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Health informatics is the field of
science Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earli ...
and
engineering Engineering is the use of scientific principles to design and build machines, structures, and other items, including bridges, tunnels, roads, vehicles, and buildings. The discipline of engineering encompasses a broad range of more specializ ...
that aims at developing methods and technologies for the acquisition, processing, and study of patient data, which can come from different sources and modalities, such as
electronic health records An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
,
diagnostic test A medical test is a medical procedure A medical procedure is a course of action intended to achieve a result in the delivery of healthcare. A medical procedure with the intention of determining, measuring, or diagnosing a patient condition or ...
results, medical scans. The health domain provides an extremely wide variety of problems that can be tackled using computational techniques. Health informatics is a spectrum of
multidisciplinary Interdisciplinarity or interdisciplinary studies involves the combination of multiple academic disciplines into one activity (e.g., a research project). It draws knowledge from several other fields like sociology, anthropology, psychology, ec ...
fields that includes study of the design, development and application of computational innovations to improve health care. The disciplines involved combines
medicine Medicine is the science and Praxis (process), practice of caring for a patient, managing the diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, and Health promotion ...
fields with
computing Computing is any goal-oriented activity requiring, benefiting from, or creating computer, computing machinery. It includes the study and experimentation of algorithmic processes, and development of both computer hardware , hardware and software. ...
fields, in particular
computer engineering Computer engineering (CoE or CpE) is a branch of electrical engineering and computer science that integrates several fields of computer science and electronic engineering required to develop computer hardware and computer software, software. C ...
,
software engineering Software engineering is a systematic engineering approach to software development. A software engineer is a person who applies the principles of software engineering to design, develop, maintain, test, and evaluate software, computer software. Th ...
, information engineering,
bioinformatics Bioinformatics () is an interdisciplinary field that develops methods and software tools for understanding biological data, in particular when the data sets are large and complex. As an interdisciplinary field of science, bioinformatics combi ...
, bio-inspired computing,
theoretical computer science Theoretical computer science (TCS) is a subset of general computer science and mathematics that focuses on mathematical aspects of computer science such as the theory of computation, lambda calculus, and type theory. It is difficult to circumsc ...
,
information systems An information system (IS) is a formal, sociotechnical, organizational system designed to collect, process, information storage, store, and information distribution, distribute information. From a sociotechnical perspective, information systems a ...
,
data science Data science is an interdisciplinary field that uses scientific methods, processes, algorithms and systems to extract or extrapolate knowledge and insights from noisy, structured and unstructured data, and apply knowledge from data across a bro ...
,
information technology Information technology (IT) is the use of computers to create, process, store, retrieve, and exchange all kinds of Data (computing), data . and information. IT forms part of information and communications technology (ICT). An information te ...
,
autonomic computing Autonomic computing (AC) is distributed computing resources with self-management (computer science), self-managing characteristics, adapting to unpredictable changes while hiding intrinsic complexity to operators and users. Initiated by IBM in 200 ...
, and
behavior informatics Behavior informatics (BI) is the informatics of behaviors so as to obtain behavior intelligence and behavior insights. BI is a research method combining science and technology, specifically in the area of engineering. The purpose of BI includes a ...
. In
academic institution Academic institution is an educational institution dedicated to education and research, which grants academic degrees. See also academy and university. Types * Primary schools – (from French ''école primaire'') institutions where children r ...
s, medical
informatics Informatics is the study of computational systems, especially those for data storage and Information retrieval, retrieval. According to ACM ''Europe and'' ''Informatics Europe'', informatics is synonymous with computer science and computing as a ...
research focus on applications of
artificial intelligence in healthcare Artificial intelligence in healthcare is an overarching term used to describe the use of machine-learning algorithms and software, or artificial intelligence (AI), to mimic human cognition in the analysis, presentation, and comprehension of compl ...
and designing medical devices based on
embedded system An embedded system is a computer system—a combination of a computer processor, computer memory, and input/output peripheral devices—that has a dedicated function within a larger mechanical or Electronics, electronic system. It is '' ...
s. In some countries term informatics is also used in the context of applying
library science Library science (often termed library studies, bibliothecography, and library economy) is an interdisciplinary or multidisciplinary field that applies the practices, perspectives, and tools of management, information technology, education, and ...
to data management in hospitals. 'Clinical informaticians' are qualified health and social care professionals and 'clinical informatics' is a
subspecialty A subspecialty (US English) or subspeciality (international English) is a narrow field of professional knowledge/skills within a specialty of trade (occupation), trade, and is most commonly used to describe the increasingly more diverse specialty ...
within several
medical specialties A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (pediatrics, paediatrics), cancer ...
.


Subject areas within health informatics

According to Jan van Bemmel, medical informatics comprises the theoretical and practical aspects of
information processing Information processing is the change (processing) of information in any manner detectable by an observation, observer. As such, it is a process that ''describes'' everything that happens (changes) in the universe, from the falling of a rock (a ch ...
and communication based on knowledge and experience derived from processes in medicine and health care.


Archival science and databases in healthcare

Archival clinical informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to: * assess information and knowledge needs of health care professionals, patients and their families. * characterize, evaluate, and refine clinical processes, * develop, implement, and refine
clinical decision support system A clinical decision support system (CDSS) is a health information technology, provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, to help health and health care. CDSS encompasses a variety of ...
s, and * lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems. Clinicians collaborate with other health care and information technology
professionals A professional is a member of a profession A profession is a field of work that has been successfully '' professionalized''. It can be defined as a disciplined group of individuals, '' professionals'', who adhere to ethical standards and ...
to develop health informatics tools which promote patient care that is safe, efficient, effective, timely, patient-centered, and equitable. Many clinical informaticists are also computer scientists. In October 2011 American Board of Medical Specialties ( ABMS), the organization overseeing the certification of specialist MDs in the United States, announced the creation of MD-only physician certification in clinical informatics. The first examination for board certification in the
subspecialty A subspecialty (US English) or subspeciality (international English) is a narrow field of professional knowledge/skills within a specialty of trade (occupation), trade, and is most commonly used to describe the increasingly more diverse specialty ...
of clinical informatics was offered in October 2013 by
American Board of Preventive Medicine The American Board of Preventive Medicine (ABPM) is a member of the American Board of Medical Specialties that issues "certificates of special knowledge" in the specialty of preventive medicine. These certificates are known as "Board Certification ...
(ABPM) with 432 passing to become the 2014 inaugural class of Diplomates in clinical informatics. Fellowship programs exist for physicians who wish to become board-certified in clinical informatics. Physicians must have graduated from a medical school in the United States or Canada, or a school located elsewhere that is approved by the ABPM. In addition, they must complete a primary residency program such as Internal Medicine (or any of the 24 subspecialties recognized by the ABMS) and be eligible to become licensed to practice medicine in the state where their fellowship program is located. The fellowship program is 24 months in length, with fellows dividing their time between Informatics rotations, didactic method, research, and clinical work in their primary specialty.


Integrated data repository

One of the fundamental elements of biomedical and translation research is the use of integrated data repositories. A survey conducted in 2010 defined "integrated data repository" (IDR) as a data warehouse incorporating various sources of clinical data to support queries for a range of research-like functions. Integrated data repositories are complex systems developed to solve a variety of problems ranging from identity management, protection of confidentiality, semantic and syntactic comparability of data from different sources, and most importantly convenient and flexible query. Development of the field of clinical informatics led to the creation of large data sets with
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
data integrated with other data (such as genomic data). Types of data repositories include operational data stores (ODSs), clinical data warehouses (CDWs), clinical data marts, and clinical registries. Operational data stores established for extracting, transferring and loading before creating warehouse or data marts. Clinical registries repositories have long been in existence, but their contents are disease specific and sometimes considered archaic. Clinical data stores and clinical data warehouses are considered fast and reliable. Though these large integrated repositories have impacted clinical research significantly, it still faces challenges and barriers. One big problem is the requirement for ethical approval by the institutional review board (IRB) for each research analysis meant for publication. Some research resources do not require IRB approval. For example, CDWs with data of deceased patients have been de-identified and IRB approval is not required for their usage. Another challenge is
data quality Data quality refers to the state of qualitative or quantitative pieces of information. There are many definitions of data quality, but data is generally considered high quality if it is "fit for tsintended uses in operations, decision making ...
. Methods that adjust for bias (such as using propensity score matching methods) assume that a complete health record is captured. Tools that examine data quality (e.g., point to missing data) help in discovering data quality problems.


