Medical informatics

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Electronic patient chart of a HIS

Medical Informatics is the name given to the application of information technology to healthcare. It is the:

"understanding, skills and tools that enable the sharing and use of information to deliver healthcare and promote health" (British Medical Informatics Society).

Medical informatics is often called healthcare informatics or biomedical informatics, and forms part of the wider domain of eHealth. These later-generation terms reflect the substantive contribution of the citizen & non-medical professions to the generation and usage of healthcare data and related information. Additionally, medical informaticians are active in bioinformatics and other fields not strictly defined as health care.


Contents

Aspects of the field

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A HIS's automatic immunization data entry in the patient's admission module.

These include:

  • architectures for electronic medical records and other health information systems used for billing, scheduling or research.
  • decision support systems in healthcare
  • messaging standards for the exchange of information between health care information systems (e.g. through the use of the HL7 data exchange standard) - these specifically define the means to exchange data, not the content
  • controlled medical vocabularies such as the Standardized Nomenclature of Medicine, Clinical Terms (SNOMED-CT) or Logical Observation Identifiers Names and Codes (LOINC) - used to allow a standard, accurate exchange of data content between systems and providers.
  • use of hand-held or portable devices to assist providers with data entry/retrieval or medical decision-making

History

Medical informatics began in the 1950s with the rise of useable computation devices, computers.

Early names for medical informatics included medical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science, medical software engineering and medical computer technology.

The earliest use of computation for medicine was for dental projects in the 1950's at the National Bureau of Standards by Robert Ledley.

The next step in the mid 1950s were the development of expert systems such as MYCIN and INTERNEST-I. In 1965, the National Library of Medicine started to use MEDLINE and MEDLARS. At this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett's Laboratory of Computer Science at Massachusetts General Hospital in Boston. In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system was used to support MUMPS language specifications. As of 2004, a descendent of this system is being used in the United States Veterans Affairs hospital system.

In the United States in 1996, HIPAA regulations concerning privacy and medical record transmission created the impetus for large numbers of physicians to move towards using EMR software, primarily for the purpose of secure medical billing.

In the UK moves towards registration and regulation of those involved in Health Informatics have begun with the formation of the UK Council for Health Informatics Professions (UKCHIP) (http://www.ukchip.org.uk/)

In the US, progress towards a standardized health information infrastructure is underway. In 2004, the US Department of Health and Human Services (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT) (http://www.hhs.gov/healthit/), headed by David J. Brailer, M.D., Ph.D. The mission of this office is to achieve widespread adoption of interoperable electronic health records (EHRs) in the US within 10 years. For more information regarding federal initiatives in this area, see QIOs.

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