Health informatics

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Health Informatics (also called health care informatics , healthcare informatics , medical informatics , nursing informatics , clinical informatics , or biomedical informatics ) is the information engineering applied to the health care field, basically the management and use of patient health information. It is a multidisciplinary field that uses health information technology (HIT) to improve health care through a combination of higher quality, higher efficiency (spurring lower costs and greater availability), and new opportunities. Disciplines involved include information science, computer science, social sciences, behavioral science, management science, and others. The NLM defines health informatics as "an interdisciplinary study of the design, development, adoption and application of IT-based innovation in healthcare delivery, management and planning". It deals with the resources, tools and methods necessary to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools including computers, clinical guidelines, official medical terminology, and information and communication systems, among others. It is applied in the fields of nursing, clinical medicine, dentistry, pharmacy, public health, occupational therapy, physical therapy, biomedical research, and alternative medicine, all designed to enhance the overall effectiveness of patient care delivery by ensuring that the data produced is of high quality.

International standards on subjects are covered by ICS 35.240.80 where ISO 27799: 2008 is one of the core components.

Video Health informatics

Sub Specialization

Health information includes sub-areas of clinical informatics, such as pathology informatics, clinical research informatics (see below), imaging informatics, public health informatics, public health informatics, home health informatics, nursing informatics, medical informatics, consumer health informatics, clinical bioinformatics , and informatics for education and research in the fields of health and medicine, pharmaceutical informatics.

Maps Health informatics

Health Informatics

Clinical information

Clinical informatics is concerned with the use of information in health care by and for physicians.

Clinical informatics, also known as clinical informatics, transforms health care by analyzing, designing, implementing and evaluating information and communication systems that improve individual and population health outcomes, improve patient care, and strengthen doctor-patient relationships. Clinical informatics use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to:

• assesses the information and knowledge needs of health care professionals, patients and their families.
• characterize, evaluate, and improve clinical processes,
• develop, implement, and improve clinical decision support systems, and
• lead or participate in the procurement, adaptation, development, implementation, management, evaluation, and continuous improvement of clinical information systems.

Doctors collaborate with health care and other information technology professionals to develop health informatics tools that promote safe, efficient, effective, timely, patient-centered, and fair patient care. Many clinical informatics are also computer scientists.

In October 2011, the American Board of Medical Specialties (ABMS), the organization that oversees the MD specialist certification in the United States, announces the certification of MD specialist doctors in clinical informatics. The first examination for board certification in subspecialty of clinical informatics is offered in October 2013 by the American Board of Preventive Medicine (ABPM) with 432 graduating into 2014 Prime Class Diplomates in clinical informatics.

Fellowship programs exist for doctors who want to become certified in clinical informatics. Doctors must graduate from medical school in the United States or Canada, or schools located elsewhere approved by ABPM. In addition, they must complete major residency programs such as Drug Disease (or one of 24 sub-specialties recognized by the ABMS) and qualify to become licensed for medical practice in the state where their scholarship program is located. The fellowship program is 24 months long, with people sharing the time between Rotation Informatics, didactic, research, and clinical work in their main specialties.

Integrated data repository

One of the fundamental elements of biomedical and translational research is the use of an integrated data repository. A survey conducted in 2010 defines "integrated data storage" (IDR) as a data warehouse that combines multiple sources of clinical data to support queries for similar research functions. An integrated data repository is a complex system developed to solve problems ranging from identity management, confidentiality protection, semantic compatibility and data syntax from multiple sources, and most importantly easy and flexible demand. The development of the field of clinical informatics leads to the creation of large data sets with electronic health records data integrated with other data (such as genome data). Types of data repositories include operational data storage (ODS), clinical data warehouse (CDW), mart clinical data, and clinical registries. Operational data storage is created to extract, transfer and load before creating a warehouse or data mart. Clinical records storage repositories have long been present, but their contents are disease-specific and are sometimes considered ancient. Clinical data storage and clinical data warehouses are considered fast and reliable. Although this large integrated repository has significantly affected clinical research, it still faces challenges and obstacles. One major problem is the requirement for ethical approval by the institutional review board (IRB) for any research analysis intended for publication. Some research sources do not require IRB approval. For example, CDW with data of deceased patients has been deformed and IRB approval is not required for its use. Another challenge is data quality. Methods that adjust the bias (such as using the trend score matching method) assume that a complete health record is taken. Tools that check data quality (e.g., Shows lost data) help in finding data quality issues.

Informatics clinical research

Informatics clinical research (CRI) is a subfield of health informatics that seeks to improve the efficiency of clinical research using informatics methods. Some of the problems handled by CRI are: the creation of data-data data warehouses that can be used for research, data collection support in clinical trials using electronic data retrieval systems, simplifying ethical approvals and updates (in the US responsible entities are local institutional review boards) , maintenance of a repository of past clinical trials data (unidentified).

CRI is a fairly new branch of informatics and has met with increasing pain as does the upcoming field. Some of the problems facing CRI are the ability for statisticians and architects of computer systems to work with clinical research staff in designing systems and lack of funding to support the development of new systems. Researchers and informatics teams have a difficult time coordinating plans and ideas for designing a user-friendly system for the research team but in accordance with computer team system requirements. Lack of funding can be a hindrance to CRI development. Many organizations that do research struggle to get financial support to do research, let alone invest the money in informatics systems that will not give them more revenue or improve research results (Embi, 2009).