Data science and knowledge representation in healthcare


Clinical research informatics

Clinical research informatics (CRI) is a sub-field of health informatics that tries to improve the efficiency of
clinical research Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug us ...
by using informatics methods. Some of the problems tackled by CRI are: creation of data warehouses of health care data that can be used for research, support of data collection in
clinical trials Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
by the use of electronic data capture systems, streamlining ethical approvals and renewals (in US the responsible entity is the local
institutional review board An institutional review board (IRB), also known as an independent ethics committee (IEC), ethical review board (ERB), or research ethics board (REB), is a committee that applies research#Research ethics, research ethics by reviewing the methodolog ...
), maintenance of repositories of past clinical trial data (de-identified). CRI is a fairly new branch of informatics and has met growing pains as any up and coming field does. Some issue CRI faces is the ability for the statisticians and the computer system architects to work with the clinical research staff in designing a system and lack of funding to support the development of a new system. Researchers and the informatics team have a difficult time coordinating plans and ideas in order to design a system that is easy to use for the research team yet fits in the system requirements of the computer team. The lack of funding can be a hindrance to the development of the CRI. Many organizations who are performing research are struggling to get financial support to conduct the research, much less invest that money in an informatics system that will not provide them any more income or improve the outcome of the research (Embi, 2009). Ability to integrate data from multiple
clinical trials Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
is an important part of clinical research informatics. Initiatives, such as PhenX and
Patient-Reported Outcomes Measurement Information System The Patient-Reported Outcomes Measurement Information System (PROMIS) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient per ...
triggered a general effort to improve secondary use of data collected in past human clinical trials. CDE initiatives, for example, try to allow clinical trial designers to adopt standardized research instruments ( electronic case report forms). A parallel effort to standardizing how data is collected are initiatives that offer de-identified patient level clinical study data to be downloaded by researchers who wish to re-use this data. Examples of such platforms are Project Data Sphere, dbGaP, ImmPort or Clinical Study Data Request. Informatics issues in data formats for sharing results (plain CSV files,
FDA The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
endorsed formats, such as CDISC Study Data Tabulation Model) are important challenges within the field of clinical research informatics. There are a number of activities within clinical research that CRI supports, including: * more efficient and effective data collection and acquisition * improved recruitment into clinical trials * optimal protocol design and efficient management * patient recruitment and management * adverse event reporting * regulatory compliance * data storage, transfer, processing and analysis * repositories of data from completed clinical trials (for secondary analyses)


Translational bioinformatics

Translational Bioinformatics (TBI) is a relatively new field that surfaced in the year of 2000 when human genome sequence was released. The commonly used definition of TBI is lengthy and could be found on the AMIA website. In simpler terms, TBI could be defined as a collection of colossal amounts of health related data (biomedical and genomic) and translation of the data into individually tailored clinical entities. Today, TBI field is categorized into four major themes that are briefly described below: * Clinical
big data Though used sometimes loosely partly because of a lack of formal definition, the interpretation that seems to best describe Big data is the one associated with large body of information that we could not comprehend when used only in smaller am ...
is a collection of electronic health records that are used for innovations. The evidence-based approach that is currently practiced in medicine is suggested to be merged with the practice-based medicine to achieve better outcomes for patients. As CEO of California-based cognitive computing firm Apixio, Darren Schutle, explains that the care can be better fitted to the patient if the data could be collected from various
medical record The terms medical record, health record and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient A patient is any recipient of health care services that are performed by Health professio ...
s, merged, and analyzed. Further, the combination of similar profiles can serve as a basis for personalized medicine pointing to what works and what does not for certain condition (Marr, 2016). * Genomics in clinical care
Genomic data are used to identify the genes involvement in unknown or rare conditions/syndromes. Currently, the most vigorous area of using genomics is oncology. The identification of genomic sequencing of cancer may define reasons of drug(s) sensitivity and resistance during oncological treatment processes. * Omics for drugs discovery and repurposing
Repurposing of the drug is an appealing idea that allows the pharmaceutical companies to sell an already approved drug to treat a different condition/disease that the drug was not initially approved for by the FDA. The observation of "molecular signatures in disease and compare those to signatures observed in cells" points to the possibility of a drug ability to cure and/or relieve symptoms of a disease. * Personalized genomic testing
In the US, several companies offer direct-to-consumer (DTC)
genetic testing Genetic testing, also known as DNA testing, is used to identify changes in DNA sequence or chromosome structure. Genetic testing can also include measuring the results of genetic changes, such as RNA analysis as an output of gene expression, or t ...
. The company that performs the majority of testing is called 23andMe. Utilizing genetic testing in health care raises many ethical, legal and social concerns; one of the main questions is whether the health care providers are ready to include patient-supplied genomic information while providing care that is unbiased (despite the intimate genomic knowledge) and a high quality. The documented examples of incorporating such information into a health care delivery showed both positive and negative impacts on the overall health care related outcomes.


Artificial intelligence in healthcare

A pioneer in the use of
artificial intelligence in healthcare Artificial intelligence in healthcare is an overarching term used to describe the use of machine-learning algorithms and software, or artificial intelligence (AI), to mimic human cognition in the analysis, presentation, and comprehension of compl ...
was American biomedical informatician
Edward H. Shortliffe Edward ("Ted") Hance Shortliffe (born 1947) is a Canadian-born American biomedical informatician, physician, and computer scientist. Shortliffe is a pioneer in the use of artificial intelligence in medicine. He was the principal developer of the ...
. This field deals with utilisation of machine-learning algorithms and artificial intelligence, to emulate human cognition in the analysis, interpretation, and comprehension of complicated medical and healthcare data. Specifically, AI is the ability of computer algorithms to approximate conclusions based solely on input data. AI programs are applied to practices such as diagnosis processes, treatment protocol development, drug development, personalized medicine, and patient monitoring and care. A large part of industry focus of implementation of AI in the healthcare sector is in the
clinical decision support system A clinical decision support system (CDSS) is a health information technology, provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, to help health and health care. CDSS encompasses a variety of ...
s. As more data is collected, machine learning algorithms adapt and allow for more robust responses and solutions. Numerous companies are exploring the possibilities of the incorporation of
big data Though used sometimes loosely partly because of a lack of formal definition, the interpretation that seems to best describe Big data is the one associated with large body of information that we could not comprehend when used only in smaller am ...
in the healthcare industry. Many companies investigate the market opportunities through the realms of "data assessment, storage, management, and analysis technologies" which are all crucial parts of the healthcare industry. The following are examples of large companies that have contributed to AI algorithms for use in healthcare: * IBM's Watson Oncology is in development at
Memorial Sloan Kettering Cancer Center Memorial Sloan Kettering Cancer Center (MSK or MSKCC) is a cancer treatment Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy (oncology), hormonal therapy, targeted therapy (including immunotherapy such a ...
and
Cleveland Clinic Cleveland Clinic is a nonprofit A nonprofit organization (NPO) or non-profit organisation, also known as a non-business entity, not-for-profit organization, or nonprofit institution, is a legal entity organized and operated for a collecti ...
. IBM is also working with
CVS Health CVS Health Corporation (previously CVS Corporation and CVS Caremark Corporation) is an American Healthcare industry, healthcare company that owns CVS Pharmacy, a retail pharmacy chain; CVS Caremark, a Pharmacy benefit management, pharmacy benef ...
on AI applications in chronic disease treatment and with
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
on analysis of scientific papers to find new connections for drug development. In May 2017, IBM and
Rensselaer Polytechnic Institute Rensselaer Polytechnic Institute () (RPI) is a private university, private research university in Troy, New York, with an additional campus in Rensselaer at Hartford, Hartford, Connecticut. A third campus in Groton, Connecticut closed in 2018. ...
began a joint project entitled Health Empowerment by Analytics, Learning and Semantics (HEALS), to explore using AI technology to enhance healthcare. *
Microsoft Microsoft Corporation is an American multinational corporation, multinational technology company, technology corporation producing Software, computer software, consumer electronics, personal computers, and related services headquartered at th ...
's Hanover project, in partnership with
Oregon Health & Science University Oregon Health & Science University (OHSU) is a public In public relations and communication science, publics are groups of individual people, and the public (a.k.a. the general public) is the totality of such groupings. This is a different co ...
's Knight Cancer Institute, analyzes medical research to predict the most effective
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Poss ...
drug treatment options for patients. Other projects include medical image analysis of tumor progression and the development of programmable cells. *
Google Google LLC () is an American Multinational corporation, multinational technology company focusing on Search Engine, search engine technology, online advertising, cloud computing, software, computer software, quantum computing, e-commerce, ar ...
's
DeepMind DeepMind Technologies is a British artificial intelligence subsidiary of Alphabet Inc. and research laboratory founded in 2010. DeepMind was List of mergers and acquisitions by Google, acquired by Google in 2014 and became a wholly owned subsid ...
platform is being used by the UK
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which ...
to detect certain health risks through data collected via a mobile app. A second project with the NHS involves analysis of medical images collected from NHS patients to develop computer vision algorithms to detect cancerous tissues. *
Tencent Tencent Holdings Ltd. () is a Chinese Multinational corporation, multinational technology and entertainment Conglomerate (company), conglomerate and holding company headquartered in Shenzhen. It is one of the highest grossing multimedia companie ...
is working on several medical systems and services. These include AI Medical Innovation System (AIMIS), an AI-powered diagnostic medical imaging service; WeChat Intelligent Healthcare; and Tencent Doctorwork * Intel's venture capital arm
Intel Capital Intel Capital is a division of Intel Corporation, set up to manage corporate venture capital, global investment, mergers and acquisitions. Intel Capital makes equity investments in a range of technology startups and companies offering hardware, so ...
recently invested in startup Lumiata which uses AI to identify at-risk patients and develop care options. * Kheiron Medical developed deep learning software to detect
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipple, ...
s in
mammogram Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 Peak kilovoltage, kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, ty ...
s. *
Fractal Analytics Fractal Analytics is a multinational artificial intelligence Artificial intelligence (AI) is intelligence—perceiving, synthesizing, and inferring information—demonstrated by machines, as opposed to intelligence displayed by animal cogni ...
has incubated Qure.ai which focuses on using deep learning and AI to improve radiology and speed up the analysis of diagnostic x-rays. *
Neuralink Neuralink Corporation is a neurotechnology company that develops brain implant, implantable brain–computer interfaces (BCIs). Founded by Elon Musk and a founding team of seven other scientists and engineers, the company's headquarters is in t ...
has come up with a next generation neuroprosthetic which intricately interfaces with thousands of neural pathways in the brain. Their process allows a chip, roughly the size of a quarter, to be inserted in place of a chunk of skull by a precision surgical robot to avoid accidental injury . Digital consultant apps like Babylon Health's GP at Hand,
Ada Health Ada is a health company based in Berlin Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city li ...
, AliHealth Doctor You, KareXpert and Your.MD use AI to give medical consultation based on personal medical history and common medical knowledge. Users report their symptoms into the app, which uses speech recognition to compare against a database of illnesses. Babylon then offers a recommended action, taking into account the user's medical history. Entrepreneurs in healthcare have been effectively using seven business model archetypes to take AI solution
buzzword A buzzword is a word or phrase, new or already existing, that becomes popular for a period of time. Buzzwords often derive from technical terms yet often have much of the original technical meaning removed through fashionable use, being simply used ...
] to the marketplace. These archetypes depend on the value generated for the target user (e.g. patient focus vs. healthcare provider and payer focus) and value capturing mechanisms (e.g. providing information or connecting stakeholders).
IFlytek iFlytek (), styled as iFLYTEK, is a partially state-owned Chinese information technology Information technology (IT) is the use of computers to create, process, store, retrieve, and exchange all kinds of Data (computing), data . and infor ...
launched a service robot "Xiao Man", which integrated artificial intelligence technology to identify the registered customer and provide personalized recommendations in medical areas. It also works in the field of medical imaging. Similar robots are also being made by companies such as UBTECH ("Cruzr") and
Softbank is a Japanese multinational Conglomerate (company), conglomerate holding company headquartered in Minato, Tokyo, Minato, Tokyo which focuses on investment management. The Group primarily invests in companies operating in technology, energy, and ...
Robotics ("Pepper"). The Indian startup
Haptik Haptik is an Indian Enterprise software, enterprise conversational AI platform founded in August 2013, and acquired by Reliance Industries Limited in 2019. The company develops technology to enable enterprises to build conversational AI systems ...
recently developed a
WhatsApp WhatsApp (also called WhatsApp Messenger) is an internationally available freeware, cross-platform, Centralized computing, centralized instant messaging (IM) and Voice over IP, voice-over-IP (VoIP) service owned by American company Meta Platfor ...
chatbot which answers questions associated with the deadly
coronavirus Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the c ...
in
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area, the List of countries and dependencies by population, second-most populous ...
. With the market for AI expanding constantly, large tech companies such as Apple, Google, Amazon, and Baidu all have their own AI research divisions, as well as millions of dollars allocated for acquisition of smaller AI based companies. Many automobile manufacturers are beginning to use machine learning healthcare in their cars as well. Companies such as BMW, GE, Tesla,
Toyota is a Japanese Multinational corporation, multinational Automotive industry, automotive manufacturer headquartered in Toyota City, Aichi, Japan. It was founded by Kiichiro Toyoda and incorporated on . Toyota is one of the Automotive industry#By ...
, and
Volvo The Volvo Group ( sv, Volvokoncernen; legally Aktiebolaget Volvo, shortened to AB Volvo, stylized as VOLVO) is a Swedish multinational manufacturing corporation headquartered in Gothenburg. While its core activity is the production, distributio ...
all have new research campaigns to find ways of learning a driver's vital statistics to ensure they are awake, paying attention to the road, and not under the influence of substances or in emotional distress. Examples of projects in computational health informatics include the COACH project.


