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'''Health informatics''' (also called '''health care informatics''', '''healthcare informatics''', '''medical informatics''', '''nursing informatics''', '''clinical informatics''', or '''biomedical informatics''') is a discipline at the intersection of [[information science]], computer science, and health care. It deals with the resources, devices, and methods required to optimize the "collection, storage, retrieval, [and] communication ... of health-related data, [[information]], and knowledge."<ref name="Hovenga1">{{cite book |url= | [[File:Doctor review brain images.jpg|thumb|360px|right|Health informatics helps manage, analyze, and integrate patient data from physician to specialist and beyond.]] | ||
'''Health informatics''' (also called '''health care informatics''', '''healthcare informatics''', '''medical informatics''', '''nursing informatics''', '''clinical informatics''', or '''biomedical informatics''') is a discipline at the intersection of [[information science]], computer science, and health care. It deals with the resources, devices, and methods required to optimize the "collection, storage, retrieval, [and] communication ... of health-related data, [[information]], and knowledge."<ref name="Hovenga1">{{cite book |url=https://books.google.com/books?id=eckD3fSrPagC |title=Health Informatics: An Overview |chapter=Chapter 2: Health Informatics - An Introduction |editor=Hovenga, E.J.S. |publisher=IOS Press |year=2010 |page=9–15 |isbn=1607500922}}</ref> Health informatics is applied to the areas of nursing, clinical care, dentistry, pharmacy, public health, occupational therapy, and biomedical research. Health informatics resources include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. | |||
Early names for health informatics included medical information data processing, medical information science, medical informatics<ref name="EncyCompSci">{{cite book |url= | Early names for health informatics included medical information data processing, medical information science, medical informatics<ref name="EncyCompSci">{{cite book |url=https://books.google.com/books?id=L7NOABDqaMcC |title=Encyclopedia of Computer Science and Technology |chapter=Medical Informatics |author=Blum, B.I. |editor=Kent, A.; Williams, J.G. |volume=22 |issue=7 |publisher=CRC Press |year=1990 |page=205–224 |isbn=0824722728}}</ref><ref name="Hovenga1" />, medical computer science, and medical computing.<ref name="3rdKnoMan">{{cite book |url=https://books.google.com/books?id=hD4I12296jYC |title=Proceedings of the 3rd International Conference on Intellectual Capital and Knowledge Management |chapter=Knowledge Informatics: A New Academic Discipline Underpinning Knowledge-based Organisations and Contributing to the Transformation from the Information Age to the Knowledge Age |author=Dayyani, B. |editor=Griffiths, P. |publisher=Academic Conferences Limited |year=2006 |page=127–138 |isbn=1905305362}}</ref> | ||
==History== | ==History== | ||
Worldwide use of technology in medicine began in the early 1950s with the rise of computers.<ref name="univ">{{ | Worldwide use of technology in medicine began in the early 1950s with the rise of computers.<ref name="univ">{{cite web |url=http://healthinformatics.uic.edu/history-of-health-informatics |archiveurl=http://web.archive.org/web/20121126102550/http://healthinformatics.uic.edu/history-of-health-informatics/ |title=The History of Health Informatics |work=Health Informatics Guide - The History of Health Informatics |publisher=University of Illinois at Chicago |archivedate=26 November 2012 |accessdate=05 January 2015}}</ref> In 1949, Gustav Wager established the first professional organization for informatics in Germany.<ref name="nyu">{{cite web |url=http://www.nyuinformatics.org/education/degree-programs |archiveurl=https://web.archive.org/web/20100323111213/http://www.nyuinformatics.org/education/degree-programs |title=NYU Graduate Training Program in Biomedical Informatics (BMI): A Brief History of Biomedical Informatics as a Discipline |work=www.nyuinformatics.org |publisher=NYU Langone Medical Center |archivedate=23 March 2010 |accessdate=20 March 2020}}</ref> The prehistory, history, and future of medical information and [[health information technology]] are discussed in reference.<ref name="Robson_first">{{cite book |last=Robson |first=B. |last2=Baek |first2=O. K. |year=2009 |title=The engines of Hippocrates: From the Dawn of Medicine to Medical and Pharmaceutical Informatics |location=Hoboken, NJ |publisher=John Wiley & Sons |isbn=9780470289532 }}</ref> Specialized university departments and informatics training programs began during the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units then began to appear during the 1970s in Poland and in the U.S.<ref name="nyu" />, with medical informatics conferences springing up as early as 1974.<ref name="Hovenga1" /> Since then, the development of high-quality health informatics research, education, and infrastructure has been the goal of the U.S. and the European Union.<ref name="nyu" /><ref name="Hovenga1" /> | ||
By the mid-2000s, work in the U.K. by the voluntary registration body the | By the mid-2000s, work in the U.K. by the voluntary registration body the U.K. Council of Health Informatics Professions led to the creation of eight key constituencies within the domain of health informatics: information and communication technologies; health records; information management; knowledge management; health informatics service and project management; clinical informatics; education, training, and development; and research.<ref name="8HIConst">{{cite web |url=http://www.ukchip.man.ac.uk/Library/Policies&Standards/registrationstandardsoct06 |archiveurl=https://web.archive.org/web/20070228020800/http://www.ukchip.man.ac.uk/Library/Policies&Standards/registrationstandardsoct06 |format=PDF |title=UK Council for Health Informatics Professions (UKCHIP): Mapped Registration Requirements |publisher=UKCHIP |date=26 September 2006 |archivedate=28 February 2007 |accessdate=20 March 2020}}</ref> Those constituencies—already based on U.K. National Health Service standards (NHS)—later found their way into the NHS' Health Informatics Career Framework in a slightly modified format.<ref name="HICF">{{cite web |url=https://www.hicf.org.uk/AboutHICF.aspx |archiveurl=https://web.archive.org/web/20160328115710/https://www.hicf.org.uk/AboutHICF.aspx |title=About the Health Informatics Career Framework (HICF) |publisher=National Health Service |archivedate=28 March 2016 |accessdate=20 March 2020}}</ref> {{As of|2020}} tens of datasets, publications, guidelines, specifications, meetings, conferences, and organizations around the world continue to shape what health informatics is today.<ref name="HSRIC">{{cite web |url=https://hsric.nlm.nih.gov/hsric_public/topic/informatics/ |archiveurl=https://web.archive.org/web/20200122062539/https://hsric.nlm.nih.gov/hsric_public/topic/informatics/ |title=HSRIC: Health Informatics |publisher=U.S. National Library of Medicine |archivedate=22 January 2020 |accessdate=06 January 2022}}</ref> | ||
===Health informatics in North America=== | ===Health informatics in North America=== | ||
====Argentina==== | ====Argentina==== | ||
Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Argentina's Asociación Argentina de Informática Médica (AAIM).<ref name="IMIA_LAC">{{cite web |url= | Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Argentina's Asociación Argentina de Informática Médica (AAIM).<ref name="IMIA_LAC">{{cite web |url=https://imia-medinfo.org/wp/imia-lac-regional-federation-of-health-informatics-for-latin-america-and-the-caribbean/ |title=IMIA LAC: Regional Federation of Health Informatics for Latin America and the Caribbean |publisher=International Medical Informatics Association |accessdate=20 March 2020}}</ref> | ||
From 1997 until about 2014, the not-for-profit Buenos Aires Biomedical Informatics Group also represented the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere. The group strove to promote informatics technology and related content within the research and health administration spheres, especially those relating to the biomedical field.<ref name="GIBBA">{{cite web |url=http://www.gibba.org.ar/GIBBAWEB2009/index.php |archiveurl=https://web.archive.org/web/20140201044226/http://www.gibba.org.ar/GIBBAWEB2009/ |title=Grupo de Informática Biomédica de Buenos Aires - GIBBA |publisher=GIBBA |archivedate=01 February 2014 |accessdate=20 March 2020}}</ref> | |||
====Brazil==== | ====Brazil==== | ||
"In 1968 the Pan American Health Organization set up the Regional Library of Medicine and Health Sciences (BIREME) in the Paulista Medical School in São Paulo under an agreement with the Government of Brazil."<ref name="LatAmerNet">{{cite journal | "In 1968 the Pan American Health Organization set up the Regional Library of Medicine and Health Sciences (BIREME) in the Paulista Medical School in São Paulo under an agreement with the Government of Brazil."<ref name="LatAmerNet">{{cite journal |title=The Latin American network of biomedical and health information: Experience and future development |journal=Educación Médica y Salud |author=Sonis, A. |volume=15 |issue=4 |year=1981 |pages=474–493 |pmid=7030712}}</ref> The library also made possible access to the MEDLINE and MEDLARS systems<ref name="EnLiInfo43_8">{{cite book |url=https://books.google.com/books?id=sFqds9V6heMC |title=Encyclopedia of Library and Information Science |chapter=Brazil, The Organization Of Scientific and Technological Information In |author=Garcia, M.L.A. |editor=Kent, A. |publisher=CRC Press |volume=43 |issue=8 |pages=38–47 |year=1987 |isnb=0824720431}}</ref>, and it would eventually go on to become the "hub of the Latin American network of biomedical and health information."<ref name="LatAmerNet" /> | ||
