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Health Informatics and Medical Librarianship in the Philippines

Ayedee Ace Domingo, MD MAHLAP Congress, February 2009, Tagaytay

Health Informatics and Medical Librarianship in the Philippines


Overview of health informatics Trends in health informatics in the Philippines The nature of medical data Role of medical librarianship in health informatics Tools
Health Informatics Management

Health Informatics

Library and information studies


(manages)recordable information and knowledge, and the services and technologies to facilitate their management and use, encompassing information and knowledge creation, communication, identification, selection, acquisition, organization and description, storage and retrieval, preservation, analysis, interpretation, evaluation, synthesis, dissemination and management.
(American Library Association, 1992)
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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. emphasis on information management rather than technology.
(Wyatt, BMJ, 2006)
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Branches of health informatics


Bioinformatics Clinical informatics Consumer health informatics Public health informatics

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Health Informatics Management

Bioinformatics
Use of health informatics methods for molecular biology

Health Informatics Management

Example : Drug design

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Health Informatics Management

Clinical informatics
Use of health informatics in the management of patients Examples : clinical decision support, security privacy and confidentiality, hospital information systems
Health Informatics Management

Example : Electronic health records


Any information related to the health of the individual in electronic format for the primary purpose of providing health care

Health Informatics Management

Health Informatics Management

Consumer health informatics


Study and development of systems that support access to health and lifestyle information Example : telehealth, e-health

Health Informatics Management

Example : Web portals


Aggregators of health content WebMD, Rxpinoy

Health Informatics Management

Health Informatics Management

Public health informatics


Health informatics in public health Example : syndromic surveillance, national health information systems

Health Informatics Management

Example : POGS ISIS


Integrated Statistical Information System of the Philippine Obstetrical and Gynecological Society Electronic statistics on ob and gyn 150 hospitals nationwide
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Health Informatics Management

Health Informatics in the Philippines

Health informatics in the Philippines


Hospitals Universities and medical schools Physicians Government

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Hospitals
Hospital information systems
Philippine Heart Center, St. Lukes, Cardinal Santos, Asian Hospital BizBox, Microsoft Amalga

Radiology information systems


GE Centricity and Siemens (TMC), DR Systems (SLMC)

Laboratory information systems


TD Synergy
Health Informatics Management

Example : The Medical City SHAMAN


Strategic Hospital and Medical Automation Network Hospital information management system of TMC Homegrown, internally developed
Health Informatics Management

Example : The Medical City SHAMAN


6 Core / Multi-mode 1Gbps 10 Gbps Fiber Optic Cables Doctors Clinics/Homes P4 PCs, Laptops w/ WinXP, OfcXP & Oracle Clients

Category 6 10/100/1000 Mbps Copper Cables IBM P-650 Servers w/ AIX5 & Oracle 9i

Sub-terrain Black Fiber (Ortigas-loop)

IBM X-Series Servers w/ Win2K for DNS, PDC, Mail, etc.

Health Informatics Management PLDT I-Gate


Nortel Passport 8500 Core Switch & Edge Switches

Universities and Medical Schools


Integration of health informatics into the curriculum Short courses and elective : DLSU-EAC, UPCM MS in Health Informatics : UPCM MBA : ASMPH and AGSB
Health Informatics Management

Physicians
Electronic patient records and clinic information systems Klinika, Medbrilliance

Health Informatics Management

Government
National Telehealth Program
Remote consultation using Internet

National Epidemic Sentinel Surveillance System


Detection of outbreaks

Field Health Service Information System


Aggregation of public health data from the RHU
Health Informatics Management

Medical Librarianship and Health Informatics

Role of the librarian


In the previous lecture, the librarian is the information mediary Infomediary Same as the physician; the librarian is the learned intermediary.
Health Informatics Management

A New Model : The Informationist


Bridges the gap between clinician and patient Understands both clinical and information science Experts in the practice of retrieving, synthesizing, and presenting medical information Designs, evaluates and improves information systems
(Davidoff, Annals of Internal Medicine, 2000)
Health Informatics Management

Role of ML in Health Informatics


1. Manage information in health information systems 2. Provide access to clinicians to evidence-based information and clinical decision support tools 3. Provide access to patients to easy-to-understand health information
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Information management in HIS


Health information systems
Electronic patient records Hospital information systems Public health information systems

Skills in organizing and classifying information and optimizing access Help develop policy on technical standards
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Technical standards
ICD-10
International Classification of Diseases Used for billing and epidemiology

HL7
Health Level 7 Used for exchange for health information
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Access to information for EBM and CDS


To actually do a good search on Medline you have to be a biomedical librarian.
Enrico Coeira, Professor of Medical Informatics, University of New South Wales

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Access to information for EBM and CDS


Every hospital and clinic should have access to good medical information, whether print or online Free up physicians time to care for patients Give access to the best evidence-based information on treatment Provide access to tools for improved clinical decisionmaking
Diagnosis (E.g. : GIDEON) Drugs (E.g. : Epocrates)
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Epocrates

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GIDEON
Global Infectious Disease and Epidemiology Network Commercial Diagnostic aid for infectious diseases

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GIDEON

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Access to health information for patients


Patient empowerment Access to the Internet Patient-centered care Emphasis on health promotion, rather than treatment Greater role of patient education
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Tools

Tools
The Internet is your library. Archive not just books, but also online resources and software I will focus on free (and legal) resources, since most of the commercial vendors already surround you.
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Tools
Online journals
Medline www.freemedicaljournals.com (including BMJ, NEJM) Herdin (www.herdin.ph, doh.herdin.ph)

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Tools
Search engine
Google! Advanced tools (e.g. health informatics filetype:ppt) Keywords (e.g. anemia vs. decreased blood) RightHealth
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Tools
References
Emedicine (www.emedicine.com) Disease information written by physicians Patient education materials Continuing medical education

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Tools
References
WebMD Mayo Clinic Medline Plus

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Tools
Software
Portal Download.com (www.download.com) (sure to be virus free) Handheldmedicine.ca

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Tools
Software
Clinical Epocrates Archimedes (medical calculator) Research Epi info Epi Maps Google Earth
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Conclusion
Health informatics is becoming an integral aspect of the delivery of healthcare in the Philippines Librarian and information science skills are essential in the development of health informatics in the country.
Organization of health information Access to reliable clinical information Access to easy to understand information for patients
Health Informatics Management

Thank you.

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