Telehealth and telemedicine

Telehealth Telehealth is the distribution of Health care, health-related services and information via electronic information and Telecommunication, telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders ...
is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective. Telerehabilitation (or e-rehabilitation 041]) is the delivery of rehabilitation services over telecommunication networks and the Internet. Most types of services fall into two categories: clinical assessment (the patient's functional abilities in his or her environment), and clinical therapy. Some fields of rehabilitation practice that have explored telerehabilitation are: neuropsychology, speech-language pathology, audiology, occupational therapy, and physical therapy. Telerehabilitation can deliver therapy to people who cannot travel to a clinic because the patient has a disability or because of travel time. Telerehabilitation also allows experts in rehabilitation to engage in a clinical consultation at a distance.


Medical signal processing

An important application of information engineering in medicine is medical signal processing. It refers to the generation, analysis, and use of signals, which could take many forms such as image, sound, electrical, or biological.


Medical image computing and imaging informatics

Imaging informatics and
medical image computing Medical image computing (MIC) is an interdisciplinary field at the intersection of computer science Computer science is the study of computation, automation, and information. Computer science spans theoretical disciplines (such as algori ...
develops computational and mathematical methods for solving problems pertaining to medical images and their use for biomedical research and clinical care. Those fields aims to extract clinically relevant information or knowledge from medical images and computational analysis of the images. The methods can be grouped into several broad categories:
image segmentation In digital image processing Digital image processing is the use of a digital computer to process digital images through an algorithm. As a subcategory or field of digital signal processing, digital image processing has many advantages over ana ...
,
image registration Image registration is the process of transforming different sets of data into one coordinate system. Data may be multiple photographs, data from different sensors, times, depths, or viewpoints. It is used in computer vision, medical imaging, milit ...
, image-based physiological modeling, and others.


Other fields in healthcare technology


Medical robotics and autonomic computing

A medical robot is a robot used in the medical sciences. They include surgical robots. These are in most telemanipulators, which use the surgeon's activators on one side to control the "effector" on the other side. There are the following types of medical robots: *
Surgical robots Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of pati ...
: either allow surgical operations to be carried out with better precision than an unaided human surgeon or allow
remote surgery Remote surgery (also known as telesurgery) is the ability for a doctor to perform surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that ...
where a human surgeon is not physically present with the patient. * Rehabilitation robots: facilitate and support the lives of infirm, elderly people, or those with dysfunction of body parts affecting movement. These robots are also used for rehabilitation and related procedures, such as training and therapy. * Biorobots: a group of robots designed to imitate the cognition of humans and animals. * Telepresence robots: allow off-site medical professionals to move, look around, communicate, and participate from remote locations. *
Pharmacy automation Pharmacy automation involves the mechanical processes of handling and distributing medications. Any pharmacy task may be involved, including counting small objects (e.g., Tablet (pharmacy), tablets, capsule (pharmacy), capsules); measuring and mix ...
: robotic systems to dispense oral solids in a retail pharmacy setting or preparing sterile IV admixtures in a hospital pharmacy setting. * Companion robot: has the capability to engage emotionally with users keeping them company and alerting if there is a problem with their health. * Disinfection robot: has the capability to
disinfect A disinfectant is a chemical A chemical substance is a form of matter having constant chemical composition and characteristic properties. Some references add that chemical substance cannot be separated into its constituent Chemical elemen ...
a whole room in mere minutes, generally using pulsed
ultraviolet light Ultraviolet (UV) is a form of electromagnetic radiation with wavelength from 10 nanometer, nm (with a corresponding frequency around 30 Hertz, PHz) to 400 nm (750 Hertz, THz), shorter than that of visible light, but longer than ...
. They are being used to fight
Ebola virus disease Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
.


Computer engineering in healthcare

Field of computer engineering is known in Europe as technical informatics and is closely related to engineering informatics which includes also information engineering. Computer engineers create computer-based devices for the health service, in particular
embedded system An embedded system is a computer system—a combination of a computer processor, computer memory, and input/output peripheral devices—that has a dedicated function within a larger mechanical or Electronics, electronic system. It is '' ...
s.


Neuroengineering & Neuroinformatics

Neuroinformatics Neuroinformatics is the field that combines informatics and neuroscience. Neuroinformatics is related with neuroscience data and information processing by artificial neural networks. There are three main directions where neuroinformatics has to be ...
is a scientific study of information flow and processing in nervous system. Institute scientists utilize brain imaging techniques, such as
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. Physics of magnetic resonance imaging#MRI scanner, MRI scanners use strong magnetic ...
, to reveal the organization of brain networks involved in human thought. Brain simulation is the concept of creating a functioning
computer model Computer simulation is the process of mathematical modelling, performed on a computer, which is designed to predict the behaviour of, or the outcome of, a real-world or physical system. The reliability of some mathematical models can be deter ...
of a brain or part of a brain. There are three main directions where neuroinformatics has to be applied: * the development of
computational model A computational model uses computer programs to simulate and study complex systems using an algorithmic or mechanistic approach and is widely used in a diverse range of fields spanning from physics, chemistry and biology to economics, psychology, ...
s of the
nervous system In Biology, biology, the nervous system is the Complex system, highly complex part of an animal that coordinates its Behavior, actions and Sense, sensory information by transmitting action potential, signals to and from different parts of its ...
and neural processes, * the development of tools for analyzing data from devices for neurological diagnostic devices, * the development of tools and databases for management and sharing of patients brain data in healthcare institutions.


