Introduction to Health Informatics

Sandra Alarcon-Lovenia
Dept of Information Systems & Computer Science
Course Description
Health is a complex field whose optimal operations are mostly
dependent on good quality information.

Compared to other industries like banking, agriculture and

commerce, health lags behind in the way technology is used to
enhance its operations. The result is an ineffective and
inefficient health system which underutilizes information and
communications technology.

This course introduces the student to the Philippine health

situation and shows how ICT can be employed to improve
health care delivery.
Local Health Situation
• How would you describe it?
• Where do you go for your medical needs?
• Is it the same for the rest of the Philippine
population?
Local Health Situation
• Health care is mostly fee-for-service
– Those who have the money can get high quality
care.
– Those who don’t have to go to the public health
system
Local Health Situation
• Congested public hospitals
• Expensive private health facilities
• Rural areas: cannot generate enough income
for health professionals
Global Health Situation
• Health care is improving in many developed
countries
• People are living longer with better quality of
life
• Increasing need for health professionals
(doctors, nurses, etc. ) in developed countries
Need > more than what they can produce
Local Health Situation
• Many health professionals are leaving the
country
• Doctors in rural areas are transferring to the
cities
• Doctors are taking up nursing so they can
leave
• No doctors left in rural areas where health care
is most needed
Not so recent study…
• The Brain Drain Phenomenon and Its
Implications for Health
• 2005 Report By Jaime Galvez-Tan, Fernando
Sanchez, Virginia Balanon
• Health Services, Health Services Human
Resources
• Proposed 10 Strategic solutions
Philippine Health Services
• Percent of children who were delivered by a health
professional 59.8 % (2003) b
• Percent of children who were delivered in a health
facility 37.9% (2003) b
• Percent of deaths attended by a health professional
48% (2003) a
• Percent of children 12-23 months fully immunized
60% (2003)b
• Contraceptive Prevalence Rate 48.9 (2003 b
• Physicians per 100,000 people 124 (2002)c
Philippine Health Services SWOT Analysis
Attempt?
• Internal
– Strengths
– Weaknesses
• External
– Opportunities
– Threats
• IT: one area of opportunity for improving
health services
Internet in the Philippines
• 24M users in 2009, 30M by 2012 (Nielsen, 2009)
• Filipinos use the Internet for an average of 3.8 hours
per day
• 81% between the ages of 10 and 39
Factors driving Internet adoption

• Highly educated middle class

• Decreasing connectivity cost
• Increasing channels (3G, DSL, WiFi)
• Increasing number of Filipino expatriates (i.e. usage
of IM, VOIP calling such as Skype)
• Sachet marketing : prepaid cards allowed usage of
Internet for as low as Php 10
Filipinos are the one of the most significant
populations on the Internet.
• No. 1 users on Friendster
– 13M users out of 95M
• No. 1 on Multiply.com
– 2M of 10M users
– ABS-CBN owns 5% of Multiply which they paid $5M
• No. 8 on Facebook
– 10M out of 450M
– Facebook is now the no. 1 site in the Philippines, dethroning
Inquirer.net
• Used to be the No. 1 users on Youtube
Health Opportunity in IT?
Health is a complex field whose optimal
operations are mostly dependent on good
quality information.
What is Informatics
• All about INFORMATION
– The science of information
– Information processing
– Applications that process information
Informatics + Discipline
• Organization and management of
– Data
– Information
– Knowledge
of the specific discipline
General and Specific Disciplines
• Social Informatics
• Organizational Informatics
• Health-Care Informatics
• Nursing Informatics
• Business Informatics
• Community Informatics
• Bioinformatics
Medical Informatics
• The organization and management of
information in support of
– Patient care
– Education
– Research
– Administration
Health informatics
• “Study and application of methods to improve the
management of patient data, medical knowledge,
population data and other information relevant to
patient care and community health.”

