Nursing and medicine are the leaders in healthcare concerning the study and application of informatics to practice, but all healthcare disciplines are realizing the need to manage and process the vast amounts of information needed to guide their practices. The term “medical informatics,” coined in the mid-1970s, borrows from the French expression informatique médicale. It describes “those collected informational technologies which concern themselves with the patient care, medical, decision-making process” Experts use the term “health informatics,” which he defines as the use of information technology with information management concepts and methods to support the delivery of healthcare. Mandil’s definition encompasses medical, nursing, dental, and pharmacy informatics, as well as all other healthcare disciplines. His definition of health informatics focuses attention on the recipient of care rather than on the discipline of the caregiver.
Each allied health discipline has distinct, discrete information needs based on the scientific basis and practice of that profession. Accordingly, each discipline has particular information requirements and may structure its information processes differently, but the basis of informatics is the same in all disciplines. In the broadest sense, informatics for healthcare professionals is the management and processing of information to support decision making in practice. It encompasses all information needs related to a healthcare practice. Information systems do not have to be electronic, but electronic systems certainly increase accessibility, accuracy, and efficiency. Informatics supports all areas of practice, including education, administration, and research; it also facilitates and guides the management of data.
GOAL OF INFORMATICS
The goal of informatics is to:
• Inform healthcare providers
• Expand knowledge
• Deliver efficient, well-managed care or services
The study of informatics improves the effectiveness of data assimilation, interpretation, and representation so that healthcare professionals can make informed decisions. It is no longer an elective that is “nice to know” but a necessity in today’s competitive and rapidly changing healthcare delivery system.
FUTURE OF INFORMATICS
Healthcare organizations from acute care to outpatient care to home care are automating. These organizations need knowledgeable practitioners to investigate, implement, and use automation to support their practice. In the future, practitioners will be hired not so much for their knowledge of skills as for their ability to handle information to make decisions that produce favorable, cost-efficient results.
Monday, November 29, 2010
Healthcare Informatics Science Components
With knowledge of the importance of information in healthcare practice and awareness of the information explosion, a need developed for specialists to manage and process information. The specialty is healthcare informatics. Informatics is multidisciplinary, and healthcare informatics is a combination of:
• Computer science
• Healthcare science
• Information science
• Cognitive science
Computer science refers primarily to the development, configuration, and architecture of computer hardware and software. The size of the memory, storage capacity, processing speed, and method by which computers communicate are all part of computer science. The power of computer hardware doubles approximately every 18 months. “Programs” and “software” refer to the way in which a simple, logical set of instructions (algorithms) is used to solve a problem to generate a product. Algorithms help create expert systems that, along with a set of rules and laws, assist with decision making. Software develops more slowly than hardware. The development of new automated tools has radically altered the understanding of knowledge and knowledge representations.
Healthcare science is the body of knowledge on which the healthcare profession bases its practice. The sciences of anatomy, physiology, and biology, as well as the discrete knowledge that makes each profession distinctive, offer a basis for allied health professions.
Information science and information technology involve the process of sending and receiving messages. Acquiring, transmitting, processing, and perceiving information all contribute to the effectiveness of the information. Various methods communicate information: verbal, visual but nonverbal, written, and digitized. The focus of information technology is application of information tools for the solution of business problems. Information science is interested in the flow and structure of information.
Cognitive science focuses on understanding the functions of the mind. The processes of human thinking, understanding, and remembering are part of this science. It is concerned with the nature of knowledge, its components, its sources, its development, and its deployment. How “user friendly” a computer program or piece of equipment is or how automation can reduce human error is the focus of study in cognitive science. During aur study about nursing informatics, but his observations can apply to all healthcare disciplines’ use of informatics. He suggested that informatics has evolved to include three special interest levels: technology, concepts, and function. He described early definitions ofnursing informatics that focus on technology; he also described the use of hardware, software, and system architecture in managing and processing information. Some later informaticists (Ryan & Nagle, 1994) became interested mainly in the underlying concepts of theory, arguing that without a well-articulated theoretical basis to guide the gathering of data, the practitioner will be inundated with meaningless data and information. They stressed the need for definitions, a standardized language, and criteria for organization of the data. Other informaticists interested in function focused on how the management and processing of information help nurses enter, organize, or retrieve information. They emphasized the usability of the applications to achieve specific purposes. Informatics includes all these areas, but the field has become so large that it is difficult for one person to be knowledgeable in all areas. This textbook gives an overview of all of the areas of informatics.
