| Health Informatics is ...
the use of computer technologies in healthcare to store, share,
transmit and analyse clinical knowledge and data.
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| Definitions |
Health or Medical Informatics
is the "scientific field that deals with biomedical information,
data, and knowledge - their storage, retrieval, and optimal use
for problem solving and decision making. It accordingly touches
on all basic and applied fields in biomedical science and is closely
tied to modern information technologies, notably in the areas
of computing and communication (medical computer science)"
[Stanford
Medical Informatics].
"Medical information science is the science of using system-analytic
tools . . . to develop procedures (algorithms) for management,
process control, decision making and scientific analysis of medical
knowledge."
[Shortliffe EH. The science of biomedical computing.
Med Inform 1984;9:185-93.]
"Medical Informatics comprises the theoretical and practical
aspects of information processing and communication, based on
knowledge and experience derived from processes in medicine and
health care."
[Van Bemmel JH. The structure of medical informatics.
Med Inform 1984;9:175-80.]
"Information management constitutes a major activity of the
health care professional. Currently a number of forces are together
focusing attention on this function. Medical informatics is the
field that concerns itself with the cognitive, information processing,
and communication tasks of medical practice, education, and research,
including the information science and the technology to support
these tasks. It is an intrinsically interdisciplinary field, with
a highly applied focus, but it also addresses a number of fundamental
research problems as well as planning and policy issues. After
many years of development of information systems to support the
infrastructure of medicine, a new generation of systems and tools
are aimed at physicians and other health care managers and professionals
- to support education, decision making, communication, and may
other aspects of professional activity. Health care institutions
are beginning to make large-scale commitments to information systems
and to services that will affect every aspect of their organization's
function. Academic units of medical informatics are being established
at a number of medical schools, medical informatics professionals
are being sought to serve on faculties and hospital staffs, and
medical informatics is emerging as a distinct academic entity.
"
[R. A. Greenes & E. H. Shortliffe,
Medical Informatics: An Emerging Discipline with Academic and
Institutional Perspectives, Journal of the American Medical
Association 263(8):1114-1120, 1990.]
"The rational study of the way we think about patients, and
the way that treatments are defined, selected and evolved. It
is the study of how medical knowledge is created, shaped, shared
and applied."
[Enrico Coiera]
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| Health Informatics literature |
Trends in Medical Informatics literature:
"The volume of Medical Informatics literature has increased 5-fold
since 1987, with around 320,000 potentially relevant papers published between 1987 and
2003.
"Among the research types classified by MeSH, reviews dominate and
there are relatively few controlled trials. Most research is
unclassified.
"Papers on most topics are rising but some areas, such as Clinical Laboratory Information
Systems, have shown signs of decline, and others such as Computer-Assisted
Diagnosis, have show a marked recent increase, reflecting a
change in emphasis from systems & database
architectures to support applications" [Claudia Pagliari, University of Edinburgh].
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| Links |
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| References: introductions to Health
Informatics |
Frank Sullivan and Jeremy Wyatt.
ABC of Health Informatics
Blackwell BMJ Books, 2006
[]
[Blackwell Publishing]
|
"This ABC focuses on how patient data, health knowledge, and local service information are managed during the routine tasks
that make up clinical work. It looks at medical record keeping, how to use the information that records contain for clinical,
quality improvement and research activities, how to use new media to communicate with clinical colleagues and patients, and
the availability and uses of clinical knowledge resources.
"After a short introduction to health informatics, each chapter is organised around a typical patient scenario that
illustrates information dilemmas arising in clinical consultations. These case studies help make the link between
prescribing and treatment.
"A final chapter considers the implications of informatics and eHealth for the future of the health professions and their work."
(Each chapter has been previously published in the BMJ in 2005.)
Table of Contents:
- What is health information? [Blackwell Publishing - sample chapter]
- Is a consultation needed? [PubMed]
- Why is this patient here today?
