utovguov

1. Introduction to Health
Informatics (HINF631)
Dr.Melkamu Beyene

2. Outline
• X-Informatics
• Introduction to Digital Health
• Introduction to Health Informatics (definition, history, application of ICT to healthcare) with an overview
of the basic concepts
• Introduction to public health informatics, medical health informatics, biomedical informatics
• Overview of Health informatics knowledge management
• Health Records management (manual and electronics); electronic health record, electronic medical record;
mhealth and telemedicine; (Collection, analysis, storage, retrieval)

3. Outline
• Introduction to standards for data exchange;
• Introduction to information systems for health
• Health data quality and information use
• Emerging issues in health informatics

4. Assessment Criteria
• 30%: group/individual student Term Papers, Assignments
• 20%: project with final project presentation
• 45%: Final exam
• 5%: Class participation

5. Project/Paper Ideas
• Medical Knowledge/Data Exchange-Medical Ontology
• Medical Data Repositories
• Electronic Health Records and Data Standards and Exchange
• Health Information System-Asses the existing systems implemented
• Digital Health in Ethiopia
• Strategies
• Governance
• Regulatory issues

6. X-Informatics-Paradigm Shift
• Multiple science disciplines to form new X-informatics research disciplines
• Geoinformatics, bioinformatics, cheminformatics, biodiversity informatics, ecoinformatics, materials informatics, and the
emerging discipline of astroinformatics.
• Xinformatics is intended to provide both the common informatics knowledge as well as how it is implemented in specific
disciplines
• Informatics' theoretical basis arises from information science, cognitive science, social science, library science as well as
computer science
• Health Informatics
• Application of Computer Science/Information Science to Healthcare
• Is this a simple application of Informatics to healthcare
• Paradigm shift in the way we do science

7. Health Informatics-Definitions
• It is a scientific field that deals with the storage, retrieval, sharing, and optimal use of biomedical
information, data, and knowledge for problem solving and decision making.
• Health informatics looks into ways to optimize clinical knowledge creation, sharing and application to
deliver better healthcare and to promote health.
• incorporating the complex mixture of people, organizations, illnesses, patient care and treatment.

8. 8
HEALTH INFORMATICS
Simplistic definition:
• Medical informatics is the application of computers, communications
and information technology and systems to all fields of medicine -
medical care, medical education and medical research.
• Health informatics is a multidisciplinary field that uses data analytics to
develop insights and drive innovations in the health care industry.

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HEALTH INFORMATICS
• Medical informatics is the rapidly developing scientific field that deals
with resources, devices and formalized methods for optimizing the
storage, retrieval and management of biomedical information for
problem solving and decision making.
• Healthcare informatics work provides electronic access to medical
records for patients, doctors, nurses, hospital administrators, insurance
companies, and health information technicians.

10. 10
HEALTH INFORMATICS
• Medical Informatics is the branch of science concerned with the use of
computers and communication technology to acquire, store, analyze,
communicate, and display medical information and knowledge to
facilitate understanding and improve the accuracy, timeliness, and
reliability of decision-making.

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Health Informatics Motives
• Information Explosion/Knowledge base of biomedicine is essentially unmanageable by traditional paper-based methods
• Health care industry generates as much as 30% of the world's data and intension to use the data for scientific inquiry, problem-solving, and decision making.
• The requirements to keep sensitive data confidential
• Numerous applications of EHR systems do not communicate effectively with one another. Interoperability is the ability of different information systems, devices, and applications
(“systems”) to access, exchange, integrate, and cooperatively use data in a coordinated manner both within and across organizational, regional, and national boundaries.
Interoperability supports the provision of timely and seamless information delivery and optimizes individuals’ and populations’ health globally.
• The need for technologies to support open, proactive, two-way communication between hospitals, clinicians, patients, vendors, and other healthcare stakeholders.
• The digitization of healthcare systems in clinical settings combined with the explosion of personal data collection devices provides the opportunity of using data for revolutionizing
approaches to care at all levels with an emphasis on precision medicine and person-centered care. The ability to take advantage of this Big Data opportunity requires expertise at the
intersection of health informatics, data science, and computational modeling.
• Healthcare institutions transition from paper to exclusively digital medical record system, the EHR impacts every aspect of a healthcare institution’s operations.
• Initiatives to transform the digital health
• Improved clinical outcomes with lower cost of care, improved experiences for both patients and providers, and to provide better care in a more cost-effective manner.

