Chapter – 11

Principles of Health Informatics

Arashgeet Kaur
Learning Objectives
• To describe the principles of health informatics
• To explain the way data, knowledge and information can be used for effective
healthcare
Chapter Outline
• Introduction to Health Informatics
• Area of Health Informatics
• Evolution of Health Informatics
• Need and Objectives of Health Informatics
• Dimensions of Health Informatics
• Benefits of Health Informatics
• Limitations & Challenges of Health Informatics
• Use of Data & Knowledge for Effective Healthcare
• Electronic Health Record
Introduction to Health Informatics
• Health Informatics is a discipline at the intersection of information science, computer science and
health care.
• Health Informatics aims to positively impact patient – physician relationship.
• Health Informatics helps effective collection, understanding, storage and safeguarding of the health
data.
• Health Informatics thus combines the power of data and computer science to healthcare.
• Health Informatics deals with resources, devices and methods to optimize the acquisition, storage,
retrieval, and use of information in health.
Definition of Health Informatics
Health Informatics science is defined as
"The integrative discipline that arises from the synergistic application of
computational, informational, cognitive, organizational, and other
sciences whose primary focus is the acquisition, storage, and use of
information in the health/biomedical domain."

• Four core elements of health informatics:

• The way healthcare professionals think about patients
• Making and evaluating diagnosis, as well as defining, selecting, and evolving treatments
• Creating, sharing and applying medical knowledge
• Organizing and running healthcare systems
Area of Health Informatics
Four major focus research areas in Health Informatics:
• Medical/ Bio Informatics – Physician and research based
• Nursing Informatics – Clinical and research based
• Public Health Informatics – Public health and bio surveillance based
• Applied Informatics – Policy, Process and Technological solutions
R&R of Health Informatics Professional
• Design & development of information systems that meet needs and requirements of users,
management and stakeholders.
• Development of systems allowing real-time communication/ diagnosis/ consultation using audio,
video & web-based technologies.
• Development of methods to gather, analyse and implement solutions using existing resources and
devices.
• Storing, organizing & analysing health records for easy retrieval and improving healthcare
outcomes.
• Developing protocols with medical facilities.
• Ensuring concerned medical staff can quickly and efficiently access patient’s medical records.
• Ensuring that accurate data can be shared efficiently and securely within the entire connected
ecosystem of multiple medical facilities.
• Ensuring that said systems are compliant to patient privacy and overall security requirements.
• Integration of multiple requirements into one user-friendly system.
 Evolution of Health Informatics
• ENIAC, first modern computer, was built. In India, The Ministry of Health &
1940s
Family Welfare (MoH&FW) came out
• Health informatics took off in the US, with its earliest use in with standards for Electronic Health
1950s dental projects in late 50s.
Record (EHR) for India in September
• Specialized training programs in Informatics in Europe. 2013, based on the recommendations
1960s • HMSS established to improve healthcare efficiency. made by the EMR Standards
• Increased use of computers for billing/ data processing. Committee.
1970s • Medical Informatics Research Units est. in Poland / US.

• HMSS changed to HIMSS

1980s • AMIA formed in 1988.

• Data Protection Laws came into effect in US & Europe.

1990s

• Electronic Personal Health Records were devloped.

2000s • Telehealth & Telemedicine gained popularity.

• Medical Reimbursement Programs linked to EHRs in US

AMIA: American Medical Informatics Association
2010s • Implementation of EHRs by major organizations HMSS: Hospital Management Systems Society
HIMSS: Health Information & Management Systems Society
Need of Health Informatics
• To enable patients to have electronic access to their health records, diagnosis and treatment for
increased knowledge and awareness.
• To enable physicians provide better and quicker care due to availability of shared knowledge in
EHR.
• To increase coordination among specialists by communicating diagnosis to all health care
providers.
• To aid effective decision making for better overall outcome.
• To increase savings for patients by avoiding repeat procedures.
Objectives of Health Informatics
• To study the general principles of processing data, information and knowledge in medicine and
healthcare.
• To provide solutions for data and information storage, retrieval and acquisition, and knowledge
processing.
• To provide an efficient method for communicating, sharing and applying clinical evidence.
• To minimize resource use during organizational processes while securing maximum benefit.
• To save time while providing care.
• To develop tools and methods to achieve the above objectives.

The ultimate goal of health informatics is to be provide quality patient care.

Objectives of Health Informatics…Contd.
• Patient is the central focus of health
informatics.
• Patient is the centre of communication
within hospitals.
• Without patient, there would be no data.
• Data management focuses on diagnosis
and treatment of the patients.

