care for various goals and objectives 21 10/14/2023
  • 22. Electronic Medical Record (EMR) • Electronic record of health-related information on an individual – Within one health care organization 22 10/14/2023
  • 23. Electronic Health Record (EHR) • Electronic record of health-related information on an individual – Across more than one health care organization 23 10/14/2023
  • 24. Health Information Exchange (HIE) • Electronic movement of health-related information among organizations • Involves networks • Local, state, and national HIE initiatives 24 10/14/2023
  • 25. What is the Practice of Informatics? • The practice requires – A set of skills and methodological tools – Knowledge, experience, and activity 25 10/14/2023
  • 26. Skills/Tools of Health Informaticians • Derived from knowledge of – Computer Science (hardware/software) – Clinical Science – Basic Biomedical Science – Cognitive Science – Bioengineering – Management Science – Epidemiology & Statistics 26 10/14/2023
  • 27. Application Domains • Examples – Cognitive/human factors and interfaces – Data structures – Database design – Information retrieval – Knowledge representation – Networking/architecture – Ontology/vocabulary – Software engineering 27 10/14/2023
  • 28. Health Informatics Team • Informaticians with different backgrounds, experience, and education – Skills, roles, and responsibilities depend on • Levels of education • Stages of career progression 28 10/14/2023
  • 29. Bioinformaticians • Develop and apply computational tools and approaches for expanding the use of biological data 29 10/14/2023
  • 30. Health Informaticians • Required training – Processes associated with • Acquisition • Storage • Retrieval • Privacy and security • Presentation and • Use of information 30 10/14/2023
  • 31. Health Informaticians • Varied assortment of responsibilities such as – Help design software for patient care – Build and maintain research systems for clinical research – Purchase and implement information systems – Provide training and assistance to health care providers in using health information technology – Conduct analyses of large health datasets – Conduct research and development 31 10/14/2023
  • 32. Environments Where Health Informaticians Work • Academic • Research • Health care delivery • Health care related industries such as government, medical software firms, medical information services, insurance or medical device companies 32 10/14/2023
  • 33. Academic Role • Professors – Focus • Teaching and research – Responsibilities • Educate those interested in the field of health informatics • Conduct research to improve the acquisition, storage, retrieval, representation, and use of information in health and biomedicine 33 10/14/2023
  • 34. Research Role • Researchers – Focus • Informatics applications in clinical and translational research – Responsibilities • Advancement of medical science and public health • Advancement of informatics science 34 10/14/2023
  • 35. Health Care Delivery Role • Clinical personnel – Physicians, Nurses, Pharmacists, Dentists • Focus – Patient care • Responsibilities – Manage and process clinical data, information, and knowledge to support clinical practice 35 10/14/2023
  • 36. Clinical Informaticians • Assess information and knowledge needs • Characterize, evaluate, and refine clinical processes • Develop, implement, and refine clinical decision support systems • Lead or participate in the various facets of clinical information systems 36 10/14/2023
  • 37. Health Care Delivery Role • Health information professionals – Health information management professionals, health information exchange specialists, programmers and software engineers, privacy and security specialists – Focus • Clinical information resources, workflow, end-user support, and connectivity – Responsibilities • Varies by individual – Example: creating health networks that allow doctors and nurses to share knowledge and best practices 37 10/14/2023
  • 38. Application Domains • Health care/clinical informatics • Bioinformatics and/or computational biology • Clinical research and translational informatics • Public health informatics 38 10/14/2023
  • 39. Health Informaticians • Possess cognitive skills in logical and analytical thinking • Have a technical understanding of the computing environment • Possess an awareness of privacy and security policies around health informatics • Have different backgrounds, experience, and education • Varied assortment of responsibilities • Transform data into information and information into knowledge 39 10/14/2023

Editor's Notes

  1. This introductory lecture will define information management, information system (technology), and informatics, describe the fundamental theorem of informatics, explain the meaning of biomedical and health informatics as a field of study, offer definitions of the major biomedical informatics areas of applications, and provide an overview of informatics drivers and trends. Let’s begin with defining information management, information system (technology), and informatics. According to the American Health Information Management Association (AHIMA), information management is “The generation, collection, organization, validation, analysis, storage, and integration of data as well as the dissemination, communication, presentation, utilization, transmission, and safeguarding of the information” (AHIMA, 2012, p. 181). If the type of information were health, then health information management would entail acquisition, organization, storage, retrieval, and dissemination of health information from a multitude of places. The purpose is ensuring availability, accuracy, and protection of health information that is needed by a variety of individuals in the delivery of health care services and to support decision-making activities. An example of information management would be deploying a content or document management system.
