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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
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Medical Informatics
Knowledge
Management
Communication
Clinical Information
Management
Decision Support
7
Informatics Use in Health Care
 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
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Medical Informatics
Changing Medicine
Knowledge
Management
Communication
Information
Management
Decision Support
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Institute of Medicine
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Vision of
Quality Chasm Report
 Standardized information infrastructure
 Support care teams - Enhances patientcentered 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
Informatics Programs
 Degree
 Fellowships
 Certificates
 Short courses
 Medical schools
 Information Studies
 Nursing schools
 Public health schools
 Dental schools
 Health care organizations
https://www.amia.org/informatics-academic-training-programs
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
35%
34%
14%
3%
14%
Stakeholder Attitudes and Perceptions
Rogers, E. M. & Shoemaker, F. F. (1971). Communication of Innovation. New York: The Free Press.
Innovators
Early Adopters
Early Majority
Late Majority
Laggard
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

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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
Informatics Curriculum
 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
24
Infrastructure to Support
Informatics Curriculu.
 Hardware/Software
 Support Issues
 Workflow/Mindset Issues
 Training Issues
 Budgeting Issues
25
Infrastructure
Student
and Faculty PDAs
Essential Evidence Plus
PEPID
ePocrates
Harrison’s Pracrtice
Pediatric Care Online
GAYF
Virtual Library
Resources
Data Collection and
Evaluation System
Arcstream System
Avantgo Server
SQL Server
College of Medicine
Network Infrastructure
Technology Enhanced Classrooms
Campus Wide Wireless Coverage
Video Conferencing
File, Exchange, Web Servers
Student
Wireless Tablet PCs
Microsoft Office Professional
Stedman’s Medical Spellchecker
Photoshop Elements
Endnote
Blackboard
Courseware
All Courses
IT Section Support
Database Development
Web design
Video Editing
Tech Support
26
Technology
 Wireless Laptops for
each student





Microsoft Office
Professional
Stedman’s Medical
Spellchecker
Endnotes
Adobe Photoshop
Elements
Medical References
 PDAs for each student






Evidence Based Ref.
Disease Reference
Medical Calculator
Drug Reference
Medical Dictionary
The CDCS system
 Computer Lab


Student teaching
Faculty development
27
2001-2002
 Issued Palm devices to
first class





InfoRetriever
ePocrates Drug
Reference
Avantgo
PDxMD
Stedman’s Medical
Dictionary
28
2010-2011
 Switched from HP
iPAQ to iPod Touch


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
Epocrates Essentials
PEPID
Essential Evidence Plus
Dynamed
Harrison’s Practice
Pediatric Care Online
29
Hands on Experience
Knowledge
Management
Decision Support
Clinical Information
Management
Order entry, EMR, Billing
Communications
30
Medical Education
31
Basic Sciences Classes
 Anatomy lab video
enabled
 BacusLabs digital webslide program
 Gold Standard
Multimedia*
 Cross Sectional
Anatomy
 QuestionMark Testing
Program



Question bank
Computer-based testing
Item analysis/grading
 United Streaming
Videos


Anatomy
Histology
 WebPath
32
Knowledge Management
33
Knowledge Management
 20th Century Medical Library
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


Bricks and morter
Print journals, books, quick reference manuals
Interlibrary loans
Microfiche, Microfilm, dimes
 21st Century Medical Library
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Books, Journals and Manuals
35
Point of Care Clinical Tools
 EBM Resources
 Online Point of Care
Resources
 Drug Resources
 Patient Education
Resources
36
Decision Support
37
Handheld Applications
 ePocrates
 5 Minute Clinical
Consult
 Medical Calculators
 Immunization schedule
38
Communications
39
Secure E-mail
 Private, secure e-mail between Doctor and
Patient
 http://www.medocs.net
40
Clinical Information Systems
41
Clinical Information Systems
 SOAPware Electronic Medical Record
System





Loaded on each student computer
Used all 3rd year in Longitudinal weekly clinic
Follow 6 patients with chronic disease
Build entire medical record
Use Flow Sheets, Reminder System
42
Field Trip to Doctors Office
43
Fly UP