In 1986 the Brazilian Society of Health Informatics (Sociedade Brasileira de Informática em Saúde) was founded to better expand the use of informatics technology within the country. The same year saw the first Brazilian Congress of Health Informatics held, and the first ''Brazilian Journal of Health Informatics'' was published.<ref name="SBISHist">{{cite web |url=http://www.sbis.org.br/ | In 1986, the Brazilian Society of Health Informatics (Sociedade Brasileira de Informática em Saúde) was founded to better expand the use of informatics technology within the country. The same year saw the first Brazilian Congress of Health Informatics held, and the first ''Brazilian Journal of Health Informatics'' was published.<ref name="SBISHist">{{cite web |url=http://www.sbis.org.br/historia-da-sbis-por-lincoln-moura?showall=1 |archiveurl=https://web.archive.org/web/20200320213023/http://www.sbis.org.br/historia-da-sbis-por-lincoln-moura?showall=1 |title=História da SBIS por Lincoln Moura (2002) |publisher=Sociedade Brasileira de Informática em Saúde |archivedate=20 March 2020 |accessdate=06 January 2022}}</ref> | ||
Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Brazil's Sociedade Brasileira de Informática em Saúde (SBIS).<ref name="IMIA_LAC" /> | Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Brazil's Sociedade Brasileira de Informática em Saúde (SBIS).<ref name="IMIA_LAC" /> | ||
====Canada==== | ====Canada==== | ||
Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems. A national, federally-funded, not-for-profit organization called Canada Health Infoway was created in 2001 to foster the development and adoption of electronic health records across Canada. | Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems. A national, federally-funded, not-for-profit organization called Canada Health Infoway was created in 2001 to foster the development and adoption of electronic health records across Canada. In 2013, there were 380 health informatics projects under way in Canadian [[Hospital|hospitals]], health-care facilities, pharmacies, and laboratories, with an investment value of $2.1 billion since its inception.<ref name="CHIReport12-13">{{cite web |url=https://www.infoway-inforoute.ca/en/component/edocman/1686-annual-report-2012-2013/view-document?Itemid=101 |format=PDF |title=Canada Health Infoway Annual Report 2012–13 |publisher=Canada Health Infoway |page=9 |date=26 July 2013 |accessdate=20 March 2020}}</ref> Canada Health Infoway expected to see those projects finally come to completion by the 2019–2020 fiscal year.<ref name="CHIReport18-19">{{cite web |url=https://www.infoway-inforoute.ca/en/component/edocman/3726-annual-report-2018-2019/view-document?Itemid=101 |format=PDF |title=Canada Health Infoway Annual Report 2018–19 |publisher=Canada Health Infoway |page=21 |date=31 March 2019 |accessdate=20 March 2020}}</ref> | ||
Provincial and territorial programs | Provincial and territorial programs have included the following: | ||
*'''eHealth Ontario''' was created as an Ontario provincial government agency in September 2008. It has been plagued by delays, and its CEO was fired over a multi-million dollar contract scandal in 2009.<ref>{{cite news |url= | *'''eHealth Ontario''' was created as an Ontario provincial government agency in September 2008. It has been plagued by delays, and its CEO was fired over a multi-million dollar contract scandal in 2009.<ref>{{cite news |url=https://www.cbc.ca/news/canada/head-of-ehealth-ontario-is-fired-amid-contracts-scandal-gets-big-package-1.797216 |title=Head of eHealth Ontario is fired amid contracts scandal, gets big package |work=CBC News |date=07 June 2009 |accessdate=20 March 2020}}</ref> | ||
*'''Alberta Netcare''' Portal was created in 2006 by the Government of Alberta. The Netcare portal is used daily by thousands of clinicians. It provides access to demographic data, prescribed/dispensed drugs, known allergies/intolerances, immunizations, laboratory test results, diagnostic imaging reports, the diabetes registry and other medical reports. Netcare interface capabilities are being included in electronic medical record products which are being funded by the provincial government.<ref name="NetcareHist">{{cite web |url= | *'''Alberta Netcare''' Portal was created in 2006 by the Government of Alberta. The Netcare portal is used daily by thousands of clinicians. It provides access to demographic data, prescribed/dispensed drugs, known allergies/intolerances, immunizations, laboratory test results, diagnostic imaging reports, the diabetes registry and other medical reports. Netcare interface capabilities are being included in electronic medical record products which are being funded by the provincial government.<ref name="NetcareHist">{{cite web |url=https://www.albertanetcare.ca/History.htm |title=Alberta Netcare: The History of the EHR |publisher=Government of Alberta |accessdate=30 October 2013}}</ref> | ||
====United States==== | ====United States==== | ||
Even though the idea of using computers in medicine sprouted as technology advanced in the early twentieth century, it was not until the 1950s that informatics made a realistic impact in the United States.<ref name="univ" /> Robert Ledley led the charge in the 1950s with his early use of medical computation in his dental projects at the United States National Bureau of Standards.<ref name="Ledley">{{cite journal | Even though the idea of using computers in medicine sprouted as technology advanced in the early twentieth century, it was not until the 1950s that informatics made a realistic impact in the United States.<ref name="univ" /> Robert Ledley led the charge in the 1950s with his early use of medical computation in his dental projects at the United States National Bureau of Standards.<ref name="Ledley">{{cite journal |title=The Story Behind the Development of the First Whole-body Computerized Tomography Scanner as Told by Robert S. Ledley |journal=Journal of the American Medical Informatics Association |author=Sittig, D.F.; Ash, J.S.; Ledley, R.S. |volume=13 |issue=5 |pages=465–9 |year=2006 |pmid=16799115 |pmc=1561796 |doi=10.1197/jamia.M2127}}</ref> | ||
By the mid-1950s expert systems such as MYCIN and | By the mid-1950s expert systems such as [[MYCIN]] and [[INTERNIST-I]] were developed, and the National Library of Medicine started using even the even more advanced MEDLINE and MEDLARS systems by 1965. Around this same time a flurry of activity occurred. At the University of Utah, Dr. Homer R. Warner, one of the fathers of medical informatics<ref name="MedInfoEd">{{cite journal |title=Medical Informatics Education: The University of Utah Experience |journal=Journal of the American Medical Informatics Association |author=Patton, G.A., Gardner, R.M. |volume=6 |issue=6 |pages=457–65 |year=1999 |pmid=10579604 |pmc=61389}}</ref>, was already offering graduate-level classes in medical computer applications. Meanwhile Neil Pappalardo, Curtis Marble, and Robert Greenes were developing the Massachusetts General Hospital Utility Multi-Programming System (MUMPS) in Octo Barnett's Laboratory of Computer Science at Massachusetts General Hospital in Boston.<ref name="APLISReview">{{cite journal |title=Anatomic Pathology Laboratory Information Systems: A Review |journal=Advances in Anatomic Pathology |author=Park, S.L; Pantanowitz, L.; Sharma, G.; Parwani, A.V. |volume=19 |issue=2 |page=81–96 |year=2012 |doi=10.1097/PAP.0b013e318248b787 |pmid=22313836}}</ref><ref name="MileCompSci">{{cite book |url=https://books.google.com/books?id=JTYPKxug49IC |title=Milestones in Computer Science and Information Technology |author=Reilly, E.D. |publisher=Greenwood Publishing Group |year=2003 |page=161 |isbn=9781573565219 |accessdate=20 March 2020}}</ref> Yet due to its advanced nature, fragmented use across multiple entities, and inherent difficulty in extracting and analyzing data from the database, development of healthcare and laboratory systems on MUMPS was sporadic at best.<ref name="HistMedInfo">{{cite book |url=https://books.google.com/books/about/A_History_of_medical_informatics.html?id=AR5rAAAAMAAJ |title=A History of Medical Informatics |author=Blum, B.I.; Duncan, K.A. |publisher=ACM Press |year=1990 |pages=141–53 |isbn=0201501287 |accessdate=20 March 2020}}</ref> | ||
By the 1980s, however, the advent of Structured Query Language (SQL), relational database management systems (RDBMS), and [[Health Level 7]] (HL7) allowed software developers to expand the functionality and interoperability of health informatics systems, including the application of business analytics and business intelligence techniques to clinical data.<ref name="PractPathInfo">{{cite book |url= | By the 1980s, however, the advent of Structured Query Language (SQL), relational database management systems (RDBMS), and [[Health Level 7]] (HL7) allowed software developers to expand the functionality and interoperability of health informatics systems, including the application of business analytics and business intelligence techniques to clinical data.<ref name="PractPathInfo">{{cite book |url=https://books.google.com/books?id=WerUyK618fcC |title=Practical Pathology Informatics: Demstifying Informatics for the Practicing Anatomic Pathologist |author=Sinard, J.H. |publisher=Springer |year=2006 |pages=393 |isbn=0387280588 |accessdate=20 March 2020}}</ref> By the early 2010s, web-based and database-centric internet applications of [[laboratory informatics]] software had further changed the way researchers and technicians interact with data, with web-driven data formatting technologies like [[Extensible Markup Language]] (XML) making interoperability of health and laboratory informatics software a much-needed reality.<ref name="OverBarEMR">{{cite journal |title=Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study |journal=Health Informatics Journal |author=Kumar, S.; Aldrich, K. |volume=16 |issue=4 |year=2010 |doi=10.1177/1460458210380523}}</ref> [[Software as a service|SaaS]] and cloud computing technologies have further changed how informatics systems are implemented in the U.S and worldwide, while at the same time raising new questions about security and stability.<ref name="APLISReview" /> | ||
