Chapter 3 Health informatics terminology.pdf

Chapter Three: Health informatics terminologies
1

Objectives
At the end of the chapter the student will:
❖ Define information management, information system
(technology) and informatics
❖ Explain the basic theoretical concept that underlies informatics
practice
❖ Identify Domains of Health informatics and Information
hierarchy
2

Definitions
Informatics
❖ Originated in 1957 in German computer scientist Karl Steinbuch coined
the word Informatik by publishing a paper called Informatik: Automatis
che Information sverarbeitung ("Informatics: Automatic Information
Processing").
❖ The French term informatique was coined in 1962 as a combination of
"information" and "automatic" to describe the science of automating
information.
❖ Popularized by Soviets (Informatika) considered a branch of social
sciences and other countries (including France) considered it to be applied
computer science.
❖ In the U.S. continued to use term “computer science”
❖ Informatics sciences concerned with gathering, manipulating, storing,
retrieving, and classifying recorded information.
❖ Informatics is the application of information technologies to optimize the
information management function within an organization.
❖ In general term Informatics is the science of information, the practice
of information processing, and the engineering of information systems.
3

Definition..
• Information management: Is assuring that the
right information is available to the right people,
within and without an organization, at the right
time and place, and for the right price.
• Information technology:-Is the study, design,
development, implementation, support and
management of computer based information
systems particularly software applications and
computer hardware.
4

• Information system (IS): refers to a system of persons, data records
and activities that process the data and information in an
organization, and it includes the organization's manual and
automated processes. In a narrow sense, the term information
system refers to the specific application software that is used to
store data records in a computer system and automates some of
the information-processing activities of the organization.
• Information System a system that provides information support
to the decision-making process at each level of an organization.
Information system is composed of five elements, People,
Procedures, Software, Hardware and Data.
Definition..
5

Figure 4- Elements of Information system.
Definition..
6

Health Informatics
❖ Health care informatics is the intersection of information
science, computer science, and health care.
❖ Health Informatics is the science that uses information to
improve health care.
❖ Health informatics is the study of how HEALTH DATA,
INFORMATION, AND KNOWLEDGE are collected, stored,
processed, communicated, and used to support the process of
health care delivery to clients and providers, administrators, and
organizations involved in health care delivery.
❖ It deals with the resources, devices, and methods required
optimizing the acquisition, storage, retrieval, and use of
information in health and biomedicine.
❖ Health informatics tools include not only computers but also
clinical guidelines, formal medical terminologies, and information
and communication systems.
❖ It is applied to the areas of nursing, clinical care, dentistry,
pharmacy, public health and (bio) medical research.
Definition..
7

Some definitions of health informatics…
❖‘an umbrella term referring to the application of the
methodologies and techniques of information science,
computing, networking and communications to support health
and health related disciplines such as medicine, nursing,
pharmacy, dentistry etc……’ WHO
❖‘ the field that concerns itself with the cognitive, information
processing, and communication tools of medical practice,
education, and research including the information science and
the technology to support these tasks’ (Shortliffe)
‘
8

9
Defining Informatics
Health
knowledge
Informatics as a
crossroads where
information,
ICT,
knowledge and
wisdom
meet.

eHealth (also written e-health)
❖ Is a relatively recent term for healthcare practice which is
supported by electronic processes and communication.
❖ The term is inconsistently used: some would argue it is
interchangeable with health informatics and a sub set of health
informatics, while others use it in the narrower sense of
healthcare practice using the Internet.
Definition..
10

mHealth( m-health or sometimes mobile health)
❖ It is medical and public health practice supported by mobile
devices, such as mobile phones, patient monitoring
devices, PDAs, and other wireless devices.
❖ mHealth applications include :
✓ the use of mobile devices in collecting community and clinical
health data,
✓ delivery of healthcare information to practitioners, researchers,
and patients,
✓ real-time monitoring of patient vital signs, and direct provision
of care (via mobile telemedicine)
Definition..
11

