Health Informatics

Chapter 1 of 11

 

1.1. DEFINITION

The National Library of Medicine (NLM) defines Health Informatics as “the interdisciplinary study of the design, development, adoption, and application of Information Technology (IT)-based innovations in healthcare services delivery, management, and planning.” Health Informatics is a multidisciplinary field that uses information technology to improve the healthcare system, which aims to achieve higher quality and efficiency. Health Informatics focuses on the proper use of resources, devices, systems, and methods to attain efficient acquisition, storage, retrieval, and use of information. Health Informatics utilizes IT to deliver accurate information to the right people at the right time.

Health Informatics is also referred as Medical Informatics or Health Information Systems. It is the study of how Health Information Technology can be applied to healthcare or medical fields. It leverages information technology devices, related healthcare resources, and relevant methodology to effectively communicate healthcare and medical information to its patients and healthcare providers. It also provides medical professionals, consultants, doctors, nurses, and hospital administrators with easy and quick access to electronic or digital records.

Health Informatics strives to overcome challenges developing methods and tools to process information for diagnostics, early recognition, prevention, therapy, and therapy simulation. It aims to resolve issues in health consulting and reporting, medical information documentation, and knowledge-based decision-making.

1.2. PURPOSE

With proper collection, storage, and communication of information resources, healthcare providers can make better administrative and clinical decisions that yield better care.

1.3. HISTORY

Health Informatics has revolutionized patient information collection, recording, and retrieval by replacing archaic collection methods. In 1949, a German physician named Gustav Wagner founded the German Society for Medical Documentation, Computer Science and Statistics, the world’s first professional informatics organization. Healthcare professionals and healthcare establishments rapidly embraced the use of computers. In the 1960s, Germany, Belgium, France, and the Netherlands pioneered specialized university departments and informatics training programs. In the 1970s, the United States and Poland revolutionized medical informatics research. Subsequently, high-caliber research in Health Informatics, education, and infrastructure has been one of the top priorities in the implementation of health programs.

The American Society for Testing and Materials (ASTM) established the first standards in healthcare data reporting. Data reporting included electronic healthcare system properties, laboratory data exchange, message exchange, health information security system, and data content. Healthcare informatics has dramatically improved over the years, with pharmacy and radiology standardized data exchange protocols growing fast. Today, pharmacy informatics and imaging informatics are two unique specialty studies under the umbrella of Health Informatics.

Health Informatics professionals still face the challenge of achieving interoperability between different formats to make information available across all areas of the healthcare sector. Healthcare organizations are forced to utilize custom programming solutions to make dissimilar systems compatible for information exchange. Individuals who have ample knowledge of and training in IT and patient care standards are presented with ample opportunities in the continuously evolving and improving new branch of informatics.

Health Informatics was influenced by the health data analytic systems, and the Electronic Health Record (EHR), by Centers for Medicare and Medicaid Services. Over time it has expanded with the initiation of health data exchange systems like Fast Health Interoperability Resources (FHIR) and Health Level 7 (HL7).

The first period, lasting from 1955 to 1965, was dedicated to testing and scrutinizing of different emerging technologies related to the medical field. The pioneers of the first period were Joshua Lederberg and William S. Yamamoto who showed interest in automatic calculation in the 1940s. As the first medical expert to work on a computer in relation to medical science, Robert S. Ledley (1926-2012) developed his first important work in automated medical decision making, together with Lee Browning (1994-).

The development of the Biomedical Programs (BMDP) software by Wilfrid J. Dixon (1915-2008) paved the way for the use of computers in biostatistics. This was another major step in the early development period of Health Informatics. The introduction of Arpanet invented by Timothy John Berners-Lee (1955-), is considered an essential step for the development of computerized medical applications.

The second period lasted from 1965 until 1975. By this period, Western European countries were mounting various healthcare systems such as medical equipment with built-in computers. New biomedical engineering methods were also developed, as well as new therapeutic procedures and diagnostic practices. Health Informatics development was pioneered in Europe by Peter L. Reichertz (1930-1987), Germany and Francois Gremy (1929-), France.

