Health Informatics PHTR 498 Spring 2015

Lecture #2 Introduction to Health Informatics Amar Hijazi, Majed Alameel, Mona Almohaid

“By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.” 1 President George W. Bush أن الصحة الالكترونية أحد مقومات نجاح الرعاية الصحية الحديثة فلقد أولت الصحة الالكترونية اهتمامها وأوجدت كوادر متميزة للاهتمام بها وأنشأت لجانًا استشارية من جميع القطاعات الصحية. 2 وزير الصحة د. عبدالله الربيعة 1.M. Allen, “Bush Touts Plan for Electronic Medicine,” Washington Post, 28 May

What is the common definition? “The knowledge, skills and tools which enable information to be collected, managed, used and shared to support the delivery of healthcare and promote health.” Making Information Count: A Human Resources Strategy for Health Informatics Professionals Department of Health (October 2002) “The understanding, skills and tools that allow knowledge and information to be available as and when it is needed, so that it can be shared and used effectively across the entire healthcare delivery process.” Protti, D “The science of information management in healthcare, and its application to support clinical practice, decision-making and research.” Adapted from: Wyatt J Medical Informatics –Artefact or Science? Methods Inf Med 1996;3: Health informatics made simple Health informatics explained, for healthcare professionals in the NHS The definitions identify that technology plays a central role, but the scope of health informatics is much broader than just the use of computers.

“the computerization of medicine, including medical services, education, and research” Collen (1977) “knowledge and experience gained from processing and communicating medical and health care information via a paired theoretical-practical lens on the medical process” van Bemmel (1984) “As an integrative discipline that interweaves the applications of computational, cognitive, informational, organizational, and other sciences on the processes and use of clinical and biomedical information” Hersh (2002) “scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem solving and decision making” Shortliffe (1995)

Informatics Definition Health informatics is the field of information science concerned with management of healthcare data and information through the application of computers and other technologies In reality, it is more about applying information in the healthcare field than it is about technology per se. Dr. Safran of the American Medical Informatics Association “technology is not the destination, it is the transportation.”

Why so many definitions? The definition of health informatics is dynamic because the field is relatively new and rapidly changing

Health Informatics Synonyms Clinical informatics Medical informatics Biomedical informatics

What informatics is and isn’t By:Charles P Friedman J Am Med Inform Assoc 2013;20:224–226. doi: /amiajnl

INFORMATICS AS CROSS-TRAINING Locate in discipline space where (1) a particular set of relevant basic sciences meets (2) an application domain that is typically a field of professional practice

Cross-training creates unique forms of creative potential and problem-solving capability Cross-training also enables communication with both the basic scientists and the full-time professionals

THE ‘FUNDAMENTAL THEOREM’ “that persons supported by information technology will be better than the same persons performing the same task unassisted.” The theorem emphasizes how and why informatics is a field about people as much as it is about technology

Informatics is not Scientists or clinicians tinkering with computers Analysis of large datasets per se Circumscribed roles related to deployment and configuration of electronic health records in pursuit of meaningful use The profession of health information management Anything done using a computer

Health Informatics Programs Can be degree, certificate, fellowship and short courses The majority of health informatics students in the past have come from healthcare fields

Influences Health Informatics Specialties e.g. nursing informatics RegulationComputer Science Biomedical Engineering Medical specialties Other basic and applied sciences

Who wants health informatics? Increasing patient expectation and education Increasing litigation (legal problems) Demand for transparent processes Clinical governance and audit

Health Challenges In 2007, national health care expenditures in the United States totalled $2.2 trillion or 16% of its gross domestic product, a 14% increase from This represents an average of more than $7,400 per person 1.National Center for Health Statistics. Health, United States, 2009, with chartbook on trends in the health of Americans. Hyattsville, MD: 2010.

IOM’s Wake up call To Err is Human: Building a Safer Health System (IOM, 1999) – Identified that at least 44,000 and perhaps as many as 98,000 hospitalized Americans die every year from medical errors Preventing Medication Errors (IOM, 2007) – Medication errors injure 1.5M people

Who wants health informatics? 11% of lab tests repeated Because result is lost 30% of treatment orders are undocumented 70% of acutely ill patients get right treatment 30% get contraindicated treatment 500% growth in number of new drugs in a decade

Who wants health informatics?

Can the Technology help? In 2005, a study estimates that the American health sector can save up to $77.8 billion a year by introducing standardized, exchanged health care information systems