Aspects of the field
- architectures for electronic medical records and other health information systems used for billing, scheduling, and research
- decision support systems in healthcare, including clinical decision support systems and information workflows
- standards (e.g. DICOM, HL7) and integration profiles (e.g. Integrating the Healthcare Enterprise) to facilitate the exchange of information between healthcare information systems—these specifically define the means to exchange data, not the content
- controlled medical vocabularies (CMVs) such as the Systematized Nomenclature of Medicine, Clinical Terms (SNOMED CT), MEDCIN, Logical Observation Identifiers Names and Codes (LOINC), OpenGALEN Common Reference Model or the highly complex UMLS—used to allow a standard, accurate exchange of data content between systems and providers
- use of hand-held or portable devices to assist providers with data entry/retrieval or medical decision-making, sometimes called mHealth.
- The international standards on the subject are covered by ICS 35.240.80[1] in which ISO 27799:2008 is one of the core components.[2]
- Molecular bioinformatics and clinical informatics have converged into the field of translational bioinformatics.
History
Informatics were a central part of the Nazi health care system, which included Nazi eugenics as one of it's fundamental principles. New systems and technology, like electronic punch card tabulating and sorting machines, and the science of medical statistics, were used to gather, sort, and analyze personal information on a vast scale unseen before in human history. The information was used to help find and eliminate the 'genetically inferior' through sterilization or wholesale murder. Many of the architects of these systems would go on to play a role in the post-war medical informatics field. [3]
World wide use of technology in medicine began in the early 1950s with the rise of the computers.[4] In 1949, Gustav Wager established the first professional organization for informatics in Germany.[5] The prehistory, history, and future of medical information and health information technology are discussed in reference.[6][5] Since then the development of high-quality health informatics research, education and infrastructure has been the goal of the U.S. and the European Union.[5] Specialized university departments and Informatics training programs began during the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units began to appear during the 1970s in Poland and in the U.S.
Early names for health informatics included medical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science, medical software engineering, and medical computer technology.[citation needed]
The health informatics community is still growing, it is by no means a mature profession, but work in the UK by the voluntary registration body, the UK Council of Health Informatics Professions has suggested eight key constituencies within the domain - information management, knowledge management, portfolio/programme/project management, ICT, education and research, clinical informatics, health records(service and business-related), health informatics service management. These constituencies accommodate professionals in and for the NHS, in academia and commercial service and solution providers.
Since the 1970s the most prominent international coordinating body has been the [[International Medical Informatics Association]] (IMIA).[citation needed]
Medical informatics in the United States
Even though the idea of using computers in medicine sprouted as technology advanced in the early twentieth century, it was not until the 1950s that informatics made a realistic impact in the United States.[4]
The earliest use of computation for medicine was for dental projects in the 1950s at the United States National Bureau of Standards by Robert Ledley.[7]
The next step in the mid 1950s were the development of expert systems such as MYCIN and Internist-I. In 1965, the National Library of Medicine started to use MEDLINE and MEDLARS. At this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett's Laboratory of Computer Science [8] at Massachusetts General Hospital in Boston.[9] In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system was used to support MUMPS language specifications. As of 2004, a descendent of this system is being used in the United States Veterans AffairsVeterans Health Information Systems and Technology Architecture (VistA). A graphical user interface known as the Computerized Patient Record System (CPRS) allows health care providers to review and update a patient’s electronic medical record at any of the VA's over 1,000 health care facilities. hospital system. The VA has the largest enterprise-wide health information system that includes an electronic medical record, known as the [update]
In the 1970s a growing number of commercial vendors began to market practice management and electronic medical records systems. Although many products exist, only a small number of health practitioners use fully featured electronic health care records systems.
Homer R. Warner, one of the fathers of medical informatics,[10] founded the Department of Medical Informatics at the University of Utah in 1968. The American Medical Informatics Association (AMIA) has an award named after him on application of informatics to medicine.
Health informatics law
For more details on this topic, see Health law.
Health informatics law deals with evolving and sometimes complex legal principles as they apply to information technology in health-related fields. It addresses the privacy, ethical and operational issues that invariably arise when electronic tools, information and media are used in health care delivery. Health Informatics Law also applies to all matters that involve information technology, health care and the interaction of information. It deals with the circumstances under which data and records are shared with other fields or areas that support and enhance patient care.
Clinical Informatics
Clinical Informatics is concerned with use information in health care by clinicians.[32][33]
Clinical informaticians transform health care by analyzing, designing, implementing, and evaluating informationcommunication systems that enhance individual and population health outcomes, improve [patient] care, and strengthen the clinician-patient relationship. Clinical informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to: and
- assess information and knowledge needs of health care professionals and patients,
- characterize, evaluate, and refine clinical processes,
- develop, implement, and refine clinical decision support systems, and
- lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems.
Clinicians collaborate with other health care and information technology professionals to develop health informatics tools which promote patient care that is safe, efficient, effective, timely, patient-centered, and equitable.
