FUNDAMENTALS OF

HEALTH INFORMATICS

BY Edres Darsa(Bsc)

Edres Darsa(Bsc) 1
CHAPTER ONE

OVER VIEW OF
HEALTH
INFORMATICS

Edres Darsa(Bsc) 2
 LEARNING OBJECTIVE
AT THE END THE CHAPTER YOU WILL BE
• Introduce to health informatics
• Define health informatics
• Describe roots of informatics within the
computer and information science
• Discuss terms related to Health
informatics

Edres Darsa(Bsc) 3
 Introduction to HI
• Health informatics is thus as much about
computers as cardiology is about stethoscopes.
Rather than drugs, X-ray machines or surgical
instruments,
• The tools of informatics are more likely to be
clinical guidelines, formal health languages,
information systems or communication systems
like the Internet.
• The term ‘health informatics’ only came into use
around 1973 (Protti, 1995)
Edres Darsa(Bsc) 4
 Introduction to HI….
• HI was born the day that a clinician first wrote
down some impressions about a patient’s
illness, and used these to learn how to treat
their next patient.

• Informatics has grown considerably as a clinical

discipline in recent years, fuelled in part, no
doubt, by the advances in computer technology

Edres Darsa(Bsc) 5
 Introduction to HI….
Health informatics is particularly focused on:
● understanding the fundamental nature of these
information and communication systems, and
describing the principles which shape them
● developing interventions which can improve
upon existing information and communication
systems
● developing methods and principles which allow
such interventions to be designed
● evaluating the impact of these interventions on the way
individuals or organizations work, or on the outcome of 6
the work.
 Introduction to HI….
Health informatics is particularly focused on:
● Specific subspecialties of health informatics
include
 Clinical informatics, which focuses
on the use of information in support of patient
care and
 Bioinformatics, which focuses on
the use of genomic and other biological
information.

Edres Darsa(Bsc) 7
 Introduction to HI….
• Informatics is concerned with
how people use information,
usually aided by technology,
to improve aspects of the
World

• HI More about information than technology, but

technology is essential
Edres Darsa(Bsc) 8
 Introduction to HI….
• Goal of informatics is:

And not

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 Definition Of Health Informatics

• Informatics has been also defined as the study,

invention, and implementation of structures and
algorithms to improve communication,
interpretation, understanding and
management of information in order to help
solve application-specific problems
• In our case, the application is healthcare

• Computer Science and Informatics are practically

synonyms: the difference in emphasizing the
application aspect Edres Darsa(Bsc) 10
 Definition of HI……..
• Health Informatics is the science that uses information
to improve health care.

• Health informatics is an interdisciplinary field that applies

technology and information to enhance health care
delivery, support biomedical research, and foster
education of health professionals and the public.

• HI is the study of how health data, information, and

knowledge are collected, stored, processed,
communicated, and used to support the process of health
care delivery to clients and providers, administrators, and
organizations involved in health care delivery. 11
 Definition of HI……..
• Health informatics (HI) is the field concerned
with the optimal use of information, often aided
by technology, to improve individual health,
healthcare, public health, and biomedical
research

– Differs from information technology (IT) in that

• Is strongly rooted in domains (e.g., health)
• IT is one (of many) tools employed
• Practitioners of HI are usually called informaticians
(sometimes informaticists)
12
Edres Darsa(Bsc)
 Definition of HI……..

What should the word(s) in front of

informatics be?
– Medical? – Implies only the work of doctors
– Biomedical? – Implies the biomedical model
– Health? – Too broad, leaves out bio-
– Bio-? – Implies basic science
– Nursing? Pathology? Public Health? -Too focused

13
Edres Darsa(Bsc)
 Health Informatics–
WHY?
• It involves using resources such as health information
systems in collecting, storing, retrieving, analyzing
and utilizing healthcare information for a variety of
purposes.
• Among the most common purposes served by health
informatics are enabling better collaboration and
coordination among healthcare providers.
• Designing or providing medical quality assurance
processes.
• improving cost-efficiency in healthcare delivery and
• increasing accuracy and efficiency in facility/practice
management. 14
Edres Darsa(Bsc)
Health Informatics–WHY?
• 11% of lab tests repeated
– Because result is lost
• 30% of treatment orders are
undocumented
• 70% of acutely ill patients get right
treatment
• – 30% get contraindicated treatment

• Edres Darsa(Bsc) 15
Health Informatics–WHY?
• Increasing patient expectation and
education
– Increasing legal action
• Demand for transparent processes
– Clinical governance and audit
•

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Why Health Informatics?
•
• Health Informatics provides information to make
decisions
• Better information leads to better decisions
• Health care, management, planning and policy all
need good information
• Health care, health management, health policy and
health planning all depend on having good
information to make decisions.

