What is Health Informatics?

Health Informatics is a discipline that deals with the collection, storage, retrieval, communication and optimal use of health related data, information and knowledge. It recognizes the role of citizens in their own health care as well as the information handling roles of the healthcare professionals, and is now considered a critically essential and pervasive element in sustainable health care delivery. There is a recognized need for the advancement and teaching of knowledge about the application of information and communication technologies to healthcare - the place where health, information and computer sciences, psychology, epidemiology and engineering intersect. (Health Informatics Society of Australia, 1994; UK Health Informatics Society, 2007)

What are the benefits of Health Informatics? 1. Cost Reduction Through health informatics, some labor-intensive medical procedures can be automated, thereby saving precious health care dollars. Procedures rife with human error, such as physician medical orders, can be computerized, reducing the potential for mistaken interpretation of written orders and possible malpractice lawsuits. The use of health informatics has opened up the doors for clinics to be more capable of treating patients in a more efficient manner, and helps these clinics refine their current process to make it more streamlined.

2. Electronic Health Reduction The data retrieved by the use of heath informatics provides statistical information that can have a profound effect on how medicine is distributed, surgery is performed and how healing is tracked. It also helps hospitals better track patients past records so they can be treated faster in the future. Example: When families relocate, childhood immunization records can be misplaced or past physician names forgotten. A comprehensive electronic patient health record can solve these problems. This can be a network of existing health care systems or a newly developed electronic health record, a records system that follows a patient through his entire life.

3. Patient Education Physicians know that patients do not always follow their medical advice. Health informatics helps determine patient motivation and provides solutions. If a physician is serving a low-literacy patient population, instead of providing medical literature and written information on medication, health informaticians can develop multimedia materials and audio instructions.

QUIZ 1. What do you think are the other benefits of using Health Informatics in the practice of Rehabilitation Sciences? Cite some examples.

History of Health Informatics Health informatics as a discipline has a long and interesting history that would be impossible without Charles Babbages ideas about the first analytical computer system way back in the nineteenth century. Even though there was talk about using computers in medicine as technology advanced in the early twentieth century, it was not until the 1950s that informatics really took off in the United States. Robert Ledley, who would later invent the first full body CT scanner, is often credited as one of the founding fathers of U.S. informatics. His use of computers in dental projects with the National Bureau of Standards set the stage for later advancements in applying information technology to medicine.

Following the invention of the LISP programming language in the late 1950s and the advance in computing technology and data storage in the 1960s, doctors, graduate students, and computer specialists began working at several different locations to create diagnostic systems and other medical computer programs. The MUMPS programming language created at Massachusetts General Hospital by Pappalardo, Greenes, and Marble from 19661967 was also an important step in the growing field of health informatics. MUMPS allowed for the creation and integration of medical databases. It continues to form the basis for many healthcare records programs. The most famous uses of the LISP language would not occur until the 1970s with the development of the computer systems MYCIN and INTERNIST-1

MYCIN was created at Stanford University in order to help doctors identify the bacteria behind several infections and to recommend antibiotics and dosage amounts for treatment. It was also designed to help with the treatment of blood clotting abnormalities. Edward Shortliffe invented this system, which performed better than many Stanford medical school faculty in tests of ability, though it never was used in actual medical practice. INTERNIST-1, developed at the University of Pittsburgh as a system that would provide medical information to persons who were not medical experts, likewise never achieved commercial use. However, the benefit of both of these systems was that they established the possibility of creating and using more advanced health informatics technology. Starting in the 1980s, the U.S. Veterans Administration began using the MUMPS language to develop individual health records for its patients. Today it uses an awardwinning program called CPRS (Computerized Patient Record System), a graphic interface that creates a long-term view of a patients health record. Its features include a notification system to make users aware of significant clinical events for the patient and a reminder system that works to make sure the right treatments are given at the right time.

Practically speaking, the widespread adoption of electronic medical records will probably be the most significant application of health informatics in the foreseeable future. The electronic storage of patient data has created many privacy concerns, and in 1996, President Bill Clinton signed the Health Insurance Portability and Accountability Act (HIPAA). This law prevents healthcare providers, insurers, and clearinghouses from sharing medical information about a patient without the patients consent.

These privacy safeguards have made providers and patients alike more willing to adopt costeffective electronic billing software because they know that personal health information is not being shared with others in the process of billing and payment. Providers who use this billing software can only do so if they adhere to HIPAA regulations.

The U.S. Department of Health and Human Services oversees the enforcement of HIPAA, and is overseeing a plan to ensure widespread adoption of electronic medical records by 2014. Grants and other assistance are being given to communities to achieve this goal in the hope that the adoption of electronic medical records will lower healthcare costs and improve patient care across the board. Building Blocks of a Health System According to World Health Organization (WHO) What is Health System?

A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behavior change programmes; vectorcontrol campaigns; health insurance organizations; occupational health and safety legislation. It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well known determinant of better health. (WHO, 2007)

The six building blocks of a health system: aims and desirable attributes (WHO, 2007) 1. Good health services are those which deliver effective, safe, quality personal and nonpersonal health interventions to those who need them, when and where needed, with minimum waste of resources.

2. A well-performing health workforce is one which works in ways that are responsive, fair and efficient to achieve the best health outcomes possible, given available resources and circumstances. I.e. there are sufficient numbers and mix of staff, fairly distributed; they are competent, responsive and productive.

3. A well-functioning health information system is one that ensures the production, analysis, dissemination and use of reliable and timely information on health determinants, health systems

performance and health status.

4. A well-functioning health system ensures equitable access to essential medical products, vaccines and technologies of assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use.

5. A good health financing system raises adequate funds for health, in ways that ensure people can use needed services, and are protected from financial catastrophe or impoverishment associated with having to pay for them.

6. Leadership and governance involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition building, the provision of appropriate regulations and incentives, attention to system-design, and accountability. Building blocks of health systems

QUIZ 2. What is the importance of knowing the building blocks of health systems in relation with the practice of Health Informatics?