• Computer science
• Healthcare science
• Information science
• Cognitive science
Computer science refers primarily to the development, configuration, and architecture of computer hardware and software. The size of the memory, storage capacity, processing speed, and method by which computers communicate are all part of computer science. The power of computer hardware doubles approximately every 18 months. “Programs” and “software” refer to the way in which a simple, logical set of instructions (algorithms) is used to solve a problem to generate a product. Algorithms help create expert systems that, along with a set of rules and laws, assist with decision making. Software develops more slowly than hardware. The development of new automated tools has radically altered the understanding of knowledge and knowledge representations.
Healthcare science is the body of knowledge on which the healthcare profession bases its practice. The sciences of anatomy, physiology, and biology, as well as the discrete knowledge that makes each profession distinctive, offer a basis for allied health professions.
Information science and information technology involve the process of sending and receiving messages. Acquiring, transmitting, processing, and perceiving information all contribute to the effectiveness of the information. Various methods communicate information: verbal, visual but nonverbal, written, and digitized. The focus of information technology is application of information tools for the solution of business problems. Information science is interested in the flow and structure of information.
Cognitive science focuses on understanding the functions of the mind. The processes of human thinking, understanding, and remembering are part of this science. It is concerned with the nature of knowledge, its components, its sources, its development, and its deployment. How “user friendly” a computer program or piece of equipment is or how automation can reduce human error is the focus of study in cognitive science. During aur study about nursing informatics, but his observations can apply to all healthcare disciplines’ use of informatics. He suggested that informatics has evolved to include three special interest levels: technology, concepts, and function. He described early definitions ofnursing informatics that focus on technology; he also described the use of hardware, software, and system architecture in managing and processing information. Some later informaticists (Ryan & Nagle, 1994) became interested mainly in the underlying concepts of theory, arguing that without a well-articulated theoretical basis to guide the gathering of data, the practitioner will be inundated with meaningless data and information. They stressed the need for definitions, a standardized language, and criteria for organization of the data. Other informaticists interested in function focused on how the management and processing of information help nurses enter, organize, or retrieve information. They emphasized the usability of the applications to achieve specific purposes. Informatics includes all these areas, but the field has become so large that it is difficult for one person to be knowledgeable in all areas. This textbook gives an overview of all of the areas of informatics.
The Five Rights Of Medical Information
Information has five rights:
• Right information
• Right person
• Right time
• Right place
• Right amount
To be useful, information must be the right information. It must be accurate, free of error, and meaningful. When examining a patient with tooth pain, a dentist does not want or need to know that the patient had braces when he was 13. The dentist wants a description of the present problem. If the pain is on the right side but the preliminary information stated that the pain was on the left side, then the information is not only incorrect, it is also misleading and potentially harmful. A real-life example brings this point home with alarming finality. In a Florida hospital, a surgeon mistakenly removed a diseased left leg instead of the more diseased right leg, as was intended. Visual inspection could not be used to identify the leg because both legs were seriously diseased.
The surgical schedule incorrectly said that the left leg was to be amputated. The error was noticed, but only one copy of the schedule was corrected. When the surgeon scrubbed for the operation, therefore, he used an operating room schedule saying that the left leg should be amputated. The wrong information had disastrous consequences. Information must be given to the right person to be useful. Laboratory results that go to a unit secretary who files them are of no use. The results must be communicated to the person who will respond to them. It may be a physician, nurse, pharmacist, or therapist. The timing of the information can be crucial to the patient’s health. Information must be given at the right time. Laboratory results are most useful when given to the decision maker within a few minutes or hours. If the care provider does not receive the results until the patient has gone home or has had serious sequelae, the results may be useless. Information must be delivered to the right place. The report of a consultation with a social worker that is misplaced in a paper chart is of no value. Laboratory results that are filed in a chart rather than communicated to the physician at his or her office or in the car or on rounds will result in delayed action and a possible increase in the number of days of
illness.
Information must also come in the right amount. No manager wants to wade through piles of reports to retrieve one piece of information. Many reports contain much more information than anyone wants on a regular basis. Most managers want only a few pieces of information on a consistent basis. Time can be managed more efficiently and decisions made faster when only the desired information is available. Addressing each of the five rights is important when managing information. Ignoring any of the rights weakens the usefulness of the information and can potentially harm the patient.
• Right information
• Right person
• Right time
• Right place
• Right amount
To be useful, information must be the right information. It must be accurate, free of error, and meaningful. When examining a patient with tooth pain, a dentist does not want or need to know that the patient had braces when he was 13. The dentist wants a description of the present problem. If the pain is on the right side but the preliminary information stated that the pain was on the left side, then the information is not only incorrect, it is also misleading and potentially harmful. A real-life example brings this point home with alarming finality. In a Florida hospital, a surgeon mistakenly removed a diseased left leg instead of the more diseased right leg, as was intended. Visual inspection could not be used to identify the leg because both legs were seriously diseased.
