Health informatics

Health informatics is a multi-field study of healthcare that uses technological resources to develop innovations in the planning, management, and delivery of healthcare. Health informatics is not the technology itself but how it gathers, shares, and applies information to the entire healthcare process. The field has become an essential part of the healthcare landscape.

Background

informatics has its origins in 1949. At that time, German scientist Gustav Wagner started a professional organization for those who worked with healthcare information. Wagner went on to edit a journal that dealt with healthcare information.

In the 1960s, computer technology became sophisticated enough and widely available enough to be used consistently for healthcare information. The American Society for Testing and Materials (known as ASTM International) established the first standards for using the technology. These standards included rules for the parameters of the systems used for health information, guidelines for the types of data to be included, security requirements, and protocols for communication among laboratories. One of the earliest databases for medical information was Medline, which began in 1971. Medline was eventually updated to include over thirty-one million records, with information going back to 1781. This database became a trusted and widely used source of information about medical information, which remained online in the twenty-first century through the National Library of Medicine’s PubMed interface.

During the 1950s and 1960s, cardiologist Homer R. Warner became interested in the potential for computers to improve healthcare. He helped pioneer systems used to monitor cardiac patients in hospital intensive care units and other equipment used in clinical settings. After observing a nurse having difficulty interpreting what a variety of flashing lights on one piece of equipment meant for the patient's condition, Warner wrote a new software program called the Health Evaluation through Logical Processing (HELP) system. It sorted the available data on a patient by importance to help the healthcare provider better prioritize patient care. Warner also established a department of medical informatics at the University of Utah, one of the first and largest educational sites for health informatics.

The 1970s were a critical decade for the growth of health informatics. The work of Warner and other pioneers in the field, coupled with rapidly improving technology, led to the development of electronic health records. These records included computerized copies of patients' medical information in a standardized format. They made it easier for a patient and their physicians to access the patient's information. They allowed physicians to deliver better care faster and eliminated duplication of tests and procedures. Health informatics at this time was used to help keep track of diagnoses, admissions and discharges, and billing. In 1970, Dutch researchers Ben Hesper and Paulien Hogeweg first introduced the term bioinformatics to describe the gathering and study of information related to the health of certain populations or people in general rather than a single individual.

The development of the Internet and improvements to computerized technology continued to propel the growth of health informatics. Further developments increased mobile technology availability, known as mHealth, allowing medical professionals to access electronic data while caring for patients. As technology continued to evolve, methods and equipment enabled medical professionals across fields to gather information that allowed them to care for individual patients, track diseases, and follow developing trends in overall health. In the 1990s, the American Medical Informatics Association formed to help educate healthcare professionals on using technology to supplement and improve healthcare.

As mHealth continued to evolve, it grew to include smartphone applications and digital platforms to allow patients to monitor chronic conditions, access test results, communicate with providers, and manage medications. Patient portals similarly empowered individuals to actively participate in their healthcare. The integration of artificial intelligence (AI), machine learning, and predictive analytics enabled more accurate diagnosis, risk analysis, decision support, and treatment planning. Telehealth and remote monitoring tools accelerated in the early 2020s during the COVID-19 pandemic, allowing clinicians to gather real-time patient data through wearable devices like smartwatches and fitness trackers. Health informatics can also play a critical role in global health surveillance, helping international agencies like the World Health Organization track and manage infectious disease outbreaks using real-time data collection and analytics.

Overview

Health informatics is an overall term for a field that includes the gathering, measurement, analysis, compiling, storage, and application of data across a range of medical fields. It is also known as medical informatics or clinical informatics. It includes bioinformatics, or the gathering, studying, and sharing of biological information relevant to groups of people, such as DNA sequencing. Public health informatics addresses issues that affect the population of a specific geographic area, including the presence and spread of diseases and other issues that affect community health. In addition to medical health, health informatics can apply to information related specifically to nursing, pharmacy, dental, and veterinary health.

Before the development of health informatics systems, all healthcare records were kept on paper. Physicians' notes were handwritten, as were all prescriptions and orders for tests and procedures. Bills were typed up individually, with healthcare staff often laboriously looking up the amounts to be billed for each procedure. If multiple physicians saw one patient, paper records had to be passed between physicians, or physicians had to rely on information shared verbally by the patient or another healthcare provider. This system was cumbersome and time-consuming. It required additional staff, was prone to error, and could result in the duplication of services.

The development of health informatics allowed medical professionals not only to gather all this information in a convenient and easy-to-understand format but also to analyze the information more readily. As a result, health professionals were able to identify treatments that worked better or did not work, recognize trends in the development of illnesses and health conditions, and create guidelines for better delivery of healthcare. Health informatics provides a vast pool of information for researchers to study to help develop new ways to treat illnesses.

The increased use of technology to gather and share large amounts of healthcare information was very helpful but also brought concerns about privacy and security. In 1996, US President Bill Clinton signed the Health Insurance Portability and Accountability Act (HIPAA), which, among other things, protected patients' right to privacy and control over how their health information was shared. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act strengthened the enforcement of HIPAA regulations and expanded consumer protections. Technology continued to allow patients greater control over their health information, but with the expanding digitalization of health data, cybersecurity issues like ransomware attacks also evolved.

Bibliography

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