The third period lasted from 1975 until 1985. The development of technology made computer systems cheaper and led to the development of IT at all healthcare system levels. More people began to access adequate education to Health Informatics using computer systems. This paved the way for the emergence for more HI experts.

This period gave rise to numerous healthcare software packages, and the rights to purchase and own personal computers with boosted technology and memory capacities. This development in IT influenced Health Informatics. Computers from home could be connected directly to healthcare information systems in health care centers.

The fourth period lasted from 1985 till 1995. This period marked an entirely new phase in the development of Health Informatics and IT at large. Artificial Intelligence (AI) began its development. Various researches were conducted on the improvement of health information methods and the possibility of infusing AI with the healthcare system, alongside the of this system in therapy and medical diagnostics.

AI was originally developed in Health Informatics as a separate sub-field and was used by various healthcare expert systems. The systems in this period constituted commutative elements by the infusion of modern communication systems.

The Fifth period began in 1995 and is still ongoing. The emergence and development of Health Informatics have significantly expanded from the regular use of computers. The development of Health Informatics influenced the development of telecommunication technologies and the microprocessor. Without electronic devices, Health Informatics would not be in existence today. The introduction of electronic computers with network terminals infused various methods of informatics into healthcare work sites, which served as part of the basis for healthcare development.

1.4. COMPONENTS

Health Informatics is an evolving discipline caught in the intersection of changing fields. Some view the field as an engineering and management discipline, whilst others see it as a science which may be both theoretical and applied. Health Informatics comprises Information Technology, Health Information Administration, and Clinical Informatics.

1.4.1. HEALTH INFORMATION TECHNOLOGY

Health Information Technology provides an ideal medium for the secure and efficient exchange of medical information among healthcare providers, patients, and other involved parties. One can expect an improvement in quality and administrative efficiencies: reduction of medical errors, reduction in paperwork, therefore lowering costs. It is imperative to preserve the privacy and security of the electronic health information transmitted across various medical practices.

1.4.2. HEALTH INFORMATION ADMINISTRATION

Health Information Administration is comprised of business administration and computer technology-integrated medical record keeping. It involves a diverse range of studies which include technical communications, accounting, medical terminology, medical coding, statistical analysis, and ethics. Its application involves health information service, clinical record-keeping, patient information management, patient data analysis, medical coding, and compliance and insurance analysis.

Experts design and manage healthcare information systems to meet medical, legal and ethical standards. They also supervise computer information systems, collect and analyze patient information records, and use classification guidelines and medical terminologies. Unlike health information technicians, health information administrators also oversee record departments and operate in the business administration.

1.4.3. CLINICAL INFORMATICS

Clinical Informatics bridge the gap between computer technology, research, and medical skills. Experts in Clinical Informatics use their experience in biomedical informatics to solve problems in the various domains of healthcare. Clinical informaticists, through analyzing medical data or images, help clinical healthcare providers access information. Clinicians can easily access and use health data through developed Health IT systems.

Clinical Informatics encompasses a wide scope of topics ranging from clinical support, decision-making, visual imaging, clinical documentation of information, order entry systems, system design, as well as implementation and adoption issues. These topics play a center role in specialties such as dermatology, pathology, and ophthalmology.

Clinical Informatics experts are not only expected to be proficient in computer programming, they should also know human anatomy and other basic fields of medicine.

  • Clinical research Informatics
  • Community Health Informatics
  • Pathology Informatics
  • Home Health Informatics
  • Clinical Bioinformatics
  • Pharmacy Informatics
  • Public Health Informatics
  • Nutritional Informatics, etc.

1.4.4. CONSUMER HEALTH INFORMATICS

Consumer Health Informatics is a system which enables healthcare practitioners to reach consumers and patients directly through digital communication devices and systems. This system extracts and analyzes consumer-specific needs and makes the information easily accessible to consumers. It also modifies consumer-specifics into the general health information systems.

Recent Developments in the field of consumer Health Informatics includes:

  • The expansion of Healthcare IT focus from medical and health practitioners to patients and consumers
  • More health IT establishments are seeking new ways to further expand the quality of tailored health information being uploaded on the internet. It is important to consider the issue of educating consumers and encouraging self-regulation.