The surgical schedule incorrectly said that the left leg was to be amputated. The error was noticed, but only one copy of the schedule was corrected. When the surgeon scrubbed for the operation, therefore, he used an operating room schedule saying that the left leg should be amputated. The wrong information had disastrous consequences. Information must be given to the right person to be useful. Laboratory results that go to a unit secretary who files them are of no use. The results must be communicated to the person who will respond to them. It may be a physician, nurse, pharmacist, or therapist. The timing of the information can be crucial to the patient’s health. Information must be given at the right time. Laboratory results are most useful when given to the decision maker within a few minutes or hours. If the care provider does not receive the results until the patient has gone home or has had serious sequelae, the results may be useless. Information must be delivered to the right place. The report of a consultation with a social worker that is misplaced in a paper chart is of no value. Laboratory results that are filed in a chart rather than communicated to the physician at his or her office or in the car or on rounds will result in delayed action and a possible increase in the number of days of
illness.
Information must also come in the right amount. No manager wants to wade through piles of reports to retrieve one piece of information. Many reports contain much more information than anyone wants on a regular basis. Most managers want only a few pieces of information on a consistent basis. Time can be managed more efficiently and decisions made faster when only the desired information is available. Addressing each of the five rights is important when managing information. Ignoring any of the rights weakens the usefulness of the information and can potentially harm the patient.
The Structure Of Information
Experts suggests that keeping abreast of the revolutionary and evolutionary changes in medicine is extremely challenging. He poses the question: “How do we make sense of the roller-coaster ride we have embarked upon?” His answer is that “we turn to professional journals, textbooks, and the proceedings of specialty meetings to find answers.” But medical information in scientific and medical journals has grown beyond a manageable level. Approximately 34,000 references from over 4000 journals are added monthly to the National Library of Medicine’s MEDLINE database. These journals represent only 4 percent of the scientific journals currently published. They also suggests that if someone were to read every potentially important biomedical piece published in these journals, it would be necessary to read 6000 articles a day. By the year 2000, the knowledge available in 1950 has not only doubled but is found in 30 times as many publications which means that one new article is added to the medical literature every 20 seconds.
But the overabundance of information can actually keep an individual from finding the information needed. While drowning in information, the individual may starve for knowledge. Students often feel this way when they have stuffed themselves with information that has no relevance or meaning to them. John Lawton, a veteran reporter speaking to the American Association of Broadcast Journalists in 1995, said, “The irony of the information age is [that] it gives new respectability to the uninformed opinion. The question is “How much information is transferred to the minds of readers and is incorporated into practice or changes of behavior?”
As the body of worldwide information explodes, knowing how to manage and process that information in order to make decisions that support practice is of monumental importance. Information technology provides a solution for managing the abundance of information and has become part of the daily professional life of all allied health disciplines. Throughout the past 3 decades, the literature in all healthcare fields has described the growing impact of technology on health and human services.
But the overabundance of information can actually keep an individual from finding the information needed. While drowning in information, the individual may starve for knowledge. Students often feel this way when they have stuffed themselves with information that has no relevance or meaning to them. John Lawton, a veteran reporter speaking to the American Association of Broadcast Journalists in 1995, said, “The irony of the information age is [that] it gives new respectability to the uninformed opinion. The question is “How much information is transferred to the minds of readers and is incorporated into practice or changes of behavior?”
As the body of worldwide information explodes, knowing how to manage and process that information in order to make decisions that support practice is of monumental importance. Information technology provides a solution for managing the abundance of information and has become part of the daily professional life of all allied health disciplines. Throughout the past 3 decades, the literature in all healthcare fields has described the growing impact of technology on health and human services.
Information Explosion
Experts suggests that keeping abreast of the revolutionary and evolutionary changes in medicine is extremely challenging. He poses the question: “How do we make sense of the roller-coaster ride we have embarked upon?” His answer is that “we turn to professional journals, textbooks, and the proceedings of specialty meetings to find answers.” But medical information in scientific and medical journals has grown beyond a manageable level. Approximately 34,000 references from over 4000 journals are added monthly to the National Library of Medicine’s MEDLINE database. These journals represent only 4 percent of the scientific journals currently published. They also suggests that if someone were to read every potentially important biomedical piece published in these journals, it would be necessary to read 6000 articles a day. By the year 2000, the knowledge available in 1950 has not only doubled but is found in 30 times as many publications which means that one new article is added to the medical literature every 20 seconds.
But the overabundance of information can actually keep an individual from finding the information needed. While drowning in information, the individual may starve for knowledge. Students often feel this way when they have stuffed themselves with information that has no relevance or meaning to them. John Lawton, a veteran reporter speaking to the American Association of Broadcast Journalists in 1995, said, “The irony of the information age is [that] it gives new respectability to the uninformed opinion. The question is “How much information is transferred to the minds of readers and is incorporated into practice or changes of behavior?”
