Medical Informatics: Why Care? Kevin Chang, MD, MS Scott and White Healthcare 8/13/2013

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1 Medical Informatics: Why Care? Kevin Chang, MD, MS Scott and White Healthcare 8/13/2013

2 About me Education and Training UMKC School of Medicine, BA Chemistry, MD UTMB Austin IM Resident and Chief Resident Regenstrief Institute NLM Medical Informatics Fellow JAMIA publication MS Health Informatics Hospitalist and Moonlighter SVH MI Internship with Dr. Alan Snell, CMIO Scott and White Healthcare 0.5 Hospitalist 0.5 Informatics: Lead CPOE Physician, Inpatient Physician Champion Project Phoenix Zynx Health Quality Assurance Consultant

3 OBJECTIVES 1. A Hook 2. Overview of Medical Informatics 3. Putting it into Perspective 4. Summary and Closing Thoughts

4 A HOOK PCN discovered in 1928 Purified and isolated, mass production began in 1945 Millions of lives saved Chemical manufacturing Pharmaceutical industry Number of meds a generalist needed to know in 1950 Number of meds a hospitalist needs to know today

5 FDA DRUG APPROVALS Since 1938 ~18,000 drugs submitted to FDA ~1500 were new molecular entities (structurally unique active ingredients never before marketed) ~12,000 approved Drug Approvals ` `: MARY.jpg

6 SO? In the last 22 years ~600 new drugs have been established Indication MOA Pharmacokinetics / Bioavailability Drug-Drug Interactions / Allergies Side Effects Cost

7 TO ERR IS HUMAN: BUILDING A SAFER HEALTH SYSTEM 44,000-98,000 Americans die each year from preventable medical errors Annual cost associated with treating preventable adverse drug events to a 700-bed teaching hospital estimated $2.8 million: Applied nationally ~ $2 billion Hospitalized patients represent a small portion of total population at risk Estimated total costs $17 billion - $29 billion per year in hospitals nationwide The problem is not bad people; the problem is that the system needs to be made safer.

8 OTHER INDUSTRIES Finance Banking, Investment (10-15%) Media/Recreation News, Magazines, Gaming Aviation Global Economy Communication, Global Markets Healthcare ~2% Basit Chaudhry, Jerome Wang, Shinyi Wu, Margaret Maglione, Walter Mojica, Elizabeth Roth, Sally C. Morton, Paul G. Shekelle; Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Annals of Internal Medicine May;144(10): ement_story1&domain=hhnmag

9 OBJECTIVES 1. A Hook 2. Overview of Medical Informatics 3. Putting it into Perspective 4. Summary and Closing Thoughts

10 Info-what? Russian Oznovy Informatika 1968 (Foundation of Informatics) Structure and properties of scientific information French informatique de medecine 1968 (Universities) 1970s Columbia University Medical Information Science Medical Informatics

11 INITIATIVES 1900s ECGs in US automated interpretations 1950s digital computers in dental projects NIH introduces concept of computers to biology and medicine 1970s MYCIN (Stanford), INTERNIST-I (U. of Pittsburgh) Early successful expert systems 1980s results reporting, outpatient, clinical and database research 1990s integration, communication research, vocabulary, interfaces, coding

12 Medical informatics deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making.

13 Medical Knowledge Patient Applications Databases

14 DISCIPLINES: Clinical Bioinformatics Public health Nursing Pharmacy Consumer health Dental Veterinary

15 Will computers replace us? Diagnosing is an art and science Systems cannot navigate complex human psychology and behavior The legal responsibility is ours

16 OBJECTIVES 1. A Hook 2. Overview of Medical Informatics 3. Putting it into Perspective 4. Summary and Closing Thoughts

17 Good technology might facilitate Tele-health (radiology got this right) Evidence-based medicine Web-enabled medicine Public health surveillance Better outcomes, Pt satisfaction, Reduced costs?

18 *Over 300 software vendors selling EMRs today I ve seen: Cerner NextGen Gopher Eclipsys Allscripts NetAccess Sequoia Epic Partial Vendor List: Allscripts: acquired Eclipsys 2010 Cerner Corporation eclinicalworks Epic Systems, Inc. GE Healthcare Medical Information Technology (MEDITECH, Inc.) McKesson Corporation NextGen Healthcare Information Systems/QSI Quadramed Corp. Siemens Medical Solutions

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