  2. The next definition in the series of terms closely related to information management and informatics is information system or technology. AHIMA defines information system as “An automated system that uses computer hardware and software to record, manipulate, store, recover, and disseminate data (that is, a system that receives and processes input and provides output); often used interchangeably with information technology (IT)” (AHIMA, 2012, p. 181). When you think of information technology, some things that should come to mind are computer networks, database and systems administration, security, and programming. Therefore, information technology could be used in the management of information. Connecting information technology to health, consider the following defintion by the Office of the National Coordinator for Health Information: “Health Information Technology (HIT) – The application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making” (U.S. Department of Health and Human Services, 2009, para. 8). An example of health information technology would be administrative and financial systems that facilitate billing, accounting, and other administrative tasks.
  3. The final definition in this “information” series comes from authors Elmer Bernstam, Jack Smith, and Todd Johnson in their article, What is Biomedical Informatics? Based on their research they determined data, information, and knowledge were central to informatics. Their literature review and subsequent analysis concluded in the following definition of informatics: “Informatics is the science of information, where information is defined as data with meaning” (Bernstam, Smith, & Johnson, 2009, p. 106). Thus, the similarity between all three terms is that all involve information in some way. However a critical difference between information management, information technology, and informatics is in the object of study where information management focuses on the organization and dissemination of information, information technology on the tools and machines, and informatics on the optimal use of meaningful data.
  4. In order to gain a better understanding of informatics, one needs to learn the differences between data, information, knowledge, and wisdom. As explained on the previous slide, the research performed by Bernstam, Smith, & Johnson (2009) showed that data, information, and knowledge were central to informatics. In their article, they referenced Ackoff’s Data, Information, Knowledge, and Wisdom (DIKW) hierarchy. Jennifer Rowley, explored further the DIKW hierarchy. Rowley states, “The hierarchy is used to contextualize data, information, knowledge, and sometimes wisdom, with respect to one another and to identify and describe the processes involved in the transformation of an entity at a lower level in the hierarchy…to an entity at a higher level in the hierarchy (e.g. information). The implicit assumption is that data can be used to create information; information can be used to create knowledge, and knowledge can be used to create wisdom” (Rowley, 2007, p. 164). Data are simple symbols, isolated facts, and measurements. When such data are processed, put into a context, and combined within a structure, information emerges. Information provides the answers to “who, what, when and where.” When information is given meaning by interpreting it, that is there is an application of data, information becomes knowledge. Knowledge answers the “how” questions. Finally, wisdom is evaluated understanding and answers the “why” questions. Central to informatics is the processing of data so it becomes meaningful.
  5. Now that you have a better understanding of informatics, let’s look at where one would find this science applied. As one would expect there is not just one segment or domain for informatics. Any domain where there is a need for analysis of data and dissemination of information through the use of computer applications is a possible application domain. These include a wide range of industries including entertainment, hotel management, law and law enforcement, health care, and many other fields where computer technology interfaces with people. As the focus of this unit is “What is Health Informatics?,” informatics and its application to health care will be explored further.
  6. While various perspectives of informatics and its application to health care have been published, two have been chosen for review and discussion because of their significance within the field. The first definition comes from the American Medical Informatics Association or AMIA. AMIA is a non-profit organization dedicated to the development and application of medical informatics in the support of patient care, teaching, research, and health administration. This organization is seen as the prominent informatics organization in the US. According to their web site, “AMIA is the professional home of leading informaticians: clinicians, scientists, researchers, educators, students, and other informatics professionals who rely on data to connect people, information, and technology” (AMIA, 2011, para. 2). AMIA’s definition, therefore, is essential to understand. Accordingly, “Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health” (AMIA's Academic Forum, n.d., para. 3). The second definition comes from another highly respected source for biomedical informatics material, the textbook Biomedical Informatics: Computer Applications in Health Care and Biomedicine. Shortliffe and Blois define biomedical informatics as “the scientific field that deals with biomedical information, data, and knowledge – their storage, retrieval, and optimal use for problem solving and decision making” (Shortliffe & Blois, 2001, p. 24). As a field of study, Shortliffe and Blois state biomedical informatics is “concerned with the broad range of issues in the management and use of biomedical information, including biomedical computing and the study and nature of biomedical information itself” (Shortliffe & Blois, 2001, p. 920).