Common Common data elements (CDE) in clinical research

The ability to integrate data from multiple clinical trials is an important part of clinical research informatics. Initiatives, such as PhenX and Patient Resulted Measurement Information Systems Patients sparked a general effort to increase secondary use of data collected in human clinical trials in the past. The CDE initiative, for example, tries to allow clinical experiment designers to adopt standardized research instruments (electronic case report forms).

Data sharing platform for clinical study data

A parallel effort to standardize how data is collected is an initiative that offers unidentified patient-level clinical study data to be downloaded by researchers who wish to reuse this data. Examples of such platforms are Project Data Sphere, dbGaP, ImmPort, or Clinical Study Data Request. Informatics issues in data formats for revenue sharing (regular CSV files, FDA-approved formats, such as the CDISC Study Data Tabulation Model) are important challenges in the field of clinical research informatics.

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Human bioinformatics

Bioinformatics translations

With the completion of the human genome and the recent emergence of high throughput sequencing and genome association studies of single nucleotide polymorphisms, the fields of molecular bioinformatics, biostatistics, statistical genetics and clinical informatics converge into emerging fields of translational bioinformatics. br> The link between bioinformatics and health informatics, while conceptually linked under the umbrella of biomedical informatics, is not always very clear. The TBI community is particularly motivated by the development of an approach to identify links between basic biological and clinical information Along with complementary areas of emphasis, such as those focused on systems development and approaches within the context of clinical research, insights from TBI can enable a new paradigm for the study and treatment of diseases.

Translational bioinformatics (TBI) is a relatively new field that emerged in 2000 when the sequence of the human genome was released. The commonly used definition of TBI is long and can be found on. In simpler terms, TBI can be defined as a large pool of health-related data (biomedical and genomic) and data translation into individually tailored clinical entities. Today, the field of TBI is categorized into four main themes outlined below:

1. Large clinical data
   A large clinical data is a collection of electronic health records used for innovation. The evidence-based approach currently practiced in medicine is recommended to be combined with practice-based drugs to achieve better outcomes for patients. As CEO of California-based cognitive computing company Apixio, Darren Schutle, explains that care can be better installed in patients if data can be collected from various medical records, combined, and analyzed. Furthermore, a combination of similar profiles may serve as a basis for drugs tailored to what works and what is not for certain conditions (Marr, 2016).
2. Genomics in clinical care
   Genomic data is used to identify gene involvement under unknown or rare conditions/syndromes. Currently, the most aggressive area of ​​genomics is oncology. Identification of cancer genomic sequencing can determine the reason for drug sensitivity and resistance during oncology treatment process.
3. Omic for drug discovery and repurposing
   Drug repurposing is an interesting idea that allows pharmaceutical companies to sell approved drugs to treat different conditions/diseases that FDA did not initially agree to by the drug. The observation of "molecular signatures in diseases and comparing them with signatures observed in cells" suggests the possibility of the drug's ability to heal and/or alleviate symptoms of the disease.
4. Personal genome testing - In the US, some companies offer genetic testing directly to consumers (DTC). Companies that do most of the testing are called 23andMe. Utilizing genetic testing in health care raises many ethical, legal and social problems; one of the key questions is whether the health care provider is ready to include the patient's genomic information while providing unbiased treatment (despite intimate genome knowledge) and high quality. Documented examples to include such information into the delivery of health services show a positive and negative impact on overall health care-related outcomes.

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Computational computer informatics

Computer computational informatics is a branch of computer science that deals specifically with relevant computing techniques in health care. Computational health informatics is also a branch of health informatics, but orthogonal to much of the work that takes place in health informatics due to the interest of computer scientists especially in understanding the nature of computing. Health informatics, on the other hand, mainly deals with understanding the nature of drugs that allow for computer intervention. Health domains provide a wide range of problems that can be solved using computational techniques, and computer scientists strive to make a difference in medicine by learning the basic principles of computer science that will allow for the application of meaningful algorithms and systems (for medicine). developed. Thus, computer scientists working in computational health informatics and health scientists working in medical health informatics join to develop next generation health technologies.

Using computers to analyze health data has been around since the 1950s, but only in the 1990s the first robust models emerged. The development of the internet has helped develop computational health informatics over the last decade. Computer models are used to examine various topics such as how sports affect obesity, health care costs, and more.

Examples of projects in computational health informatics include the COACH project.

