1. Overview and introduction to health informatics & Dental Informatics (DI)
Dr Ebtissam M. Al-Madi

2. Overview and introduction to health informatics & Dental Informatics (DI)
Different definitions of Health informatics, medical informatics and Dental informatics
History of Health and Informatics
The discipline of Health Informatics
Scope of Health informatics
Scope of Dental Informatics
Uses of health & dental informatics
Current issues in health informatics

3. Health & Medical Informatics
Different definitions of Health informatics, medical informatics and Dental informatics
Health & Medical Informatics

4. "Medical informatics is the application of computers, communications and information technology and systems to all fields of medicine - medical care, medical education and medical research.“
definition by MF Collen (MEDINFO '80, Tokyo, later extended)

5. Medical Informatics
"Medical informatics is a developing body of knowledge
and a set of techniques concerning the organizational
management of information in support of medical
research, education, and patient care.... Medical
informatics combines medical science with several
technologies and disciplines in the information and
computer sciences and provides methodologies by which
these can contribute to better use of the medical
knowledge base and ultimately to better medical care.“
Definition by Asso. of American Medical Colleges (AAMC) 1986

6. Health Informatics
Health informatics, Health care informatics or medical informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. It is applied to the areas of nursing, clinical care, dentistry, pharmacy, public health and (bio)medical research.

7. Analysis of definition
patient care, research, and education
combination of and interface between several disciplines
not just computers but information in general (eg DA)
practical goal: to provide better health care

8. Origin of term "Medical Informatics"
Russian = informatika 1968
structure and properties of scientific information
French = informatique de medecine 1968
university departments established with this title
English = first appeared in 1970s
Name changed from Medical Information Science

9. Dental Informatics
Dental informatics is the application of computer and information science to improve dental practice, research, education and management.

10. Origin of field interface among disciplines
initially: computer science (AI) applied to medicine
later: biostatistics, DA, economics, cognitive psychology

11. Appearance of computers in medicine
1960s - practical = early use only in departmental research = early ECG and diagnosis
1970s - practical = Huge size- administrative & departmental, imaging (CT), early bibliographic retrieval & research
1980s - practical = results reporting, outpatient services growth of clinical systems and databases research = Artificial Intelligence, Information Retrieval
1990s - practical = integration, communication research = vocab, interfaces, coding, evaluation
Note how medicine lags computer hardware

12. Slow at first Computers have been slow to enter clinical care:
# hosp with billing, Administrative vs lab + clinical, Artificial Intelligence.
# offices with clinical systems.
but clinical care is largely the management of info.
primarily in the background: practice mgmt, libraries, billing, financial

13. Gaining popularity recent increase of medical informatics
not new field but marked increase in popularity, funding, publication
eg 1984 AAMC recommended formation of MI academic units (first done in Europe, esp France, in the 1960s)

14. Factors in recent increase of medical informatics
increase in use of technology - more data generated
mobility of population - need to communicate
specialization - need to communicate
managed care systems - need to communicate
rise in health care costs - attempt to control care
improved hardware - faster and more memory
improved methods - acquisition, transfer, retrieval
reduced computer costs
increased awareness

15. Factors in lack of use of computers in clinical care
involves complex organisms (unlike physical processes)
if over-simplify, not useful (vs bank transaction)
therefore need sophisticated abstraction + detail
technology for gathering complex info. just emerging, eg low use of QMR or Dxplain therefore providers have not entered info.
reimbursement has not been linked to clinical info., therefore many admin. systems but few clinical
health care administered by individuals, small groups
less need for coordination
inertia
fear: "cookbook medicine"
liability
ignorance
money
security, integrity
lack of standards
language
previous failures
rapid turnover of technology

16. Discipline of Health Informatics
Why need a new discipline?
often cannot get credit in related fields for work at the interface of related disciplines
few were championing clinical applications
Medical informatics as a science
broad spectrum (theory to practice)
basic science (knowledge for itself, models)
experimental science (hypothesis, experiment, analysis)
applied science, engineering (practical goals)

17. Composition of medical informatics groups
MDs, RNs, dentists, other health care workers
PhDs, esp computer science (also physics, ...)
Administrators, policy planners
Masters, PhD programs in medical informatics
Industry
Part-time vs full-time
Institutional organization
Division within medicine
Aspect of computer science
Inter-disciplinary center
Department (like biostatistics): relatively unusual in USA

18. Scope of Health Informatics
Health informatics encompasses all the areas where technology and information contribute to the support of health care delivery, management, planning and research.
Related to the core areas are themes such as ethics, attitudes learning, coping with third party interactions – all ‘into and utilizing’ health informatics.
Other research has been identified into content provision, generating an evidence base and knowledge management.

19. Scope of Dental Informatics
Information Science:
is the collection, classification, storage, retrieval, and dissemination of recorded knowledge treated both as a pure and as an applied science.
Computer science:
is a discipline that involves the understanding and design of computers and computational processes. Here, the emphasis is not on information, but how it is represented, processed, manipulated, and managed in computing systems.

20. Scope of Dental Informatics
Cognitive science:
is a research area that draws on several fields (such as psychology, artificial intelligence, linguistics, and philosophy) to develop theories of perception, thinking, and learning.
Cognitive science relates to information science as we try to understand how information is represented in the human mind.
Computer science relates to information science as try to simulate our mental processes in computing environments.
Biomedicine is replete with complex cognitive processes (such as diagnosis, treatment planning, and evaluation).

21. Scope of Dental Informatics
Telecommunications:
Is the science that deals with communication at a distance.
Transmission of digital images efficiently resulted in new approaches to image compression and transmission.
Another example is aggregating information from many different sources, such as information about the same patient from different healthcare providers.

22. Current Issues in Health Informatics
Current issues in clinical care
Cost
Accessibility of health care
Coordinating care and setting policy
Standards of terminology
Acquisition and retrieval of data (eg across inst.)
Data Privacy, confidentiality and security
Acquisition and sharing of knowledge (eg specialist).

23. Current Issues in Health Informatics
Medical informatics research mirrors clinical issues
Data acquisition
Data storage - databases, modeling
Vocabularies - format, content
Organization of data
Machine interfaces - standards like HL7, security
Data retrieval - query languages
Knowledge acquisition
Knowledge representation
Application of knowledge when needed –
Decision analysis, alerts, diagnosis
Education
Care plans and practice guidelines

24. Current Issues in Health Informatics
General research questions in medical informatics
Knowledge extraction from databases
Structuring knowledge: impact on acquisition, storage and retrieval
Linking different classes of knowledge
Using knowledge to make decisions
Human factors in computing
Taxonomy
Linking disparate systems

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26. Any Questions?
Thank you
Dr Ebtissam Al-Madi