  7. Another term you may come across is health informatics. It has various interpretations but each one connects information science to health care in some fashion. For example, AMIA’s perspective is “The informatics community typically uses the term health informatics to refer to applied research and practice of informatics across the clinical and public health domain” (AMIA, 2011, para. 3). While AHIMA defines health care informatics as “The field of information science concerned with the management of all aspects of health data and information through the application of computers and computer technologies” (AHIMA, 2012, pp. 154-155). As you can imagine, applying information science to health care requires health informatics standards to define acceptable methods for collecting, organizing, maintaining, and exchanging data among health management information systems.
  8. Shortliffe & Blois (2001) view biomedical informatics as four subfields which is represented by Figure 1.2 shown on the slide: Public health informatics, clinical informatics, imaging informatics, and bioinformatics each with a specific focus as represented by the left-hand side. The right hand side lists the component sciences in biomedical informatics which includes computer science, clinical science, basic biomedical science, cognitive science, bioengineering, management science, and epidemiology and statistics. The next few slides explain Figure 1.2 further.
  9. Let’s now explore what is a driving force in health care, that is fueling the need for informatics applications. The American Recovery and Reinvestment Act or ARRA is officially Public Law 111-5 signed into law February 2009. The Health Information Technology for Economic and Clinical Health, often referred to as HITECH, is a provision of the American Recovery and Reinvestment Act. The HITECH section of ARRA deals with many of the health information communication and technology provisions. ARRA, and specifically HITECH, has become a major driver of health informatics through its many different stimulus opportunities, one of which is $19.2 billion for health information technology. The Office of the National Coordinator for Health Information Technology defines health information technology (HIT) as “The application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making” (U.S. Department of Health and Human Services, 2009, para. 8). The funding is expected to assist providers and states in adopting and utilizing health IT in order to achieve widespread adoption of health IT and enable electronic exchange of health information.
  10. Why else are informatics applications a growing need? Trends which are stimulating the need for health informatics applications include: the focus on eHealth, the adoption and implementation of electronic medical records or EMRs, and electronic health records or EHRs, and the growing desire to be able to electronically exchange health information across organizations within a region, community or hospital system. The application of information technology to health care is a critical tool in achieving the benefits of eHealth, EMRs, EHRs, and health information exchange. As you will learn later in this unit, practitioners of informatics known as informaticians use information technology to advance cost-effective care, high-quality care, and patient safety. But first, let’s review the connection informatics has to eHealth, electronic medical records, electronic health records, and health information exchange.
  11. A general direction with regards to health IT relates to the global environment. The World Health Organization or WHO, a United Nations agency responsible for directing and coordinating international health activities, recognized a trend involving the use of information and communication technologies and its impact on health care delivery, public health, research and health-related activities. With this recognition, WHO set about defining eHealth and developing a WHO eHealth strategy to help direct WHO’s activities on eHealth. As defined by the WHO, “eHealth is the use of information and communication technologies (ICT) for health to, for example, treat patients, pursue research, educate students, track diseases and monitor public health” (WHO, 2011). The HIMSS definition is “The application of Internet and other related technologies in the healthcare industry to improve the access, efficiency, effectiveness, and quality of clinical and business processes utilized by healthcare organizations, practitioners, patients, and consumers to improve the health status of patients” (HIMSS, 2003, p.4). Thus, there is a very close connection between eHealth and informatics as it is the combined use of electronic communication and information technology in the health segment. Some in the industry see eHealth as a sub-discipline of health informatics. Certainly, the application of information and communication technology to health care is a critical tool in achieving the benefits of eHealth, such as improving health care delivery. An example of eHealth is telemedicine which is delivery of health care at a distance most often via the Internet.
  12. Another trend of health IT which is impacting the field of health informatics is the adoption of electronic medical records or EMRs, and electronic health records or EHRs. These applications could be thought of as centerpieces of health informatics. The report, Defining Key Health Information Technology Terms defines an EMR as “an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization” (NAHIT, 2008, p. 6). An electronic medical record is a record of medical care created, managed, and maintained by one health care organization. EMRs, being an electronic equivalent of an individual’s legal medical record for use by providers and staff within one health care organization, are part of the health information technology infrastructure and have a direct tie to health informatics.
  13. A related trend driving the health IT market, and the direction the health care industry is going, is the implementation of electronic health records. As with electronic medical records, EHRs could be considered to be the center of health informatics. In the report, Defining Key Health Information Technology Terms, is this definition: “An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization” (NAHIT, 2008, p. 6). Key components of electronic health records include: administrative system components, laboratory system components, radiology system components, pharmacy system components, computerized provider order entry, and clinical documentation. Being a repository of individual health records that reside in numerous information systems and locations, EHRs are intended to support efficient, high-quality integrated health care, independent of the place and time of health care delivery. Consequently, EHRs, too, are part of a health information technology infrastructure, and therefore, linked to health informatics.
