Medical informatics

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A holistic view of an e-patient record
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Contents

Introduction

See also Bioinformatics, Canada Health Infoway, Electronic patient record and web 2.0

Medical informatics (MI) - see also health informatics - is a discipline at the nexus of information science, medicine and health care. As such, it deals with the devices, methods and resources needed for the storage, retrieval and use of medical information. In computerizing health care, the focus is to augment the overall effectiveness of activities by processing as much information as possible and integrating it with care. MI utilizes computers in patient care and places importance on the electronic patient record. MI encompasses a range of tools including clinical guidelines, medical terminologies and communication systems.

Subdomains of biomedical or health care informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, bioinformatics and pharmacy informatics. Rapid development of health informatics is due to advances in computing, communication technology and an increasing awareness that the knowledge base of medicine is essentially unmanageable by traditional paper-based methods. (See also Medical education in Canada).

Medical informatics in North America

In 1965, the U.S. National Library of Medicine offered access to MEDLINE, which spurred on several decades of innovation in computer use and clinical medicine. In the 1990s, the Health Insurance Portability and Accountability Act (HIPAA) regulations created the impetus for large numbers of physicians to move towards using medical records software, 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 (EHRs) within 10 years. The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the U.S. Department of Health and Human Services to develop a set of standards for electronic health records (EHR). In July 2006, CCHIT released its first list of 22 certified ambulatory EHR products.

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.

Canadian context

Medical informatics (MI) is widely used as a term in the health disciplines in Canada. Its profile has risen since the late 1990s when the University of Victoria started a medical informatics program in the faculty of Health Information Science. Degrees to the PhD-level are now offered across Canada where considerable informatics-related research takes place. In searching for information about informatics, terms such as "health informatics", "pharmacy informatics" and "nursing informatics" can be used; or, 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 skills or whether information literacy is really 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

Websites

  • AMIA - American Medical Informatics Association - AMIA "is the premier association in the United States dedicated to the development and application of medical informatics in the support of patient care, teaching, research, and health care administration."
  • Canadian Health Infostructure is a national health information highway utilizing the newest information and communications technologies (ICTs).
  • COACH - Canada's Health Informatics Association founded in 1975, is a leading and growing organization with a membership in excess of 750. It is in the forefront of the Canadian healthcare information resource and technology field by working co-operatively with health institutions, professions, associations, consultants, vendors of information technology and applications, government and regulatory organizations in the persuit of its mandate.
  • HIMSS - The Healthcare Information and Management Systems Society (HIMSS) is a not-for-profit organization dedicated to promoting understanding of health care information and management systems. HIMSS represents over 6,000 clinical systems, information systems, management engineering and telecommunications professionals. Its mission is to provide leadership in the management of systems, information, and change through high-quality publications and educational opportunities. The society is regarded as an resource for health care professionals, policy makers, developers and those whose goal is the continuous improvement of health care delivery systems.
  • HIRU - The Health Information Research Unit at McMaster University conducts research in the field of health information science and is dedicated to the generation of new knowledge about the nature of health and clinical information problems, the development of new information resources to support evidence-based health care, and the evaluation of various innovations in overcoming health care information problems.
  • IMIA - International Medical Informatics Association Since 1978, a group of professionals has been active within the framework of IFIP and under the name of IMIA, with the objective of serving the specific needs of the application of information technology in the field of health care and biomedical research.

References
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