===Health informatics in Europe=== | ===Health informatics in Europe=== | ||
The European Union's Member States are committed to sharing their best practices and experiences to create a European eHealth Area, thereby improving access to and quality health care at the same time as stimulating growth in a promising new industrial sector. The associated European eHealth programs | The European Union's Member States are committed to sharing their best practices and experiences to create a European eHealth Area, thereby improving access to and quality health care at the same time as stimulating growth in a promising new industrial sector. The associated European eHealth programs play a fundamental role in the European Union's strategy. Work on this initiative involves a collaborative approach among several parts of the Commission services.<ref name="ResearchIneHealth">{{cite web |url=https://ec.europa.eu/digital-single-market/en/research-and-innovation-ehealth |archiveurl=https://web.archive.org/web/20201103052623/https://ec.europa.eu/digital-single-market/en/research-and-innovation-ehealth |title=Shaping Europe's Digital Future: Research and Innovation in eHealth |publisher=European Commission |archivedate=03 November 2020 |accessdate=06 January 2022}}</ref> Additionally, the not-for-profit European Institute for Health Records or EuroRec has promoted the use of high quality [[electronic health record]] systems in the European Union since its foundation in late 2002.<ref name="EHREuro">{{cite web |url=https://www.esa.int/SPECIALS/Telemedicine_Alliance/SEMWC7SMD6E_0.html |title=Electronic Health Records for Europe |publisher=European Space Agency |date=30 March 2005 |accessdate=06 January 2022}}</ref><ref name="EuroRecPPT">{{cite web |url=https://slideplayer.com/slide/10421896/ |title=The EuroRec Institute: Structure, Activities and New Services |author=Mennerat, F. |work=SlidePlayer |publisher=EuroRec |date=10 October 2006 |accessdate=20 March 2020}}</ref> | ||
epSOS (European Patients - Smart Open Services) | epSOS (European Patients - Smart Open Services) represented another key European initiative to "build and evaluate a service infrastructure that demonstrates cross-border interoperability between electronic health record systems in Europe."<ref name="epSOSAbout">{{cite web |url=http://www.epsos.eu/home/about-epsos.html |archiveurl=https://web.archive.org/web/20180116073447/http://www.epsos.eu/home/about-epsos.html |title=About epSOS |publisher=European Commission |archivedate=16 January 2018 |accessdate=20 March 2020}}</ref> Co-funded by the European Commission Competitiveness and Innovation Programme since 2008, the initiative—which finish on June 31, 2014—was devised with the vision of giving patients in Europe the opportunity to use cross-border [[electronic medical record]] services for healthcare-related activities in participating epSOS pilot countries.<ref name="epSOSAbout" /> A follow-up letter at the end of the project highlighted how it had encompassed "25 countries and about 50 beneficiaries," achieving the "development of a solid basis for the eprescription and patient summary services, considering: governance, use cases, data content, semantics, specifications, architecture, testing mechanisms, etc."<ref name="EUCross14">{{cite web |url=https://ec.europa.eu/digital-single-market/en/news/cross-border-health-project-epsos-what-has-it-achieved |archiveurl=https://web.archive.org/web/20190327112520/https://ec.europa.eu/digital-single-market/en/news/cross-border-health-project-epsos-what-has-it-achieved |title=Cross-border health project epSOS: What has it achieved? |publisher=European Commission |archivedate=27 March 2019 |accessdate=20 March 2020}}</ref> | ||
====In the United Kingdom==== | ====In the United Kingdom==== | ||
The U.K. health informatics community has long played a key role in international activity, joining Technical Committee Four (TC 4) of the International Federation of Information Processing in 1968<ref name="IFIP50Chart">{{cite web |url=http://www.ifip.org/50th_anni/Chart0.htm |title=Chart 0: IFIP at a Glance |author=Zemanek, H.; Brunnstein, K. |work=A Quarter Century of IFIP |publisher=IFIP |date=31 March 2011 |accessdate=31 October 2013}}</ref>, which eventually became the International Medical Informatics Association (IMIA) in 1979.<ref name="IFIPNL2002">{{cite journal |url=http://www.ifip.org/newsletters/News2002/News_Sep_2002. | The U.K. health informatics community has long played a key role in international activity, joining Technical Committee Four (TC 4) of the International Federation of Information Processing in 1968<ref name="IFIP50Chart">{{cite web |url=http://www.ifip.org/50th_anni/Chart0.htm |title=Chart 0: IFIP at a Glance |author=Zemanek, H.; Brunnstein, K. |work=A Quarter Century of IFIP |publisher=IFIP |date=31 March 2011 |accessdate=31 October 2013}}</ref>, which eventually became the International Medical Informatics Association (IMIA) in 1979.<ref name="IFIPNL2002">{{cite journal |url=http://www.ifip.org/newsletters/News2002/News_Sep_2002.pdf |journal=IFIP Newsletter |title=The IFIP Presidents |author=Nedkov, P. |editor=Rosenfeld, J.L. |volume=19 |issue=1–3 |year=2002 |page=7}}</ref><ref name="MIEuro">{{cite book |url=https://books.google.com/books?id=pGHWtG5_xIgC |title=Medical Informatics in a United and Healthy Europe |chapter=After Three Decades of Medical Informatics Europe Congresses |author=Dezelic, G. |editor=Adlassnig, K.-P. (ed.) |publisher=IOS Press |year=2009 |pages=3–7 |isbn=1607500442}}</ref> In 1978, the Medical Specialist Group of the British Computer Society organized the first European Federation for Medical Informatics (EFMI) Medical Informatics Europe (MIE) conference in Cambridge.<ref name="MIEuro" /> | ||
In 2002, the idea of a profession of health informatics across the U.K. was first implemented as the U.K. Council for Health Informatics Professions (UKCHIP), which has a formal Code of Professional Conduct, standards for expressing competences which are used for entry, confirmation of fitness to practice, re-grading and personal development. Consistent standards express competences of health informatics professionals in both domain-specific and generic informatics professional areas. The consistency is intended to apply in operational care delivery organizations, academia, and the commercial service and solution providers.<ref name="8HIConst" /> | In 2002, the idea of a profession of health informatics across the U.K. was first implemented as the U.K. Council for Health Informatics Professions (UKCHIP), which has a formal Code of Professional Conduct, standards for expressing competences which are used for entry, confirmation of fitness to practice, re-grading and personal development. Consistent standards express competences of health informatics professionals in both domain-specific and generic informatics professional areas. The consistency is intended to apply in operational care delivery organizations, academia, and the commercial service and solution providers.<ref name="8HIConst" /> | ||
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=====England===== | =====England===== | ||
In 2002 the National Health Service (NHS) in England contracted several vendors for a national health informatics system called the National Programme for IT or "NPfIT." By 2010, however, the project drastically behind schedule, forcing a wide consultation to be launched as part of a wider "Liberating the NHS" plan. "Following three reports on the National Programme by both the National Audit Office and this Committee, and a review by the Major Projects Authority, the Government announced in September 2011 that it would dismantle the National Programme but keep the component parts in place with separate management and accountability structures."<ref name="DismantleNPfIT">{{cite web |url= | In 2002, the National Health Service (NHS) in England contracted several vendors for a national health informatics system called the National Programme for IT or "NPfIT." By 2010, however, the project drastically behind schedule, forcing a wide consultation to be launched as part of a wider "Liberating the NHS" plan. "Following three reports on the National Programme by both the National Audit Office and this Committee, and a review by the Major Projects Authority, the Government announced in September 2011 that it would dismantle the National Programme but keep the component parts in place with separate management and accountability structures."<ref name="DismantleNPfIT">{{cite web |url=https://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/npfit-report/ |archiveurl=https://web.archive.org/web/20130921171844/https://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/npfit-report/ |title=MPs publish report on the dismantled National Programme for IT in the NHS |publisher=U.K. Parliament |date=18 September 2013 |archivedate=21 September 2013 |accessdate=06 January 2022}}</ref> The program was officially dismantled in September 2013, officially dubbed "one of the worst and most expensive contracting fiascos in the history of the public sector."<ref name="DismantleNPfIT" /> | ||
