Overview of Health Informatics (March 4, 2019)
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The document presents an overview of health informatics, detailing definitions, distinctions, and the interdisciplinary nature of the field. It emphasizes the importance of information processing in healthcare, distinguishing between concepts such as biomedical informatics, health informatics, and their applications. Additionally, it highlights the roles and training necessary for informatics professionals and explores various health IT applications.
![3
What Is “Informatics”
• French: informatique = the science and
technology of information processing using
computers (Greenes & Shortliffe, 1990)
• “[T]he discipline focused on the acquisition,
storage, and use of information in a specific
setting or domain” (Hersh, 2009)
• “[T]he science of information”
(Bernstam et al, 2010)](https://image.slidesharecdn.com/overviewofhealthinformatics-190304030611/85/Overview-of-Health-Informatics-March-4-2019-3-320.jpg)
![6
But What Is M/B/H Informatics Anyway?
• Medical computing/computers in medicine?
• ‘[R]eferring to biomedical informatics as
“computers in medicine” is like defining
cardiology as “stethoscopes in medicine”.’
(Bernstam et al, 2010)
• “[T]he field concerned with the cognitive,
information processing, and communication
tasks of medical practice, education, and
research, including the information science and
technology to support these tasks”
(Greenes & Shortliffe, 1990)](https://image.slidesharecdn.com/overviewofhealthinformatics-190304030611/85/Overview-of-Health-Informatics-March-4-2019-6-320.jpg)
![7
More Definitions of M/B/H 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)](https://image.slidesharecdn.com/overviewofhealthinformatics-190304030611/85/Overview-of-Health-Informatics-March-4-2019-7-320.jpg)
![23
Back to Earlier Definitions of Informatics
M/B/H Informatics is...
• “[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)
Informatics focuses on “I”, not “T”](https://image.slidesharecdn.com/overviewofhealthinformatics-190304030611/85/Overview-of-Health-Informatics-March-4-2019-23-320.jpg)
Overview of Health Informatics (March 4, 2019)
- 1. Overview of Health Informatics Nawanan Theera-Ampornpunt, M.D., Ph.D. Faculty of Medicine Ramathibodi Hospital For 9th Healthcare CIO, Ramathibodi Hospital Administration School March 4, 2019 Except where citing other works
- 2. 2 Session Outline • Overview of Health Informatics – This presentation • Overview of Health IT – Next presentation
- 3. 3 What Is “Informatics” • French: informatique = the science and technology of information processing using computers (Greenes & Shortliffe, 1990) • “[T]he discipline focused on the acquisition, storage, and use of information in a specific setting or domain” (Hersh, 2009) • “[T]he science of information” (Bernstam et al, 2010)
- 4. 4 Medical Informatics • “Ancient” term • Being retired • Future use discouraged by experts • Only retained in titles of professional organizations Main Problems • Medical = Doctor? (e.g. not nursing?) • Medical informatics vs. Clinical informatics
- 5. 5 Better Terms • Biomedical informatics • Health informatics • Biomedical and Health informatics A Few Subtleties • Health informatics suggests the goal is “health” • Health informatics vs Public health informatics • Health informatics includes Bioinformatics? • No clear winner between Biomedical informatics vs. Health informatics
- 6. 6 But What Is M/B/H Informatics Anyway? • Medical computing/computers in medicine? • ‘[R]eferring to biomedical informatics as “computers in medicine” is like defining cardiology as “stethoscopes in medicine”.’ (Bernstam et al, 2010) • “[T]he field concerned with the cognitive, information processing, and communication tasks of medical practice, education, and research, including the information science and technology to support these tasks” (Greenes & Shortliffe, 1990)
- 7. 7 More Definitions of M/B/H 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)
- 8. 8 Summary About M/B/H Informatics • Focuses more on information, not technology • Task-oriented view: Collection Processing Storage Utilization Communication/ Dissemination/ Presentation
- 9. 9 Summary About M/B/H Informatics • Areas under the domain of M/B/H informatics – Health service delivery (health care) • Medical, dental, nursing, pharmacy, etc. • IT management in health care organizations – Public health • Policy & administration, epidemiology, environmental health, health services research, etc. – Individual patient/consumer’s health – Education of health professionals – Biomedical research (clinical trials, public health research, research in biomedical sciences)
- 10. 10 So....What Is Information? Data-Information-Knowledge-Wisdom (DIKW) Pyramid Wisdom Knowledge Information Data
- 12. 12 Example Wisdom Knowledge Information Data Contextualization/ Interpretation Processing/ Synthesis/ Organization Judgment 100,000,000 I have 100,000,000 baht in my bank account I am rich!!!!! I should buy a BMW (and a BIG house)!