Telemedicine
❖ can be defined as the use of telecommunications technologies that
provide and support health care when distance separates the
participants.
❖ At the simplest level of technology, the most commonplace
telemedicine application is the 911emergency call number, tele-
surgery, involve exotic technologies and procedures that are still in
the experimental stage.
❖ Telemedicine consultation frequently brings to mind an image of
two-way high-resolution video interaction for clinical consultation.
❖ In disaster situations, for example, a variety of applications can be
valuable.
❖ In the acute phase, there seems to be little use thus far for
telemedicine consultations between first responders and
colleagues outside the disaster site, where triage is the priority
Definition..
12

teleHealth
❖is the delivery of health-related services and
information via telecommunications technologies.
❖Telehealth delivery could be as simple as two
health professionals discussing a case over the
telephone, or as sophisticated as using
videoconferencing between providers at facilities
in two countries, or even as complex as robotic
technology.
❖telehealth is an expansion of telemedicine, and
unlike telemedicine (which more narrowly focuses
on the curative aspect) it encompasses preventive,
promotive and curative aspects.
Definition..
13

Clinical uses of telehealth technologies
❖ Transmission of medical images for diagnosis (often referred to
as store and forward telehealth)
❖ Groups or individuals exchanging health services or education
live via videoconference (real-time telehealth)
❖ Transmission of medical data for diagnosis or disease
management (sometimes referred to as remote monitoring)
❖ Advice on prevention of diseases and promotion of good health
by patient monitoring and followup.
❖ Health advice by telephone in emergent cases(referred to as
teletriage).
Definition..
14

Nonclinical uses of telehealth technologies
❖ Distance education including continuing medical education,
grand rounds, and patient education
❖ Administrative uses including meetings among telehealth
networks, supervision, and presentations overall healthcare
system management patient movement and remote
admission.
Telehealth modes
❖ Store-and-forward telehealth
❖ Real-time telehealth
Definition..
15

❖In resent health care system there are more than
eighty sub-domain of health informatics. It
includes :
▪ clinical informatics,
▪ nursing informatics,
▪ imaging informatics,
▪ consumer health informatics,
▪ public health informatics,
▪ dental informatics,
▪ clinical research informatics,
▪ translational research informatics,
▪ bioinformatics,
▪ veterinary informatics,
▪ pharmacy informatics,
▪ healthcare management informatics … etc
Sub-domains of health informatics
16

❖ Bioinformatics
1. Biological structure informatics
2. Computational biology
3. Expression profiling and microarrays
4. Genomic ontologies
5. Genomics
6. Linking the genotype and phenotype
7. Neuroinformatics
8. Pharmacogenomics
9. Proteomics
17
❖ Clinical Informatics
10. Barriers to clinical system implementation
11. Clinical systems in ambulatory care
12. Clinical systems in high intensity care
13. Careflow and process improvement systems
14. Disease management
15. E-health and clinical communication
16. Evaluation of health information systems
17. Health data warehousing
18. Health information systems
19. Integrated health and financial systems
This is health informatics!

❖ Human Information Processing and Organizational
Behavior
28. Cognitive models and problem solving
29. Data visualization
30. Natural language understanding and text
generation
31. Human factors and usability
32. Human factors and user interfaces
33. Human-computer interaction
34. Models of social and organizational behavior
35. Natural language processing
❖ Education and Training
20. Computer-assisted medical education
21. Consumer health information
22. E-learning or distance learning
23. Education and training
24. Library information systems
25. Medical informatics teaching
26. Patient education and self-care
27. Professional education
Sub-domains of health informatics…
18

Imaging and Signal Analysis
36. Image processing and transmission
37. Image recognition, registration, and
segmentation methods
38. Imaging and signal standards
39. Knowledge representation and ontologies for
imaging
40. Model-based imaging
41. Signal processing and transmission
42. Virtual reality and active vision methods and
applications
❖ Nursing Informatics
61. Nursing informatics
62. Nursing care systems
63. Nursing vocabulary and
terminology
64. Nursing education/Curriculum
in nursing informatics
65. Nursing documentation
❖ Innovative Technologies in Health Care
43. Computer-communication infrastructures
44. Internet applications
45. Mobile computing and communication
46. Portable patient records
47. Security and data protection
48. Software agents and distributed systems
49. Telemedicine
50. Virtual reality
51. Wireless applications and handheld devices
❖ Knowledge Management
52. Automated learning and discovery
53. Clinical guidelines and protocols
54. Controlled terminology, vocabularies, and
ontologies
55. Intelligent data analysis and data mining
56. Decision support systems
57. Knowledge management
58. Knowledge representation
59. Neural network techniques
60. Pattern recognition/classification
19

