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What is Medical Informatics?

What is Medical Informatics?. Nancy B. Clark, M.Ed. Director of Medical Informatics Education Florida State University. Health (Medical) Informatics. Simplistic definition:

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What is Medical Informatics?

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  1. What is Medical Informatics? Nancy B. Clark, M.Ed. Director of Medical Informatics Education Florida State University

  2. Health (Medical) Informatics Simplistic definition: • 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. MF Collen, MEDINFO '80, Tokyo

  3. Health (Medical) Informatics • Medical informatics is the rapidly developing scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem solving and decision making.Edward Shortliffe, M.D., Ph.D. What is medical informatics? Stanford University, 1995.

  4. Health (Medical) Informatics • Medical Informatics is the branch of science concerned with the use of computers and communication technology to acquire, store, analyze, communicate, and display medical information and knowledge to facilitate understanding and improve the accuracy, timeliness, and reliability of decision-making. Warner, Sorenson and Bouhaddou, Knowledge Engineering in Health Informatics, 1997

  5. Health Informatics Defined • Information Technology • Health care • Research • Education • Fundamentals • Communication • Knowledge Management • Decision support • Clinical Information Management

  6. Medical Informatics Knowledge Management Clinical InformationManagement Communication Decision Support

  7. Communication Telemedicine Tele-radiology Patient e-mail Presentations Knowledge management Journals Consumer Health information Evidence-based medical information Decision Support Reminder systems Diagnostic Expert Systems Drug Interaction Information Management Electronic Medical Records Billing transactions Ordering Systems Informatics Use in Health Care

  8. Medical Informatics Changing Medicine Knowledge Management InformationManagement Communication Decision Support

  9. Institute of Medicine

  10. Vision of Quality Chasm Report • Standardized information infrastructure • Support care teams - Enhances patient-centered care • Supports care coordination • Measure outcomes - Improve outcomes • Enhance safety - Reduces errors • Enables quality measurement/monitoring - Reward quality

  11. The Case of Betsy A. Lehman “How long, Oh Lord, must this continue? …That’s 21 years ago…Isn’t it time that basic computerization be part of the expected, and required, care at medical facilities?”

  12. Reducing Errors • Order entry systems • Reduce medication errors • Detect potential drug interactions • Clinical decision support systems • Improve drug dosing • Improve preventive care • Not diagnosis

  13. Degree Fellowships Certificates Short courses Medical schools Information Studies Nursing schools Public health schools Dental schools Health care organizations Informatics Programs http://www.amia.org/resource/acad&training/f1.html

  14. Innovative Continuing Education/Schools in Informatics • NYU Medical Center Educational Services Department • U of Utah School of Nursing • U of Sheffield, UK • Stanford Medical School • Stanford Center for Advanced Technology in Surgery

  15. Informatics Education Research • Comparisons traditional to electronic • Retention • Satisfaction • Medical Education • Cost effective • CME • Informatics skills • Not evidence based practice skills

  16. Barriers to Implementation of Technology Rogers, P. L. (2000). Barriers to adopting emerging technologies in education. Journal of Educational Computing Research, 22(4), 455-472.

  17. Educational Barriers to Achieving Vision • Lack of resources • Relationship/behavioral changes required • Variability and lack of receptivity • Discipline specific issues • Continuing education restrictions

  18. Regulatory/Policy Barriers to Achieving Vision • Concerns over privacy • Unsupportive laws • Lack of financial resources • Lack of/bad experiences • Lack of standards

  19. Internal Barriers Stakeholder Attitudes and Perceptions Rogers, E. M. & Shoemaker, F. F. (1971). Communication of Innovation. New York: The Free Press. 

  20. External Barriers in Medicine Lack of: • Universally agreed-on medical vocabulary • Principled and standard formats for laboratory data, medical images, medical record… • Standardization of medical literature formats--structured abstracts • Health care standards -- treatment guidelines • Standards for health data exchange

  21. Educational Strategies • Didactic vs problem solving • Competencies • Word processing • Information retrieval • Information management • Data analysis • Presentation • Communication skills • E-mail, file transfer, web

  22. AAMC MSOP • Medical School Objectives Project • Informatics competencies for medical students • http://www.aamc.org/meded/msop/msop2.pdf

  23. Computer Literacy Word processing Graphics Life-long learning Medical Reference Clinical Information management Research Data analysis Communication skills E-mail, web, presentation Evidence Based Medicine Informatics Curriculum

  24. Infrastructure to Support Informatics Curriculu. • Hardware/Software • Support Issues • Workflow/Mindset Issues • Training Issues • Budgeting Issues

  25. Infrastructure

  26. Wireless Laptops for each student Microsoft Office Professional Stedman’s Medical Spellchecker Endnotes Adobe Photoshop Elements Medical References InfoRetriever PDAs for each student Evidence Based Ref. Disease Reference Medical Calculator Drug Reference Medical Dictionary The CDCS system Computer Lab Student teaching Faculty development Technology

  27. 2003-2004 • Switch from Palm OS to PocketPC • Dell Axim • InfoRetriever • ePocrates Drug Reference • Avantgo • PDxMD • Stedman’s Medical Dictionary

  28. Hands on Experience KnowledgeManagement Clinical InformationManagement Order entry, EMR, Billing Decision Support Communications

  29. Medical Education

  30. Anatomy lab video enabled BacusLabs digital web-slide program Gold Standard Multimedia* Cross Sectional Anatomy LXR Testing Program Question bank Computer-based testing Item analysis/grading United Streaming Videos Anatomy Histology WebPath Basic Sciences Classes

  31. Knowledge Management

  32. Knowledge Management • 20th Century Medical Library • Bricks and morter • Print journals, books, quick reference manuals • Interlibrary loans • Microfiche, Microfilm, dimes • 21st Century Medical Library

  33. Books, Journals and Manuals • StatRef • Pubmed • PDxMD • MDConsult • Dynamed

  34. Consumer Health Information • Health Finder • Familydoctor.org • More consumer health websites

  35. Evidence Anyway You Want It • Cochrane Collaboration • InfoRetriever • Web • Desktop • PDA

  36. Decision Support

  37. Handheld Applications • ePocrates • 5 Minute Clinical Consult • Medical Calculators • Immunization schedule

  38. Communications

  39. E-mail • Private, secure e-mail between Doctor and Patient • http://www.medocs.net

  40. Clinical Information Systems

  41. Clinical Information Systems • Practice Partner Electronic Medical Record System • Drug Interaction • Allergy checks • Internal e-mail • Integrated with billing and appointments • Links to knowledge base • Patient Education handouts

  42. Field Trip to Doctors Office

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