Health Informatics. Dr. Gopalrao Jogdand, M.D. Ph.D. Professor & Head, Department of community medicine

Transcription

1 Health Informatics Dr. Gopalrao Jogdand, M.D. Ph.D. Professor & Head, Department of community medicine

2 Goals for this presentation Explore the state of development in health informatics and health care Draw implications for nursing and allied health science education: Substance what does a health professional need to know? Style the dual benefit of informatics-driven

3 Health Informatics: What is it?... the application of computers, communications, and information technology and systems to all fields of medicine (Morris Collen)...transformation of data to information, information to knowledge (M. Scott Blois)...Integration of clinical disciplines, their information and information management, with information processing and communications technology to support world health (IMIA)

4 Scientific Foundations of HEALTH INFORMATICS

5 Computer & Information Science Clinical & Basic Biomedical Sciences Organizational Science Scientific Foundations of HEALTH INFORMATICS Cognitive Science Public Health Science Decision Science

6 ACCOMPLISHMENTS IN HEALTH INFORMATICS: ~50 YEARS OF GROWTH

7 Computer-based Patient Records UCSF Washington U Regenstrief Mayo PITT MGH Yale Brigham & Women's Univ Utah/LDS/Interm ountain Columbia Duke Vanderbilt

8 Knowledge at the Point of Care Regenstrief PITT BIDMC MGH Brigham & Women's UCSF Stanford SMI Univ Utah/LDS/Inter mountain Duke

9 Univ Washington OHSU PITT Yale Brigham & Women's Stanford SMI Columbia Baylor Imaging and Bioinformatics

10 Consumer Health & Telemedicine Univ Washington OHSU Univ Wisconsin Mayo U Iowa BIDMC MIT Kaiser- Permanente Colorado Missouri Georgia

11 Health Information Infrastructure Unified Medical Language System IAIMS

12 On the horizon... Integration of different data types, with particular emphasis on time-variant data Intelligent agents and meta-data that support efficient use of knowledge resources (text, images, sound) Merging of public health and personal health data Re-engineering of clinical practice to capitalize on informatics advances

13 GRAND CHALLENGE IN Health Care

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15 Translational Medicine the marriage between new discoveries in basic science and valid treatments in clinical practice

16 The Importance of Health Informatics to Translational Medicine: Fast-tracking Accelerating the trajectory from bench to bedside Rapid synthesis of research evidence and clinical data at the point of care

17 Patients and Translational Medicine

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19 SMART Patients Self-assured Motivated Aware Resourceful Talented Scared Minors! Reluctant Anxious Time consuming

20 Health Informatics Support for Translational Medicine Basic Research Clinical Research Health Services Bioinformatics and image management Knowledge resources (literature, gene, images) Intelligent access to distributed resources Researcher s workstation & network

21 Health Informatics Support for Translational Medicine Basic Research Clinical Research Health Services Common terms and data models Participant recruitment Research Registries and Data Repositories Virtual reality environments

22 Health Informatics Support for Translational Medicine Basic Research Clinical Research Health Services Organized, accessible clinical data Common terms and standard definitions Intervention infrastructure Guidelines delivered to the point of care

23 AN INVESTMENT MODEL for HEALTH INFORMATICS + Health Care Infrastructure Development Informatics Applications Integrated Training Programs

24 Infrastructure Development Pathways and Networks (NGI, NII) Reference Data Model Naming Conventions

25 Informatics Applications Data capture devices New tools that deliver clinical interventions Substantive content specific to selected clinical trials Treat informatics like statistics: expect it in every project!

26 Integrated Training Link informatics research training with basic and clinical research training Interdisciplinary research and practice models begin with interdisciplinary training

27 WHAT S LEFT UNDONE? Scaleable, portable applications that support distributed access to knowledge resources Integration of health information technologies into the work-life of busy clinicians Policies and regulations that support privacy while enhancing access to key health data Tools that support SMART patients

28 Educational implications Who needs to be educated? What do they need to learn? How can it be taught?

29 Who needs to be educated? Health Informatics Professionals Applications-oriented: Nursing informatics specialists, medical librarians (master s level) Inquiry-oriented: generators of new knowledge (PhD) Health Professionals Entry-level degree candidates Life-long learners Patients Basic Health information competence Just-in-time learning

30 What needs to be learned: The Substance of Informatics Knowledge Management Distributed knowledge Integrated records Formal languages and vocabularies New Data Types Images Time-variant data Clinical Practice Factors Patients and lay people as legitimate users Practice-enhancing technologies Organizational change

31 Educational needs of health informatics professionals Knoweldge management New Data Types Clinical Practice Factors Knowledge representation Emerging technologies Integration strategies Impact of information and information technology on individuals and organizations

32 Educational needs of nursing and allied health professionals Knowledge management New Data Types Clinical Practice Factors Acquiring information for practice Using emerging technologies to advance practice goals Re-engineering practice to capitalize on technology Share the workload Extend practice options

33 Educational needs of patients Knowledge management New Data Types Clinical Practice Factors Acquiring, evaluating, interpreting, and applying consumer health information Accessing emerging technologies Becoming an informed and informing user of health information

34 Journey to the Curriculum

35 Education & Informatics Both content and process! Substance: Educating about informatics Style: Educating people about health science using informatics Informatics-enhanced clinical experiences Distance learning Informatics-enhanced classroom strategies

36 Deciding what belongs in the curriculum Evaluate contemporary practice Clinical interventions Practice Models Exploit emerging technologies Clinical Technologies (translational medicine) Informatics Technologies Critically appraise what must be learned in anticipation of practice, and what must be delivered in the context of practice --and choose from the former, not the latter!

37 General Guidelines Information is inseparable from structure So informatics must be integrated throughout Therefore, informatics is everyone s job To the extent possible, the skills used in the educational experience should mimic those employed in the practice world Technology should enhance learning

38 General Guidelines Information is inseparable from structure To the extent possible, the skills used in the educational experience should mimic those employed in the practice world Knowledge resource access Information Integration Distributed records management Technology should enhance learning

39 General Guidelines Information is inseparable from structure To the extent possible, the skills used in the educational experience should mimic those employed in the practice world Technology should enhance learning Skill development Individualized progression Tailoring to personal preferences and styles

40 Incentives and mandates for the Faculty

41 Using Informatics to accomplish clinical science learning goals

42 Informatics that advance clinical learning Reliance on Aggregate Data and Databases Privacy, confidentiality and integration Telemedicine, including Just-in-time, point-of-service learning systems and distributed knowledge systems

43 Strategies to use Informatics to accomplish clinical science curricular goals Include terminology and knowledge representation activities along with clinical exercises Require J-I-T identification and synthesis of distributed knowledge resources Employ simulated environments judiciously to develop skills for asynchronous practice

44 Cyberscalpel: Precise Surgical training methods Surgical techniques can be practiced with precision Haptic devices provide resistance feedback Visualization confirms image

45 Faculty Responsibilities Technological Competence Curricular control Responsive, Reflective, collaborative learning environments

46 Patient-centered Informatics Education Establish a philosophy of patient-centered practice and adhere to it! Where possible, introduce informatics tools congruent with the philosophy of patient-centered practice Be explicit about discrepancies between the curriculum philosophy and that of clinical agencies

47 Education direct to patients Collaborate with other health education initiatives in primary schools and public libraries Evaluate the relevance of professional literatures and materials for consumer use Initiate patient-accessible records systems and the knowledge resources to support them Map patient vernacular to formal health care languages

48 Thank you