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Health Informatics: a rant to begin the new year

I was woken by the sound of a text message arriving on my mobile phone. Ahh, I thought, a message from my old university chum who lives in Mauritius. Or, maybe my Mother has learned to text and is about to impress me with a New Year's greeting.

No such luck. A message from my accountant telling me that my VAT (UK sales tax) return is due. Brought down to earth with a bleep and a buzz. As Bono sings: "Nothing changes on New Year's day".

Suitably grumpy, I thought I would write about this field of Health Informatics that has been on my mind.

I took a partial sabbatical from health to work in other areas of the UK public sector, thinking to expand my experience and skills. During my time away from full-time engagement in healthcare IT, Health Informatics in the UK seems to have grown from an egg into an assertive fledgling.

I looked up a definition of it on Wikipedia:

“Health Informatics or sometimes Medical Informatics is the intersection of information science, medicine 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 biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems.”

Now, having worked for about 15 years in healthcare IT and led three major Electronic Patient Record Implementations I became used to walking the tightrope between the views of clinicians and NHS IT professionals. In general, over the years these two poles have learned to co-exist.

Into that polarization—for me rather uneasily—come the Health Informaticians. Are they clinicians, healthcare IT professionals or a new breed of academic? Why are there no fields called Finance Informatics or Supermarket Informatics..?

Wikipedia's entry did little to help me, giving the following as aspects of the field:

  • Architectures for electronic medical records and other health information systems used for billing, scheduling or research

  • decision support systems in healthcare

  • messaging standards for the exchange of information between health care information systems (e.g., through the use of the HL7 data exchange standard) - these specifically define the means to exchange data, not the content controlled medical vocabularies such as the Standardized Nomenclature of Medicine, Clinical Terms (SNOMED-CT), Logical Observation Identifiers Names and Codes (LOINC) or OpenGALEN Common Reference Model - 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

If this is a correct description (and it may not be, given the democratic nature of Wikipedia) it seems to sit firmly on the IT professional end of my conceptual tightrope.

Having read the Wikipedia description and having looked at a HI text book it seems to me that this field misses best half of our affair: the integration of IT into, and the transformation of, medical practice. To succeed it is essential that IT becomes fully integrated into care. Is Health Informatics the best way to bring that about?

Only joking about the grumpiness. In fact, it is a lovely day here in London and I enjoyed my run!

I wish you all a happy and successful 2006.

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