=====Scotland===== | =====Scotland===== | ||
In 1984, Scotland saw the implementation of the General Practice Administration System (GPASS), developed and controlled by NHS Scotland.<ref name="BMAGPASS">{{cite web |url=http://web.bma.org.uk/pressrel.nsf/wlu/GGRT-5AZK3T |title=Scotland’s doctors welcome review of GPASS |publisher=BMA Scotland |date=11 June 2002 | | In 1984, Scotland saw the implementation of the General Practice Administration System (GPASS), developed and controlled by NHS Scotland.<ref name="BMAGPASS">{{cite web |url=http://web.bma.org.uk/pressrel.nsf/wlu/GGRT-5AZK3T |archiveurl=https://web.archive.org/web/20131101185822/http://web.bma.org.uk/pressrel.nsf/wlu/GGRT-5AZK3T |title=Scotland’s doctors welcome review of GPASS |publisher=BMA Scotland |date=11 June 2002 |archivedate=01 November 2013 |accessdate=20 March 2020}}</ref> It was provided free to all general practitioners in Scotland. However, an agreement was reached in 2008 to shut down the electronic system due to "a series of problems and critical reports."<ref name="GPASSNoMo">{{cite web |url=http://www.ehi.co.uk/news/ehi/8005/scotland's-gpass-is-no-more |archiveurl=https://web.archive.org/web/20130319115435/http://www.ehi.co.uk/news/ehi/8005/scotland's-gpass-is-no-more |title=Scotland's GPASS is no more |author=Todd, R. |work=EHealth Insider |publisher=EHealth Media Limited |date=20 August 2012 |archivedate=19 March 2013 |accessdate=20 March 2020}}</ref> The system was formally shut down in August 2012, with all practices having moved to new systems called EMIS and INPS. | ||
===Health informatics in Asia and Oceania=== | ===Health informatics in Asia and Oceania=== | ||
In Asia, Australia, and New Zealand, the regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1993 and now consists of more than 15 member regions in the Asia Pacific Region.<ref name="APAMIAbout">{{Cite web |url= | In Asia, Australia, and New Zealand, the regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1993 and now consists of more than 15 member regions in the Asia Pacific Region.<ref name="APAMIAbout">{{Cite web |url=https://www.apami.org/about-apami/ |title=About APAMI |publisher=Asia Pacific Association of Medical Informatics |accessdate=20 March 2020}}</ref> | ||
====Australia==== | ====Australia==== | ||
Founded in 2002, the Australasian College of Health Informatics (ACHI) | Founded in 2002, the Australasian College of Health Informatics (ACHI) was a professional association for health informatics in the Asia-Pacific region. It represented the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere through a commitment to quality, standards, and ethical practice.<ref name="ACHI">{{cite web |url=https://www.achi.org.au/ |archiveurl=https://web.archive.org/web/20200320223619/https://www.achi.org.au/ |title=Australasian College of Health Informatics |publisher=ACHI |archivedate=20 March 2020 |accessdate=20 March 2020}}</ref> ACHI was also a sponsor of the ''e-Journal for Health Informatics''<ref name="eJSpons">{{cite web |url=http://www.ejhi.net/ojs/index.php/ejhi/about/journalSponsorship |archiveurl=https://web.archive.org/web/20180411031005/http://www.ejhi.net/ojs/index.php/ejhi/about/journalSponsorship |title=eJHI - Journal Sponsorship |publisher=eJHI |archivedate=11 April 2018 |accessdate=20 March 2020}}</ref>, an indexed and peer-reviewed professional journal. ACHI had also supported the Australian Health Informatics Education Council (AHIEC) since its founding in 2009.<ref name="AHIEC">{{cite web |url=http://www.ahiec.org.au/ |archiveurl=https://web.archive.org/web/20131113083536/http://www.ahiec.org.au/ |title=Australian Health Informatics Education Council |publisher=AHIEC |archivedate=13 November 2013 |accessdate=20 March 2020}}</ref> | ||
Although | Although many health informatics organizations have been active in Australia, the Health Informatics Society of Australia (HISA) was generally regarded as the major umbrella group and a member of the International Medical Informatics Association (IMIA). Nursing informaticians were the driving force behind the formation of HISA, with the membership coming from many parts of the informatics spectrum, from students to corporate affiliates. HISA had a number of branches (Queensland, New South Wales, Victoria and Western Australia) as well as special interest groups such as nursing (NIA), pathology, aged and community care, industry, and medical imaging.<ref name="HISAAbout">{{cite web |url=http://www.hisa.org.au/?about |archiveurl=https://web.archive.org/web/20131128161833/http://www.hisa.org.au/?about |title=About HISA |publisher=Health Informatics Society of Australia |archivedate=28 November 2013 |accessdate=20 March 2020}}</ref> | ||
In February 2020, ACHI and HISA announced that they had formally agreed to merge to form the Australsian Institute of Digital Health (AIDH). "Australasia’s leading organisations for health informatics and digital health ACHI and HISA were formed 25+ years ago in a different world. Imagine the challenges, the foresight and forward thinking required then to see the potential future of healthcare."<ref name="ACHI" /> The new AIDH cited two primary factors for the merger: "meeting demand for education, training, professional pathways, certification and leadership development across digital health" and meeting the need for "a single unified voice from digital health leaders and experts at a time when consumers were looking for informed opinion, advice and guidance."<ref name="AIDHHowThe20">{{cite web |url=https://digitalhealth.org.au/about/the-story/ |title=How the institute was formed |publisher=Australasian Institute of Digital Health |date=February 2020 |accessdate=20 March 2020}}</ref> | |||
====China==== | ====China==== | ||
In Hong Kong a computerized patient record system called the Clinical Management System (CMS) has been developed by the Hospital Authority since 1994. This system has been deployed at all the sites of the Authority (40 hospitals and 120 clinics) and is used by | In Hong Kong a computerized patient record system called the Clinical Management System (CMS) has been developed by the Hospital Authority since 1994. This system has been deployed at all the sites of the Authority (more than 40 hospitals and 120 clinics) and is used by some 79,000 staff on a daily basis.<ref name="HKHAIntro">{{cite web |url=https://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=10008&Lang=ENG&Dimension=100&Parent_ID=10004 |title=Introduction |publisher=Hong Kong Hospital Authority |date=31 March 2019 |accessdate=20 March 2020}}</ref> The comprehensive records of seven million patients are available online in the Electronic Patient Record (ePR), with data integrated from all sites. Since 2004, radiology image viewing has been added to the ePR, with radiography images from any HA site being available as part of the ePR. | ||
The Hong Kong Hospital Authority placed particular attention to the governance of clinical systems development, with input from hundreds of clinicians being incorporated through a structured process. The health informatics section of the Hong Kong Hospital Authority has close relationship with the information technology department and clinicians to develop healthcare systems for the organization to support the service to all public hospitals and clinics in the region.<ref name="HKHosp">{{cite web |url=http://www3.ha.org.hk/hi/Welcome.html |title=Hong Kong Hospital Authority and Health Informatics Section |publisher=Hong Kong Hospital Authority |accessdate= | The Hong Kong Hospital Authority placed particular attention to the governance of clinical systems development, with input from hundreds of clinicians being incorporated through a structured process. The health informatics section of the Hong Kong Hospital Authority has held a close relationship with the information technology department and clinicians to develop healthcare systems for the organization to support the service to all public hospitals and clinics in the region.<ref name="HKHosp">{{cite web |url=http://www3.ha.org.hk/hi/Welcome.html |archiveurl=https://web.archive.org/web/20120829213043/http://www3.ha.org.hk/hi/Welcome.html |title=Hong Kong Hospital Authority and Health Informatics Section |publisher=Hong Kong Hospital Authority |date=November 2007 |archivedate=29 August 2012 |accessdate=20 March 2020}}</ref> | ||
The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in healthcare. The eHealth Consortium has been formed to bring together clinicians from both the private and public sectors, medical informatics professionals, and the IT industry to further promote IT in healthcare in Hong Kong.<ref name="IPROA">{{cite web |url=http://www.iproa.org/index.php/en-GB/other-projects/227-ehealth-consortium.html |title=eHealth Consortium |publisher=IPROA |accessdate= | The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in healthcare. The eHealth Consortium has been formed to bring together clinicians from both the private and public sectors, medical informatics professionals, and the IT industry to further promote IT in healthcare in Hong Kong.<ref name="IPROA">{{cite web |url=http://www.iproa.org/index.php/en-GB/other-projects/227-ehealth-consortium.html |archiveurl=https://web.archive.org/web/20200320230409/http://www.iproa.org/index.php/en-GB/other-projects/227-ehealth-consortium.html |title=eHealth Consortium |publisher=IPROA |archivedate=20 March 2020 |accessdate=06 January 2022}}</ref> | ||