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HEALTH INFORMATICS
Knowledge
Management
Clinical Information
Management
Communication Decision Support

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INFORMATICS USE IN HEALTH CARE
• Knowledge management
• Journals/Data Repositories
• Consumer Health information
• Evidence-based medical information
• Communication
• Telemedicine
• Tele-radiology
• Patient e-mail
• Presentations
• Decision Support
• Reminder systems
• Diagnostic Expert Systems
• Analysis, interpretation, and
comprehension of complicated medical
and healthcare data
• Drug development, personalized
medicine
• Information Management
• Electronic Medical Records
• Ordering Systems

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WHAT IS KNOWLEDGE MANAGEMENT?
“Knowledge management involves the capture of your organization’s
information and experience so that it becomes part of your
organization’s know-how and expertise which can be pooled,
disseminated and used by your skilled staff in doing and winning
profitable business.”

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KNOWLEDGE HIERARCHY
Knowledge
Information
Data

16. 16
DATA
• Raw data is the simplest and most abundant component of a
knowledge management system
• “Data on its own has no meaning…”

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INFORMATION
• Once organized and defined, data becomes information.
• “Data on its own has no meaning, only when interpreted by some kind
of data processing does it take on meaning and become information.”
Source: The Free On-line Dictionary of Computing

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KNOWLEDGE
• Information that has been processed.
• “If information is data plus meaning then knowledge is information plus
processing.”

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AN EXAMPLE TO CLARIFY…
• “1234567.89’ is data.
• ‘You’re bank balance jumped 8,087% to $1,234,567.89’ is
information.
• ‘Nobody owes me that much money’ is knowledge.”

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TWO KINDS OF KNOWLEDGE
• Explicit Knowledge
As a general rule of thumb, explicit knowledge consists of anything that can be
documented, archived and codified, often with the help of IT
• Examples of Explicit Knowledge include:
• Any step-by-step process that has been documented
• Company policies and manuals
• Tacit Knowledge
“… The know-how contained in people’s heads
• Examples of Tacit Knowledge:
• Knowing how to do surgery
• Knowledge in any job where you can skip steps/contacts to get what you need more quickly

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What Is Knowledge Management Trying to Solve?
• The problem of spending more time trying to find information than
actually using it.
• Increase consistency of information/standardization of processes in
order to improve efficiency and/or effectiveness.
• Retain knowledge as workers retire or leave the company.
• Avoid “re-inventing the wheel.”
• Increase efficiency of accessing the specific information that workers
need.

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Different Aspects Of Knowledge Management
• Creation and Capture of knowledge
• Sharing of information
• Codification of information
• Protection of information
• Retrieval of information
• Ability to update information easily

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• Old Knowledge Equation:
• “Knowledge = Power, so hoard it.”
• New Knowledge Equation:
• “Knowledge = Power, so share it and it will multiply.”
WHY KNOWLEDGE MANAGEMENT?

24. Knowledge Management in HealthCare
• The healthcare sector relies heavily on knowledge in its daily activities, and mainly, the delivery of care depends upon the collaboration of
various partners that should share knowledge in order to provide quality outcomes for patients.
• Treating an individual patient is dependent on accessing a huge amount of knowledge and expertise
• Healthcare providers must not only share clinical knowledge but also standard operating procedures. Information is constantly changing as
the medical field evolves, with new research published and as new treatments become available.
• The paradox is that healthcare workers have rich data but poor information/Knowledge
• Balance this against the fact that finding the right information at the right time can quite literally save lives.
• In a scenario where a patient comes to their doctor with symptoms that are perplexing, the doctor makes an educated guess as to what may
be wrong and writes a treatment plan for the patient.
• It would be much better if the doctor not only had his or her own knowledge to help the patient, but access to the knowledge of every other
medical professional in the hospital.

