Health informatics

Health care informatics or medical informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and bio-medicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. It is applied to the areas of nursing, clinical care, dentistry, pharmacy, public health and (bio)medical research.

Medical informatics began to take off in the US in the 1950s with the rise of the microchip and computers.

Early names for medical informatics included medical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science, medical software engineering, and medical computer technology.

Since the 1970s the coordinating body has been the International Medical Informatics Association (IMIA)

Medical informatics in the United States

The earliest use of computation for medicine was for dental projects in the 1950s at the United States National Bureau of Standards by Robert Ledley.^[3]

The next step in the mid 1950s were the development of expert systems such as MYCIN and INTERNIST-I. In 1965, the National Library of Medicine started to use MEDLINE and MEDLARS. At this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett's Laboratory of Computer Science ^[4] at Massachusetts General Hospital in Boston.^[5] In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system was used to support MUMPS language specifications. As of 2004^[update], a descendent of this system is being used in the United States Veterans Affairs hospital system. The VA has the largest enterprise-wide health information system that includes an electronic medical record, known as the Veterans Health Information Systems and Technology Architecture (VistA). A graphical user interface 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.

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.

Homer R. Warner, one of the fathers of medical informatics,^[6] founded the Department of Medical Informatics at the University of Utah in 1968, and the American Medical Informatics Association (AMIA) has an award named after him on application of informatics to medicine.

Aspects of the field

• architectures for electronic medical records and other health information systems used for billing, scheduling, and research
• decision support systems in healthcare, including clinical decision support systems
• standards (e.g. DICOM, HL7) and integration profiles (e.g. Integrating the Healthcare Enterprise) to facilitate the exchange of information between healthcare information systems - these specifically define the means to exchange data, not the content
• controlled medical vocabularies (CMVs) such as the Systematized Nomenclature of Medicine, Clinical Terms (SNOMED CT), MEDCIN, Logical Observation Identifiers Names and Codes (LOINC), OpenGALEN Common Reference Model or the highly complex UMLS - used to allow a standard, accurate exchange of data content between systems and providers
• use of hand-held or portable devices to assist providers with data entry/retrieval or medical decision-making, sometimes called mHealth.
• The international standards on the subject are covered by ICS 35.240.80^[1] in which ISO 27799:2008 is one of the core components.^[2]
• Bioinformatics and medical informatics are expected to (partially) converge in the future