====New Zealand==== | ====New Zealand==== | ||
Health Informatics | Health Informatics has been taught at several New Zealand universities since the early 2000s. The most mature and established is the Otago program, which has been offered since the mid-1990s.<ref name="HINZRepo">{{cite web |url=http://homepages.mcs.vuw.ac.nz/~peterk/healthinformatics/tec-hi-report-06.pdf |archiveurl=https://web.archive.org/web/20140704133906/http://homepages.mcs.vuw.ac.nz/~peterk/healthinformatics/tec-hi-report-06.pdf |format=PDF |title=Health Informatics Capability Development In New Zealand - A Report to the Tertiary Education Commission |author=Karolyn Kerr |coauthors=Cullen, R.; Duke, J.; Holt, A. et al. |publisher=National Steering Committee for Health Informatics Education in New Zealand |date=November 2006 |archivedate=04 July 2014 |accessdate=20 March 2020}}</ref> Also notable is Health Informatics New Zealand (HINZ), the national organization that advocates for health informatics. HINZ organizes a conference every year and also publishes the online journal ''Healthcare Informatics Review Online''.<ref name="HINZAbout">{{cite web |url=https://www.hinz.org.nz/page/AboutHINZ |title=About HINZ |publisher=Health Informatics New Zealand |accessdate=20 March 2020}}</ref> | ||
===Health informatics in the Middle East=== | ===Health informatics in the Middle East=== | ||
====Saudi Arabia==== | ====Saudi Arabia==== | ||
The Saudi Association for Health Information (SAHI) was established in 2006 to work under direct supervision of King Saud University for Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable studies.<ref name="SAHIObj">{{cite web |url=http://www.sahi.org.sa/ | The Saudi Association for Health Information (SAHI) was established in 2006 to work under direct supervision of King Saud University for Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable studies.<ref name="SAHIObj">{{cite web |url=http://www.sahi.org.sa/?page_id=2296 |title=Who we are |publisher=Saudi Association for Health Informatics |accessdate=20 March 2020}}</ref> | ||
==Regulation and standards== | ==Regulation and standards== | ||
The international standards on the subject are covered by ICS 35.240.80<ref name="itah">{{cite web |url= | The international standards on the subject are covered by ICS 35.240.80<ref name="itah">{{cite web |url=https://www.iso.org/ics/35.240.80/x/ |title=35.240.80: IT applications in health care technology |publisher=ISO |accessdate=20 March 2020}}</ref>, in which ISO 27799:2016 is one of the core components.<ref name="isosm">{{cite web |url=https://advisera.com/27001academy/blog/2016/06/13/how-iso-27001-and-iso-27799-complement-each-other-in-health-organizations/ |title=How ISO 27001 and ISO 27799 complement each other in health organizations |author=Segovia, A.J. |publisher=Advisera Expert Solutions Ltd |date=13 June 2016 |accessdate=20 March 2020}}</ref> | ||
===In the United States=== | ===In the United States=== | ||
In 2004 the U.S. Department of Health and Human Services (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT). The mission of this office is widespread adoption of interoperable electronic health records (EHRs) in the | In 2004 the [[United States Department of Health and Human Services|U.S. Department of Health and Human Services]] (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT). The mission of this office is widespread adoption of interoperable electronic health records (EHRs) in the U.S. within 10 years. | ||
The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the U.S. Department of Health and Human Services to develop a set of standards for [[electronic health record]]s (EHR) and supporting networks, and certify vendors who meet them. In July, 2006 CCHIT released its first list of 22 certified ambulatory EHR products, in two different announcements.<ref name="HOISE">{{cite web |url=http://www.hoise.com/vmw/06/articles/vmw/LV-VM-08-06-22.html |title=CCHIT Announces First Certified Electronic Health Record Products |author=Certification Commission for Healthcare Information Technology |publisher=Virtual Medical Worlds |date=18 July 2006 |accessdate= | The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the U.S. Department of Health and Human Services to develop a set of standards for [[electronic health record]]s (EHR) and supporting networks, and certify vendors who meet them. In July, 2006 CCHIT released its first list of 22 certified ambulatory EHR products, in two different announcements.<ref name="HOISE">{{cite web |url=http://www.hoise.com/vmw/06/articles/vmw/LV-VM-08-06-22.html |archiveurl=https://web.archive.org/web/20120526040832/http://www.hoise.com/vmw/06/articles/vmw/LV-VM-08-06-22.html |title=CCHIT Announces First Certified Electronic Health Record Products |author=Certification Commission for Healthcare Information Technology |publisher=Virtual Medical Worlds |date=18 July 2006 |archivedate=26 May 2012 |accessdate=06 January 2022}}</ref> | ||
==Clinical | ==Clinical informatics== | ||
While health informatics and clinical informatics are often considered the same, some make a distinction between the two. The American Medical Informatics Association, for example, states clinical informatics is concerned with the use of information in health care by clinicians.<ref name="AMIACore">{{cite journal | While health informatics and clinical informatics are often considered the same, some make a distinction between the two. The American Medical Informatics Association, for example, states clinical informatics is concerned with the use of information in health care by clinicians.<ref name="AMIACore">{{cite journal |journal=Journal of the American Medical Informatics Association |title=Core content for the subspecialty of clinical informatics |author=Gardner, R.M.; Overhage J.M.; Steen, E.B. et al. |volume=16 |issue=2 |pages=153–7 |year=2009 |pmid=19074296 |pmc=2649328 |doi=10.1197/jamia.M3045}}</ref> By extension, clinical informaticians analyze, design, implement, and evaluate information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship. | ||
Clinical informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to: | Clinical informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to: | ||
* assess information and knowledge needs of health care professionals and patients | * assess information and knowledge needs of health care professionals and patients | ||
* characterize, evaluate, and refine clinical processes | * characterize, evaluate, and refine clinical processes | ||
* develop, implement, and refine clinical decision support systems | * develop, implement, and refine clinical decision support systems | ||
* lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems | * lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems | ||
Clinicians collaborate with other health care and information technology professionals to develop health informatics tools which promote patient care that is safe, efficient, effective, timely, patient-centered, and equitable. | Clinicians collaborate with other health care and information technology professionals to develop health informatics tools which promote patient care that is safe, efficient, effective, timely, patient-centered, and equitable. | ||
==Further reading== | ==Further reading== | ||
* {{cite book |url=https://books.google.com/books?id=DHzOJaNaOYkC |title=Progress in Standardization in Health Care Informatics |editor=De Moor, Georges J. E. ; McDonald, Clement J.; van Goor, J. M. Noothoven |publisher=IOS Press |year=1993 |pages=215 |isbn=9051991142}} | |||
* {{cite book |url= | * {{cite book |url=https://books.google.com/books?id=eckD3fSrPagC |title=Health Informatics: An Overview |editor=Hovenga, Evelyn J. S. |publisher=IOS Press |year=2010 |pagea=507 |isbn=1607500922}} | ||
* {{cite book |url=https://books.google.com/books?id=6bqruAAACAAJ |title=Health Informatics: Practical Guide For Healthcare And Information Technology Professionals |editor=Hoyt, Robert E.; Bailey, Nora; Yoshihashi, Ann |publisher=Lulu Enterprises Incorporated |year=2012 |pages=492 |isbn=1105437558}} | |||
* {{cite book |url= | * {{cite book |url=https://books.google.com/books?id=UnxeDwAAQBAJ |title=Health Informatics: Practical Guide |edition=7th |author=Hoyt, R.E.; Hersh, W.R. |publisher=Informatics Education |year=2018 |pages=488 |isbn=9781387827503}} | ||
* {{cite book |url= | |||
* {{cite book |url= | |||
==See also== | ==See also== | ||
* [[Informatics (academic field)]] | * [[Informatics (academic field)]] | ||
* [[:Category:Health informatics]] | * [[:Category:Health informatics]] | ||
* [[Hospital information system]] | * [[Hospital information system]] | ||
* [[Laboratory information system]] | * [[Laboratory information system]] | ||
==Notes== | |||
Some elements of this article are reused from [https://en.wikipedia.org/wiki/Health_informatics the Wikipedia article]. | |||
==References== | ==References== | ||
{{Reflist|3}} | |||
<!---Place all category tags here--> | |||
[[Category:Informatics]] | [[Category:Informatics]] |
Latest revision as of 21:02, 6 January 2022
Health informatics (also called health care informatics, healthcare informatics, medical informatics, nursing informatics, clinical informatics, or biomedical informatics) is a discipline at the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the "collection, storage, retrieval, [and] communication ... of health-related data, information, and knowledge."[1] Health informatics is applied to the areas of nursing, clinical care, dentistry, pharmacy, public health, occupational therapy, and biomedical research. Health informatics resources include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems.