25. HealthCare Knowledge Management-Advantage
• Doctors can use it to search for symptoms and other valuable data that will make a huge
difference to outcomes for their patients
• Organize, store, and share knowledge between employees and boost operational efficiency
• Raise the standard of care for patients
• Access to the right knowledge in healthcare is paramount
• Improve collaboration between practitioners and boost the availability of knowledge throughout
the organization
• Knowledge is capital for the healthcare sector.
• It is an intangible asset that may not appear in market value but help to improve and build a
powerful organization.
• It’s crucial to organize this knowledge in such a way as to make it manageable for your
practitioners.
• The knowledge that is not accessible is of no use to anyone.

26. Benefits of Knowledge Management in Healthcare
• Avoid malpractices
• Informed decision making
• Educate and empower medical practitioners
• Capture tactical knowledge gained by practitioners
• Boost operational efficiency
• Improve patient satisfaction
• Leads to digital transformation
• Promotes collaboration between healthcare workers

27. Challenges of Knowledge Management in Healthcare
• Lack of Leadership
• Organizational Culture
• Lack of organizational structure
• Limited tech infrastructure
• Lack of knowledge management strategy
• The attitude of physicians and staff toward KM
• Knowledge Management Best Practices for Healthcare

28. Assignment
• Whose knowledge shall be managed in Healthcare
• Professionals
• Patients
• External knowledge
• Identify knowledge management software implemented so far in Ethiopia
• Propose an appropriate KM software to be implemented
• Explore online Knowledge Management Tools
• Identify free software and Customize these tools for local context

29. Communication
• Communication is imperative for effective planning, coordination, control, and decision-
making
• Standard communication processes are becoming increasingly insufficient to meet the
many needs of the healthcare industry and medical practices
• Electronic patient communication is the solution for convenient, cost-effective, and fast
patient engagement
• Electronic communication is a type of modern communication through which messages, files, and other
information are shared and transmitted via computers, laptops, mobile devices, telephones, and other
electronic devices over networks.
• Electronic communication helps providers establish an intimate conversation with their patients while
responsibly sharing important healthcare information (images, lab results, prescriptions, or other
protected health information) via electronic means.

30. Communication-Advantage
• Speed and Convenience
• Share information such as appointment details, multimedia messages, and other information or files very
quickly.
• The speed of vital health information can save patient lives
• Low Cost
• Patients no longer need to bear the cost of transportation
• access to expertise
• building costs
• Reaches Patients Anywhere
• Enable patients to always stay in touch with their healthcare providers
• Do their tasks anywhere, even when they are away from home — at a conference perhaps or on a plane
• Electronic communications allows Patients to get care from anywhere
• Infrastructure (network) costs
• Getting cheaper
• Equipment costs
• Getting smaller and cheaper

31. Communication-DisAdvantages
• Vulnerable to Security Breaches
• Security threats are a significant disadvantage of electronic communication. They include
cybercriminal attacks and other forms of computer security threats.
• Large Volume of Data
• The volume of telecommunication data you receive may quickly increase at a rate that your
management may not be able to absorb within the relevant time limit.
• Difficult for Those Who are "Technologically Challenged"
• Not everyone knows how to use electronic communication properly
• Difficult for Those Who have no Technology
• Digital divide