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Informatics for education and research in health and medicine

Informatics clinical research

Informatics clinical research (CRI) is the incorporation of clinical informatics and research. Featuring clinical informatics and research, CRI has an important role in clinical research, patient care, and the construction of health care systems (Katzan & Rudick, 2012). CRI is one of the fastest growing biomedical informatics subdivisions that play an important role in developing new informatics theories, tools, and solutions to accelerate the full transition continuum (Kahn & Weng, 2012). The evolution of CRI is very important in Informatics because there is a remarkable increase in the scope and pace of the advancement of clinical and translational science (Katzan & Rudick, 2012). Informatics clinical research takes the core foundations, principles, and technologies associated with Health Informatics, and applies them to the context of clinical research. Thus, CRI is a sub-discipline of health informatics, and interests and activities within CRI have greatly improved in recent years due to the tremendous problems associated with the explosive growth of clinical research data and information. There are a number of activities in CRI-supported clinical trials, including:

• more efficient and effective data collection and acquisition
• increase recruitment in clinical trials
• optimal protocol design and efficient management
• recruitment and patient management
• reporting adverse events
• regulatory compliance
• data storage, transfers, processing, and analysis
• data repository from complete clinical trial (for secondary analysis)

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History

The widespread use of computer technology in the medical world began in the early 1950s with the advent of computers. In 1949, Gustav Wagner founded the first professional organization for informatics in Germany. Prehistoric, historical, and future medical information and health information technologies are discussed as references. Majors of specialized universities and informatics training programs began in the 1960s in France, Germany, Belgium, and the Netherlands. The medical informatics research unit began to emerge during the 1970s in Poland and in the US. Since then, the development of high quality health, education, and infrastructure informatics research has become the goal of the US and EU.

The initial names for health informatics include medical computing, biomedical computing, computer medical science, computer medicine, electronic medical data processing, automatic medical data processing, medical information processing, medical information science, medical software engineering, and medical computer technology.

The health informatics community is still growing, it is by no means a mature profession, but is working in the UK by a voluntary registration agency, the UK Council of Health Informatics Professions has suggested eight key constituencies in the domain - information management, knowledge management, project portfolio/program/management , ICT, education and research, clinical informatics, health records (services and business-related), health informatics management services. This constituency accommodates professionals in and for the NHS, in academia and commercial services and solutions providers.

Since the 1970s the most prominent international coordinating body is the International Medical Informatics Association (IMIA).

In the United States

Although the idea of ​​using computers in medicine emerged as an advanced technology in the early 20th century, it was not until 1950 that informatics began to have an effect in the United States.

The earliest use of electronic digital computers for drugs was for dental projects in the 1950s at the Bureau of National Standards of the United States by Robert Ledley. During the mid-1950s, the United States Air Force (USAF) conducted several medical projects on its computers while also encouraging civilian institutions such as the National Academy of Sciences - National Research Council (NAS-NRC) and the National Institutes of Health ) NIH) to sponsor such work. In 1959, Ledley and Lee B. Lusted published "Basic Medical Diagnostic Reasoning," a widely read article in Science, which introduced computational techniques (especially surgical research) to medical workers. Ledley and Lusted articles have remained influential for decades, especially in the field of medical decision making.

Guided by Ledley's late 1950s computer usage survey in biology and medicine (conducted for NAS-NRC), and by his article and Lusted, NIH made the first major effort to introduce computers to biology and medicine. This effort, initiated initially by the NIH Advisory Committee on Computers in Research (ACCR), chaired by Lusted, spent more than $ 40 million between 1960 and 1964 to establish dozens of large and small biomedical research centers in the US.

One early use of computers (1960, non-ACCRs) was to help measure the normal human movement, as a precursor to measuring scientific deviations from normal, and the design of prostheses. The use of computers (IBM 650, 1620, and 7040) allows the analysis of large sample sizes, and more measurements and subgroups than was previously practical with mechanical calculators, thus allowing an objective understanding of how human movers vary by age and body. characteristics. The co-authors of the study were the Dean of the Marquette University Faculty of Engineering; this work led to discrete Biomedical Engineering departments there and elsewhere.

The next step, in the mid-1960s, was the development (sponsored by NIH) expert systems such as MYCIN and Internist-I. In 1965, the National Library of Medicine began using MEDLINE and MEDLAR. Around this time, Neil Pappalardo, Curtis Marble, and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) at Octo Barnett's Laboratory of Computer Science at Massachusetts General Hospital in Boston, another biomedical computing center that received significant support from NIH. In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system is used to support the MUMPS language specification. In 2004, the offspring of this system were used in the Veterans hospital system of the United States. VA has the largest enterprise-wide health information system that includes an electronic medical record, known as Health Information System and Veterans Health System Architecture (VISTA). The graphical user interface known as the Computerized Patient Record System (CPRS) allows healthcare providers to review and update a patient's electronic medical record at one of more than 1,000 VA health care facilities.

During the 1960s, Morris Collen, a physician working for the Kaiser Permanente Research Division, developed a computerized system to automate many aspects of multiphasic health checks. This system became the basis of a larger medical database developed by Kaiser Permanente during the 1970s and 1980s. American College of Medical Informatics (ACMI) since 1993 annually conferred Morris F. Collen, MD Medal for Extraordinary Contributions to Medical Informatics. Kaiser permanente

In the 1970s, more and more commercial vendors began marketing practices and electronic medical records management systems. Although many products are available, only a small number of health practitioners use a full-featured system of electronic health care records. In 1970, Warner Slack, MD, and Howard Bleich, MD, co-founded the academic division of clinical informatics at Beth Israel Deaconess Medical Center and Harvard Medical School. Warner Slack was a pioneer in the development of electronic medical history of patients, and in 1977 Dr. Bleich created the first user-friendly search engine for the world's biomedical literature. In 2002, Dr. Slack and Dr. Bleich was awarded the Morris F. Collen Award for their pioneering contributions to medical informatics.