Consumer Health Informatics seeks to create a bridge to general Health Informatics. Driving factors in this change are influenced by evidence-based medicine and the growing awareness of the need to equalize relationships between health professionals and laypeople. This, in the long run, helps consumers cut down on healthcare costs once useful information is accessible through the internet or any other digital platform. This would help strike a balance between healthcare issues an individual can handle, and healthcare issues that would require a professional.

Consumer Health Informatics applications are designed to interact directly with the consumer, with or without the presence of a healthcare professional. It is broadly divided into:

  • Community informatics resources – such as health kiosks.
  • Community online networks and “cybermedicine” applications that anyone with a home computer can access
  • Clinical informatics resources, which are provided to selected groups or patients.

1.5. TOOLS & TECHNIQUES
1.5.1. COMPUTERS

Health Informatics is not achievable without computers. They store a bulk of medical information in an organized fashion. Hospitals are required to store vast amounts of patient information, clinical data, medical history, pharmacy data, and management information. Using a computer database, Healthcare personnel can quickly access and retrieve patient information, medical history, and other essential data.

1.5.2. CLINICAL GUIDELINE

Clinical guidelines influence the quality of care given to patients. They serve as the blueprint for formulating, developing, and customizing the right kind of Health Informatics system suited for an establishment’s needs. In return, Health Informatics systems provide medical practitioners with access to the clinical guidelines and other essential information that leads to best practices within the hospital setting. This may include reminders about key guideline recommendations in patient records, clinical audit, the involvement of patients in decision-making (to improve the quality of care), and others.

1.5.3. MEDICAL TERMINOLOGIES

Standardized medical terminologies, clinical vocabularies, and coding system serve as the main “language of health” for the global use of Health Informatics systems. Using a common computerized medical language, health professionals around the world can make use of standardized electronic data collection, retrieval, and reuse of clinical information. “Language of health” is universal.

1.5.4. INTERNET

The Internet serves as the Health Informatics medium of information exchange between healthcare institutions. Internet-based Health Informatics applications expedite the transfer of data and clinical information because they eliminate the need to physically hand out and data.

1.6. HEALTH INFORMATICS RECENT DEVELOPMENT
1.6.1. TELEMEDICINE

Through the development of Telemedicine, patients can easily seek medical attention from specialists online. For minor cases, diagnosis, and treatment can be completed online. Today’s “cyberdocs” on the internet may be viewed in the future as trustworthy “cyber-licensed” professionals (who are specially trained and whose practice is monitored for quality) counseling patients online. This development is underway in the United Kingdom with the introduction of services such as NHS Direct, which provides advice to patients both on the web and over the phone. The EHR has made it easy for patient health records to be stored and easily transferred to experts online. There are two fundamental ways of letting patients have access to their medical records – either through direct access (the internet) or through the adoption of smart cards which is mostly known in European nations.

1.6.2. THE INTERNET OF MEDICAL THINGS (IOMT)

By infusing the Internet of Things (IoT) with telehealth and telemedicine technologies, a new Health Informatics system was born. Using wearable healthcare devices (this also applies to wearable devices at home) like EKG and ECG monitors, healthcare issues can be easily detected.

1.6.3. ARTIFICIAL INTELLIGENCE (AI) IN HEALTHCARE

AI in healthcare aids in speeding up diagnosis through automated expected responses to possible questions asked. Analytics also produce a track of similar symptoms to help healthcare practitioners select methods for treatment. Algorithms in Health Informatics are used to research biological and chemical activities to market new drugs faster and can be transmitted to easily understood dashboards.

1.7. BEST PRACTICES

Six basic standards govern the best practices of Health Informatics:

1.7.1. COMMUNICATION

Communication of accurate medical or health information, with the legal or regulatory bounds, is one of the core components of best practices in Health Informatics. The transfer of information must always be accurate, effective, and timely. The transfer of sensitive patient data and other medical information must abide with the legal and regulatory guidelines while upholding the standards of information confidentiality.