As the body of worldwide information explodes, knowing how to manage and process that information in order to make decisions that support practice is of monumental importance. Information technology provides a solution for managing the abundance of information and has become part of the daily professional life of all allied health disciplines. Throughout the past 3 decades, the literature in all healthcare fields has described the growing impact of technology on health and human services.
But the overabundance of information can actually keep an individual from finding the information needed. While drowning in information, the individual may starve for knowledge. Students often feel this way when they have stuffed themselves with information that has no relevance or meaning to them. John Lawton, a veteran reporter speaking to the American Association of Broadcast Journalists in 1995, said, “The irony of the information age is [that] it gives new respectability to the uninformed opinion. The question is “How much information is transferred to the minds of readers and is incorporated into practice or changes of behavior?”
As the body of worldwide information explodes, knowing how to manage and process that information in order to make decisions that support practice is of monumental importance. Information technology provides a solution for managing the abundance of information and has become part of the daily professional life of all allied health disciplines. Throughout the past 3 decades, the literature in all healthcare fields has described the growing impact of technology on health and human services.
Impact Of Information Technology On Healthcare
Not only does technology affect society’s relationships, government, learning, and teaching, it also has an astounding impact on healthcare. Information technology is part of the daily life of healthcare professionals. Throughout the past three decades, the healthcare literature has described the growing impact of technology on health and human services. According to Steven Smith,Vice President and Editorial Director for Medscape, Inc. (1998), physicians spend 38 percent of their time charting in the medical record. Other healthcare professionals spend this amount of time or more gathering, sharing, or seeking information. Technology assists in managing all stages of information. If information is power, healthcare information affects the power to promote health and wellness.
As exemplified in the opening scenario of this chapter, automation enables the practitioner to process information that is accurate, unduplicated, error free, and accessible from remote areas by multiple persons at one time. Information that is rapidly available through technology affects decision making in healthcare. Informed decision makers produce better patient outcomes. Competition has also become a driving force in the pricing and marketing of healthcare. Federal programs like Medicare and Medicaid, health maintenance organizations, and managed-care programs encourage payment methodologies that promote competition. To offer competitive and quality service, information must be readily available to make decisions. Information technology allows this to happen. A leadership survey conducted by Hospitals & Health Networks in 1997 reveals that adding information technology is one of the top two goals of hospitals, managed care organizations, and group practices. To stay competitive in national and international healthcare, the healthcare delivery system, including all allied health professions, must be receptive to new information and ideas.
As exemplified in the opening scenario of this chapter, automation enables the practitioner to process information that is accurate, unduplicated, error free, and accessible from remote areas by multiple persons at one time. Information that is rapidly available through technology affects decision making in healthcare. Informed decision makers produce better patient outcomes. Competition has also become a driving force in the pricing and marketing of healthcare. Federal programs like Medicare and Medicaid, health maintenance organizations, and managed-care programs encourage payment methodologies that promote competition. To offer competitive and quality service, information must be readily available to make decisions. Information technology allows this to happen. A leadership survey conducted by Hospitals & Health Networks in 1997 reveals that adding information technology is one of the top two goals of hospitals, managed care organizations, and group practices. To stay competitive in national and international healthcare, the healthcare delivery system, including all allied health professions, must be receptive to new information and ideas.
Impact Of Information Technology On Government
To remain competitive in a global society, nations must remain receptive to new technology and ideas. Knowledge is power, and information is one source of knowledge that gives power. According to Swerdlow (1995), repressive governments that attempt to control information are finding it increasingly difficult to do so. In China and Burma, government propaganda machines indoctrinated their soldiers to believe that student demonstrators were foreigners or Communists who were trying to take over the country. The soldiers, believing that they were defending their country, opened fire on the student demonstrators. They did not learn until later that the students were fellow countrymen demonstrating for democracy. Romania tried, but failed, to ban the use of typewriters in an attempt to suppress information. Information gained through technology continually assaults authority. Free-flowing information nurtures democracy.
Technology also affects democratic governments. Politicians are perfecting 5-second sound bites and eye-catching visual messages. People want fast, frequent, and abbreviated news rather than lengthy, in-depth analysis. Government officials, academic experts, and policy makers have less effect on decisions, whereas public opinion, informed through various media, plays a larger role in public policy and diplomacy.
Technology also affects democratic governments. Politicians are perfecting 5-second sound bites and eye-catching visual messages. People want fast, frequent, and abbreviated news rather than lengthy, in-depth analysis. Government officials, academic experts, and policy makers have less effect on decisions, whereas public opinion, informed through various media, plays a larger role in public policy and diplomacy.
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