• Scope:
from DNA  Individual  Community
• Area:
Data, Information Knowledge
Health Informatics: Scope

bioinformatics medical informatics public health informatics

DNA Individuals/Organisms Populations

Health Informatics: Areas
• Data
– Clinical data gathering
• Information
– Health records management
• Knowledge
– Clinical Decision support
– Community health management
Data
• Symbols or signs
• Property, attribute of an object, event or
environment
• Does not have a meaning on its own
• Raw facts

3.75
240
Information
• Related data given meaning
• Relationship is established as a result of processing
• Answers questions
– What
– Who
– When
– Where

2009 Yearly QPI is 3.75

Cholesterol level is 240
Knowledge
• Appropriate collection of information and data
• Deterministic process
• Result of understanding patterns
– Probabilities, likely associations

Student can run for Honors (cumulative QPI is 3.65)

Patient has high cholesterol, and has high risks for heart
disease
Assignment: Research and Online Discussion on the
Philippine Health Situation
• Search for more recent (2009-2010) news articles,
journal articles, or reports that characterize the
Philippine Health Situation. Share the one that struck
you the most. Briefly explain what struck you in that
article.
• Post that article as an entry in Moodle Online
Discussion: Philippine Health Situation
• Read at least one of your classmate’s entry, post a
meaningful reaction to his/her entry
Health Data
• Specific facts and parameters
• Characteristics of Data
– Accuracy
– Completeness
– Relevance
– Reliability
– Security
– Timeliness
Clinical Data
• Vs. Financial and Accounting Data

• In many different forms

• In different episodes
• May be entered by different clinicians,
departments, at different times
Medical Knowledge
• Cumulative experience of applying useful
clinical information management techniques to
yield timely and significant decision
Health Informatics in the Philippines
• National Telehealth Center
– UP Manila Center
– Mandated to enhance health care through ICT
• Synapse Health
– IT Company focusing on Health solutions
Some Ongoing Projects
• Electronic Health Records
– Community Health Information Tracking System
or CHITS
– Open MRS (Medical Records System)
• Telehealth/Telemedicine
– Pasay SMS
– M-Dok
– ASCeNt (Physicians for Peace Prosthesis)
E-Health: National Telehealth Example
• Electronic Health Records
• E-Learning
• Telemedicine
E-Learning
• Learning through the Internet
– Health professionals can receive more training in
remote areas
– Health education of rural communities
Telemedicine
• Health professionals available over the
Internet
• Develop applications that will allow patients to
consult their doctors using ICT
• Concerns: Privacy, Authentication,
Confidentiality
Health Informatics
• Electronic Health Records
– Electronic Patient Records
– Electronic Medical Records
Health Informatics
• Decision Support Systems
– Help medical professionals make informed
decisions
– Help prevent medical errors
– Provides evidence on the best treatment available
• Requires EHR
Health Informatics
• Expert Systems
– Software systems that collect input variables and
generate treatment options ranked according to
different parameters
– Example: Appendicitis
• Surgery? Medicine? Combination?
• Requires EHR
Health Informatics
• Bioinformatics
– Understand origin of diseases
– Develop new vaccines, new drugs
Health Informatics
• Public health informatics
– Data warehousing (from EHR data)
– Geographic information systems
– Predictive analysis of outbreaks and epidemics
References
• The Brain Drain Phenomenon and Its Implications for Health
http://www.up.edu.ph/oldforum/2005/Jul-Aug05/brain_drain.htm
(accessed on April 12, 2010)
• CS187.1 2009 slides (Andrei Coronel)
• HIMA 2009 slides (Ayedee Domingo, MD)
• UP Manila - National Telehealth Center website http://plone.telehealth.ph
(accessed on April 10, 2010)
• Asia-Pacific Development Information Programme website
http://www.apdip.net/projects/ictrnd/map/ph (accessed on April 12, 2010)
• Data, Information, Knowledge and Wisdom
http://www.systems-thinking.org/dikw/dikw.htm (accessed on April 13,
2010)
• Medical Informatics
http://books.google.com.ph/books?id=13-OAIr2GiAC&printsec=frontcove
r#v=onepage&q&f=false
(accessed on April 10, 2010)