1.7.2. ANALYSIS

Analysis of pertinent medical information and other patient data for a designated purpose is an essential qualitative and quantitative requirement of Health Informatics. Through the assessment and proper synthesis of information, healthcare professionals can determine the best course of action relevant to the data presented. Health Informatics experts and healthcare providers can determine which health information can be shared with patients, healthcare personnel, and community. Through standard analysis, they can appraise the accuracy of the data and whether the information they have gathered is reported and disseminated within the regulatory and legal bounds.

1.7.3. ABSTRACTING AND CODING

Health Informatics professionals should understand the basic and advanced principles of evaluating medical records and other medical documents and apply their knowledge of medical codes and terminologies. These experts are expected to extract pertinent medical record information and other related documents for a wide range of purposes. Through the Health Informatics experts’ proper abstracting and coding, medical record personnel can easily extract accurate and appropriate information for billing and reimbursement purposes. Medical professionals can choose the medical terminology for a patient and then the healthcare organization can apply the information for legal purposes.

1.7.4. INFORMATION SYSTEMS

Health Informatics experts are responsible for securing the resources as well as establishing and maintaining the flow of all the medical information. They should ensure a user-friendly information system and analyze how the system interacts to facilitate a timely and accurate flow of information. They should evaluate the efficiency of the system and make recommendations for any improvement.

1.7.5. DOCUMENTATION

Health Informatics professionals should have a good grasp of the diverse uses of health information. They are required to convey such information in a way that is within the scope of legal and regulatory processes, they must know how to document and assemble the required information, interpret the collected information, and understand the purposes of information collection. They must learn how to prepare documentations for regulatory and legal purposes. It is imperative to understand how to impart accurate information to different kinds of audiences using standard systems, guidelines and evaluations, and recommend system processes for possible improvement.

1.7.6. OPERATIONS

Health Informatics experts must have a thorough understanding of the broad scope of operations in which healthcare services are administered. It is vital to know how to retrieve, maintain, and analyze patient information from internal and external sources. Health Informatics professionals are responsible for projecting possible outcomes from the interconnected components of an established healthcare system and selecting the appropriate systems and information for a particular task. Health Informatics professionals are responsible for participating in the design of operational systems as well as evaluating such systems and processes for possible improvements.

1.8. COMPUTATIONAL HEALTH INFORMATICS

This is a branch of computer science focuses on computational elements that are applicable to healthcare. It doubles as a branch of Health Informatics. As a branch of computer science, computer experts channel their focus to dealing with it from the aspect of computation – analyzing the underlying attributes. While the healthcare informaticists handle it from the aspect of analyzing the underlying elements of medicine that can be infused into technology, and the development of useful algorithms and systems.

Using computers to analyze health data has existed since the 1950s, but it wasn’t until the 1990’s that the first sturdy models appeared. Computer models are used to examine various topics, such as how exercise affects obesity, healthcare costs, and many more. The development of ICT led to an expansion in Health Informatics and all sectors of healthcare.

Computers are becoming an integral part of the medical equipment (for example, computerized tomography-ct). Computers are being used for surgeries, and for monitoring mini documentation for the needs of expert work and scientific researcher for the interpretation of signals.

The combination of medical science with IT and computer science creates methodologies with which both sciences meet to establish a useful collaboration. Basic medical knowledge is not only given but treatment as well. The technologies being used in Health Informatics are reexamined over again to achieve proper evaluation reports.

The creation of Health Informatics as a scientific discipline requires:

  • Data collection and test evaluation method
  • Analyzing the content of data information
  • Analysis of most effective medical treatment, actions, and opinions
  • Evaluation of medical treatment, actions, and opinions to determine the usefulness
  • Modeling and simulation analysis of healthcare systems

1.9. OUTCOMES

The primary goal of using Health Informatics in the medical field is to improve the overall health and healthcare management of patients. This can be achieved through integration of basic medical science and engineering insights with the help of useful applications. Using Health Informatics in hospitals, public surveillance, emergency responses, nursing care, health preservation, and healthcare administration can help properly collect, assess and improve better patient care delivery and management. Through the close collaboration between healthcare professionals and Health Informatics experts, new insights in the clinical practice can be appreciated. More efficient and effective use of Health Informatics can lead to the advancement of healthcare practice and clinical care.

1.10. CITATIONS

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