- 13. Identify/exemplify data, information, knowledge, and wisdom Class Exercise #1
- 14. 14 Class Exercise #1: Problem A • Patient A has a blood pressure reading of 170/100 mmHg
- 15. 15 Class Exercise #1: Problem B • Patient B is allergic to penicillin. He was recently prescribed amoxicillin for his sore throat.
- 16. 16 Class Exercise #1: Problem C • Patient C’s plain film X-ray is as shown:
- 17. 17 Class Exercise #1: Problem A • Patient A has a blood pressure reading of 170/100 mmHg
- 18. 18 Class Exercise #1: Problem A • Patient A has a blood pressure reading of 170/100 mmHg • Data: 170/100 • Information: BP of Patient A = 170/100 mmHg • Knowledge: Patient A has high blood pressure • Wisdom: – Patient A needs to be investigated for cause of HT – Patient A needs to be treated with anti-hypertensives – Patient A needs to be referred to a cardiologist
- 19. 19 Class Exercise #1: Problem B • Patient B is allergic to penicillin. He was recently prescribed amoxicillin for his sore throat.
- 20. 20 Class Exercise #1: Problem B • Patient B is allergic to penicillin. He was recently prescribed amoxicillin for his sore throat. • Data: Penicillin, amoxicillin, sore throat • Information: – Patient B has penicillin allergy – Patient B was prescribed amoxicillin for his sore throat • Knowledge: – Patient B may have allergic reaction to his prescription • Wisdom: – Patient B should not take amoxicillin!!!
- 21. 21 Class Exercise #1: Problem C • Patient C’s plain film X-ray is as shown:
- 22. 22 Class Exercise #1: Problem C • Patient C’s plain film X-ray • Data: • Information: – Patient C’s plain film X-ray is as seen in the image – There is a break in the continuity of the periosteum of Patient C’s left radius and ulna • Knowledge: – Patient C has fractures of left radius and ulna • Wisdom: – Patient C’s fractures need to be properly treated Image Source: http://en.wikipedia.org/wiki/Bone_fracture
- 23. 23 Back to Earlier Definitions of Informatics M/B/H Informatics is... • “[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) Informatics focuses on “I”, not “T”
- 24. What is “Biomedical Informatics”? Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 25. 25 Biomedical Informatics 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. Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 26. 26 Biomedical Informatics: Corollaries to the Definition 1. BMI develops, studies and applies theories, methods and processes for the generation, storage, retrieval, use, and sharing of biomedical data, information, and knowledge. 2. BMI builds on computing, communication and information sciences and technologies and their application in biomedicine. Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 27. 27 3. BMI investigates and supports reasoning, modeling, simulation, experimentation and translation across the spectrum from molecules to populations, dealing with a variety of biological systems, bridging basic and clinical research and practice, and the healthcare enterprise. 4. BMI, recognizing that people are the ultimate users of biomedical information, draws upon the social and behavioral sciences to inform the design and evaluation of technical solutions and the evolution of complex economic, ethical, social, educational, and organizational systems. Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics: Corollaries to the Definition
- 28. Basic Research Applied Research And Practice Biomedical Informatics Methods, Techniques, and Theories Bioinformatics Clinical Informatics Imaging Informatics Public Health Informatics Biomedical Informatics ≠ Bioinformatics Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 29. 29 Interdisciplinary Nature of Biomedical Informatics Biomedical Informatics Cognitive Science & Decision Making Management Sciences Clinical Sciences Basic Biomedical Sciences Epidemiology And Statistics Bioengineering Computer Science (hardware) Computer Science (software) Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 30. Biomedical Informatics Textbook (4th edition) Springer Verlag - 2013 Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science- informatics)