  14. The final trend is the utilization of health IT, in order to achieve widespread adoption of health IT and enable electronic exchange of health information. Included in the report, Defining Key Health Information Technology Terms, is the following definition for health information exchange (HIE): “The electronic movement of health-related information among organizations according to nationally recognized standards” (NAHIT, 2008, p. 6). HIE involves networks that give providers the ability to electronically transmit in a secure manner an individual’s health records. Through the utilization of EHRs, HIE supports the sharing of health-related information to facilitate coordinated care. EHRs draw information from many sources through health information exchange. Thus, the process of health information exchange is another piece of the health information technology infrastructure and informatics. There are many local, state, and national HIE initiatives going on throughout the U.S.
  15. To begin to gain an understanding of the individuals involved with informatics applications and the type of work they do, let’s first settle on what is the practice of informatics? According to the report Training the Next Generation of Informaticians, “The practice of informatics, most generally requires the presence of two components: (1) a set of skills and methodologic tools derived from knowledge of the basic informational and computing sciences and (2) knowledge, experience, and activity in one or more application domains. The coexistence of, and interactions between, these key components give meaning and significance to informatics as a field” (Friedman, et al., 2004, p.169) For example, many who practice informatics have training in the subject of human-computer interaction, an application domain covering how people use computers and how to design computer systems that help people use them more effectively.
  16. Taking into consideration the first component, a set of skills and methodological tools derived from knowledge of the basic informational and computing sciences, let’s review the list of component sciences. Shortliffe & Blois (2001) state that the sciences biomedical informatics draws on and contributes to include computer science, clinical science, basic biomedical science, cognitive science, bioengineering, management science, epidemiology and statistics. Individuals working in the informatics field possess cognitive skills in logical and analytical thinking and have a technical understanding of the computing environment that is the basis for informatics work.
  17. The report Training the Next Generation of Informaticians also identified a second component to the practice of informatics as the knowledge, experience, and activity in one or more application domains. Some examples of domains identified by (Friedman, et al., 2004) include: Cognitive/human factors and interfaces Data structures Database design Information retrieval Knowledge representation Networking/architecture Ontology/vocabulary Software engineering For example, a review of coursework at several universities on knowledge representation indicated the course covers how knowledge can be represented in a computer system and what kinds of reasoning can be done with the use of the knowledge.
  18. So, given the definition of the practice of informatics, who would be involved in this field of study? Practitioners of informatics. These individuals are known as informaticians. Members of the team vary in the types of skills, roles, and responsibilities which in turn are tied to their level of education and experience gained through stages of career progression. For example, the team might consist of individuals with an Associate’s degree whose role is clinical data analyst; individuals with a Bachelor’s degree whose role is research and development scientist; an individual with a Master’s degree taking on the role of nursing informatics officer, and an individual with a Doctorate whose role is chief medical informatics officer. Health informaticians use information technology to advance cost-effective care, high-quality care, and patient safety. Therefore, no matter their level of education or experience, all health informaticians need to know how to efficiently and responsibly use information and communication technology. However, a professional with a Bachelor’s degree right out of school uses information differently, compared to a professional with the same degree who has been in the field for 10 years. Likewise, a professional with a two-year degree uses information differently compared to a professional with a Master’s degree.
  19. Just as there are subdisciplines of biomedical informatics there are subdisciplines of the informaticians. As expected, the informatics applications utilized and the type of work they do will vary. For example, the University of Minnesota’s Institute for Health Informatics Web site states “bioinformaticians develop, and apply computational tools and approaches for expanding the use of biological data, including those to acquire, store, organize, archive, analyze, or visualize such data” (University of Minnesota, 2011, para. 4). The type of work would involve analysis/modeling of genomic datasets. The health care industry requires all types of informaticians to meet the ever-increasing information needs.
  20. From a more general view, health informaticians are professionals in health care who acquire knowledge in the component sciences and skills in information processing and information and communication technology. To perform the duties of a health informatician, they must have training in the processes associated with the acquisition, storage, retrieval, privacy and security, presentation, and use of information in health and biomedicine.
  21. Health informaticians may have a varied assortment of responsibilities. Some of those functions include “health informaticians help to design software for patient care, build and maintain research systems for clinical research, purchase and implement information systems that support health care, provide training and assistance to health care providers in using health information technology, conduct analyses of large health datasets, conduct research and development to advance the science of health informatics” (University of Minnesota, 2011, para. 2).
  22. Health informaticians are in great demand and may work in many different environments including colleges and universities, research facilities, health care delivery organizations, local, state and federal government agencies, medical software firms, medical information services companies, and other private industries such as insurance or medical device companies to name a few. Roles for the health informaticians in the first three environments are discussed in the next few slides.