The computerized system involved in patient care has led to a number of changes. Such changes have led to improvements in electronic health records that are now capable of sharing medical information among various health stakeholders (Zahabi, Kaber, & Swangnetr, 2015); thereby, supporting the flow of patient information through a variety of treatment modalities.

The current use of computers involves a wide range of capabilities including but not limited to doctor diagnosis and documentation, scheduling of patient appointments, and billing. Many field researchers have identified improvements in the quality of the health care system, the decline in error by healthcare workers, and lastly the savings of time and money (Zahabi, Kaber, & Swangnetr, 2015). But the system is not perfect and will continue to need improvement. Frequently quoted factors of concern involve user usability, security, accessibility, and friendliness (Zahabi, Kaber, & Swangnetr, 2015). As leaders in the field of medical informatics improve the factors of concern above, the overall provision of health services will continue to increase.

Homer R. Warner, one of the fathers of medical informatics, founded the Department of Medical Informatics at the University of Utah in 1968. The American Medical Informatics Association (AMIA) has an award named after he applies informatics applications to medicine.

Informatics certification

As with other IT training specialties, there is an Informatics certification available to help informatics professionals stand out and be recognized. The American Nurses Credentialing Center (ANCC) offers board certification in Nursing Informatics. For Radiology Informatics, Certified Imaging Informatic Professional (CIIP) certification is made by ABII (American Information Agency) established by SIIM (Society for Imaging Informatics in Medicine) and ARRT (American Registry of Radiologic Technologists) in 2005. CIIP certification requires experience documented work in Imaging Informatics, formal testing and is a limited time credential that requires updates every five years. Test exams for a combination of IT technical knowledge, clinical understanding, and project management experience are considered to represent a typical workload of PACS administrators or other radiological roles of IT radiology. The certification from PARCA (PACS Administrator Registry and Certification Association) is also recognized. Five-storey PARCA certification from the initial level to the architect level. The American Association of Health Information Management offers credentials in medical coding, analytics, and data administration, such as Registered Health Information Administrator and Certified Coding Associate.

Certification is widely requested by employers in health informatics, and overall demand for certified informatics workers in the United States exceeds supply. The American Health Information Management Association reports that only 68% of applicants pass the certification exam on the first try.

In the United Kingdom

The widespread history of health informatics has been captured in the book of British Health Computing: Recollections and reflections, Hayes G, Barnett D (Eds.), BCS (May 2008) by those active in the field, especially members of BCS Health and its constituent groups. This book illustrates the path taken as 'early development of irregular and idiosyncratic health informatics'. In the early 1950s, it was requested by those involved in NHS finance and only in the early 1960s did solutions including those in pathology (1960), radiotherapy (1962), immunization (1963), and primary care (1968) emerged. Many of these solutions, even in the early 1970s, were developed in-house by pioneers in the field to meet their own needs. Partly because some areas of health care (eg immunization and vaccination of children) are still provided by the Local Authority. Interestingly, this is a situation that the coalition government widely proposes to get back into the 2010 strategy Equity and Excellence: Freeing the NHS (July 2010); states:

"We will place patients at the heart of the NHS, through information revolution and greater choice and control 'with shared decision making being the norm:' no decision about me without me 'and patients have access to the information they want, to make choices about their care.They will improve control over their own care records. "

This type of statement provides significant opportunities for health informants to leave the back office and take on a frontline role that supports clinical practice, and care-giving businesses. The British health informatics community has long played a key role in international activity, joining TC4 from the International Federation of Information Processing (1969) which became IMIA (1979). Under the auspices of BCS Health Cambridge is the host for the first EFMI Medical Informatics Europe (1974) conference and London is the location for the tenth global IMIA congress (MEDINFO2001).

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Policy initiatives and current state

Argentina

Since 1997, the Buenos Aires Biomedical Informatics Group, a non-profit group, represents the interests of various clinical and non-clinical professionals working in the field of Health Informatics. The purpose is:

• Promote the application of computer tools in health care activities, scientific research, health administration, and in all fields related to health sciences and biomedical research.
• Support, promote, and disseminate content-related activities with the management of information and medical devices they normally use under the name Biomedical informatics.
• Promote cooperation and exchange of actions generated in the field of biomedical informatics, both at the public and private, national and international levels.
• Interacting with all recognized, academic scientists encourages the creation of new instances that share the same goals and are inspired by the same goals.
• To promote, organize, sponsor and participate in events and activities for computer and information training and disseminate developments in this field that may be useful to team members and health-related activities.

The Argentine health system is heterogeneous in its function, and therefore the development of informatics shows a heterogeneous stage. Many private healthcare centers have developed systems, such as the Aleman Hospital of Buenos Aires, or the Italiano de Buenos Aires Hospital which also has residential programs for health informatics.