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The area has evolved during the
last decades

18
Edres Darsa(Bsc)
Health informatics tools
and methods
• Health Informatics are not just “Computers in
Healthcare”.
• They also include
•  clinical guidelines
•  medical terminologies
•  Clinical dictionaries and nomenclatures 
• Information and communication systems

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Health Informatics ≠ IT

•  Information Technology in hospitals is not Health

Informatics
•  Information technology is hardware & software
•  Health Informatics helps IT ‘work appropriately.’
•  But it also “works” vice versa:
• IT is used to facilitate the use and integration of
health informatics methods and technologies.

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 Who are involved in
Health Informatics
• Clinical Staff – they need suitable information in
caring for patients •
• Nonclinical Staff: educators, administrators, research
scientists – they need relevant data and information
to perform their duties
• • Information science – IT professionals use
computing technologies to manage information to
fulfill need and requirements of other end users
• • External “Players”-policy makers, insurance
companies

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 In a broader sense: who are
served by Health Informatics

•  Patients
•  The Community
•  Health care providers (MDs, nurses, pharmacists...)
•  Primary Care/GP’s  Management in Hospitals
•  Government Bodies and Policy makers
•  Facility management/operational management
•  Healthcare researchers
•  Healthcare educators and their students

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Knowledge Areas of health informatics and
Technologies in health informatics

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 Areas of Health Informatics

•  Communication Systems and networks

•  Modeling, Classification and coding
•  Healthcare Information Systems
•  Electronic Health Record Systems
•  Decision Support Systems
•  Knowledge based Systems-Expert Systems
•  Biosignal and Image Processing
•  Tele-care and Telemedicine
•  Health reports
•  Education and Consultation
•  Healthcare Management and Public Health Systems
•  Health Promotion and Patient Education

Edres Darsa(Bsc) 24
 
 What services does Health
Informatics involve?

•  Data processing- (health is a data intense

industry). Includes collection, processing,
transformation, presentation & use
•  Communication – main emphasis should be on
supporting communication between professionals
•  Knowledge based services-Includes online
knowledge-base services, on-line practice guidelines,
drug lists, decision-support and reminder systems

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 Applications of Health
Informatics

•  Medication •  Imaging equipment

dispensing/ordering •  Support and inform managers
•  Purchasing equipment to make better decisions
•  Resource allocation and
•  Clinical Pathways
planning
•  Labour management  •  Risk management
Patient scheduling •  Training
•  Budget analysis •  Patient Assessment
•  Research •  Monitoring patients
•  National database •  Tracking patients in hospital
•  Quality Assurance  Stock management
•  Donor databases •  Tracking sterile supplies
•  Mobile computing
•  Devices
•  Monitors
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Edres Darsa(Bsc)
 Systemisation
• “There is now consensus that a systematic approach of the,
management and use of information or health informatics –in
health – can greatly enhance the quality and efficiency of medical
care.
• “Health informatics encompass issues from the personal to the
global, ranging through from medical records for individual patients,
to sharing data about disease outbreaks among government and
international health organizations.

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 Systemisation…….
 Systemization can prevent and minimize the 5
universal healthcare problems:
• Errors and mistakes
• Poor quality healthcare
• Waste
• Poor patient experience
• Failure to get new evidence into practice

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Edres Darsa(Bsc)
Biomedical Informatics.

• Some prefer the broader term biomedical informatics because it

encompasses bioinformatics as well as medical, dental, nursing,
public health, pharmacy, medical imaging and veterinary
informatics.
• The American Medical Informatics Association (AMIA) and the
American Health Information Management Association (AHIMA)
proposed the following definition of biomedical informatics.
• the interdisciplinary field that studies and pursues the effective
uses of biomedical information and knowledge for scientific
inquiry, problem solving and decision making, motivated by
efforts to improve human health.

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Biomedical Informatics

• The AMIA uses the term "medical informatics" solely to refer to

the branch of clinical informatics that deals with disease
diagnosis and management, with an emphasis on physicians.
• Bioinformatics is sub-field of biomedical informatics that is
concerned with biological data, particularly DNA and genomic
information.
• Health information technology (HIT or healthIT) is defined as the
application of computers and technology in healthcare settings.
• Health information management (HIM) traditionally focused on
the paper medical record and coding.