[PubMed]
- How decision support tools help define clinical problems [PubMed]
- How computers can help to share understanding with patients [PubMed]
- How informatics tools help deal with patients' problems [PubMed]
- How computers help make efficient use of consultations [PubMed]
- Referral or follow-up? [PubMed]
- Keeping up: learning in the workplace [PubMed]
- Improving services with informatics tools [PubMed]
- Communication and navigation around the healthcare system [PubMed]
- eHealth and the future: promise or peril? [PubMed]
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Paul Taylor, From Patient Data to Medical Knowledge - The Principles and Practice of Health Informatics, Blackwell Scientific, 2006
[From Patient Data to Medical Knowledge (Blackwell Publishing)]
[Free sample chapter: 1. Introduction]
|
The book is "aimed primarily
at ... people who study Health Informatics
in postgraduate courses."
The book is in three parts. "The first consists of an introductory
chapter and three further chapters each of which deals with
one of [the Health Informatics] 'Grand Challenges'...
The second part deals with various techniques used
in Health Informatics and the theory behind some of them.
A key element of this is the question of how we can represent
clinical concepts in computer programs such as electronic
health care records or decision support systems... The final part of the book explores attempts to apply health informatics in practice. "
|
| Wyatt JC, Liu JL. Basic concepts in medical
informatics. J Epidemiol Community Health. 2002 Nov;56(11):808-12.
[PubMed]
[JECH
Online]
|
" This glossary defines terms used in
the comparatively young science of medical informatics. It
is hoped that it will be of interest to both novices and professionals
in the field. " |
| J.H. van Bemmel, M.A. Musen (Editors).
The Handbook of Medical Informatics. Springer-Verlag, New
York, 1998.
[V3.3
on MIEUR website] |
|
| E. H. Shortliffe G. Wiederhold, L. E.
Perreault, L. M. Fagan (editors). Medical Informatics : Computer
Applications in Health Care and Biomedicine (2nd Edition).
Springer Verlag, New York, 2000.
[Stanford]
[Preface]
[Chapter
One]
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| References: challenges for Health
Informatics |
| Haux R. Aims and tasks of medical informatics.
Int J Med Inf. 1997 Mar;44(1):9-20; discussion 39-44, 45-52,
61-6. Review.
[PubMed]
|
" Ten major long-term aims and tasks,
so to speak 'grand challenges', for research in the field
of medical informatics, including health informatics, are
proposed and described. These are the further development
of methods and tools of information processing for: (1) diagnostics
('the visible body'); (2) therapy ('medical intervention with
as little strain on the patient as possible'); (3) therapy
simulation; (4) early-recognition and prevention; (5) compensating
physical handicaps; (6) health consulting ('the informed patient');
(7) health reporting; (8) health care information systems;
(9) medical documentation and (10) comprehensive documentation
of medical knowledge and knowledge-based decision support.
Work is, in part, already in progress. To all these aims and
tasks medical informatics can and may be should make substantial
contributions. Prior to outlining the above aims and tasks,
an account is given of the meaning of medical informatics,
of the objective it pursues in general and of its achievements
so far. The present paper intends to contribute to a broad
public discussion of the aims and tasks for research in the
field of medical informatics. " |
Gell G. The internal challenges of
medical informatics. Int J Med Inf. 1997 Mar;44(1):67-74.
[PubMed]
[]
|
" Haux's [7] basic assumption that
the object of medical informatics is: "... to assure and to
improve the quality of healthcare as well as the quality of
research and education in medicine and in the health sciences
..." is taken as a starting point to discuss the three main
topics: What is the meaning of medical informatics (i.e. what
should be the main activities of medical informatics to bring
maximum benefit to medicine)? What are the achievements and
failures of medical informatics today (again considering the
impact on the quality of healthcare)? What are the main challenges?
Concerning the definition of medical informatics it is argued
that one should not hide the link to basic informatics and,
for that matter to computers, completely behind abstract definitions.