Brazil

The first application of computers for medicine and health care in Brazil began around 1968, with the installation of the first major framework at university general hospitals, and the use of programmable calculators in scientific research applications. Minicomputers such as the IBM 1130 were installed in several universities, and the first application was developed for them, such as the hospital census at the School of Medicine of RibeirÃÆ'Â o Preto and patient master files, at the Hospital das Clánnicas da Universidade de SÃÆ'Â £ Paulo, respectively in RibeirÃÆ'Â £ o Preto cities and SÃ <â € <â € <Â £ Paulo Paulo University campus SÃÆ'Â £ Paulo. In the 1970s, several Hewlett Packard Digital and minicomputers were acquired for public hospitals and the Armed Forces, and more intensively used for intensive care units, cardiology diagnostics, patient monitoring, and other applications. In the early 1980s, with the advent of cheaper microcomputers, a substantial increase in computer applications in health took place, and in 1986, the Brazilian Society of Health Informatics was established, the first Brazilian Health Informatics Congress was held, and the first Canada

Health Informatics projects in Canada are implemented in a province, with different provinces creating different systems. A federally-funded, non-profit organization called Canada Health Infoway was created in 2001 to encourage the development and adoption of electronic health records in Canada. As of December 31, 2008 there were 276 EHR projects taking place in Canadian hospitals, other health care facilities, pharmacies and laboratories, with an investment value of $ 1.5 billion from Canada Health Infoway.

Provincial and territorial programs include:

• eHealth Ontario was created as the governing body of the Ontario provincial government in September 2008. It has been plagued by delays and its CEO was dismissed for a multimillion-dollar contract scandal in 2009.
• Alberta Netcare was created in 2003 by the Government of Alberta. Today netCARE portals are used daily by thousands of doctors. It provides access to demographic data, prescribed/distributed drugs, known allergies/intolerances, immunizations, laboratory test results, diagnostic imaging reports, diabetes registry and other medical reports. NetCARE interface capabilities are included in electronic medical record products funded by the provincial government.

United States

In 2004, President George W. Bush signed the 13335 Executive Order, creating the Office of the National Coordinator for Health Information Technology (ONCHIT) as a division of the US Department of Health and Human Services (HHS). The mission of this office is the widespread adoption of interoperable electronic health records (EHRs) in the US in 10 years. See the quality improvement organization for more information about federal initiatives in this field.

In 2014 the Department of Education approved the advanced Bachelor of Health Informatics program submitted by The University of South Alabama. The program is designed to provide specialized Health Informatics education, and is the only program in the country with the Health Informatics Lab. The program is housed at The School of Computing at Shelby Hall, a recently completed $ 50 million art teaching facility. The University of South Alabama rewards David L. Loeser on May 10, 2014 with his first Medical Science degree. The program is currently scheduled to have 100 students awarded in 2016.

The Certification Commission for Health Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the US Department of Health and Human Services to develop a set of standards for electronic health records (EHR) and support networks, and vendor certification that met them. In July 2006, CCHIT released the first list of 22 certified outpatient EHR products, in two different announcements.

Harvard Medical School adds the department of biomedical informatics by 2015. The University of Cincinnati in partnership with the Cincinnati Child Medical Center creates an informatics biomedical graduate certificate program (BMI) and in 2015 begins the BMI PhD program. The joint program allows researchers and students to observe the impact of their work on direct patient care because the invention is translated from bench to bed.

Europe

EU Member States commit to sharing their best practices and experiences to create the European eHealth Area, thereby enhancing access to and quality health care at the same time as stimulating growth in a promising new industry sector. The European eHealth Action Plan plays a fundamental role in the EU strategy. Working on this initiative involves a collaborative approach among some parts of the Commission's services. The European Institute for Health Records is involved in the promotion of high quality electronic health record systems in the European Union.

English

There are various models of health informatics submissions in each country of origin (UK, Scotland, Northern Ireland and Wales) but some bodies such as UKCHIP ref & gt; UKCHIP & lt;/ref & gt; (See below) operates for 'in and for' all countries of origin and beyond.

English

The NHS informatics in the UK are contracted out to several vendors for national health informatics solutions under the National Information Technology (NPfIT) label in the early to mid 2000s, under the auspices of NHS Connecting for Health (part of the Health and Social Care Information Center as of April 1 2013). NPfIT initially divides the country into five areas, with a strategic 'systems integration' contract awarded to one of several Local Service Providers (LSPs). Specific technical solutions are required to connect securely with the NHS 'Spine', a system designed to bridge data between different systems and maintenance settings. NPfIT dropped significantly behind schedule and its scope and design is being revised in real time, aggravated by the media and the political sluggishness of Program spending (past and projected) on the proposed budget. In 2010, a consultation was launched as part of the White Paper of the New Conservative/Liberal Democratic Government, "Freeing the NHS". This initiative provides little in the way of innovative thinking, especially re-stating the existing strategy in the proposed new context of the Coalition's vision for the NHS. The level of computerization in NHS secondary care is quite high prior to NPfIT, and the program stagnates further development from the base of the installation - the original NPfIT regional approach does not provide a single, national or local healthcare community or agility solution to buy the system but instead try to deal with the inland center.

Almost all common practices in England and Wales are computerized under the GP Systems of Choice (GPSoC) program, and patients have relatively broad, computerized primary care clinical records. The choice of system is the responsibility of each common practice and while none of the standard GP systems, GPSoC establishes relatively rigid minimum performance standards and minimum functions to adhere to by vendors. Interoperability between the primary and secondary care systems is rather primitive. It is hoped that the focus on interworking (for interfacing and integration) standards will stimulate synergies between primary and secondary care in sharing the information necessary to support individual care. Notable success to date is in electronic demand and viewing test results, and in some areas doctors have access to digital x-ray images from secondary care systems.