Early names for health informatics included medical information data processing, medical information science, medical informatics[2][1], medical computer science, and medical computing.[3]
History
Worldwide use of technology in medicine began in the early 1950s with the rise of computers.[4] In 1949, Gustav Wager established the first professional organization for informatics in Germany.[5] The prehistory, history, and future of medical information and health information technology are discussed in reference.[6] Specialized university departments and informatics training programs began during the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units then began to appear during the 1970s in Poland and in the U.S.[5], with medical informatics conferences springing up as early as 1974.[1] Since then, the development of high-quality health informatics research, education, and infrastructure has been the goal of the U.S. and the European Union.[5][1]
By the mid-2000s, work in the U.K. by the voluntary registration body the U.K. Council of Health Informatics Professions led to the creation of eight key constituencies within the domain of health informatics: information and communication technologies; health records; information management; knowledge management; health informatics service and project management; clinical informatics; education, training, and development; and research.[7] Those constituencies—already based on U.K. National Health Service standards (NHS)—later found their way into the NHS' Health Informatics Career Framework in a slightly modified format.[8] As of 2020[update] tens of datasets, publications, guidelines, specifications, meetings, conferences, and organizations around the world continue to shape what health informatics is today.[9]
Health informatics in North America
Argentina
Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Argentina's Asociación Argentina de Informática Médica (AAIM).[10]
From 1997 until about 2014, the not-for-profit Buenos Aires Biomedical Informatics Group also represented the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere. The group strove to promote informatics technology and related content within the research and health administration spheres, especially those relating to the biomedical field.[11]
Brazil
"In 1968 the Pan American Health Organization set up the Regional Library of Medicine and Health Sciences (BIREME) in the Paulista Medical School in São Paulo under an agreement with the Government of Brazil."[12] The library also made possible access to the MEDLINE and MEDLARS systems[13], and it would eventually go on to become the "hub of the Latin American network of biomedical and health information."[12]
In 1986, the Brazilian Society of Health Informatics (Sociedade Brasileira de Informática em Saúde) was founded to better expand the use of informatics technology within the country. The same year saw the first Brazilian Congress of Health Informatics held, and the first Brazilian Journal of Health Informatics was published.[14]
Since 1996, the International Medical Informatics Association's Latin America and the Caribbean regional group has sought to develop health informatics within the region, including Brazil's Sociedade Brasileira de Informática em Saúde (SBIS).[10]
Canada
Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems. A national, federally-funded, not-for-profit organization called Canada Health Infoway was created in 2001 to foster the development and adoption of electronic health records across Canada. In 2013, there were 380 health informatics projects under way in Canadian hospitals, health-care facilities, pharmacies, and laboratories, with an investment value of $2.1 billion since its inception.[15] Canada Health Infoway expected to see those projects finally come to completion by the 2019–2020 fiscal year.[16]
Provincial and territorial programs have included the following:
- eHealth Ontario was created as an Ontario provincial government agency in September 2008. It has been plagued by delays, and its CEO was fired over a multi-million dollar contract scandal in 2009.[17]
- Alberta Netcare Portal was created in 2006 by the Government of Alberta. The Netcare portal is used daily by thousands of clinicians. It provides access to demographic data, prescribed/dispensed drugs, known allergies/intolerances, immunizations, laboratory test results, diagnostic imaging reports, the diabetes registry and other medical reports. Netcare interface capabilities are being included in electronic medical record products which are being funded by the provincial government.[18]
United States
Even though the idea of using computers in medicine sprouted as technology advanced in the early twentieth century, it was not until the 1950s that informatics made a realistic impact in the United States.[4] Robert Ledley led the charge in the 1950s with his early use of medical computation in his dental projects at the United States National Bureau of Standards.[19]
By the mid-1950s expert systems such as MYCIN and INTERNIST-I were developed, and the National Library of Medicine started using even the even more advanced MEDLINE and MEDLARS systems by 1965. Around this same time a flurry of activity occurred. At the University of Utah, Dr. Homer R. Warner, one of the fathers of medical informatics[20], was already offering graduate-level classes in medical computer applications. Meanwhile Neil Pappalardo, Curtis Marble, and Robert Greenes were developing the Massachusetts General Hospital Utility Multi-Programming System (MUMPS) in Octo Barnett's Laboratory of Computer Science at Massachusetts General Hospital in Boston.[21][22] Yet due to its advanced nature, fragmented use across multiple entities, and inherent difficulty in extracting and analyzing data from the database, development of healthcare and laboratory systems on MUMPS was sporadic at best.[23]
By the 1980s, however, the advent of Structured Query Language (SQL), relational database management systems (RDBMS), and Health Level 7 (HL7) allowed software developers to expand the functionality and interoperability of health informatics systems, including the application of business analytics and business intelligence techniques to clinical data.[24] By the early 2010s, web-based and database-centric internet applications of laboratory informatics software had further changed the way researchers and technicians interact with data, with web-driven data formatting technologies like Extensible Markup Language (XML) making interoperability of health and laboratory informatics software a much-needed reality.[25] SaaS and cloud computing technologies have further changed how informatics systems are implemented in the U.S and worldwide, while at the same time raising new questions about security and stability.[21]
Health informatics in Europe
The European Union's Member States are committed to sharing their best practices and experiences to create a European eHealth Area, thereby improving access to and quality health care at the same time as stimulating growth in a promising new industrial sector. The associated European eHealth programs play a fundamental role in the European Union's strategy. Work on this initiative involves a collaborative approach among several parts of the Commission services.[26] Additionally, the not-for-profit European Institute for Health Records or EuroRec has promoted the use of high quality electronic health record systems in the European Union since its foundation in late 2002.[27][28]
epSOS (European Patients - Smart Open Services) represented another key European initiative to "build and evaluate a service infrastructure that demonstrates cross-border interoperability between electronic health record systems in Europe."[29] Co-funded by the European Commission Competitiveness and Innovation Programme since 2008, the initiative—which finish on June 31, 2014—was devised with the vision of giving patients in Europe the opportunity to use cross-border electronic medical record services for healthcare-related activities in participating epSOS pilot countries.[29] A follow-up letter at the end of the project highlighted how it had encompassed "25 countries and about 50 beneficiaries," achieving the "development of a solid basis for the eprescription and patient summary services, considering: governance, use cases, data content, semantics, specifications, architecture, testing mechanisms, etc."[30]
In the United Kingdom
The U.K. health informatics community has long played a key role in international activity, joining Technical Committee Four (TC 4) of the International Federation of Information Processing in 1968[31], which eventually became the International Medical Informatics Association (IMIA) in 1979.[32][33] In 1978, the Medical Specialist Group of the British Computer Society organized the first European Federation for Medical Informatics (EFMI) Medical Informatics Europe (MIE) conference in Cambridge.[33]
In 2002, the idea of a profession of health informatics across the U.K. was first implemented as the U.K. Council for Health Informatics Professions (UKCHIP), which has a formal Code of Professional Conduct, standards for expressing competences which are used for entry, confirmation of fitness to practice, re-grading and personal development. Consistent standards express competences of health informatics professionals in both domain-specific and generic informatics professional areas. The consistency is intended to apply in operational care delivery organizations, academia, and the commercial service and solution providers.[7]
The broad history of health informatics in the U.K. has been captured in the 2008 book U.K. Health Computing : Recollections and Reflections by Glyn M. Hayes and Denise E. Barnett. The book describes the early development of health informatics in the country as "unorganized and idiosyncratic."
England
In 2002, the National Health Service (NHS) in England contracted several vendors for a national health informatics system called the National Programme for IT or "NPfIT." By 2010, however, the project drastically behind schedule, forcing a wide consultation to be launched as part of a wider "Liberating the NHS" plan. "Following three reports on the National Programme by both the National Audit Office and this Committee, and a review by the Major Projects Authority, the Government announced in September 2011 that it would dismantle the National Programme but keep the component parts in place with separate management and accountability structures."[34] The program was officially dismantled in September 2013, officially dubbed "one of the worst and most expensive contracting fiascos in the history of the public sector."[34]
Scotland
In 1984, Scotland saw the implementation of the General Practice Administration System (GPASS), developed and controlled by NHS Scotland.[35] It was provided free to all general practitioners in Scotland. However, an agreement was reached in 2008 to shut down the electronic system due to "a series of problems and critical reports."[36] The system was formally shut down in August 2012, with all practices having moved to new systems called EMIS and INPS.
Health informatics in Asia and Oceania
In Asia, Australia, and New Zealand, the regional group called the Asia Pacific Association for Medical Informatics (APAMI) was established in 1993 and now consists of more than 15 member regions in the Asia Pacific Region.[37]
Australia
Founded in 2002, the Australasian College of Health Informatics (ACHI) was a professional association for health informatics in the Asia-Pacific region. It represented the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere through a commitment to quality, standards, and ethical practice.[38] ACHI was also a sponsor of the e-Journal for Health Informatics[39], an indexed and peer-reviewed professional journal. ACHI had also supported the Australian Health Informatics Education Council (AHIEC) since its founding in 2009.[40]
Although many health informatics organizations have been active in Australia, the Health Informatics Society of Australia (HISA) was generally regarded as the major umbrella group and a member of the International Medical Informatics Association (IMIA). Nursing informaticians were the driving force behind the formation of HISA, with the membership coming from many parts of the informatics spectrum, from students to corporate affiliates. HISA had a number of branches (Queensland, New South Wales, Victoria and Western Australia) as well as special interest groups such as nursing (NIA), pathology, aged and community care, industry, and medical imaging.[41]
In February 2020, ACHI and HISA announced that they had formally agreed to merge to form the Australsian Institute of Digital Health (AIDH). "Australasia’s leading organisations for health informatics and digital health ACHI and HISA were formed 25+ years ago in a different world. Imagine the challenges, the foresight and forward thinking required then to see the potential future of healthcare."[38] The new AIDH cited two primary factors for the merger: "meeting demand for education, training, professional pathways, certification and leadership development across digital health" and meeting the need for "a single unified voice from digital health leaders and experts at a time when consumers were looking for informed opinion, advice and guidance."[42]
China
In Hong Kong a computerized patient record system called the Clinical Management System (CMS) has been developed by the Hospital Authority since 1994. This system has been deployed at all the sites of the Authority (more than 40 hospitals and 120 clinics) and is used by some 79,000 staff on a daily basis.[43] The comprehensive records of seven million patients are available online in the Electronic Patient Record (ePR), with data integrated from all sites. Since 2004, radiology image viewing has been added to the ePR, with radiography images from any HA site being available as part of the ePR.
