Medical informatics
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Medical Informatics. "Medical informatics is the application of computer technology to all fields of medicine - medical care, medical teaching, and medical research." Morris F. Collen, 1977

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Medical Informatics

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Medical informatics

Medical Informatics

  • "Medical informatics is the application of computer technology to all fields of medicine - medical care, medical teaching, and medical research." Morris F. Collen, 1977

  • "Medical informatics is the scientific field that deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making." M.S. Blois and Edward H. Shortliffe, 1990


Medical informatics1

Medical Informatics

  • Deals with all aspects of understanding and promoting the effective organization, analysis, management, and use of information in health care (American Medical Informatics Association website)

  • Improve and optimize use of health care information to improve decision making


Examples of medical informatics tools

Examples of Medical Informatics Tools

  • Desktop and laptop computers

  • Handheld wireless devices (e.g., PDAs)

  • Networks

  • Databases


Examples of medical informatics applications

Examples of Medical Informatics Applications

  • Electronic medical records

  • Electronic order entry

  • Automated reminders

  • Computerized expert systems

  • Electronic mail

  • Telemedicine

  • Digital imaging

  • Voice recognition


Safety

Safety

  • Computerized order entry systems can reduce medication errors

    • Improve drug prescribing

    • Improve drug dosing

    • Drug-drug interactions

    • Drug allergies

      Bates et al. JAMA. 1998; Bates et al. J Am Med Inform Assoc. 1999; Teich et al. Arch Intern Med. 2000


Effectiveness

Effectiveness

  • Computerized reminders can improve compliance with recommended guidelines

    • Increase preventive services

    • Increase use of appropriate medications

    • Increase use of other interventions

      Hunt et al. JAMA. 1998; Shea et al. J Am Med Inform Assoc. 1996


Quality of care

Quality of Care

  • Computerized decision support can improve quality

    • Prevention of venous thromboembolism

    • Use of antibiotics

      Durieux et al. JAMA. 2000; Teich et al. Arch Intern Med. 2000;

      Evans et al. N Engl J Med. 1998


Costs

Costs

  • Electronic medical records with decision support can reduce costs

    • Reducing medical errors and adverse events

    • Recommending equally effective but less costly alternative interventions

    • Reducing the use of inappropriate tests

    • Reducing the ordering of redundant tests

      Teich et al. Arch Intern Med. 2000; Bates et al. JAMA. 1998; Glaser et al. Proc Healthcare Information and Management Systems Society Annual Conf. 1996


Outcomes vs process measures

Outcomes vs Process Measures

  • Most studies have evaluated process measures

  • Many studies have demonstrated improvements in process measures using decision support systems

  • Few studies have assessed patient outcomes


Patient centered care

Patient Centered Care

  • Information

  • Communication

  • Shared decision making


Other technologies

Other Technologies

  • Wireless devices

  • Automated data capture and transmission

  • Smart cards

  • Bar coding

  • Smart automated medication dispensers

  • Interactive patient decision support

  • Computer simulation for education and training


Barriers

Barriers

  • Lack of technology infrastructure

  • Lack of standards

  • Cultural barriers

    • Eminence-based medicine

    • Tradition

    • Resistance to change

  • Complexity of medicine

  • Workflow issues

  • Human factor issues


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