Scotland has an approach to ongoing central connections that are more advanced than English in some ways. Scotland has a GPASS system whose source code is owned by the State, and is controlled and developed by NHS Scotland. GPASS was accepted in 1984. It has been provided free to all doctors in Scotland but has grown poorly. Open source discussion as a drug is going on.

Wales

Wales has a dedicated Health Informatics function that supports NHS Wales in leading a new integrated digital information service and promotes Health Informatics as a career.

Dutch

In the Netherlands, health informatics is now a priority for research and implementation. The Netherlands Medical Center Federation (NFU) has created Citrienfonds , which includes eHealth and Registration programs in Source. The Netherlands also has a national organization Society for Healthcare Informatics (VMBI) and Nictiz, the national center for standardization and eHealth.

Emerging Directions (European R & D)

The preference of the European Commission, as exemplified in Framework 5 and the pilot project currently pursued, is for Libre and Open Source (FLOSS) Software for health care. Other currents of current research focus on the "big data" aspect of health information systems. For background information on related aspects of data in health informatics, see, for example, the book "Biomedical Informatics" by Andreas Holzinger.

Asia and Oceania

In Asia and Australia-New Zealand, a regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1994 and now comprises more than 15 member regions in the Asia Pacific Region.

Australia

Higher Education Informatic Informatics Australasia (ACHI) is a professional association for health informatics in the Asia-Pacific region. It represents the interests of various clinical and non-clinical professionals working within the scope of health informatics through a commitment to quality, ethical standards and practice. ACHI is a member of the academic institution of the International Medical Informatics Association (IMIA) and a full member of the Australian Council of Professions. ACHI is the sponsor of the "e-Journal for Health Informatics", a professional journal indexed and reviewed by colleagues. ACHI also supports the "Australian Board of Health Informatics Education" (AHIEC) since its inception in 2009.

Although there are a number of health informatics organizations in Australia, the Health Informatics Society of Australia (HISA) is considered the main umbrella group and is a member of the International Medical Informatics Association (IMIA). Nursing Informatics is the driving force behind the formation of HISA, which now the company is limited by member guarantees. Membership comes from the entire spectrum of informatics from students to affiliates. HISA has a number of branches (Queensland, New South Wales, Victoria and Western Australia) as well as special interest groups such as nursing (NIA), pathology, age and community care, industrial and medical imaging (Conrick, 2006).

China

After 20 years, China made a successful transition from a planned economy to a socialist market economy. Along with these changes, China's health care system has also undergone significant reforms to follow and adapt to this historical revolution. In 2003, data (released from the Ministry of Health of the People's Republic of China) showed that health care expenditures related to national health care totaled RMB 662.33 billion in total, accounting for 5.56% of the national gross domestic product. Before the 1980s, all health care costs were covered in the central government's annual budget. Since then, the construction of supporters funded by health care has begun to change gradually. Most expenditures were contributed by health insurance schemes and private spending, each accounting for 40% and 45% of total expenditures. Meanwhile, the government's financial contribution has declined by 10%. On the other hand, in 2004, up to 296,492 health facilities were recorded in the Ministry of Health statistics summary, and an average of 2.4 clinical beds per 1000 people were also mentioned.

In Chinese

Along with the development of information technology since the 1990s, healthcare providers realized that the information could generate significant benefits for improving their services with computerized cases and data, such as getting information to direct patient care and assessing the best patient care for a particular clinic. condition. Therefore, substantial resources are gathered to build China's own health informatics system. Most of these resources are structured to build a hospital information system (HIS), which aims to minimize waste and unnecessary repetition, furthermore to promote the efficiency and quality control of health care. In 2004, China has successfully deployed HIS through approximately 35-40% of national hospitals. However, the spread of HIS held by hospitals varies greatly. In eastern China, more than 80% of hospitals build HIS, in northwestern China equivalent to no more than 20%. In addition, all the Centers for Disease Control and Prevention (CDC) are above the rural level, about 80% of health care organizations are above the rural level and 27% of city hospitals have the ability to transmit reports on real-time epidemics. the situation through public health information systems and to analyze infectious diseases by dynamic statistics.

China has four levels in its health care system. The first level is a road and workplace health clinic and this is cheaper than the hospital in terms of medical billing and acts as a preventive center. The second level is a county hospital and a company along with a specialist clinic and it provides second-rate treatment. The third level is a temporary hospital and a temporary general hospital and teaching hospital that provides third-level care. At its own level is a national hospital administered by the Ministry of Health. China has greatly improved its health informatics since it finally opened its doors to the outside world and joined the World Trade Organization (WTO). In 2001, it was reported that China has 324,380 medical institutions and most of them are clinics. The reason is that clinics are prevention centers and Chinese people like using traditional Chinese medicine as opposed to Western medicine and usually work for small cases. China has also increased its higher education in terms of health informatics. By the end of 2002, there were 77 medical universities and medical faculties. There are 48 university medical colleges offering undergraduate, master, and doctoral degrees in medicine. There are 21 higher medical specialists offering diplomas so in total, there are 147 higher medical and educational institutions. Since joining the WTO, China has worked hard to improve its education system and bring it to international standards. SARS plays a big role in China by rapidly improving its health care system. Back in 2003, there was a SARS outbreak and that made China rush to deploy HIS Information Systems or Hospitals and over 80% of hospitals had HIS. China has compared itself to Korean care systems and figuring out how the system works better. There are studies conducted that survey six hospitals in China that have HIS. The result was that doctors did not use so many computers that it was not used as much as possible for clinical practice rather than for administrative purposes. The survey asked whether the hospital created any website and concluded that only four of them had created the website and the three companies had third-party companies that made it for them and one was made by hospital staff. In conclusion, all agree or strongly agree that the provision of health information on the Internet should be utilized.