The Hong Kong Hospital Authority placed particular attention to the governance of clinical systems development, with input from hundreds of clinicians being incorporated through a structured process. The health informatics section of the Hong Kong Hospital Authority has held a close relationship with the information technology department and clinicians to develop healthcare systems for the organization to support the service to all public hospitals and clinics in the region.[44]
The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in healthcare. The eHealth Consortium has been formed to bring together clinicians from both the private and public sectors, medical informatics professionals, and the IT industry to further promote IT in healthcare in Hong Kong.[45]
New Zealand
Health Informatics has been taught at several New Zealand universities since the early 2000s. The most mature and established is the Otago program, which has been offered since the mid-1990s.[46] Also notable is Health Informatics New Zealand (HINZ), the national organization that advocates for health informatics. HINZ organizes a conference every year and also publishes the online journal Healthcare Informatics Review Online.[47]
Health informatics in the Middle East
Saudi Arabia
The Saudi Association for Health Information (SAHI) was established in 2006 to work under direct supervision of King Saud University for Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable studies.[48]
Regulation and standards
The international standards on the subject are covered by ICS 35.240.80[49], in which ISO 27799:2016 is one of the core components.[50]
In the United States
In 2004 the U.S. Department of Health and Human Services (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT). The mission of this office is widespread adoption of interoperable electronic health records (EHRs) in the U.S. within 10 years.
The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, was funded in 2005 by the U.S. Department of Health and Human Services to develop a set of standards for electronic health records (EHR) and supporting networks, and certify vendors who meet them. In July, 2006 CCHIT released its first list of 22 certified ambulatory EHR products, in two different announcements.[51]
Clinical informatics
While health informatics and clinical informatics are often considered the same, some make a distinction between the two. The American Medical Informatics Association, for example, states clinical informatics is concerned with the use of information in health care by clinicians.[52] By extension, clinical informaticians analyze, design, implement, and evaluate information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship.
Clinical informaticians use their knowledge of patient care combined with their understanding of informatics concepts, methods, and health informatics tools to:
- assess information and knowledge needs of health care professionals and patients
- characterize, evaluate, and refine clinical processes
- develop, implement, and refine clinical decision support systems
- lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems
Clinicians collaborate with other health care and information technology professionals to develop health informatics tools which promote patient care that is safe, efficient, effective, timely, patient-centered, and equitable.
Further reading
- De Moor, Georges J. E. ; McDonald, Clement J.; van Goor, J. M. Noothoven, ed. (1993). Progress in Standardization in Health Care Informatics. IOS Press. pp. 215. ISBN 9051991142. https://books.google.com/books?id=DHzOJaNaOYkC.
- Hovenga, Evelyn J. S., ed. (2010). Health Informatics: An Overview. IOS Press. ISBN 1607500922. https://books.google.com/books?id=eckD3fSrPagC.
- Hoyt, Robert E.; Bailey, Nora; Yoshihashi, Ann, ed. (2012). Health Informatics: Practical Guide For Healthcare And Information Technology Professionals. Lulu Enterprises Incorporated. pp. 492. ISBN 1105437558. https://books.google.com/books?id=6bqruAAACAAJ.
- Hoyt, R.E.; Hersh, W.R. (2018). Health Informatics: Practical Guide (7th ed.). Informatics Education. pp. 488. ISBN 9781387827503. https://books.google.com/books?id=UnxeDwAAQBAJ.
See also
- Informatics (academic field)
- Category:Health informatics
- Hospital information system
- Laboratory information system
Notes
Some elements of this article are reused from the Wikipedia article.
References
- ↑ 1.0 1.1 1.2 1.3 Hovenga, E.J.S., ed. (2010). "Chapter 2: Health Informatics - An Introduction". Health Informatics: An Overview. IOS Press. p. 9–15. ISBN 1607500922. https://books.google.com/books?id=eckD3fSrPagC.
- ↑ Blum, B.I. (1990). "Medical Informatics". In Kent, A.; Williams, J.G.. Encyclopedia of Computer Science and Technology. 22. CRC Press. p. 205–224. ISBN 0824722728. https://books.google.com/books?id=L7NOABDqaMcC.
- ↑ Dayyani, B. (2006). "Knowledge Informatics: A New Academic Discipline Underpinning Knowledge-based Organisations and Contributing to the Transformation from the Information Age to the Knowledge Age". In Griffiths, P.. Proceedings of the 3rd International Conference on Intellectual Capital and Knowledge Management. Academic Conferences Limited. p. 127–138. ISBN 1905305362. https://books.google.com/books?id=hD4I12296jYC.
- ↑ 4.0 4.1 "The History of Health Informatics". Health Informatics Guide - The History of Health Informatics. University of Illinois at Chicago. Archived from the original on 26 November 2012. http://web.archive.org/web/20121126102550/http://healthinformatics.uic.edu/history-of-health-informatics/. Retrieved 05 January 2015.
- ↑ 5.0 5.1 5.2 "NYU Graduate Training Program in Biomedical Informatics (BMI): A Brief History of Biomedical Informatics as a Discipline". www.nyuinformatics.org. NYU Langone Medical Center. Archived from the original on 23 March 2010. https://web.archive.org/web/20100323111213/http://www.nyuinformatics.org/education/degree-programs. Retrieved 20 March 2020.
- ↑ Robson, B.; Baek, O. K. (2009). The engines of Hippocrates: From the Dawn of Medicine to Medical and Pharmaceutical Informatics. Hoboken, NJ: John Wiley & Sons. ISBN 9780470289532.
- ↑ 7.0 7.1 "UK Council for Health Informatics Professions (UKCHIP): Mapped Registration Requirements" (PDF). UKCHIP. 26 September 2006. Archived from the original on 28 February 2007. https://web.archive.org/web/20070228020800/http://www.ukchip.man.ac.uk/Library/Policies&Standards/registrationstandardsoct06. Retrieved 20 March 2020.
- ↑ "About the Health Informatics Career Framework (HICF)". National Health Service. Archived from the original on 28 March 2016. https://web.archive.org/web/20160328115710/https://www.hicf.org.uk/AboutHICF.aspx. Retrieved 20 March 2020.
- ↑ "HSRIC: Health Informatics". U.S. National Library of Medicine. Archived from the original on 22 January 2020. https://web.archive.org/web/20200122062539/https://hsric.nlm.nih.gov/hsric_public/topic/informatics/. Retrieved 06 January 2022.
- ↑ 10.0 10.1 "IMIA LAC: Regional Federation of Health Informatics for Latin America and the Caribbean". International Medical Informatics Association. https://imia-medinfo.org/wp/imia-lac-regional-federation-of-health-informatics-for-latin-america-and-the-caribbean/. Retrieved 20 March 2020.
- ↑ "Grupo de Informática Biomédica de Buenos Aires - GIBBA". GIBBA. Archived from the original on 01 February 2014. https://web.archive.org/web/20140201044226/http://www.gibba.org.ar/GIBBAWEB2009/. Retrieved 20 March 2020.
- ↑ 12.0 12.1 Sonis, A. (1981). "The Latin American network of biomedical and health information: Experience and future development". Educación Médica y Salud 15 (4): 474–493. PMID 7030712.
- ↑ Garcia, M.L.A. (1987). "Brazil, The Organization Of Scientific and Technological Information In". In Kent, A.. Encyclopedia of Library and Information Science. 43. CRC Press. pp. 38–47. https://books.google.com/books?id=sFqds9V6heMC.
- ↑ "História da SBIS por Lincoln Moura (2002)". Sociedade Brasileira de Informática em Saúde. Archived from the original on 20 March 2020. https://web.archive.org/web/20200320213023/http://www.sbis.org.br/historia-da-sbis-por-lincoln-moura?showall=1. Retrieved 06 January 2022.
- ↑ "Canada Health Infoway Annual Report 2012–13" (PDF). Canada Health Infoway. 26 July 2013. p. 9. https://www.infoway-inforoute.ca/en/component/edocman/1686-annual-report-2012-2013/view-document?Itemid=101. Retrieved 20 March 2020.
- ↑ "Canada Health Infoway Annual Report 2018–19" (PDF). Canada Health Infoway. 31 March 2019. p. 21. https://www.infoway-inforoute.ca/en/component/edocman/3726-annual-report-2018-2019/view-document?Itemid=101. Retrieved 20 March 2020.
- ↑ "Head of eHealth Ontario is fired amid contracts scandal, gets big package". CBC News. 07 June 2009. https://www.cbc.ca/news/canada/head-of-ehealth-ontario-is-fired-amid-contracts-scandal-gets-big-package-1.797216. Retrieved 20 March 2020.
- ↑ "Alberta Netcare: The History of the EHR". Government of Alberta. https://www.albertanetcare.ca/History.htm. Retrieved 30 October 2013.