After an analysis of the purposes of the definition of a discipline,
a differentiated definition of the scope of medical informatics,
rather general when concerning the field of scientific interest,
more focused when concerning the practical (constructive)
applications, is proposed. Contrasting Haux's chapter on achievements
of medical informatics we concentrate on and analyse non fulfilled
promises of medical informatics to derive lessons for the
future and to propose 'generic' (or core) tasks of medical
informatics to meet the challenges of the future. A set of
'internal challenges' of medical informatics to change priorities
and attitudes within the discipline is put forward to enable
medical informatics to meet the 'external challenges' listed
by Haux. " |
Talmon JL, Hasman A. Medical informatics
as a discipline at the beginning of the 21st century. Methods
Inf Med. 2002;41(1):4-7.
[PubMed]
[]
|
" OBJECTIVES: To analyse the present
situation of the discipline medical informatics and to propose
actions for change. METHODS: Evaluation of the current situation
mainly based on anecdotal evidence. RESULTS: The difference
between the scientific and the engineering aspects of medical
informatics get blurred. Because of the requirements of European
funding medical informatics focuses more on engineering than
on science. Too many manuscripts are submitted that describe
engineered artefacts without a scientific purpose. Some of
the subjects (like security issues) that are studied in medical
informatics are not considered important by medical faculties
thus impeding support. CONCLUSIONS: The methodological underpinnings
of our research should be strengthened, impact studies should
be more frequently performed; the quality of results reporting
should be increased. " |
Altman RB. Informatics in the care
of patients: ten notable challenges. West J Med. 1997 Feb;166(2):118-22.
[PubMed]
[]
|
" What is medical informatics, and
why should practicing physicians care about it? Medical informatics
is the study of the concepts and conceptual relationships
within biomedical information and how they can be harnessed
for practical applications. In the past decade, the field
has exploded as health professionals recognize the importance
of strategic information management and the inadequacies of
traditional tools for information storage, retrieval, and
analysis. At the same time that medical informatics has established
a presence within many academic and industrial research facilities,
its goals and methods have become less clear to practicing
physicians. In this article, I outline 10 challenges in medical
informatics that provide a framework for understanding developments
in the field. These challenges have been divided into those
relating to infrastructure, specific performance, and evaluation.
The primary goals of medical informatics, as for any other
branch of biomedical research, are to improve the overall
health of patients by combining basic scientific and engineering
insights with the useful application of these insights to
important problems. " |
| Sittig DF. Grand challenges in medical
informatics? J Am Med Inform Assoc. 1994 Sep-Oct;1(5):412-3.
[PubMed]
[PubMedCentral]
|
" 'Grand challenges' are fundamental
scientific or technologic problems whose solutions require
significant increases in our current levels of scientific
knowledge and/or technical capabilities. Their solutions should
significantly improve both the quality and the delivery of
health care while decreasing its costs. Finally, solutions
to these problems should be achievable within a decade.
Development of a list of the grand challenges facing the field
of medical informatics could serve several purposes. First,
it could attract support from funding agencies by identifying
and prioritizing projects worthy of economic and political
support. Second, it could serve as a method for drawing young
people facing difficult career choices into the field by highlighting
the key intellectual or technologic challenges within the
field and the potential benefits that might accrue to society
upon their solution. Third, it could provide an alternative
definition of the field. ... " |
| Greenes RA, Shortliffe EH. Medical
informatics. An emerging academic discipline and institutional
priority. JAMA. 1990 Feb 23;263(8):1114-20.
[PubMed]
[]
|
" Information management constitutes
a major activity of the health care professional. Currently,
a number of forces are focusing attention on this function.