Standard in Chinese

Information collected at different times, by different participants or systems can often lead to problems of misunderstanding, comparison or exchange. To design a minor-issue system, healthcare providers recognize that certain standards are the basis for information sharing and interoperability, but less standardized systems will be a major obstacle to disrupting the upgrading of appropriate information systems. Given that standardization for health informatics depends on the competent authorities, the event of standardization should be involved with the government and further relevant funding and support is essential. In 2003, the Department of Health released the Lay-out Development of National Health Informatics (2003-2010) demonstrating the identification of standardization for health informatics that 'combines the adoption of international standards and the development of national standards'.

In China, the establishment of standardization was initially facilitated by the development of vocabulary, classification and coding, conducive to storing and transmitting information for premium management at the national level. In 2006, 55 international, vocabulary, classification and coding standards were presented in hospital information systems. In 2003, the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and ICD-10 Clinical Modification (ICD-10-CM) was adopted as a standard for diagnostic classification and the classification of acute care procedures. At the same time, the International Primary Care Classification (ICPC) is translated and tested in local environments applied in China. Another coding standard, named Identification Name and Logical Identity Code (LOINC), is applied to serve as a common identifier for clinical observation in the hospital. Personal identification codes are widely used in different information systems, involving names, gender, nationality, family relations, education and employment levels. However, these codes in different systems are inconsistent, when sharing between different regions. Given the vast amount of vocabulary, classification and coding standards between different jurisdictions, healthcare providers recognize that using multiple systems can generate resource wastage problems and unconventional national standards are beneficial and necessary. Therefore, at the end of 2003, the health informatics group at the Ministry of Health released three projects to address the lack of national health information standards, which are China's National Health Information Framework and Standards, the Basic Data Sets for Hospital Information Systems and Basic Data Set of Standards Public Health Information System.

Comparison between Chinese EHR Standard and Segment of ASTM E 1384 Standard

Recently, researchers from local universities evaluated the performance of China Electronic Health Record Standards (EHR) in comparison with the American Society for the Testing and Practice of Materials Standard for Electronic Record and Record Structure in the United States (ASTM E 1384 Standard).

The table above shows the details of this comparison that indicate the specific repair domains for subsequent revisions of the EHR Standard in China. In detail, these shortcomings are listed in the following list.

1. Lack of privacy and security support. ISO/TS 18308 stipulates that "EHR must support the use of personal information in an ethical and legal manner, in accordance with established, culturally appropriate or specific jurisdictional principles and frameworks" (ISO 18308: Health Informatics Information for Electronic Health Records Architecture 2004). However, the Chinese EHR Standard does not achieve any of the fifteen requirements in the subclass of privacy and security.
2. Lack of support for various data types and references. Given that only ICD-9 is referred to as China's external external coding system, other similar systems, such as SNOMED CT in clinical terminology presentations, can not be considered as familiar to Chinese specialists, which could lead to a deficiency of international information sharing.
3. Lack of a more general and wider lower level data structure. China's large and complex EHR standards are built for all medical domains. However, the attributes of specific clinical data elements, set of values, and templates often identify that these once-for-all goals can not lead to practical consequences.

Hong Kong

In Hong Kong, a computerized patient records system called Clinical Management System (CMS) has been developed by the Hospital Authority since 1994. The system has been used in all authority sites (40 hospitals and 120 clinics). It is used for up to 2 million transactions daily by 30,000 clinical staff. A comprehensive record of 7 million patients is available on-line in electronic patient records (ePR), with integrated data from all sites. Since 2004, radiological image viewing has been added to the ePR, with radiographic images of each available HA site as part of the ePR.

The Hong Kong Hospital Authority paid particular attention to the governance of the development of a clinical system, with input from hundreds of physicians entered through a structured process. The health informatics section of the Hospital Authority has close links with information technology departments and physicians to develop an organization's health care system to support services to all public hospitals and clinics in the region.

The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in health care. The eHealth consortium has been set up to bring together physicians from both the private and public sectors, medical informatics professionals and the IT industry to further promote IT in health care in Hong Kong.

India

• School of Medicine Informatics eHCF
• eHealth-Care Foundation

Malaysia

Since 2010, the Department of Health (MOH) has been working on the Malaysia Health Data Warehouse project (MyHDW). MyHDW aims to meet the diverse needs of providing and managing health information on time, and acting as a platform for standardization and integration of health data from various sources (Health Information Center, 2013). The Ministry has initiated the introduction of Electronic Hospital Information System (HIS) at several public hospitals including Serdang Hospital, Selayang Hospital and Health Center of Malaysia National University (UKMMC) under the Ministry of Higher Education (MOHE).