- ↑ Sittig, D.F.; Ash, J.S.; Ledley, R.S. (2006). "The Story Behind the Development of the First Whole-body Computerized Tomography Scanner as Told by Robert S. Ledley". Journal of the American Medical Informatics Association 13 (5): 465–9. doi:10.1197/jamia.M2127. PMC 1561796. PMID 16799115. https://www.ncbi.nlm.nih.gov/pmc/articles/1561796.
- ↑ Patton, G.A., Gardner, R.M. (1999). "Medical Informatics Education: The University of Utah Experience". Journal of the American Medical Informatics Association 6 (6): 457–65. PMC 61389. PMID 10579604. https://www.ncbi.nlm.nih.gov/pmc/articles/61389.
- ↑ 21.0 21.1 Park, S.L; Pantanowitz, L.; Sharma, G.; Parwani, A.V. (2012). "Anatomic Pathology Laboratory Information Systems: A Review". Advances in Anatomic Pathology 19 (2): 81–96. doi:10.1097/PAP.0b013e318248b787. PMID 22313836.
- ↑ Reilly, E.D. (2003). Milestones in Computer Science and Information Technology. Greenwood Publishing Group. p. 161. ISBN 9781573565219. https://books.google.com/books?id=JTYPKxug49IC. Retrieved 20 March 2020.
- ↑ Blum, B.I.; Duncan, K.A. (1990). A History of Medical Informatics. ACM Press. pp. 141–53. ISBN 0201501287. https://books.google.com/books/about/A_History_of_medical_informatics.html?id=AR5rAAAAMAAJ. Retrieved 20 March 2020.
- ↑ Sinard, J.H. (2006). Practical Pathology Informatics: Demstifying Informatics for the Practicing Anatomic Pathologist. Springer. pp. 393. ISBN 0387280588. https://books.google.com/books?id=WerUyK618fcC. Retrieved 20 March 2020.
- ↑ Kumar, S.; Aldrich, K. (2010). "Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study". Health Informatics Journal 16 (4). doi:10.1177/1460458210380523.
- ↑ "Shaping Europe's Digital Future: Research and Innovation in eHealth". European Commission. Archived from the original on 03 November 2020. https://web.archive.org/web/20201103052623/https://ec.europa.eu/digital-single-market/en/research-and-innovation-ehealth. Retrieved 06 January 2022.
- ↑ "Electronic Health Records for Europe". European Space Agency. 30 March 2005. https://www.esa.int/SPECIALS/Telemedicine_Alliance/SEMWC7SMD6E_0.html. Retrieved 06 January 2022.
- ↑ Mennerat, F. (10 October 2006). "The EuroRec Institute: Structure, Activities and New Services". SlidePlayer. EuroRec. https://slideplayer.com/slide/10421896/. Retrieved 20 March 2020.
- ↑ 29.0 29.1 "About epSOS". European Commission. Archived from the original on 16 January 2018. https://web.archive.org/web/20180116073447/http://www.epsos.eu/home/about-epsos.html. Retrieved 20 March 2020.
- ↑ "Cross-border health project epSOS: What has it achieved?". European Commission. Archived from the original on 27 March 2019. https://web.archive.org/web/20190327112520/https://ec.europa.eu/digital-single-market/en/news/cross-border-health-project-epsos-what-has-it-achieved. Retrieved 20 March 2020.
- ↑ Zemanek, H.; Brunnstein, K. (31 March 2011). "Chart 0: IFIP at a Glance". A Quarter Century of IFIP. IFIP. http://www.ifip.org/50th_anni/Chart0.htm. Retrieved 31 October 2013.
- ↑ Nedkov, P. (2002). Rosenfeld, J.L.. ed. "The IFIP Presidents". IFIP Newsletter 19 (1–3): 7. http://www.ifip.org/newsletters/News2002/News_Sep_2002.pdf.
- ↑ 33.0 33.1 Dezelic, G. (2009). "After Three Decades of Medical Informatics Europe Congresses". In Adlassnig, K.-P. (ed.). Medical Informatics in a United and Healthy Europe. IOS Press. pp. 3–7. ISBN 1607500442. https://books.google.com/books?id=pGHWtG5_xIgC.
- ↑ 34.0 34.1 "MPs publish report on the dismantled National Programme for IT in the NHS". U.K. Parliament. 18 September 2013. Archived from the original on 21 September 2013. https://web.archive.org/web/20130921171844/https://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/npfit-report/. Retrieved 06 January 2022.
- ↑ "Scotland’s doctors welcome review of GPASS". BMA Scotland. 11 June 2002. Archived from the original on 01 November 2013. https://web.archive.org/web/20131101185822/http://web.bma.org.uk/pressrel.nsf/wlu/GGRT-5AZK3T. Retrieved 20 March 2020.
- ↑ Todd, R. (20 August 2012). "Scotland's GPASS is no more". EHealth Insider. EHealth Media Limited. Archived from the original on 19 March 2013. https://web.archive.org/web/20130319115435/http://www.ehi.co.uk/news/ehi/8005/scotland's-gpass-is-no-more. Retrieved 20 March 2020.
- ↑ "About APAMI". Asia Pacific Association of Medical Informatics. https://www.apami.org/about-apami/. Retrieved 20 March 2020.
- ↑ 38.0 38.1 "Australasian College of Health Informatics". ACHI. Archived from the original on 20 March 2020. https://web.archive.org/web/20200320223619/https://www.achi.org.au/. Retrieved 20 March 2020.
- ↑ "eJHI - Journal Sponsorship". eJHI. Archived from the original on 11 April 2018. https://web.archive.org/web/20180411031005/http://www.ejhi.net/ojs/index.php/ejhi/about/journalSponsorship. Retrieved 20 March 2020.
- ↑ "Australian Health Informatics Education Council". AHIEC. Archived from the original on 13 November 2013. https://web.archive.org/web/20131113083536/http://www.ahiec.org.au/. Retrieved 20 March 2020.
- ↑ "About HISA". Health Informatics Society of Australia. Archived from the original on 28 November 2013. https://web.archive.org/web/20131128161833/http://www.hisa.org.au/?about. Retrieved 20 March 2020.
- ↑ "How the institute was formed". Australasian Institute of Digital Health. February 2020. https://digitalhealth.org.au/about/the-story/. Retrieved 20 March 2020.
- ↑ "Introduction". Hong Kong Hospital Authority. 31 March 2019. https://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=10008&Lang=ENG&Dimension=100&Parent_ID=10004. Retrieved 20 March 2020.
- ↑ "Hong Kong Hospital Authority and Health Informatics Section". Hong Kong Hospital Authority. November 2007. Archived from the original on 29 August 2012. https://web.archive.org/web/20120829213043/http://www3.ha.org.hk/hi/Welcome.html. Retrieved 20 March 2020.
- ↑ "eHealth Consortium". IPROA. Archived from the original on 20 March 2020. https://web.archive.org/web/20200320230409/http://www.iproa.org/index.php/en-GB/other-projects/227-ehealth-consortium.html. Retrieved 06 January 2022.
- ↑ Karolyn Kerr; Cullen, R.; Duke, J.; Holt, A. et al. (November 2006). "Health Informatics Capability Development In New Zealand - A Report to the Tertiary Education Commission" (PDF). National Steering Committee for Health Informatics Education in New Zealand. Archived from the original on 04 July 2014. https://web.archive.org/web/20140704133906/http://homepages.mcs.vuw.ac.nz/~peterk/healthinformatics/tec-hi-report-06.pdf. Retrieved 20 March 2020.
- ↑ "About HINZ". Health Informatics New Zealand. https://www.hinz.org.nz/page/AboutHINZ. Retrieved 20 March 2020.
- ↑ "Who we are". Saudi Association for Health Informatics. http://www.sahi.org.sa/?page_id=2296. Retrieved 20 March 2020.
- ↑ "35.240.80: IT applications in health care technology". ISO. https://www.iso.org/ics/35.240.80/x/. Retrieved 20 March 2020.
- ↑ Segovia, A.J. (13 June 2016). "How ISO 27001 and ISO 27799 complement each other in health organizations". Advisera Expert Solutions Ltd. https://advisera.com/27001academy/blog/2016/06/13/how-iso-27001-and-iso-27799-complement-each-other-in-health-organizations/. Retrieved 20 March 2020.
- ↑ Certification Commission for Healthcare Information Technology (18 July 2006). "CCHIT Announces First Certified Electronic Health Record Products". Virtual Medical Worlds. Archived from the original on 26 May 2012. https://web.archive.org/web/20120526040832/http://www.hoise.com/vmw/06/articles/vmw/LV-VM-08-06-22.html. Retrieved 06 January 2022.
- ↑ Gardner, R.M.; Overhage J.M.; Steen, E.B. et al. (2009). "Core content for the subspecialty of clinical informatics". Journal of the American Medical Informatics Association 16 (2): 153–7. doi:10.1197/jamia.M3045. PMC 2649328. PMID 19074296. https://www.ncbi.nlm.nih.gov/pmc/articles/2649328.