Brain mapping and simulation

Brain simulation Brain simulation is the concept of creating a functioning Computer simulation, computer model of a brain or part of a brain. Brain simulation projects intend to contribute to a complete understanding of the brain, and eventually also assist the pro ...
is the concept of creating a functioning computational model of a brain or part of a brain. In December 2006, the
Blue Brain The Blue Brain Project is a Swiss brain research initiative that aims to create a digital reconstruction of the mouse brain. The project was founded in May 2005 by the Brain and Mind Institute of ''École Polytechnique Fédérale de Lausanne'' (EP ...
project completed a simulation of a rat's neocortical column. The neocortical column is considered the smallest functional unit of the
neocortex The neocortex, also called the neopallium, isocortex, or the six-layered cortex, is a set of layers of the mammalian cerebral cortex involved in higher-order brain functions such as sense, sensory perception, cognition, generation of motor cortex ...
. The neocortex is the part of the brain thought to be responsible for higher-order functions like conscious thought, and contains 10,000 neurons in the rat brain (and 108
synapse In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell. Synapses are essential to the transmission of nervous impulses from ...
s). In November 2007, the project reported the end of its first phase, delivering a data-driven process for creating, validating, and researching the neocortical column. An
artificial neural network Artificial neural networks (ANNs), usually simply called neural networks (NNs) or neural nets, are computing systems inspired by the biological neural networks that constitute animal brains. An ANN is based on a collection of connected units ...
described as being "as big and as complex as half of a mouse brain" was run on an IBM
Blue Gene Blue Gene is an IBM project aimed at designing supercomputers that can reach operating speeds in the FLOPS, petaFLOPS (PFLOPS) range, with low power consumption. The project created three generations of supercomputers, Blue Gene/L, Blue Gen ...
supercomputer by the University of Nevada's research team in 2007. Each second of simulated time took ten seconds of computer time. The researchers claimed to observe "biologically consistent" nerve impulses that flowed through the virtual cortex. However, the simulation lacked the structures seen in real mice brains, and they intend to improve the accuracy of the neuron and synapse models.


Mind uploading

Mind uploading Mind uploading is a speculative process of whole brain emulation in which a brain scanning, brain scan is used to completely emulator, emulate the mental state of the individual in a Digital data, digital computer. The computer would then run a c ...
is the process of scanning a physical structure of the brain accurately enough to create an emulation of the mental state (including long-term memory and "self") and copying it to a computer in a
digital Digital usually refers to something using discrete digits, often binary digits. Technology and computing Hardware *Digital electronics Digital electronics is a field of electronics involving the study of digital signals and the engineering o ...
form. The
computer A computer is a machine that can be programmed to carry out sequences of arithmetic or logical operations (computation) automatically. Modern digital electronic computers can perform generic sets of operations known as Computer program, pr ...
would then run a
simulation A simulation is the imitation of the operation of a real-world process or system over time. Simulations require the use of Conceptual model, models; the model represents the key characteristics or behaviors of the selected system or proc ...
of the brain's information processing, such that it would respond in essentially the same way as the original brain and experience having a
sentient Sentience is the capacity to experience feelings and sensations. The word was first coined by philosophers in the 1630s for the concept of an ability to feel, derived from Latin '':wikt:sentientem, sentientem'' (a feeling), to distinguish it fro ...
conscious Consciousness, at its simplest, is sentience and awareness of internal and external existence. However, the lack of definitions has led to millennia of analyses, explanations and debates by philosophers, theologians, linguisticians, and scient ...
mind The mind is the set of faculties responsible for all mental Phenomenon, phenomena. Often the term is also identified with the phenomena themselves. These faculties include thought, imagination, memory, Will (philosophy), will, and Sensation (psy ...
. Substantial mainstream research in related areas is being conducted in animal brain mapping and simulation, development of faster supercomputers,
virtual reality Virtual reality (VR) is a Simulation, simulated experience that employs pose tracking and 3D near-eye displays to give the user an immersive feel of a virtual world. Applications of virtual reality include entertainment (particularly video g ...
,
brain–computer interface A brain–computer interface (BCI), sometimes called a brain–machine interface (BMI) or smartbrain, is a direct communication pathway between the brain's electrical activity and an external device, most commonly a computer or robotic limb. BC ...
s,
connectomics Connectomics is the production and study of connectomes: comprehensive maps of connections within an organism In biology, an organism () is any life, living system that functions as an individual entity. All organisms are composed of ...
, and information extraction from dynamically functioning brains. According to supporters, many of the tools and ideas needed to achieve mind uploading already exist or are currently under active development; however, they will admit that others are, as yet, very speculative, but say they are still in the realm of engineering possibility.


International history

Worldwide use of computer technology in medicine began in the early 1950s with the rise of the computers. In 1949, Gustav Wagner established the first professional organization for informatics in Germany. The prehistory, history, and future of medical information and health information technology are discussed in reference. Specialized university departments and Informatics training programs began during the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units began to appear during the 1970s in Poland and in the U.S. Since then the development of high-quality health informatics research, education and infrastructure has been a goal of the U.S. and the European Union. Early names for health informatics included medical computing, biomedical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science,
medical software Medical software is any software Software is a set of computer programs and associated software documentation, documentation and data (computing), data. This is in contrast to Computer hardware, hardware, from which the system is built and w ...
engineering, and medical computer technology. The health informatics community is still growing, it is by no means a mature profession, but work in the UK by the voluntary registration body, the UK Council of Health Informatics Professions has suggested eight key constituencies within the domain–information management, knowledge management, portfolio/program/project management, ICT, education and research, clinical informatics, health records(service and business-related), health informatics service management. These constituencies accommodate professionals in and for the NHS, in academia and commercial service and solution providers. Since the 1970s the most prominent international coordinating body has been the
International Medical Informatics Association The International Medical Informatics Association (IMIA) is an independent organization that plays a role in promoting and furthering the application of information science Information science (also known as information studies) is an ...
(IMIA).


History, current state and policy initiatives by region and country


Americas


Argentina

The Argentinian health system is heterogeneous in its function, and because of that, the informatics developments show a heterogeneous stage. Many private health care centers have developed systems, such as the Hospital Aleman of Buenos Aires, or the Hospital Italiano de Buenos Aires that also has a residence program for health informatics.


Brazil

The first applications of computers to medicine and health care in Brazil started around 1968, with the installation of the first mainframes in public university hospitals, and the use of programmable calculators in scientific research applications. Minicomputers, such as the
IBM 1130 The IBM 1130 Computing System, introduced in 1965, was IBM's least expensive computer at that time. A binary 16-bit machine, it was marketed to price-sensitive, computing-intensive technical markets, like education and engineering, succeeding the ...
were installed in several universities, and the first applications were developed for them, such as the hospital census in the School of Medicine of Ribeirão Preto and patient master files, in the Hospital das Clínicas da Universidade de São Paulo, respectively at the cities of
Ribeirão Preto Ribeirão Preto (Portuguese pronunciation: ibejˈɾɐ̃w ˈpɾetu is a municipality A municipality is usually a single administrative division Administrative division, administrative unit,Article 3(1). country subdivision, admini ...
and
São Paulo São Paulo (, ; Portuguese for 'Saint Paul') is the List of largest cities in Brazil, most populous city in Brazil, and is the capital of the São Paulo (state), state of São Paulo, the List of Brazilian states by population, most populous and ...
campuses of the
University of São Paulo The University of São Paulo ( pt, Universidade de São Paulo, USP) is a public university in the Brazil Brazil ( pt, Brasil; ), officially the Federative Republic of Brazil (Portuguese: ), is the largest country in both South America ...
. In the 1970s, several Digital Corporation and
Hewlett Packard The Hewlett-Packard Company, commonly shortened to Hewlett-Packard ( ) or HP, was an American multinational information technology company headquartered in Palo Alto, California. HP developed and provided a wide variety of hardware components ...
minicomputers were acquired for public and Armed Forces hospitals, and more intensively used for
intensive-care unit image:Intensivstation (01) 2007-03-03.jpg, 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or h ...
,
cardiology Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart d ...
diagnostics, patient monitoring and other applications. In the early 1980s, with the arrival of cheaper
microcomputer A microcomputer is a small, relatively inexpensive computer having a central processing unit (CPU) made out of a microprocessor. The computer also includes Computer memory, memory and input/output (I/O) circuitry together mounted on a printed ...
s, a great upsurge of computer applications in health ensued, and in 1986 the Brazilian Society of Health Informatics was founded, the first Brazilian Congress of Health Informatics was held, and the first ''Brazilian Journal of Health Informatics'' was published. In Brazil, two universities are pioneers in teaching and research in medical informatics, both the
University of Sao Paulo A university () is an institution Institutions are humanly devised structures of rules and norms that shape and constrain individual behavior. All definitions of institutions generally entail that there is a level of persistence and continu ...
and the Federal University of Sao Paulo offer undergraduate programs highly qualified in the area as well as extensive graduate programs (MSc and PhD). In 2015 the Universidade Federal de Ciências da Saúde de Porto Alegre,
Rio Grande do Sul Rio Grande do Sul (, , ; "Great River of the South") is a Federative units of Brazil, state in the South Region, Brazil, southern region of Brazil. It is the Federative_units_of_Brazil#List, fifth-most-populous state and the List of Brazilian st ...
, also started to offer undergraduate program.