Organizational Issues
66. Careflow management systems
67. Care delivery systems
68. Cooperative design and development
69. Economics of care
70. Ethical and legal issues
71. Health services evaluation: performance and quality
72. Organizational impact of information systems
73. Quality assessment and improvement
74. System implementation and management issues
75. Technology assessment
Patient Record
76. Cryptography, database security, and anonymization
77. Database access and delivery
78. Database design and construction
79. Data standards and enterprise data sharing
80. Patient record management
81. Privacy, confidentiality, and information protection
82. Standard medical vocabularies
83. Standards for coding
84. Standards for data transfer
20

Public Health Informatics
85. Administrative/financial systems
86. Biosurveillance
87. Consumer health informatics
88. Emergency and disaster response
89. Genetic epidemiology
90. Health intervention systems
91. Health promotion systems
92. Health outcomes assessment
93. Patient self-care and patient provider interaction
21

• Public health informatics: is the systematic application of
information and computer science and technology to public
health practice, research and learning. Activities may include:-
Collection and storage of vital statistics, Collection and reporting
of communicable diseases, Disease surveillance, Display disease
statistics and trends, Immunization and Hospital statistics …etc
• Medical Informatics: concerns itself with the cognitive,
information processing, and communication tasks of medical
practice, education, and research, including information science
and the technology to support these tasks.”Greenes and
Shortliffe, JAMA 1990, pp. 1114-20”
22

• Bioinformatics: is the application of information technology to the
field of molecular biology. Common activities in bioinformatics
include mapping and analyzing DNA and protein sequences, aligning
different DNA and protein sequences to compare them and creating
and viewing 3-D models of protein structures.
• Nursing Informatics: A combination of computer science,
information science and nursing science designed to assist in the
management and processing of nursing data and the delivery of
nursing care.
23

Data
❖Data refer to a collection of facts usually collected as
the result of experience, observation or experiment, or
processes within a computer system, or a set of
premises.
❖Data may consist of numbers, words, or images,
particularly as measurements or observations of a set
of variables.
❖Data are often viewed as a lowest level of abstraction
from which information and knowledge are derived.
❖Raw data is a collection of numbers, characters, images
or other outputs from devices to convert physical
quantities into symbols, in a very broad sense.
Information Hierarchy
24

❖Raw data is a relative term; data processing
commonly occurs by stages, and the "processed
data" from one stage may be considered the "raw
data" of the next.
❖To be useful, data must also satisfy a number of
conditions. It must be:
➢Relevant to the specific purpose
➢Complete
➢ Accurate
➢Timely
➢Available at a suitable price; the benefits of the data
must merit the cost of collecting or buying it.
Information Hierarchy…
25

Example
1. “The price of crude oil is $80 per barrel.”
2. Yes, Yes, No, Yes, No, Yes, No, Yes-Response to a market
research question-”would you buy brand X at price of y?”
3. 42, 63, 96, 74, 56, 86 Abebe’s score in the six first year
courses.
4. 1250,1293 previous and current reading of electricity
meter
26

Information
❖ Information is organized or structured data, which has been
processed in such a way that the information now has relevance
for a specific purpose or context, and is therefore meaningful,
valuable, useful and relevant.
Table 6-Difference between data and information
Data Information
Stored facts Presented facts
Inert (it exists) Active (it enables doing)
Technology based Business based
Gathered from various
sources
Transformed from data
27

Example
1. The price of crude oil is $80 per barrel-datum “The price of
crude oil has risen from $70 to $80 per barrel” gives meaning
to the data and so is said to be information to someone who
tracks oil prices
2. Abebe’s score in the six first year courses average was 69.5,
2A,1B,1C,1D,1F, GPA 2.75
28