- 31. Biomedical Informatics in Perspective Basic Research Applied Research And Practice Biomedical Informatics Methods, Techniques, and Theories Imaging Informatics Clinical Informatics Bioinformatics Public Health Informatics Molecular and Cellular Processes Tissues and Organs Individuals (Patients) Populations And Society Biomedical Informatics ≠ Health Informatics Health Informatics Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 32. Basic Research Applied Research And Practice Biomedical Informatics Methods, Techniques, and Theories Imaging Informatics Clinical Informatics Bioinformatics Public Health Informatics Molecular and Cellular Processes Tissues and Organs Individuals (Patients) Populations And SocietyContinuum with “Fuzzy” Boundaries Biomolecular Imaging Consumer Health Pharmaco- genomics Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 33. Basic Research Applied Research And Practice Biomedical Informatics Methods, Techniques, and Theories Imaging Informatics Clinical Informatics Bioinformatics Public Health Informatics Molecular and Cellular Processes Tissues and Organs Individuals (Patients) Populations And SocietyContinuum with “Fuzzy” Boundaries Clinical Translational Science Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 34. Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Computer Science Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 35. Decision Science Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 36. Cognitive Science Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 37. Information Sciences Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 38. Management Sciences Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 39. Other Component Sciences Biomedical Informatics Methods, Techniques, and Theories Applied Informatics Clinical or Biomedical Domain of Interest Contributes to…. Draws upon…. Draw upon…. Contribute to... Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Biomedical Informatics in Perspective
- 40. Education of Biomedical Informatics Researchers Basic Research Applied Research Biomedical Informatics Methods, Techniques, and Theories Bioinformatics Imaging Informatics Clinical Informatics Public Health Informatics Education and Experience at Both Levels Contributions Expected Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 41. An Envisioned Cycle That Ties Patient Care with Knowledge Creation and Dissemination Providers Caring for Patients Electronic Health Records Regional and National Public Health and Disease Registries Biomedical and Clinical Research Information, Decision-Support, and Order-Entry Systems Creation of Protocols, Guidelines, and Educational Materials Standards for Prevention and Treatment A “Learning Healthcare System” Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 42. BMI and HIT Biomedical Informatics Training, Research and Development • Academia • Research Institutes • Corporate Research Labs Clinical Systems Companies Academic Medical Centers Biomedical Research Community PEOPLE Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Hospitals, Health Systems, Practices, Healthcare Industry
- 43. BMI and HIT Biomedical Informatics Training, Research and Development • Academia • Research Institutes • Corporate Research Labs Clinical Systems Companies Academic Medical Centers Biomedical Research Community IDEAS Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) Hospitals, Health Systems, Practices, Healthcare Industry
- 44. BMI and HIT Biomedical Informatics Training, Research and Development • Academia • Research Institutes • Corporate Research Labs Clinical Systems Companies Academic Medical Centers Biomedical Research Community Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) SOFTWARE Hospitals, Health Systems, Practices, Healthcare Industry
- 45. BMI and HIT Biomedical Informatics Training, Research and Development • Academia • Research Institutes • Corporate Research Labs Clinical Systems Companies Academic Medical Centers Hospitals, Health Systems, Practices, Healthcare Industry Biomedical Research Community Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) METHODS
- 46. Biomedical Informatics Training, Research and Development • Academia • Research Institutes • Corporate Research Labs Clinical Systems Companies Academic Medical Centers Hospitals, Health Systems, Practices, Healthcare IndustrySynergies Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) BMI and HIT
- 47. Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics) BMI and HIT
- 48. AMIA: The Professional Home for Biomedical and Health Informatics Reproduced/Adapted from American Medical Informatics Association (http://www.amia.org/about-amia/science-informatics)
- 49. 49 M/B/H Informatics As A Field (Shortliffe, 2002)
- 50. 50 M/B/H Informatics As A Field (Hersh, 2009)
- 51. 51 M/B/H Informatics and Other Fields Biomedical/ Health Informatics Computer & Information Science Engineering Cognitive & Decision Science Social Sciences (Psychology, Sociology, Linguistics, Law & Ethics) Statistics & Research Methods Medical Sciences & Public Health Management Library Science, Information Retrieval, KM And More!