Canada

Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems. A national, federally funded, not-for-profit organisation called Canada Health Infoway was created in 2001 to foster the development and adoption of electronic health records across Canada. As of December 31, 2008, there were 276 EHR projects under way in Canadian hospitals, other health-care facilities, pharmacies and laboratories, with an investment value of $1.5-billion from Canada Health Infoway. Provincial and territorial programmes include the following: * eHealth Ontario was created as an Ontario provincial government agency in September 2008. It has been plagued by delays and its CEO was fired over a multimillion-dollar contracts scandal in 2009. * Alberta Netcare was created in 2003 by the Government of Alberta. Today the netCARE portal is used daily by thousands of clinicians. It provides access to demographic data, prescribed/dispensed drugs, known allergies/intolerances, immunizations, laboratory test results, diagnostic imaging reports, the diabetes registry and other medical reports. netCARE interface capabilities are being included in electronic medical record products that are being funded by the provincial government.


United States

Even though the idea of using computers in medicine emerged as technology advanced in the early 20th century, it was not until the 1950s that informatics began to have an effect in the United States. The earliest use of electronic digital computers for medicine was for dental projects in the 1950s at the United States
National Bureau of Standards The National Institute of Standards and Technology (NIST) is an agency of the United States Department of Commerce whose mission is to promote American innovation and industrial competitiveness. NIST's activities are organized into Outline of p ...
by
Robert Ledley Robert Steven Ledley (June 28, 1926 – July 24, 2012), professor of physiology and biophysics and professor of radiology at Georgetown University School of Medicine, pioneered the use of electronic digital computers in biology and medicine. In ...
. During the mid-1950s, the
United States Air Force The United States Air Force (USAF) is the Aerial warfare, air military branch, service branch of the United States Armed Forces, and is one of the eight uniformed services of the United States. Originally created on 1 August 1907, as a part ...
(USAF) carried out several medical projects on its computers while also encouraging civilian agencies such as the National Academy of Sciences – National Research Council (NAS-NRC) and the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1 ...
(NIH) to sponsor such work. In 1959, Ledley and Lee B. Lusted published "Reasoning Foundations of Medical Diagnosis," a widely read article in ''
Science Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earli ...
'', which introduced computing (especially operations research) techniques to medical workers. Ledley and Lusted's article has remained influential for decades, especially within the field of medical decision making. Guided by Ledley's late 1950s survey of computer use in biology and medicine (carried out for the NAS-NRC), and by his and Lusted's articles, the NIH undertook the first major effort to introduce computers to biology and medicine. This effort, carried out initially by the NIH's Advisory Committee on Computers in Research (ACCR), chaired by Lusted, spent over $40 million between 1960 and 1964 in order to establish dozens of large and small biomedical research centers in the US. One early (1960, non-ACCR) use of computers was to help quantify normal human movement, as a precursor to scientifically measuring deviations from normal, and design of prostheses. The use of computers (IBM 650, 1620, and 7040) allowed analysis of a large sample size, and of more measurements and subgroups than had been previously practical with mechanical calculators, thus allowing an objective understanding of how human locomotion varies by age and body characteristics. A study co-author was Dean of the Marquette University College of Engineering; this work led to discrete Biomedical Engineering departments there and elsewhere. The next steps, in the mid-1960s, were the development (sponsored largely by the NIH) of
expert system In artificial intelligence, an expert system is a computer system emulating the decision-making ability of a human expert. Expert systems are designed to solve complex problems by automated reasoning, reasoning through bodies of knowledge, repres ...
s such as MYCIN and
Internist-I {{Short description, Computer-assisted diagnostic software tool INTERNIST-I was a broad-based computer-assisted diagnostic tool developed in the early 1970s at the University of Pittsburgh as an educational experiment. The system was designed to cap ...
. In 1965, the
National Library of Medicine The United States National Library of Medicine (NLM), operated by the Federal government of the United States, United States federal government, is the world's largest medical library. Located in Bethesda, Maryland, the NLM is an institute withi ...
started to use
MEDLINE MEDLINE (Medical Literature Analysis and Retrieval System Online, or MEDLARS Online) is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medic ...
and
MEDLARS MEDLINE (Medical Literature Analysis and Retrieval System Online, or MEDLARS Online) is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medic ...
. Around this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed
MUMPS MUMPS ("Massachusetts General Hospital Utility Multi-Programming System"), or M, is an imperative, high-level programming language with an integrated transaction processing key–value database. It was originally developed at Massachusetts Gener ...
(Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett's Laboratory of Computer Science at
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End, Boston, West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital i ...
in
Boston Boston (), officially the City of Boston, is the capital city, state capital and List of municipalities in Massachusetts, most populous city of the Commonwealth (U.S. state), Commonwealth of Massachusetts, as well as the cultural and financ ...
, another center of biomedical computing that received significant support from the NIH. In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The
MUMPS MUMPS ("Massachusetts General Hospital Utility Multi-Programming System"), or M, is an imperative, high-level programming language with an integrated transaction processing key–value database. It was originally developed at Massachusetts Gener ...
operating system was used to support MUMPS language specifications. , a descendant of this system is being used in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
Veterans Affairs hospital system. The VA has the largest enterprise-wide health information system that includes an
electronic medical record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care Health care or healthcare is ...
, known as the Veterans Health Information Systems and Technology Architecture (VistA). A
graphical user interface The GUI ( "UI" by itself is still usually pronounced . or ), graphical user interface, is a form of user interface that allows User (computing), users to Human–computer interaction, interact with electronic devices through graphical icon (comp ...
known as the Computerized Patient Record System (CPRS) allows health care providers to review and update a patient's electronic medical record at any of the VA's over 1,000 health care facilities. During the 1960s, Morris Collen, a physician working for
Kaiser Permanente Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated delivery system, integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician ...
's Division of Research, developed computerized systems to automate many aspects of multi-phased health checkups. These systems became the basis the larger medical databases Kaiser Permanente developed during the 1970s and 1980s. The American College of Medical Informatics (ACMI) has since 1993 annually bestowed the Morris F. Collen, MD Medal for Outstanding Contributions to the Field of Medical Informatics. Kaiser permanente In the 1970s a growing number of commercial vendors began to market practice management and electronic medical records systems. Although many products exist, only a small number of health practitioners use fully featured electronic health care records systems. In 1970, Warner V. Slack, MD, and Howard L. Bleich, MD, co-founded the academic division of clinical informatics at Beth Israel Deaconess Medical Center and Harvard Medical School. Warner Slack is a pioneer of the development of the electronic patient medical history, and in 1977 Dr. Bleich created the first user-friendly search engine for the worlds biomedical literature. In 2002, Dr. Slack and Dr. Bleich were awarded the Morris F. Collen Award for their pioneering contributions to medical informatics. Computerised systems involved in patient care have led to a number of changes. Such changes have led to improvements in electronic health records which are now capable of sharing medical information among multiple health care stakeholders (Zahabi, Kaber, & Swangnetr, 2015); thereby, supporting the flow of patient information through various modalities of care. One opportunity for
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
s (EHR)to be even more effectively used is to utilize
natural language processing Natural language processing (NLP) is an interdisciplinary subfield of linguistics, computer science, and artificial intelligence concerned with the interactions between computers and human language, in particular how to program computers to proc ...
for searching and analyzing notes and text that would otherwise be inaccessible for review. These can be further developed through ongoing collaboration between software developers and end-users of natural language processing tools within the electronic health EHRs. Computer use today involves a broad ability which includes but isn't limited to physician diagnosis and documentation, patient appointment scheduling, and billing. Many researchers in the field have identified an increase in the quality of health care systems, decreased errors by health care workers, and lastly savings in time and money (Zahabi, Kaber, & Swangnetr, 2015). The system, however, is not perfect and will continue to require improvement. Frequently cited factors of concern involve usability, safety, accessibility, and user-friendliness (Zahabi, Kaber, & Swangnetr, 2015). As leaders in the field of medical informatics improve upon the aforementioned factors of concern, the overall provision of health care will continue to improve. Homer R. Warner, one of the fathers of medical informatics, founded the Department of Medical Informatics at the
University of Utah The University of Utah (U of U, UofU, or simply The U) is a public research university in Salt Lake City, Utah Utah ( , ) is a state in the Mountain West subregion of the Western United States. Utah is a landlocked U.S. state bor ...
in 1968. The
American Medical Informatics Association The American Medical Informatics Association (AMIA), is an American non-profit Non-governmental organization, organization dedicated to the development and application of Biomedical informatics, biomedical and health informatics in the support o ...
(AMIA) has an award named after him on application of informatics to medicine. There are Informatics certifications available to help informatics professionals stand out and be recognized. The American Nurses Credentialing Center (ANCC) offers a board certification in Nursing Informatics. For Radiology Informatics, the CIIP (Certified Imaging Informatics Professional) certification was created by ABII (The American Board of Imaging Informatics) which was founded by SIIM (the Society for Imaging Informatics in Medicine) and ARRT (the American Registry of Radiologic Technologists) in 2005. The CIIP certification requires documented experience working in Imaging Informatics, formal testing and is a limited time credential requiring renewal every five years. The exam tests for a combination of IT technical knowledge, clinical understanding, and project management experience thought to represent the typical workload of a PACS administrator or other radiology IT clinical support role. Certifications from PARCA (PACS Administrators Registry and Certifications Association) are also recognized. The five PARCA certifications are tiered from entry-level to architect level. The American Health Information Management Association offers credentials in
medical coding A clinical coder—also known as clinical coding officer, diagnostic coder, medical coder, or nosologist—is a health information professional whose main duties are to analyse clinical statements and assign standard codes using a classification ...
, analytics, and data administration, such as Registered Health Information Administrator and Certified Coding Associate. Certifications are widely requested by employers in health informatics, and overall the demand for certified informatics workers in the United States is outstripping supply. The American Health Information Management Association reports that only 68% of applicants pass certification exams on the first try. In 2017, a consortium of health informatics trainers (composed of MEASURE Evaluation, Public Health Foundation India, University of Pretoria, Kenyatta University, and the University of Ghana) identified the following areas of knowledge as a curriculum for the
digital health Digital health is a discipline that includes digital care programs, technologies with health Health, according to the World Health Organization, is "a state of complete physical, Mental health, mental and social well-being and not merely the ...
workforce, especially in low- and middle-income countries: clinical decision support;
telehealth Telehealth is the distribution of Health care, health-related services and information via electronic information and Telecommunication, telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders ...
; privacy, security, and confidentiality; workflow process improvement; technology, people, and processes; process engineering; quality process improvement and health information technology; computer hardware; software; databases; data warehousing; information networks; information systems; information exchange; data analytics; and usability methods. In 2004, President George W. Bush signed Executive Order 13335, creating the Office of the National Coordinator for Health Information Technology (ONCHIT) as a division of the U.S.
Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto ...
(HHS). The mission of this office is widespread adoption of interoperable electronic health records (EHRs) in the US within 10 years. See quality improvement organizations for more information on federal initiatives in this area. In 2014 the Department of Education approved an advanced Health Informatics Undergraduate program that was submitted by the University of South Alabama. The program is designed to provide specific Health Informatics education, and is the only program in the country with a Health Informatics Lab. The program is housed in the School of Computing in Shelby Hall, a recently completed $50 million state of the art teaching facility. The University of South Alabama awarded David L. Loeser on May 10, 2014, with the first Health Informatics degree. The program currently is scheduled to have 100+ students awarded by 2016. The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the U.S.
Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto ...
to develop a set of standards for
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
s (EHR) and supporting networks, and certify vendors who meet them. In July 2006, CCHIT released its first list of 22 certified ambulatory EHR products, in two different announcements.
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees ...
added a department of biomedical informatics in 2015. The
University of Cincinnati The University of Cincinnati (UC or Cincinnati) is a public university, public research university in Cincinnati, Ohio. Founded in 1819 as Cincinnati College, it is the oldest institution of higher education in Cincinnati and has an annual enrol ...
in partnership with
Cincinnati Children's Hospital Medical Center Cincinnati Children's Hospital Medical Center (CCHMC) is an academic An academy (Attic Greek Attic Greek is the Greek language, Greek dialect of the regions of ancient Greece, ancient region of Attica, including the ''polis'' of classical ...
created a biomedical informatics (BMI) Graduate certificate program and in 2015 began a BMI PhD program. The joint program allows for researchers and students to observe the impact their work has on patient care directly as discoveries are translated from bench to bedside.