The hospital information system (HIS) is a comprehensive integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. As the field of medical informatics, the purpose of the hospital information system is to get the best possible support from patient care and administration with electronic data processing. HIS plays an important role in planning, initiating, managing and controlling hospital subsystem operations and thereby providing synergistic organizations in the process.

New Zealand

Health informatics is taught at five New Zealand universities. The most mature and established programs have been offered for over a decade in Otago. Health Informatics New Zealand (HINZ), is a national organization advocating health informatics. HINZ organizes conferences annually and also publishes the journal - Healthcare Informatics Review Online .

Saudi Arabia

The Saudi Health Information Association (SAHI) was established in 2006 to work under the direct supervision of King Saud bin Abdulaziz University of Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable study.

Post-Soviet countries

Russian Federation

The Russian health system is based on the principles of the Soviet health system, which is oriented towards mass prophylaxis, infection prevention and epidemic diseases, vaccination and immunization of populations based on social protection. The current government health system consists of several directions:

• Preventive health care
• Primary health care
• Special medical treatments
• Obstetric and gynecological medical care
• Children's medical care
• Surgery
• Rehabilitation/Health Care Treatment

One of the major problems of the post-Soviet medical health care system is the absence of an integrated system that provides optimization of work for medical institutions with a single database and a structured appointment schedule and long clock lines. The efficiency of medical personnel may also be questionable due to administrative administration or loss of book records.

Along with the development of IT information systems and health departments in Moscow agreed on the design of systems that will improve the public service of health care institutions. Addressing the problems that arose in the existing system, the Moscow Government ordered that the system design would provide simplified electronic reservations to public clinics and automate the work of medical workers at the first level.

The system designed for that purpose is called the EMIAS (United Medical Information and Analysis System) and presents electronic health records (EHR) with most of the other services specified in the system that manages the patient flow, contains integrated card outlets in the system, to manage managerial accounting consolidation and a list of personalized medical help. In addition, the system contains information on the availability of medical institutions and various physicians.

Implementation of the system began in 2013 with the organization of a single computerized database for all patients in the city, including front-end for users. EMIAS is implemented in Moscow and the region and it is planned that this project should be extended to most countries.

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Legal

Health informatics law deals with evolving and sometimes complicated legal principles as they apply to information technology in health-related fields. It addresses the privacy, ethics and operational issues that always arise when electronic devices, information and media are used in health care delivery. The Law of Health Informatics also applies to all matters involving information technology, health care and information interaction. This relates to the circumstances in which data and records are shared with other areas or areas that support and improve patient care.

As many health care systems attempt to have patient records more available to them via the internet, it is important that providers implement security standards to ensure that patient information is secure. They must be able to ensure the confidentiality, integrity, and security of society, processes, and technology. Because there is a possibility of payment made through this system, it is very important that the personal information aspect of them will also be protected through cryptography.

The use of technology in health care settings has become popular and this trend is expected to continue. Various health facilities have triggered various types of health information technology systems in the provision of patient care, such as electronic health records (EHRs), computerized charts, etc. The growing popularity of health information technology technology and escalation in the amount of health information that can be exchanged and transferred electronically increases the risk of potential privacy violations and patient confidentiality. These concerns trigger the formation of stringent measures by individual policy makers and facilities to ensure patient privacy and confidentiality.

One federal law enforced to safeguard patient health information (medical records, billing information, treatment plans, etc.) and to ensure patient privacy is the Health Insurance Portability and Accountability Act of 1996 or HIPAA. HIPAA gives patients autonomy and control over their own health records. Furthermore, according to the US Department of Health & amp; Human Services (n.d.), this law allows patients to do the following:

• Enables patients to view their own health records
• Allow patients to request copies of their own medical records
• Change incorrect health information
• Gives patients the right to know who has access to their health records
• Gives the patient the right to ask who can and can not see/access their health information

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Health and medical informatics journal

Computers in Biomedicine and Research , published in 1967, is one of the first specialized journals for health informatics. Other early journals include Computers and Medicine , published by the American Medical Association; The Journal of Clinical Computing, published by Gallagher Printing, Journal of Medical Systems, published by Plenum Press and MD Computing published by Springer-Veriag.. In 1984, Lippincott published the first specialized nursing journal, titled Computer Journals in Nursing , now known as Computer Informatics Nursing ( CIN ) < i> Journal .

Today, there are many medical and medical informatics journals. On September 7, 2016, there are about 235 informatics journals listed in the National Library of Medicine (NLM) catalog. The following is a list of some of the best health and medical informatics journals:

• Medical Internet Research Journal
• JMIR mHealth and uHealth
• JMIR Medical Informatics
• The Human Factor of JMIR
• JMIR Public Health & amp; Supervision
• Journal of the American Association of Medical Informatics : JAMIA
• International Journal of Medical Informatics
• Implementation Science
• Medical Image Analysis
• Medical Decision Making
• Biomedical Informatics Journal
• BMC Medical Research Methodology
• Artificial Intelligence in Medicine
• CIN : Computer Nursing Informatics

src: www.ecpi.edu

See also

Related concepts <

Source of the article : Wikipedia