- 52. 52 Areas of Popular Interests (Selected) • Health IT applications & implementation – Electronic Health Records (EHRs) – Computerized Physician Order Entry (CPOE) – Clinical Decision Support Systems (CDSSs) – Picture Archiving and Communication Systems (PACS) – Other hospital IT (nursing, pharmacy, lab, etc.) – Personal Health Records (PHRs) – Telemedicine & Telehealth • eHealth, mHealth, Health Information Exchange (HIE) • Health IT adoption and use, public policy • People & organizational (POI), ethical-legal-social (ELSI) • Consumer health • Knowledge representation & discovery, NLP • Standards & Interoperability • Workforce building & education
- 53. 53 Roles of People in M/B/H Informatics • IT Executives – Chief Information Officer (CIO) – Chief Medical Information Officer (CMIO) – Chief Nursing Information Officer (CNIO) – Chief Technology Officer (CTO) • System analysts, designers, developers, implementers, engineers, project managers, trainers • Clinicians with informatics background (super-users, change agents, business analysts) • Specialists in specific areas – HIE specialists, security & privacy specialists – Health information management specialists, medical records personnel • Policy makers & policy analysts • Academicians (educators, researchers, innovators)
- 54. 54 Levels of M/B/H Informatics Training • Informatics contents in professional education – Initial training (core/electives) – Residency & fellowship training – Continuing education • Certificate programs/Short courses e.g. Ramathibodi’s Healthcare CIO, MoPH’s GEEKS • Bachelor’s degree in informatics or related fields • Master’s and doctoral degrees in informatics – U.S., Europe, Australia, New Zealand – Thailand (Master’s) • Ramkhamhaeng University • Faculty of Public Health, Mahidol University • Faculty of Tropical Medicine, Mahidol University • Clinical informatics fellowships (U.S.) • Postdoctoral fellowships (e.g. NLM)
- 55. 55 Informatics Workforce in Thailand • In other countries, 1 IT staff is employed per about 50-70 non-IT staffs (Hersh, 2008) • No available data about Thailand but... – Only a handful of “informaticians” available (both formally trained and otherwise) – Many clinicians (and executives) who got interested in IT (but many focus on the “technology” not “information” and so would usually jump up and down on the new technologies but would not be a good IT manager or executive) – Most computer science/ICT graduates lack exposure to or understanding about healthcare
- 56. 56 Professional Societies in M/B/H Informatics • International Medical Informatics Association (IMIA) – MEDINFO • American Medical Informatics Association (AMIA) – AMIA Annual Symposium • Healthcare Information and Management Systems Society (HIMSS) – HIMSS Annual Conference & Exhibition – HIMSS Asia Pac • American Health Information Management Association (AHIMA) • Thai Medical Informatics Association (TMI) – TMI Annual Conference
- 57. 57 “Bible” of Biomedical/Health Informatics Shortliffe EH, Cimino JJ, editors. Biomedical Informatics: Computer Applications in Health Care and Biomedicine. 4rd ed. New York: Springer; 2014. 965 p. https://www.amazon.com/Biomedical-Informatics-Computer-Applications- Biomedicine/dp/1447144732
- 58. 58 Useful Online Resources • Societies amia.org imia.org himss.org tmi.or.th • U.S. Office of the National Coordinator for Health IT (ONC) www.hhs.gov/healthit • Handbook of Biomedical Informatics en.wikipedia.org/wiki/Book:Handbook_of_Biomedical_Informatics • Blogs – Life as a healthcare CIO geekdoctor.blogspot.com – Informatics Professor informaticsprofessor.blogspot.com
- 59. 59 Journals in the Field (Selected) • Journal of the American Medical Informatics Association (JAMIA) www.jamia.org • International Journal of Medical Informatics (IJMI) • Journal of Biomedical Informatics (JBI) • Methods of Information in Medicine • BMC Medical Informatics and Decision Making • Journal of Medical Internet Research (JMIR) • Applied Clinical Informatics (ACI) • Healthcare Informatics Research (HIR) • Yearbook of Medical Informatics • Journal of the Thai Medical Informatics Association (JTMI) • Occasionally, Health Affairs, New Engl J Med, & JAMA • Healthcare Informatics www.healthcare-informatics.com
- 60. 60 JTMI Articles Introducing the Field
- 61. Overview of Health IT Next
- 62. 62 References • Bernstam EV, Smith JW, Johnson TR. What is biomedical informatics? J Biomed Inform. 2010 Feb;43(1):104-10. • Greenes RA, Shortliffe EH. Medical informatics. An emerging academic discipline and institutional priority. JAMA. 1990 Feb 23;263(8):1114-1120. • Hersh W. A stimulus to define informatics and health information technology. BMC Med Inform Decis Mak. 2009;9:24. • Hersh W. Health and biomedical informatics: opportunities and challenges for a twenty-first century profession and its education. Yearb Med Inform. 2008:157-164.