Information pyramid
❖Head (1967) and Nicholls (1969) were pointed out that
the nature of information invariably depends upon the
"seniority" of the manager who is using it.
❖They both resorted to the concept of the information
pyramid to convey the differences.
❖According to this model, there are three major levels of
information, namely, operational, tactical, and
strategic.
29

a) Operational information
❖ This is information needed by those at the bottom of the
corporate hierarchy.
❖ It is detailed information relating to the day-to-day running of
the divisions of the corporation.
❖ Within the health care arena this can be considered to be the
few clinical, and many administrative, systems that exit in
health facilities.
30

b) Tactical Information
❖ This is the information needed by those part-way up the
corporate hierarchy (who will usually be the managers of the
ones at the bottom).
❖ It is not as detailed as type '1' information. In fact, it frequently
summarizes it (by group, perhaps, or over time period).
❖ For this reason, it is often termed derived data, and the
systems which provide it are termed feeder systems.
c) Strategic Information
❖ This is information needed by those at the top of the corporate
hierarchy.
❖ It is highly abstracted and summarized, and typically relates to
the organization as a whole rather than to its individual
divisions.
31

Figure 5-Information Pyramid.
32

❑ Exercises: Consider which category of information (operational,
tactical or Strategic) each of the following belongs to and to whom the
information would be most appropriate?
1. Present pulse rate of a patient
2. Occupancy on a daily basis for a single hospital ward over the
past month
3. Total number of admissions to the pediatric department at
the Bedele Hospital for diarrhea and vomiting by month for
the past year
4. Total number of prenatal deaths in each of the Regions in the
past year
5. Daily urine output for a ward based renal patient
6. Total reported number of new HIV infected individuals in
Ethiopia in the past year.
33

Figure 6-Information uses within health system
34

Knowledge
❖ Knowledge is an elusive concept which is difficult to define.
❖ Knowledge is typically defined with reference to information.
❖ Definitions may refer to information having been processed,
organized or structured in some way, or else as being applied
or put into action.
❖ Information that is contextual, relevant and actionable.
Knowledge is information in action .It is higher than data and
information.
35

Example
❖ “When crude oil prices go up by $10 per barrel, it’s likely
that petrol prices will rise by 2p per litre” is knowledge.
❖ A marketing manager could use this information to decide
whether or not to raise or lower price.
❖ Abebe’s teacher could analyze the result to determine
whether or not it would be worth him resetting the course
36

Knowledge types : two types Explicit knowledge and Tacit
knowledge
❖ Explicit knowledge
✓Objective, rational, technical
✓Easily documented
✓Easily transferred / taught / learned
✓explicit knowledge represents content that has been
captured in some tangible form such as words, audio
recordings, or images
37

❖ Tacit knowledge
✓Tacit knowledge is difficult to articulate and also difficult to
put into words, text, or drawings.
✓Subjective, cognitive, experiential learning
✓reside “within the heads of knower’s,”
✓Hard to transfer / teach / learn
✓Bound up with processes, actions, situations
✓Not articulated in conscious, verbal form
✓Can do something, but can’t explain how.
38

Knowledge Management
❖ Knowledge management is an integrated systematic
approach to identifying, managing and sharing all of an
enterprise’s information assets including:
✓ databases,
✓ documents,
✓policies, and
✓procedures,
❖ Fundamentally it is about making the collective information
and experience of an enterprise available to individual
worker.
39

Some typical knowledge management objectives are to:
❖ Facilitate a smooth transition from those retiring to
their successors who are recruited to fill their positions.
❖ Minimize loss of corporate memory due to slow
destruction and retreatment.
❖ Identify critical resources and critical areas of
knowledge so that the corporation “knows what it
knows and does it well—and why.”
❖ Build up a toolkit of methods that can be used with
individuals, with groups, and with the organization to
stem the potential loss of intellectual capital
40

Wisdom
❖Is accumulated philosophical or scientific
learning
❖It is created through use of knowledge
❖Wisdom takes care of the future
41

Figure 7-Information Hierarchy (Data, information, knowledge, wisdom)
42

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Chapter 3 Health informatics terminology.pdf