32. Types of Communication
• Platform-Agnostic Email, Chat/IM, and Messaging
• Medical providers and administrators to communicate immediately with one another across a variety
of devices
• Voice, Video, and Web Meetings/Conferencing
• This encourages interaction and problem solving among providers, specialists, and experts in the
field, allowing for more collaborative care.
• Virtual Appointment Apps
• This allows providers to meet online with patients or their families and to take advantage
• Online Patient Databases
• Cloud-based databases and EHR systems offer a safe, reliable and HIPAA (Health Insurance Portability
and Accountability) compliant method for doctors, medical staff, and health administrators to
coordinate care through immediate access to patient health histories and charts.
• By leveraging database or EHR integration with the IT environment, the hospital can improve medical
staff efficiency and reduce risks of medical errors within its communication model.
• Online Patient Portals
• Patients benefit by having a secure online portal to access medical records and to obtain lab or
diagnostic testing results, rather than having to wait anxiously by the phone.

33. MHEALTH
• “…the provision of health-related services via mobile communications”
(Vital Wave Consulting, 2009)
• mHealth applications include:
• the use of mobile devices in collecting community and clinical health data
• delivery of healthcare information to practitioners, researchers, and patients
• real-time monitoring of patient vital signs and direct provision of care (via
mobile telemedicine)

34. TELEMEDICINE
• “the use of electronic signals to transfer medical data from one site to
another via the internet, telephones, PCs, satellites, or videoconferencing
equipment in order to improve access to health care”
(Brown, 1996)
• telemedicine can be
• As simple as two doctors talking about a patient through the telephone or
• As complex as a sophisticated global hospital enterprise network that supports real-
time remote surgical operations

35. DIFFERENT TYPES OF TELEMEDICINE
• Telesurgery: the ability for a doctor to perform surgery on a patient even though
they are not physically in the same location
(Wikipedia)
• Teleradiology: the transmission of radiological patient images, such as x-rays,
CTs, and MRIs, from one location to another for the purposes of interpretation
and/or consultation
• Telecare: The use of telecommunication systems to provide remote assistance in
therapy to patients (Mantas & Hasman, 2002)

36. DIFFERENT TYPES OF TELEMEDICINE
TeleHealth
• The delivery of health-related services and information via
telecommunications technologies
• Could be:
• As simple as two health professionals discussing a case over the telephone, or
• As sophisticated as using videoconferencing between providers at facilities in two
countries, or
as complex as robotic technology

37. Definitions
• "The use of medical information exchanged from one site to another
using electronic communications for the health and education of
patients or providers and to improve patient care."
• http://cms.hhs.gov/glossary/default.asp (Dept of Health and Human Services)
• "the use of medical information exchanged from one site to another via electronic
communications for the health and education of the patient or health care provider
and for the purpose of improving and extending the availability of patient care"
• http://www2.umdnj.edu/omcweb/1998/telemedicine.htm
• "access to medical care for consumers and health professionals via
telecommunications technology"
• http://www.atmeda.org/about/aboutata.htm
• e-health is the "use of the Internet for healthcare"

38. Definitions
• Starting point:
• "The use of Information and Communication Technology (ICT) to deliver
healthcare at a distance"

39. Scope
• Telemedicine and e-health are terms that are applied to the use of
Information and Communication Technologies (ICT) in medicine, health
and social care delivery
• As such, the subject divides into two main areas:
• improvements to existing services in terms of their efficiency and effectiveness - for
example, pathology, radiology, education and training, and Electronic Patient
• new service delivery development - for example, teledermatology, teleophthalmology.

40. Scope
• For our purposes, we define our area of interest as those applications
that:
• use information and communication technology …
• … to deliver health and/or social care in new ways …
• … on a person to person basis …
• … where those people are physically apart

41. CHARACTERISTICS OF TM SYSTEMS
• Interaction style
• Data types
• Equipment
• Action
• Patient numbers
• Duration

42. ASSIGNMENT
• To what extent we use electronic communication
• Which devices are used?
• What types of information is transmitted ?
• Policy in place?
• Security mechanism implemented?
• Information flow
• Real time
• To what extent feasible it is?
• Is there IS for this purpose?
• What is the experience of other countries in this regard