Source: Health informatics, Michael Imhoff, Andrew Webb and Andreas Goldschmidt in Intensive Care Med
(2001) 27: 179-186, DOI 10.1007/s001340000747
Dimensions of Health Informatics
• Health Informatics is a multi-disciplinary field.
• It incorporates the skills and abilities from the three dimensions:
• ICT – Information and Communication Technology
• HIM – Health Information Management
• HIT – Health Information Technology

ICT

HIM HIT
ICT (Information & Communication Technology)
• Information Technology (IT) facilitates use of health information of patients & communication
technologies.
• IT helps to integrate data for identification, use and in management of information systems.
• ICT helps to meet business requirements by assisting in selection & utilization of proper
information technologies.
• ICT ensures coordinated systems with appropriate health informatics standards.
• ICT ensures to relate IT best practices (Quality management systems, testing, SLA, BCP and
Incident Management) throughout the system life cycle.
• ICT is fundamental to meeting the stakeholders’ need for information.
• ICT helps follow best practices and implement solutions to maintain data and system security.
HIM (Health Information Management)
• HIM promotes appropriate use of information and knowledge.
• HIM demonstrates the need to balance the use of medical information for improved care delivery
and patient privacy.
• HIM encourages use of appropriate technology, communication channel & organizational skills to
facilitate learning at multiple levels.
• HIM aims at clinical transformation through use of quality improvement and process engineering.
• HIM helps assess & mitigate risks to safety and privacy associated with health information.
• HIM contributes to evaluation of systems functionality to support best clinical care practices.
HIT (Health Information Technology)
• HIT involves applying basic clinical/ biomedical concepts, clinical care processes and technologies.
• HIT includes demonstration of knowledge regarding analysis, design, development &
implementation of health information systems.
• HIT includes demonstration of knowledge regarding the recording, communication and
incorporation of clinical data into system use.
• HIT facilitates use of electronic decision support tools to access evidence to support practice by
clinicians.
• HIT promotes use of Health Informatics in clinical settings.
Benefits of Health Informatics
• Provides easy access to data through EHRs, i.e. Digitized patient’s data containing personal and
medical information stored and backed-up securely, for both patients & healthcare providers.
• Provides special software with modern datasets and best practices for medical professionals.
• Helps improve patient care through quick assessment and recommendation tools available to
medical professionals.
• Helps in better decision making & minimize medical errors through use of Clinical Decision
Support Systems (CDSSs).
• Empowers patients by giving them access to their EHR, history and recommendation to take care
of their own health.
• Saves time by reducing time required for scheduling, storing & sharing data due to robust
electronic systems.
Limitations of Health Informatics
• Lack of computer literacy among masses.
• Lack of awareness of health security protocols.
• Infrastructural demand and initial high cost of investment for software implementation, data back-
up provision & training of manpower.
• Lack of uniformity among software, thereby hindering sharing of information among healthcare
facilities.
• Poor management practices.
• Lack of standard privacy laws.
• Concerns of data breach and cyber security.
• Difficult to customize alerts in systems due to standardization of decision support engines.
Use of Data & Knowledge for Healthcare
• Data is the fundamental element stored in information systems and is the basis for all constructs.
• From Data to Information to Knowledge:
• Data is facts and given attributes, such as age, gender, height, weight, temperature and other vitals.
• When meaning is attached to these facts, it becomes information.
• When information is received and interpreted, it becomes knowledge.
• In a healthcare facility, different systems and facilities use patient data.
• Sharing of data between departments is must to avoid duplication & maintain only one record of
the patient.
• In case of multiple accounts: data cleansing, record clean up and linking multiple data sets is
required to create one record per patient & to maintain data as a resource.
• Implementation of Health Informatics enables multiple entities to collaborate efficiently and
provide better patient care.
• Information and knowledge sharing is possible only when there is an efficient EHR for the patient.
EHR (Electronic Health Record)
Components of EHR are:
• Identification: Patient’s personal information (name, age, weight, height, other demographic data,
allergies), contact information, immunization schedule, medication, medical history.
• Affiliation Detail: Affiliation of a patient to a company (if any), its details and contacts, medical
insurance details, etc.
• Monitoring Details: Vitals such as temperature, sugar level, blood pressure level, heartbeat, etc.
• Diagnosis/ Reports/ Findings: Details on symptoms, what reports have been run, their results,
findings, and diagnosis, disease confirmation along with treatment and consultancy.
• Treatment Details: Treatment details, staff details, medication, diet, precautions, etc.
• Billing and Payments: Operative costs, mobility cost, different charges, etc.
Summary
• Health Informatics is a multi-disciplinary field.
• Health Informatics combines the power of data and computer science to healthcare.
• It is becoming popular as healthcare industry seeks secure and accurate ways to manage the ever-
growing volumes of health data and seek coordination to save time and cost.
• The goal of Health Informatics is to improve patient care as well as develop tools to handle large
amount of patient data.
• Health Informatics covers three dimensions of ICT, HIM and HIT.
• While Health Informatics has several benefits for all the stakeholders, it still faces challenges such
as security, lack of infrastructure and skilled technicians among others.