  23. A role for health informaticians working in colleges and universities is that of a professor where the focus is on teaching and research. Health informaticians with an academic role have two main responsibilities. They are to: - Educate those interested in the field of health informatics and - Conduct research to improve the acquisition, storage, retrieval, representation, and use of information in health and biomedicine.
  24. While a health informatician working in a college or university may conduct research to improve the acquisition, storage, retrieval, and use of information in health and biomedicine, there is a research role outside of the academic setting. Research facilities hire health informaticians to focus on informatics applications in clinical and translational research for the purpose of advancing medical science and public health. Other responsibilities for researchers include conducting research in informatics in order to: - Expand the scope of the discipline of health informatics - Research and evaluate new regions or domains in health informatics, and - Lead interdisciplinary teams in the search for solutions to health informatics problems.
  25. As mentioned earlier, clinical informatics is often further broken down into specific fields or subareas. The term clinical informatician is usually associated with physicians. Other clinical personnel involved in health informatics science are called informaticians as well, and their field of study distinguishes them from each other, that is, nursing informaticians, dentistry informaticians, or pharmacy informaticians. The health care delivery role for clinical personnel focuses on the patient care domain. These individuals combine the knowledge of computer science, information science, cognitive science, and clinical science to assist in the management and processing of clinical data, information, and knowledge to support clinical practice. For example, a role for an informatician whose background is in medicine might be a chief medical informatics officer who’s managing clinical data, information, and knowledge to support clinical practice and who’s involved in the design, implementation, maintenance, and the evaluation of EMRs.
  26. Other roles for clinical informaticians involve the use of their knowledge of patient care combined with their understanding of informatics science to: “Assess information and knowledge needs of health care professionals and patients; Characterize, evaluate, and refine clinical processes; Develop, implement, and refine clinical decision support systems; and Lead or participate in the procurement, customization, development, and implementation, management, evaluation, and continuous improvement of clinical information systems such as electronic health records and order-entry systems” (AMIA, 2011, para. 2).
  27. Besides clinical personnel, there are other health care professionals involved in informatics applications in relation to health care delivery. Sometimes referred to as applied health informatics, those often found in this subarea include, but are not limited to, health information management professionals, health information exchange specialists, programmers and software engineers, and privacy and security specialists. Individuals involved with applied informatics applications provide a vital link between clinicians, technology designers, and information technology. These health information professionals focus on the strategic and operational relevance and robustness of clinical information resources, workflow, end-user support, and connectivity within the health care industry and public heath sectors. Their responsibilities include such things as: constructing computer health information systems by studying the needs of doctors, nurses, patients, and health care organizations; producing requirements and use case documents for EMRs/EHRs; building health networks that allow doctors and nurses to share knowledge and best practices; designing new methods of information delivery that motivate patients to follow treatment recommendations; and working with the vendor to implement the builds which form the documentation, order entry, and data repository system.
  28. In conclusion, let’s take a final look at informatics as a field of study and how health informaticians process data into information and knowledge for health care tasks with the support of information technology to improve patient care. First consider the application domains as described by the National Library of Medicine: “Health care/clinical informatics: Applications of informatics principles and methods to direct patient care, such as advanced clinical decision support systems and multimedia electronic health records, and to the provision of informational support to health care consumers. Bioinformatics and/or computational biology: Applications of informatics principles and methods to support basic research in such areas as genomics, proteomics, cheminformatics, systems biology, and simulation/modeling of biological systems. Clinical research and translational informatics: Applications of informatics principles and methods to “bench to bedside” translational research exploring genome-phenome relationships, to pharmacogenomics, to drug discovery, and to the support of clinical trials. Public health informatics: Applications of informatics principles and methods to build public health infrastructure, to “intelligent” support of public health agencies and practitioners, to support of research in health behavior and health literacy, and to syndromic surveillance” (NLM, 2011).
  29. Second, individuals working in the informatics field possess cognitive skills in logical and analytical thinking, and have a technical understanding of the computing environment that is the basis for informatics work. They also possess an awareness of privacy and security policies around health informatics such as the secure collection, management, retrieval, exchange, and/or analysis of information in electronic form. Given the different backgrounds, experience, and education, along with varied roles and skills described previously, who is better equipped to transform data into information and information into knowledge than health informaticians? Third, health informatics is an interdisciplinary, interrelated discipline, undergoing rapid change. As issues in health care become more complex, the amount of data collected and stored escalates. There is a widespread, generally acknowledged need for health informaticians who understand data, information, and knowledge.