Medical informatics

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Medical informatics (also called health care informatics) is a term describing the use of information technology within the health care industry. Medical informatics deals with both the clinical and public health aspects of health care. Medical informatics and bioinformatics (also known as computational biology), are sometimes grouped together and called, more broadly, Biomedical Informatics.

Classification

Bioinformatics

For more information, see: Bioinformatics.

The use of information technology in biology is the focus of bioinformatics. Generally speaking, the focus of bioinformatics is rather different, emphasizing sequence analysis, quantitative analysis of protein structure, and similar problems. It is a matter of debate how fundamentally different the two fields are, though the emphasis on healthcare delivery gives medical informatics a decidedly different focus. On the one hand, it is argued that advances in medical technology will lead to a tighter linkage of the two fields. Others argue that medical informatics is already a field with clearly defined goals and problems, and that any links between the two fields are speculative at present.

Clinical informatics

This is a very broad field including:[1][2][3][4]

  • The organization and representation of information in healthcare. This includes not only taxonomies and ontologies, but also usability studies of presenting general knowledge in a usable manner. [5][6][7]
  • The development and use of controlled vocabularies in healthcare and computer systems used in healthcare
  • More generally, the development and use of ontologies as an aid to managing health related information
  • Clinical decision support, both as a theoretical and a practical (engineering) problem, in order to promote evidence-based medicine.
  • Information retrieval[8][9], which includes information discovery (searching for information to solve a specific problem, searching for background information, and searching to keep up[10]), information recovery (pursing an article that searcher knows exists)[11], and information awareness.
  • The electronic health record (EHR) and patient record systems are another important area. A narrower but more popular and widely used system is the electronic medical record. This is an area that poses a number of technical challenges, but issues such as usability, patient safety and privacy are obviously of paramount importance. Another interesting area is mobility and portability of information. Obviously, in critical care situations it is highly desirable to have access to information that may not be maintained locally (such as adverse reactions), but making this information available raises significant privacy concerns. It also poses a number of technical challenges because systems that are developecd independently may use very disimilar means of representing and storing information. Health information systems must also be convenient to use, and sufficiently comprehensive to be of value to health care providers. If they do not add value to traditional means of information management (such as paper charts, they are unlikely to be used.

Standards

There are two (sometimes competing) standards developing organizations that have focused on developing standards for the representation and interchange of information in informatics. One is Health Level Seven (HL7), and the other is ASTM International, specifically the Technical Committee E31 (Healthcare Informatics).

Message/Interface standards

Coding systems

Specialists in medical informatics

Certification has been proposed for specialists in clinical informatics.[12]

References

  1. Taylor, Paul (2006). From Patient Data to Medical Knowledge: The Principles and Practice of Health Informatics. Blackwell Publishing Limited. ISBN 0-7279-1775-7. 
  2. Coiera, Enrico (2003). Guide to health informatics. London: Arnold. ISBN 0-340-76425-2. 
  3. Shortliffe, Edward Hance; Cimino, James D. (2006). Biomedical Informatics: Computer Applications in Health Care and Biomedicine (Health Informatics). Berlin: Springer. ISBN 0-387-28986-0. 
  4. Bordage G, Lemieux M (1990). "Which medical textbook to read? Emphasizing semantic structures". Academic medicine : journal of the Association of American Medical Colleges 65 (9 Suppl): S23–4. PMID 2400489[e]
  5. Beck AL, Bergman DA (1986). "Using structured medical information to improve students' problem-solving performance". Journal of medical education 61 (9 Pt 1): 749–56. PMID 3528494[e]
  6. Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME (2005). "Answering physicians' clinical questions: obstacles and potential solutions". Journal of the American Medical Informatics Association : JAMIA 12 (2): 217–24. DOI:10.1197/jamia.M1608. PMID 15561792. Research Blogging.
  7. Nielsen, J. Writing Inverted Pyramids in Cyberspace (Alertbox). Retrieved on 2007-11-16.
  8. Hersh, William R. (2003). Information retrieval: a health and biomedical perspective. Berlin: Springer. ISBN 0-387-95522-4. 
  9. Hersh WR, Hickam DH (1998). "How well do physicians use electronic information retrieval systems? A framework for investigation and systematic review". JAMA 280 (15): 1347–52. PMID 9794316[e]
  10. Warner, Amy J.; Lancaster, Frederick Wilfrid (1993). Information retrieval today. Arlington, Va: Information Resources Press. ISBN 0-87815-064-1. 
  11. Garfield, E. (1966). ISI eases scientists’ information problems; Provides convenient orderly access to literature. Karger Gazette, 13, p2 March 5, 1966 (reprinted in The who and why of ISI
  12. Detmer DE, Munger BS, Lehmann CU. Medical Informatics Board Certification: History, Current Status, and Predicted Impact on the Medical Informatics Workforce. Applied Clinical Informatics 2010;1(1):11-18. DOI:10.4338/ACI-2009-11-R-0016

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