health informatics its role, importance and a historical perspective (why should i care ?)
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Health Informatics its role, importance and a historical perspective (why should I care ?). David Parry, School of Computing, AUT. Agenda. Where did Health informatics come from ? What does it do ? Why should I care ?. Why you can’t keep up. - PowerPoint PPT PresentationTRANSCRIPT
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Health Informatics its role, importance and a historical
perspective (why should I care ?)
David Parry, School of Computing, AUT
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Agenda
Where did Health informatics come from ?
What does it do ? Why should I care ?
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Why you can’t keep up....
Number of clinical trials published in PUBMED 1975 -2011 per year
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Informatics is
Information-centred not computer centred
Based on getting clinical value from information
(Very) important in primary care A support for administration and
workflow as well as clinical activity A New Zealand Success story
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History
Informatics deals with handling information
Recorded ObservationsHippocrates(460-370 BC)Index Medicus –
John Shaw Billings 1879
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The broad street pump
John SnowAugust 1854,
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Computers arrive...
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Moore’s law
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People and computers
1 million years BC
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History
Internet started in 1960s – to protect networks in the case of nuclear warfare.
World Wide Web – suggested in paper published in 1988.
Browsers early 1990’s 19.2 Billion webpages in 2005 Most users now access WWW via mobile
devices.
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What does Health Informatics do ? Successful areas of Health informatics
include: Reminder systems Electronic health records Data repositories Coding, Ontologies and vocabularies Data sharing M/Uhealth
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Essentially....
Sharing
Collecting
Storing
Analysing
Presenting
Information
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Medicine needs records
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Problems with paper
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Problems with paper
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Electronic Health Records
Present in effectively all GP surgeries, and most DHB’s
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“Five uses of clinical data” (MOH)Data collected should be available for:
Supporting clinical intervention
Clinical Governance
Administration (in all parts of Health)
Strategy and policy development
Research
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The sixth use ?
Patient (consumer) self-management and self care.
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Decision support
Use data from Electronic record, combine with rules
Reminders – eg high blood pressure, protocols
Decision Analysis – need utility values
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Recall and health management Cervical Screening, Contraceptive Pill Blood pressure, diabetes Paediatric checks Moving into..
Community care Telehealth
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The Central Paradox of CaseMIX Every patient is different… BUT we want to compare them.. So we
code them
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Why use a vocabulary ? example… Pre-eclampsia Gestational Proteinuric Hypertension Toxaemia GPH PET PE All the same all map to.. pre-eclampsia
398254007 -code
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SNOMED CT
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Why is coding difficult ?
Experts don’t agree – even when a loose standard of agreement is required (Chiang 2006)
SNOMED CT is very large and changes by 5-10% each release
Data is used in ways that might be unfamiliar to the originator
Reliability of SNOMED-CT Coding by Three Physicians using Two Terminology BrowsersMichael F. Chiang, John C. Hwang, Alexander C. Yu, Daniel S. Casper, James J. Cimino, and Justin StarrenAMIA Annu Symp Proc. 2006; 2006: 131–135.
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Presenting Information -Access (distance) to health care
Population (by territorial authority) more than 30 minutes from a GP; using LCPA (least cost path algorithm)
http://www.nzma.org.nz/journal/117-1199/996/
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Sharing : Messaging :HL 7
Health level 7 Initial version going back to 1987 Extensive use around the world, and
since 1994 in New Zealand
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Why messages ?
No communication electronically at all – life is difficult
Shared universal record – so far impossible c.f. connecting for health UK
Messaging – send standard, relevant pieces of information between electronic systems.
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Pharmacy
Labs
GP
Hospital
Messages and the n(n-1) Problem
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Recall and health management Cervical Screening, Contraceptive Pill Blood pressure, diabetes Paediatric checks Moving into..
Community care Telehealth
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Mobile and ubiquitous health
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Pill dispensing
•Counts pills dispensed•Wireless device
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Why should I care ?
Informatics needs clinical input and clinical problems to work on.
Good solutions come from clinical involvement
If clinicians don’t get involved...
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What not to do...
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Keep Hardware Secure
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Keep data secure
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Useful information sources
HINZ – www.hinz.org.nz IMIA - http://www.imia.org/ Health IT cluster :
http://www.healthit.org.nz/ National Health IT board:
http://www.ithealthboard.health.nz/ HISA (Australia)- http://www.hisa.org.au/ RACGP ehealth site:
http://www.racgp.org.au/ehealth