Europe


European Union

The European Commission's preference, as exemplified in the 5th Framework as well as currently pursued pilot projects, is for Free/Libre and Open Source Software (FLOSS) for health care. Another stream of research currently focuses on aspects of "big data" in health information systems. For background information on data-related aspects in health informatics see, e.g., the book "Biomedical Informatics" by Andreas Holzinger. The European Union's Member States are committed to sharing their best practices and experiences to create a European eHealth Area, thereby improving access to and quality health care at the same time as stimulating growth in a promising new industrial sector. The European eHealth Action Plan plays a fundamental role in the European Union's strategy. Work on this initiative involves a collaborative approach among several parts of the Commission services. The
European Institute for Health Records The European Institute for Health Records or EuroRec Institute is a non-profit organization founded in 2002 as part of the ProRec initiative. On 13 May 2003, the institute was established as a non-profit organization under France, French law. Curre ...
is involved in the promotion of high quality
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
systems in the
European Union The European Union (EU) is a supranational union, supranational political union, political and economic union of Member state of the European Union, member states that are located primarily in Europe, Europe. The union has a total area of ...
.


UK

The broad history of health informatics has been captured in the book ''UK Health Computing: Recollections and reflections'', Hayes G, Barnett D (Eds.), BCS (May 2008) by those active in the field, predominantly members of BCS Health and its constituent groups. The book describes the path taken as 'early development of health informatics was unorganized and idiosyncratic'. In the early 1950s, it was prompted by those involved in NHS finance and only in the early 1960s did solutions including those in pathology (1960), radiotherapy (1962), immunization (1963), and primary care (1968) emerge. Many of these solutions, even in the early 1970s were developed in-house by pioneers in the field to meet their own requirements. In part, this was due to some areas of health services (for example the immunization and vaccination of children) still being provided by Local Authorities. The coalition government has proposed broadly to return to the 2010 strategy Equity and Excellence: Liberating the NHS (July 2010); stating: "We will put patients at the heart of the NHS, through an information revolution and greater choice and control' with shared decision-making becoming the norm: 'no decision about me without me' and patients having access to the information they want, to make choices about their care. They will have increased control over their own care records." There are different models of health informatics delivery in each of the home countries (England, Scotland, Northern Ireland and Wales) but some bodies like UKCHIP (see below) operate for those 'in and for' all the home countries and beyond. NHS informatics in England was contracted out to several vendors for national health informatics solutions under the National Programme for Information Technology (NPfIT) label in the early to mid-2000s, under the auspices of NHS Connecting for Health (part of the Health and Social Care Information Centre as of 1 April 2013). NPfIT originally divided the country into five regions, with strategic 'systems integration' contracts awarded to one of several Local Service Providers (LSP). The various specific technical solutions were required to connect securely with the NHS 'Spine', a system designed to broker data between different systems and care settings. NPfIT fell significantly behind schedule and its scope and design were being revised in real time, exacerbated by media and political lambasting of the Programme's spend (past and projected) against the proposed budget. In 2010 a consultation was launched as part of the new Conservative/Liberal Democrat Coalition Government's White Paper 'Liberating the NHS'. This initiative provided little in the way of innovative thinking, primarily re-stating existing strategies within the proposed new context of the Coalition's vision for the NHS. The degree of computerization in NHS secondary care was quite high before NPfIT, and the programme stagnated further development of the install base – the original NPfIT regional approach provided neither a single, nationwide solution nor local health community agility or autonomy to purchase systems, but instead tried to deal with a hinterland in the middle. Almost all general practices in England and Wales are computerized under the GP Systems of Choice programme, and patients have relatively extensive computerized primary care clinical records. System choice is the responsibility of individual general practices and while there is no single, standardized GP system, it sets relatively rigid minimum standards of performance and functionality for vendors to adhere to. Interoperation between primary and secondary care systems is rather primitive. It is hoped that a focus on interworking (for interfacing and integration) standards will stimulate synergy between primary and secondary care in sharing necessary information to support the care of individuals. Notable successes to date are in the electronic requesting and viewing of test results, and in some areas, GPs have access to digital x-ray images from secondary care systems. In 2019 the GP Systems of Choice framework was replaced by the GP IT Futures framework, which is to be the main vehicle used by
clinical commissioning group Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of National Health Service (England), NHS services in each of their local areas in England. On 1 July 2022 they wer ...
s to buy services for GPs. This is intended to increase competition in an area that is dominated by EMIS and TPP. 69 technology companies offering more than 300 solutions have been accepted on to the new framework. Wales has a dedicated Health Informatics function that supports NHS Wales in leading on the new integrated digital information services and promoting Health Informatics as a career. The British Computer Society (BCS) provides 4 different professional registration levels for Health and Care Informatics Professionals: Practitioner, Senior Practitioner, Advanced Practitioner, and Leading Practitioner. The Faculty of Clinical Informatics (FCI) is the professional membership society for health and social care professionals in clinical informatics offering Fellowship, Membership and Associateship. BCS and FCI are member organisations of the Federation for Informatics Professionals in Health and Social Care (FedIP), a collaboration between the leading professional bodies in health and care informatics supporting the development of the informatics professions. The Faculty of Clinical Informatics has produced a Core Competency Framework that describes the wide range of skills needed by practitioners.


Netherlands

In the Netherlands, health informatics is currently a priority for research and implementation. The Netherlands Federation of University medical centers (NFU) has created the ''Citrienfonds'', which includes the programs eHealth and Registration at the Source. The Netherlands also has the national organizations Society for Healthcare Informatics (VMBI) and Nictiz, the national center for standardization and eHealth.


Asia and Oceania

In Asia and Australia-New Zealand, the regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1994 and now consists of more than 15 member regions in the Asia Pacific Region.