After many years of development of information systems to
support the infrastructure of medicine, greater focus on the
needs of physicians and other health care managers and professionals
is occurring--to support education, decision making, communication,
and many other aspects of professional activity. Medical informatics
is the field that concerns itself with the cognitive, information
processing, and communication tasks of medical practice, education,
and research, including the information science and the technology
to support these tasks. An intrinsically interdisciplinary
field, medical informatics has a highly applied focus, but
also addresses a number of fundamental research problems as
well as planning and policy issues. Medical informatics is
now emerging as a distinct academic entity. Health care institutions
are considering, and a few are making, large-scale commitments
to information systems and services that will affect every
aspect of their organizations' function. While academic units
of medical informatics are presently established at only a
few medical institutions in the United States, increasing
numbers of schools are considering this activity and many
traditional departments are seeking and attracting individuals
with medical informatics skills. " |
| Shahar Y. Medical informatics: between
science and engineering, between academia and industry. Methods
Inf Med. 2002;41(1):8-11.
[PubMed]
|
" OBJECTIVE: To analyze the nature and
appropriate role of the Medical Informatics research and practice
area in the 21st Century, and to determine its links to academic
environments versus industrial companies and health-care organizations.
METHODS: A qualitative analysis of the state of the art of
Medical Informatics, based on observation of current medical
informatics programs and research in academic and industrial
sites. RESULTS AND CONCLUSIONS: Medical Informatics is definitely
a scientific and technological area of endeavor, although
somewhat ill-defined in scope. It is situated between science
and engineering, but much closer to the engineering world,
and its multidisciplinary nature fits well the engineering
paradigm. It is better viewed as a specialization of the informatics
field rather than as a basic medical science. However, there
are good arguments as to why Medicine should be the first
among equals to have its own informatics domain. Medical Informatics
must have extensions to both academia and industry to survive.
Medical informaticians, whether implicitly or explicitly,
exist in three different environments: academic, clinical
(user), and industrial (informatics developer); all three
environments must be considered when trying to predict the
future of this new multidisciplinary area. " |
Musen MA. Medical informatics: searching
for underlying components. Methods Inf Med. 2002;41(1):12-9.
[PubMed]
[] |
" OBJECTIVE: To discuss unifying
principles that can provide a theory for the diverse aspects
of work in medical informatics. If medical informatics is
to have academic credibility, it must articulate a clear
theory that is distinct from that of computer science or
of other related areas of study. RESULTS: The notions of
reusable domain antologies and problem-solving methods provide
the foundation for current work on second-generation knowledge-based
systems. These abstractions are also attractive for defining
the core contributions of basic research in informatics.
We can understand many central activities within informatics
in terms defining, refining, applying, and evaluating domain
ontologies and problem-solving methods. CONCLUSION: Construing
work in medical informatics in terms of actions involving
ontologies and problem-solving methods may move us closer
to a theoretical basis for our field. " |
Kaplan B, Brennan PF, Dowling AF, Friedman
CP, Peel V. Toward an informatics research agenda: key people
and organizational issues. J Am Med Inform Assoc. 2001 May-Jun;8(3):235-41.
[PubMed]
[PubMed
Central]
|
" As we have advanced in medical informatics
and created many impressive innovations, we also have learned
that technologic developments are not sufficient to bring
the value of computer and information technologies to health
care systems. This paper proposes a model for improving how
we develop and deploy information technology. The authors
focus on trends in people, organizational, and social issues
(POI/OSI), which are becoming more complex as both health
care institutions and information technologies are changing
rapidly. They outline key issues and suggest high-priority
research areas. One dimension of the model concerns different
organizational levels at which informatics applications are
used. The other dimension draws on social science disciplines
for their approaches to studying implications of POI/OSI in
informatics. By drawing on a wide variety of research approaches
and asking questions based in social science disciplines,
the authors propose a research agenda for high-priority issues,
so that the challenges they see ahead for informatics may
be met better. " |
|
| acknowledgements |
| |
Entry on OpenClinical: 2001
Redesigned: 1 January 2004 Last main update: 31 January 2004;
03 March 2005; 09 September 2005
|
|
Health
Informatics World Wide - comprehensive sets of links maintained
by Stefan Schulz and Rüdiger Klar at Freiburg University, Germany