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 Some historical perspective on
informatics
• Origin of term from Russia in late 1960s
• Achieved widespread use in France
(informatique) and later rest of Europe in
late 1960s to denote computing issues
related to information use
– European “Medical informatics” first used in 1974
• At present, most significant use is in
biomedical arena, but it is used by other
domains, such as law, chemistry, social
sciences, etc. 31
Nesredin.I(Bsc,Msc) 32
Public Health Informatics
Information is the Core
of Public Health
• Public health has been using information systems for many
years
• Full potential of information technology has yet to be
realized
– Missed opportunities
• Public health is facing serious challenges
– Bioterrorism preparedness & response
– Increasing antibiotic resistance
– Emerging infectious diseases
• Public health includes responding to the health
needs of individuals as well as populations.
• Prevention is a primary focus.
Public Health Informatics

• Definition: the systematic application of

computer & information science and
technology to public health practice,
research, and learning.

• Key to effective use of information technology

in public health
Public Health Practice Today
 Barriers to IT in Public Health
Information

• Surveillance data
– Few (only 15-20%) of reportable cases reported
– Delays of days to weeks
– Not typically in electronic form
• Other relevant data not electronically available
– Environmental
– Guidelines
– Contacts
– Training materials
Public Health Information
Strategies
• PHI strategies are increasingly used to obtain a complete picture
of a population’s health and risk status and to support effective
public health data flow and decision making in both urban and
remote areas
– eHealth tools offer ways to improve public health by gathering
data from disparate sources and rapidly transporting that data to
health workers on the ground
– Public health professionals are adapting Internet, computer
resources and mobile devices such as cell phones and personal
digital assistants (PDAs) to the health care setting.
 Challenges for public health
Informaticians
• The challenge for public health informaticians is
– how to enhance the delivery of high-quality,
contextually relevant content, focused on a broad
range of data (such as disease incidence,
immunization rates, morbidity, mortality statistics,
practice guidelines, research findings, maps and
images) so this content can be used on the ground at
the local, district and national levels
 Public health Informatics
Benefits
• Great potential for public health informatics innovations to
improve health, particularly in these areas:
– Communication among geographically dispersed health workers
and consumers
– Delivery of public-health services by strengthening and
streamlining data collection
– Support of primary and secondary prevention via electronic
health records and improved laboratory systems
– Data collection for research studies, such as drug and vaccine
trials
– Environmental health interventions, such as biosurveillance, road
safety and geographic mapping systems applications
 Public Health Informatics
Impediments
• A lack of integrated, interoperable health information
systems to support decision making at all levels.
• System fragmentation at the donor, NGO, ministries of
health, clinics and hospital levels
• Capacity shortfalls in technical support and technology
availability for day-today health information systems
tasks
• Data stewardship challenges, including the need to
provide incentives for people to collaborate on collecting
and sharing accurate and useful data
 Public Health Informatics
Impediments……
• The one-way flow of information that is sent upward, but
not back to health workers on the ground.
• Too many vertical disease silos across health sectors
• Short donor-funding horizons and investments that are
not long-term,coherent or consistent
• Inconsistencies between “industrial” IT solutions and on-
the-ground realities
• A need for national ownership
 Sample Application of Public
Health Informatics

• eHMIS software
• Automated electronic report distributions within the
different levels of the health system using e-HMIS
module of the SmartCare application.

• Insures valid data entry and helps to avoid

duplications.
• Utilizes various means of communication to send and
receive data.
 Sample Application of Public
Health Informatics……

• e-HMIS Module: Secured Communications

 Sample Application of Public
Health Informatics……

• e-HMIS Module:
Public Health Informatics Issues

1. Information Architecture
2. Avoiding Information Technology Disasters
3. Networking & the Internet
4. Databases & Database Design
5. Standards
6. Privacy, Confidentiality, & Security
7. Computer Expertise
 Information
Architecture
• Information systems are complex (like a
building)
• Detailed plans required
– Alignment of parts
– Flow of data
• Information flow, storage, processing
• Interfaces to users, other systems
• Independent layers
• Organizational discipline and control
Information Architecture….

• Information architecture refers to the totality of

the data, processes, and technology used in
a given enterprise, and the relations between
them.

• It includes databases, applications, standards,

procedures, hardware, software, networks,
etc.
Information Architecture….

• Aims to returns locus of control and decision

making to the executive level, away from the
IT community.

• An information architecture provides the basis

of business control over the distributed
development of information systems.
 Avoiding IT Disasters

• I.T. project failure rates high

• – 1/6 succeed, ½ partial success, 1/3 total failure
• Sources of risk in I.T. projects
– High level of abstraction
– Unrealistic expectations
– Management often non-intuitive
• Keys to success
– Interdisciplinary teams
– Clear requirements definition
 Informatics: Key to Healthy
Communities

• National Health Information Infrastructure

– Health care information always available when and
where needed
– Latest guidelines and research applied immediately to
patient care
• Closer integration of medical care and public health
using IT
– Protection from disease through
• Earlier detection of outbreaks
• More effective monitoring of disease patterns