Australia

The Australasian College of Health Informatics (ACHI) is the professional association for health informatics in the Asia-Pacific region. It represents the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere through a commitment to quality, standards and ethical practice. ACHI is an academic institutional member of the
International Medical Informatics Association The International Medical Informatics Association (IMIA) is an independent organization that plays a role in promoting and furthering the application of information science Information science (also known as information studies) is an ...
(IMIA) and a full member of the Australian Council of Professions. ACHI is a sponsor of the "e-Journal for Health Informatics", an indexed and peer-reviewed professional journal. ACHI has also supported the " Australian Health Informatics Education Council" (AHIEC) since its founding in 2009. Although there are a number of health informatics organizations in Australia, the Health Informatics Society of Australia (HISA) is regarded as the major umbrella group and is a member of the
International Medical Informatics Association The International Medical Informatics Association (IMIA) is an independent organization that plays a role in promoting and furthering the application of information science Information science (also known as information studies) is an ...
(IMIA). Nursing informaticians were the driving force behind the formation of HISA, which is now a company limited by guarantee of the members. The membership comes from across the informatics spectrum that is from students to corporate affiliates. HISA has a number of branches (Queensland, New South Wales, Victoria and Western Australia) as well as special interest groups such as nursing (NIA), pathology, aged and community care, industry and medical imaging (Conrick, 2006).


China

After 20 years,
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's List of countries and dependencies by population, most populous country, with a Population of China, population exceeding 1.4 billion, slig ...
performed a successful transition from its planned economy to a
socialist market economy The socialist market economy (SME) is the economic system and model of economic development employed in the People's Republic of China. The system is a market economy with the predominance of public ownership and state-owned enterprises. The ...
. Along this change, China's health care system also experienced a significant reform to follow and adapt to this historical revolution. In 2003, the data (released from Ministry of Health of the People's Republic of China (MoH)), indicated that the national health care-involved expenditure was up to
RMB The renminbi (; symbol A symbol is a mark, sign, or word that indicates, signifies, or is understood as representing an idea, object, or relationship. Symbols allow people to go beyond what is known or seen by creating linkages betw ...
662.33 billion totally, which accounted for about 5.56% of nationwide gross domestic products. Before the 1980s, the entire health care costs were covered in central government annual budget. Since that, the construct of health care-expended supporters started to change gradually. Most of the expenditure was contributed by health insurance schemes and private spending, which corresponded to 40% and 45% of total expenditure, respectively. Meanwhile, the financially governmental contribution was decreased to 10% only. On the other hand, by 2004, up to 296,492 health care facilities were recorded in statistic summary of MoH, and an average of 2.4 clinical beds per 1000 people were mentioned as well. Along with the development of information technology since the 1990s, health care providers realized that the information could generate significant benefits to improve their services by computerized cases and data, for instance of gaining the information for directing patient care and assessing the best patient care for specific clinical conditions. Therefore, substantial resources were collected to build China's own health informatics system. Most of these resources were arranged to construct hospital information system (HIS), which was aimed to minimize unnecessary waste and repetition, subsequently to promote the efficiency and quality-control of health care. By 2004, China had successfully spread HIS through approximately 35–40% of nationwide hospitals. However, the dispersion of hospital-owned HIS varies critically. In the east part of China, over 80% of hospitals constructed HIS, in northwest of China the equivalent was no more than 20%. Moreover, all of the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency, under the United S ...
(CDC) above rural level, approximately 80% of health care organisations above the rural level and 27% of hospitals over town level have the ability to perform the transmission of reports about real-time epidemic situation through public health information system and to analysis infectious diseases by dynamic statistics. China has four tiers in its health care system. The first tier is street health and workplace clinics and these are cheaper than hospitals in terms of medical billing and act as prevention centers. The second tier is district and enterprise hospitals along with specialist clinics and these provide the second level of care. The third tier is provisional and municipal general hospitals and teaching hospitals which provided the third level of care. In a tier of its own is the national hospitals which are governed by the Ministry of Health. China has been greatly improving its health informatics since it finally opened its doors to the outside world and joined the World Trade Organization (WTO). In 2001, it was reported that China had 324,380 medical institutions and the majority of those were clinics. The reason for that is that clinics are prevention centers and Chinese people like using traditional Chinese medicine as opposed to Western medicine and it usually works for the minor cases. China has also been improving its higher education in regards to health informatics. At the end of 2002, there were 77 medical universities and medical colleges. There were 48 university medical colleges which offered bachelor, master, and doctorate degrees in medicine. There were 21 higher medical specialty institutions that offered diploma degrees so in total, there were 147 higher medical and educational institutions. Since joining the WTO, China has been working hard to improve its education system and bring it up to international standards. SARS played a large role in China quickly improving its health care system. Back in 2003, there was an outbreak of SARS and that made China hurry to spread HIS or Hospital Information System and more than 80% of hospitals had HIS. China had been comparing itself to Korea's health care system and figuring out how it can better its own system. There was a study done that surveyed six hospitals in China that had HIS. The results were that doctors didn't use computers as much so it was concluded that it wasn't used as much for clinical practice than it was for administrative purposes. The survey asked if the hospitals created any websites and it was concluded that only four of them had created websites and that three had a third-party company create it for them and one was created by the hospital staff. In conclusion, all of them agreed or strongly agreed that providing health information on the Internet should be utilized. Collected information at different times, by different participants or systems could frequently lead to issues of misunderstanding, dis-comparing or dis-exchanging. To design an issues-minor system, health care providers realized that certain standards were the basis for sharing information and interoperability, however a system lacking standards would be a large impediment to interfere the improvement of corresponding information systems. Given that the standardization for health informatics depends on the authorities, standardization events must be involved with government and the subsequently relevant funding and supports were critical. In 2003, the Ministry of Health released the Development Lay-out of National Health Informatics (2003–2010) indicating the identification of standardization for health informatics which is 'combining adoption of international standards and development of national standards'. In China, the establishment of standardization was initially facilitated with the development of vocabulary, classification and coding, which is conducive to reserve and transmit information for premium management at national level. By 2006, 55 international/ domestic standards of vocabulary, classification and coding have served in hospital information system. In 2003, the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (
ICD-10 ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...
) and the
ICD-10 Clinical Modification The ICD-10 Clinical Modification (ICD-10-CM) is a modification of the ICD-10, authorized by the World Health Organization, used as a source for diagnosis codes in the United States of America. It replaces the earlier ICD-9-CM. Adoption Adoption ...
(ICD-10-CM) were adopted as standards for diagnostic classification and acute care procedure classification. Simultaneously, the
International Classification of Primary Care The International Classification of Primary Care (ICPC) is a classification method for primary care Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal po ...
(ICPC) were translated and tested in China 's local applied environment. Another coding standard, named Logical Observation Identifiers Names and Codes (LOINC), was applied to serve as general identifiers for clinical observation in hospitals. Personal identifier codes were widely employed in different information systems, involving name, sex, nationality, family relationship, educational level and job occupation. However, these codes within different systems are inconsistent, when sharing between different regions. Considering this large quantity of vocabulary, classification and coding standards between different jurisdictions, the health care provider realized that using multiple systems could generate issues of resource wasting and a non-conflicting national level standard was beneficial and necessary. Therefore, in late 2003, the health informatics group in Ministry of Health released three projects to deal with issues of lacking national health information standards, which were the Chinese National Health Information Framework and Standardization, the Basic Data Set Standards of Hospital Information System and the Basic Data Set Standards of Public Health Information System. The objectives of the Chinese National Health Information Framework and Standardization project were: # Establish national health information framework and identify in what areas standards and guidelines are required # Identify the classes, relationships and attributes of national health information framework. Produce a conceptual health data model to cover the scope of the health information framework # Create
logical data model A logical data model or logical schema is a data model of a specific problem domain expressed independently of a particular database management product or storage technology (physical data model) but in terms of data structures such as relational ta ...
for specific domains, depicting the logical data entities, the data attributes, and the relationships between the entities according to the conceptual health data model # Establish uniform represent standard for data elements according to the data entities and their attributes in conceptual data model and logical data model # Circulate the completed health information framework and health data model to the partnership members for review and acceptance # Develop a process to maintain and refine the China model and to align with and influence international health data models


