Medical informatics

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A holistic view of an e-patient record
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Contents

Last Update

  • Updated.jpg 21 January 2016

Introduction

See also Bioinformatics | Clinical data trends | Electronic health records (EHRs) | Medical education portal | Pharmacy informatics | Wearable computers

Medical informatics (see also health informatics) is an information-age profession " ...at the intersection of information science, medicine and health care". As such, it deals with devices, methods and resources needed to store, retrieve and use digital medical information. Medical informatics focuses on the improvement of electronic processes and activities that support patient care. Thus medical informatics is concerned with using computers in all aspects of caring for patients in the health care system, and as such emphasizes the electronic patient record. The field encompasses a range of tools including clinical guidelines, controlled thesauri, medical terminologies and electronic communication systems. Subdomains of biomedical or health informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, bioinformatics and pharmacy informatics. The rapid development of health informatics is due to advances in computing, communication technologies and an increased awareness that the knowledge base of medicine is essentially unmanageable using paper-based methods alone. For clinicians interested in tracking down data from clinical trials, see Missing Data UK.

Medical librarians who want to see the many roles available to them in medical informatics are advised to read King SB, Lapidus M. Metropolis revisited: the evolving role of librarians in informatics education for the health professions. J Med Libr Assoc. 2015 Jan;103(1):14-8..

Medical informatics in North America

In 1965, the National Library of Medicine provided access to searching via MEDLINE, which triggered decades of innovation in the use of computers in clinical medicine. In the 1990s, the Health Insurance Portability and Accountability Act (HIPAA) created the impetus for large numbers of physicians to move towards using medical records systems, primarily for billing purposes. Progress towards a standardized health information infrastructure in Canada and the United States is ongoing. In 2002, the Canadian Romanow Report provided several recommendations for the use of computers in medicine, and electronic patient records. In 2004, the Department of Health and Human Services (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT). Its mission is to achieve widespread adoption of interoperable electronic health records within 10 years. The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the US Department of Health and Human Services to develop a set of standards for electronic health records. In 2006, CCHIT released its first list of 22 certified ambulatory EHR products.

Clinical informatics

Clinical informatics is a scientific discipline that aims to enhance human health by implementing information technologies and knowledge management systems to prevent human disease, deliver efficient and safe patient care, increase translational research, and improve biomedical knowledge systems. According to Gardner et al (2009), "...clinical informaticians transform health care by analyzing, designing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship". Further, informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools 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
  • lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems.

See also SGS Canada - Clinical Trial Project Management 800px-Flag of Canada.svg.png

Informatics journals

Handhelds and palm-computing platforms can be of enormous value to physicians in patient monitoring and as a portable reference. Examine PDA MD and Healthy Palmpilot for examples of clinical applications. An integration of technology targeted at solving existing information management problems may be of benefit to pharmacy professionals.

  • systematic overview of medical informatics for health professionals, scientists and students
  • latest developments in clinical informatics and computing
  • disseminates original papers and interpretative reviews
  • one of the top impact factor journals in health informatics
  • peer-reviewed articles for physicians, informaticians, scientists, nurses, and other health professionals

Canadian & international contexts

Medical informatics (MI) is a term used in various health disciplines in Canada. Its profile has risen a lot since the late 1990s when the University of Victoria started a medical informatics program in its faculty of Health Information Science. Degrees to the PhD-level in medical informatics are offered across Canada, especially where informatics-related research takes place. In searching for information about informatics, terms such as "health informatics", "pharmacy informatics" and "nursing informatics" can be used; alternatively, more specific uses of information and communications technologies (ICTs) in health. A number of prominent national associations guide medical and health informatics in Canada. COACH - Canada's Health Informatics Association provides access to a diverse community of professionals who work to advance healthcare through the use of information technology. The recently-formed National Institutes of Health Informatics (NIHI) is an organization dedicated to fostering health informatics research and education in Canada. NIHI has been launched with the participation of researchers from across Canada in universities and colleges, especially where informatics is taught or the focus of research.

Many medical schools follow the AAMC and AMIA principles of medical informatics. One aspect of medical informatics that is the subject of some debate is whether health librarians should be responsible for teaching informatics or whether information literacy is what is most needed. At a national level, the Canada Health Infoway - http://www.infoway-inforoute.ca/ is an independent not-for-profit initiative that includes Canada's fourteen federal, provincial and territorial health ministries. 'Infoway' is responsible for developing electronic health information systems and electronic patient records. Health informatics in Canada is a provincial responsibility and different provinces have created different systems:

  • eHealth Ontario was created in September 2008 but it has been plagued by delays and its CEO was fired over a multimillion-dollar contracts scandal in 2009
  • Alberta Netcare was created in 2003 and the netCARE portal is used by clinicians to access demographic data, prescribed/dispensed drugs, known allergies/intolerances, immunizations, laboratory results, diagnostic imaging reports, the diabetes registry and other reports

Key websites

The following list includes Canadian and international bodies whose purpose is to promote medical informatics:

Websites

  • BioMedical and Life Sciences Division (DBIO) of the Special Libraries Association poll
  • This post compares polls which asked the same question: which medical journals are most important in your work?
  • MDs poll: New England Journal of Medicine’s “Essential Journals Study” http://nejmadsales.org/html/marketresearch.html

References

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