Overview and introduction to health informatics & Dental Informatics (DI) Dr Ebtissam M. Al-Madi

Overview and introduction to health informatics & Dental Informatics (DI) –Different definitions of Health informatics, medical informatics and Dental informatics –History of Health and Informatics –The discipline of Health Informatics –Scope of Health informatics –Scope of Dental Informatics –Uses of health & dental informatics –Current issues in health informatics

HEALTH & MEDICAL INFORMATICS Different definitions of Health informatics, medical informatics and Dental informatics

"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.“ –definition by MF Collen (MEDINFO '80, Tokyo, later extended)

Medical Informatics "Medical informatics is a developing body of knowledge and a set of techniques concerning the organizational management of information in support of medical research, education, and patient care.... Medical informatics combines medical science with several technologies and disciplines in the information and computer sciences and provides methodologies by which these can contribute to better use of the medical knowledge base and ultimately to better medical care.“ –Definition by Asso. of American Medical Colleges (AAMC) 1986

Health Informatics Health informatics, Health care informatics or medical informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. It is applied to the areas of nursing, clinical care, dentistry, pharmacy, public health and (bio)medical research. information sciencecomputer science health care

Analysis of definition patient care, research, and education combination of and interface between several disciplines not just computers but information in general (eg DA) practical goal: to provide better health care

Origin of term "Medical Informatics" Russian = informatika 1968 structure and properties of scientific information French = informatique de medecine 1968 university departments established with this title English = first appeared in 1970s Name changed from Medical Information Science

Dental Informatics Dental informatics is the application of computer and information science to improve dental practice, research, education and management.

Origin of field interface among disciplines initially: computer science (AI) applied to medicine later: biostatistics, DA, economics, cognitive psychology

Appearance of computers in medicine 1960s - practical = early use only in departmental research = early ECG and diagnosis 1970s - practical = Huge size- administrative & departmental, imaging (CT), early bibliographic retrieval & research 1980s - practical = results reporting, outpatient services growth of clinical systems and databases research = Artificial Intelligence, Information Retrieval 1990s - practical = integration, communication research = vocab, interfaces, coding, evaluation Note how medicine lags computer hardware

Slow at first Computers have been slow to enter clinical care: # hosp with billing, Administrative vs lab + clinical, Artificial Intelligence. # offices with clinical systems. but clinical care is largely the management of info. primarily in the background: practice mgmt, libraries, billing, financial

Gaining popularity recent increase of medical informatics not new field but marked increase in popularity, funding, publication eg 1984 AAMC recommended formation of MI academic units (first done in Europe, esp France, in the 1960s)

Factors in recent increase of medical informatics increase in use of technology - more data generated mobility of population - need to communicate specialization - need to communicate managed care systems - need to communicate rise in health care costs - attempt to control care improved hardware - faster and more memory improved methods - acquisition, transfer, retrieval reduced computer costs increased awareness

Factors in lack of use of computers in clinical care involves complex organisms (unlike physical processes) if over-simplify, not useful (vs bank transaction) therefore need sophisticated abstraction + detail technology for gathering complex info. just emerging, eg low use of QMR or Dxplain therefore providers have not entered info. reimbursement has not been linked to clinical info., therefore many admin. systems but few clinical health care administered by individuals, small groups less need for coordination inertia fear: "cookbook medicine" liability ignorance money security, integrity lack of standards language previous failures rapid turnover of technology

Discipline of Health Informatics Why need a new discipline? –often cannot get credit in related fields for work at the interface of related disciplines –few were championing clinical applications Medical informatics as a science –broad spectrum (theory to practice) –basic science (knowledge for itself, models) –experimental science (hypothesis, experiment, analysis) –applied science, engineering (practical goals)

Composition of medical informatics groups –MDs, RNs, dentists, other health care workers –PhDs, esp computer science (also physics,...) –Administrators, policy planners –Masters, PhD programs in medical informatics –Industry –Part-time vs full-time Institutional organization –Division within medicine –Aspect of computer science –Inter-disciplinary center –Department (like biostatistics): relatively unusual in USA

Scope of Health Informatics Health informatics encompasses all the areas where technology and information contribute to the support of health care delivery, management, planning and research. Related to the core areas are themes such as ethics, attitudes learning, coping with third party interactions – all ‘into and utilizing’ health informatics. Other research has been identified into content provision, generating an evidence base and knowledge management.

Scope of Dental Informatics Information Science: –is the collection, classification, storage, retrieval, and dissemination of recorded knowledge treated both as a pure and as an applied science. Computer science: –is a discipline that involves the understanding and design of computers and computational processes. Here, the emphasis is not on information, but how it is represented, processed, manipulated, and managed in computing systems.

Scope of Dental Informatics Cognitive science: – is a research area that draws on several fields (such as psychology, artificial intelligence, linguistics, and philosophy) to develop theories of perception, thinking, and learning. –Cognitive science relates to information science as we try to understand how information is represented in the human mind. –Computer science relates to information science as try to simulate our mental processes in computing environments. –Biomedicine is replete with complex cognitive processes (such as diagnosis, treatment planning, and evaluation).

Scope of Dental Informatics Telecommunications: –Is the science that deals with communication at a distance. –Transmission of digital images efficiently resulted in new approaches to image compression and transmission. – Another example is aggregating information from many different sources, such as information about the same patient from different healthcare providers.

Current Issues in Health Informatics Current issues in clinical care –Cost –Accessibility of health care –Coordinating care and setting policy –Standards of terminology –Acquisition and retrieval of data (eg across inst.) –Data Privacy, confidentiality and security –Acquisition and sharing of knowledge (eg specialist).

Current Issues in Health Informatics Medical informatics research mirrors clinical issues –Data acquisition –Data storage - databases, modeling –Vocabularies - format, content –Organization of data –Machine interfaces - standards like HL7, security –Data retrieval - query languages –Knowledge acquisition –Knowledge representation –Application of knowledge when needed – –Decision analysis, alerts, diagnosis –Education –Care plans and practice guidelines

Current Issues in Health Informatics General research questions in medical informatics –Knowledge extraction from databases –Structuring knowledge: impact on acquisition, storage and retrieval –Linking different classes of knowledge –Using knowledge to make decisions –Human factors in computing –Taxonomy –Linking disparate systems

This weeks assignments 1.Log on to px px 2.View this lecture online for review. 3.Read article 4.Participate in discussion 5.Submit Homework 6.Post your names and s in student list for quiz this week. ViewReadDiscussHomework Quiz

Thank you –Dr Ebtissam Al-Madi