= Comparing China's EHR Standard and ASTM E1384

= In 2011, researchers from local universities evaluated the performance of China's
Electronic Health Record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
(EHR) Standard compared with the
American Society for Testing and Materials ASTM International, formerly known as American Society for Testing and Materials, is an international standards organization that develops and publishes voluntary consensus technical International standard, standards for a wide range of material ...
Standard Practice for Content and Structure of Electronic Health Records in the United States (ASTM E1384 Standard, withdrawn in 2017). The deficiencies that were found are listed in the following. # The lack of supporting on privacy and security. The ISO/TS 18308 specifies "The EHR must support the ethical and legal use of personal information, in accordance with established privacy principles and frameworks, which may be culturally or jurisdictionally specific" (
ISO ISO is the most common abbreviation for the International Organization for Standardization The International Organization for Standardization (ISO ) is an international standard development organization composed of representatives from the na ...
18308: Health Informatics-Requirements for an Electronic Health Record Architecture, 2004). However this China's EHR Standard did not achieve any of the fifteen requirements in the subclass of privacy and security. # The shortage of supporting on different types of data and reference. Considering only
ICD-9 The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and risk factor, determinants of health and di ...
is referenced as China's external international coding systems, other similar systems, such as
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the m ...
in clinical terminology presentation, cannot be considered as familiar for Chinese specialists, which could lead to internationally information-sharing deficiency. # The lack of more generic and extensible lower level data structures. China's large and complex EHR Standard was constructed for all medical domains. However, the specific and time-frequent attributes of clinical data elements, value sets and templates identified that this once-for-all purpose cannot lead to practical consequence. In
Hong Kong Hong Kong ( (US) or (UK); , ), officially the Hong Kong Special Administrative Region of the People's Republic of China (abbr. Hong Kong SAR or HKSAR), is a List of cities in China, city and Special administrative regions of China, special ...
, a computerized patient record system called the Clinical Management System (CMS) has been developed by the
Hospital Authority The Hospital Authority is a statutory body managing all the government hospitals and institutes in Hong Kong Hong Kong ( (US) or (UK); , ), officially the Hong Kong Special Administrative Region of the People's Republic of China ( ...
since 1994. This system has been deployed at all the sites of the authority (40 hospitals and 120 clinics). It is used for up to 2 million transactions daily by 30,000 clinical staff. The comprehensive records of 7 million patients are available on-line in the electronic patient record (ePR), with data integrated from all sites. Since 2004 radiology image viewing has been added to the ePR, with radiography images from any HA site being available as part of the ePR. The
Hong Kong Hospital Authority The Hospital Authority is a statutory body A statutory body or statutory authority is a body set up by law Law is a set of rules that are created and are law enforcement, enforceable by social or governmental institutions to r ...
placed particular attention to the
governance Governance is the process of interactions through the laws, norms, power or language Language is a structured system of communication. The structure of a language is its grammar and the free components are its vocabulary. Languages ar ...
of clinical systems development, with input from hundreds of clinicians being incorporated through a structured process. The health informatics section in the Hospital Authority has a close relationship with the information technology department and clinicians to develop health care systems for the organization to support the service to all public hospitals and clinics in the region. The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in health care. The eHealth Consortium has been formed to bring together clinicians from both the private and public sectors, medical informatics professionals and the IT industry to further promote IT in health care in Hong Kong.


India

* eHCF School of Medical Informatics * eHealth-Care Foundation


Malaysia

Since 2010, the Ministry of Health (MoH) has been working on the Malaysian Health Data Warehouse (MyHDW) project. MyHDW aims to meet the diverse needs of timely health information provision and management, and acts as a platform for the standardization and integration of health data from a variety of sources (Health Informatics Centre, 2013). The Ministry of Health has embarked on introducing the electronic Hospital Information Systems (HIS) in several public hospitals including Putrajaya Hospital, Serdang Hospital and Selayang Hospital. Similarly, under Ministry of Higher Education, hospitals such as University of Malaya Medical Centre (UMMC) and University Kebangsaan Malaysia Medical Centre (UKMMC) are also using HIS for healthcare delivery. A hospital information system (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. As an area of medical informatics, the aim of hospital information system is to achieve the best possible support of patient care and administration by electronic data processing. HIS plays a vital role in planning, initiating, organizing and controlling the operations of the subsystems of the hospital and thus provides a synergistic organization in the process.


New Zealand

Health informatics is taught at five New Zealand universities. The most mature and established programme has been offered for over a decade at Otago. Health Informatics New Zealand (HINZ), is the national organisation that advocates for health informatics. HINZ organises a conference every year and also publishes a journal- ''Healthcare Informatics Review Online''.


Saudi Arabia

The Saudi Association for Health Information (SAHI) was established in 2006 to work under direct supervision of King Saud bin Abdulaziz University for Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable studies.


Russia

The Russian health care system is based on the principles of the Soviet health care system, which was oriented on mass prophylaxis, prevention of infection and epidemic diseases, vaccination and immunisation of the population on a socially protected basis. The current government health care system consists of several directions: * Preventive health care * Primary health care * Specialised medical care * Obstetrical and gynecologic medical care * Pediatric medical care * Surgery * Rehabilitation/ Health resort treatment One of the main issues of the post-Soviet medical health care system was the absence of the united system providing optimisation of work for medical institutes with one, single database and structured appointment schedule and hence hours-long lines. Efficiency of medical workers might have been also doubtful because of the paperwork administrating or lost book records. Along with the development of the information systems IT and health care departments in
Moscow Moscow ( , US chiefly ; rus, links=no, Москва, r=Moskva, p=mɐskˈva, a=Москва.ogg) is the capital and largest city of Russia Russia (, , ), or the Russian Federation, is a List of transcontinental countries, transco ...
agreed on design of a system that would improve public services of health care institutes. Tackling the issues appearing in the existing system, the Moscow Government ordered that the design of a system would provide simplified electronic booking to public clinics and automate the work of medical workers on the first level. The system designed for that purposes was called EMIAS (United Medical Information and Analysis System) and presents an
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
(EHR) with the majority of other services set in the system that manages the flow of patients, contains outpatient card integrated in the system, and provides an opportunity to manage consolidated managerial accounting and personalised list of medical help. Besides that, the system contains information about availability of the medical institutions and various doctors. The implementation of the system started in 2013 with the organisation of one computerised database for all patients in the city, including a front-end for the users. EMIAS was implemented in Moscow and the region and it is planned that the project should extend to most parts of the country.


Law

''Health informatics law'' deals with evolving and sometimes complex legal principles as they apply to information technology in health-related fields. It addresses the privacy, ethical and operational issues that invariably arise when electronic tools, information and media are used in health care delivery. Health Informatics Law also applies to all matters that involve information technology, health care and the interaction of information. It deals with the circumstances under which data and records are shared with other fields or areas that support and enhance patient care. As many health care systems are making an effort to have patient records more readily available to them via the internet, it is important that providers implement security standards in order to ensure that the patients' information is safe. They have to be able to assure confidentiality, integrity, and security of the people, process, and technology. Since there is also the possibility of payments being made through this system, it is vital that this aspect of their private information will also be protected through cryptography. The use of technology in health care settings has become popular and this trend is expected to continue. Various health care facilities had instigated different kinds of health information technology systems in the provision of patient care, such as electronic health records (EHRs), computerized charting, etc. The growing popularity of health information technology systems and the escalation in the amount of health information that can be exchanged and transferred electronically increased the risk of potential infringement in patients' privacy and confidentiality. This concern triggered the establishment of strict measures by both policymakers and individual facility to ensure patient privacy and confidentiality. One of the federal laws enacted to safeguard patient's health information (medical record, billing information, treatment plan, etc.) and to guarantee patient's privacy is the Health Insurance Portability and Accountability Act of 1996 or HIPAA.Your Rights Under HIPAA. (n.d.).
ext Ext, ext or EXT may refer to: * Ext functor In mathematics Mathematics is an area of knowledge that includes the topics of numbers, formulas and related structures, shapes and the spaces in which they are contained, and quantities and their ...
Retrieved September 5, 2016, from
HIPAA gives patients the autonomy and control over their own health records. Furthermore, according to the U.S. Department of Health & Human Services (n.d.), this law enables patients to: * view their own health records * request a copy of their own medical records * request correction to any incorrect health information * know who has access to their health record * request who can and cannot view/access their health information


Health and medical informatics journals

''Computers and Biomedical Research'', published in 1967, was one of the first dedicated journals to health informatics. Other early journals included ''Computers and Medicine'', published by the American Medical Association; ''Journal of Clinical Computing'', published by Gallagher Printing; ''Journal of Medical Systems'', published by Plenum Press; and ''MD Computing'', published by Springer-Verlag. In 1984, Lippincott published the first nursing-specific journal, titled ''Journal Computers in Nursing'', which is now known as ''Computers Informatics Nursing'' (''CIN''). As of September 7, 2016, there are roughly 235 informatics journals listed in the National Library of Medicine (NLM) catalog of journals. The ''
Journal Citation Reports ''Journal Citation Reports'' (''JCR'') is an annual publicationby Clarivate Analytics (previously the intellectual property of Thomson Reuters). It has been integrated with the Web of Science and is accessed from the Web of Science-Core Collectio ...
'' for 2018 gives the top three journals in medical informatics as the ''
Journal of Medical Internet Research The ''Journal of Medical Internet Research'' is a peer-reviewed Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work (:wiktionary:peer#Etymology 2, peers). It functions as a form ...
'' (
impact factor The impact factor (IF) or journal impact factor (JIF) of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly mean number of citations of articles published in the last two years in a given journal, as in ...
of 4.945), '' JMIR mHealth and uHealth'' (4.301) and the '' Journal of the American Medical Informatics Association'' (4.292).


Competencies, education and certification

In the United States, ''clinical informatics'' is a
subspecialty A subspecialty (US English) or subspeciality (international English) is a narrow field of professional knowledge/skills within a specialty of trade (occupation), trade, and is most commonly used to describe the increasingly more diverse specialty ...
within several
medical specialties A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (pediatrics, paediatrics), cancer ...
. For example, in
pathology Pathology is the study of the causal, causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when us ...
, the
American Board of Pathology The American Board of Pathology (ABPath) is one of 24 member boards of the American Board of Medical Specialties Established in 1933, the American Board of Medical Specialties (ABMS) is a Non-profit organization, non-profit organization which r ...
offers clinical informatics certification for pathologists who have completed 24 months of related training, and the American Board of Preventive Medicine offers clinical informatics certification within
preventive medicine Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
.


See also


Related concepts


Governance


References


Further reading

* * * * * *


External links

* {{Authority control