Presented at the Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 4, 2017.
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Medical Informatics (Now Known As
Biomedical and Health Informatics)
• “The 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)
The Eye-Opening Field
Shortliffe et al. (2001)
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A Journey in the New Direction
First Full-Time Physician
Working in the IT Division at Ramathibodi, with
support from these individuals
2004 - 2005
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A Journey in the New Direction
2009 M.S. (Health Informatics) Commencement
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A Journey in the New Direction
2011 Ph.D. (Health Informatics) Commencement
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• American Medical Informatics Association
(AMIA)
– AMIA 2012 Annual Symposium Scientific
Program Committee
– Chair (2013), AMIA Student Working Group
• Thai Medical Informatics Association (TMI)
Board Member
Other Notable Experiences
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• Shaped & transformed by medical study
Ramathibodi
• Heavily influenced by systems thinking at
Community Medicine
• Found real “passion” in health informatics
• Blessed with opportunities at Ramathibodi
• Long time spent on personal development
Looking Back
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• Find happiness in
your career
• Find happiness in
your relationships
• Keep integrity
• Most importantly,
have a purpose in life
Looking Forward
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• As the second formally-trained M.D., Ph.D.
in Health Informatics in Thailand, I am
driven and socially obligated...
• To promote personal & population health
through establishment of sustainable
foundations for eHealth and strengthening
of the field of Biomedical and Health
Informatics in Thailand before my end of
life.
My “Mission in Life”
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How To Fulfill This Mission
Health Informatics
Clinical Care
Health
Promotion &
Prevention
Health
Administration
Policy
Advocacy
Research &
Development
Workforce
Development
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“To computerize
the hospital”
“To go paperless”
“To become a
Digital Hospital”
“To have
Electronic Health
Records (EHRs)”
เราใช้ ICT ใน รพ. ไปเพื่ออะไร?
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• To Err is Human reported that:
– 44,000 to 98,000 people die in U.S.
hospitals each year as a result of
preventable medical mistakes
– Mistakes cost U.S. hospitals $17 billion to
$29 billion yearly
– Individual errors are not the main problem
– Faulty systems, processes, and other
conditions lead to preventable errors
Patient Safety
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• Humans are not perfect and are
bound to make errors
• Highlight problems in U.S. health
care system that systematically
contributes to medical errors and
poor quality
• Recommends reform
• Health IT plays a role in improving
patient safety
Summary of These Reports
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Image Source: (Left) http://docwhisperer.wordpress.com/2007/05/31/sleepy-heads/
(Right) http://graphics8.nytimes.com/images/2008/12/05/health/chen_600.jpg
To Err is Human 1: Attention
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Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine Ramathibodi Hospital
To Err is Human 2: Memory
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To Err is Human 3: Cognition
• Cognitive Errors - Example: Decoy Pricing
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Ariely (2008)
16
0
84
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32
# of
People
# of
People
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Common Errors
• Medication Errors
–Drug Allergies
–Drug Interactions
• Ineffective or inappropriate
treatment
• Redundant orders
• Failure to follow clinical practice
guidelines
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• Guideline adherence
• Better documentation
• Practitioner decision making or
process of care
• Medication safety
• Patient surveillance & monitoring
• Patient education/reminder
Documented Values of Health IT