What do you think
of when you think of healthcare informatics?
Those in the healthcare industry may have an idea what this means. It seems like an easy enough concept: take
two words, healthcare and informatics, and combine them to get one meaningful
discipline. What about those outside of
healthcare? I would imagine that for
most, whether in the healthcare industry or not, the term healthcare
informatics conjures up similar images: hospitals and computers. This is a good place to start, but an image
of hospitals and computers is very limited.
Healthcare
encompasses more than hospitals.
Hospitals, clinics, urgent care facilities, insurance companies,
research institutions, pharmaceutical and biotechnology companies, and
universities make up a bulk of what is happening in the healthcare
environment. Each generates a vast
amount of information (data).
Incorporating the complementary and alternative medicine component adds another
element to the data that is generated on a daily basis. Enter informatics. Once, data generated in each of these venues
was, largely, trapped in paper form. Not
that the information was not available, but the amount of time it would take to
retrieve the archived data was significant.
In the 1950s and 1960s, computers helped healthcare institutions with
the financial aspects of the delivery of care (Sewell & Thede, 2013). But, healthcare was slow to adopt
technologies that would allow them to digitize and store information (Kudyba,
2010). The rapid advancement of
computing technologies in the 1990s, including those that made personal
computers and information sharing more readily accessible to the masses, fueled
advances in virtually every industry.
Yet, the healthcare industry remained reluctant to adopt emerging
technologies that would allow it to let go of its strangle-hold on paper. Particularly in the U.S., healthcare was
using the most advanced diagnostic and delivery technologies in the world
concurrently with the most primitive of information storage possible: paperwork
stored in file boxes and microfiche films.
As the new century
advances, the delivery of healthcare has been mandated to adopt sharable
electronic health records (EHRs) with the goal of providing a higher level of
care in a more cost-efficient manner (Sewell & Thede, 2013). Digitizing data makes this possible. Managing the immense amount of digitized data
that is generated is in the realm of information technology. Data is not useful unless it can be linked in
useful ways - rapidly. Linking data
requires a standardized language utilized by input sources, the ways and means
to store data, search functions to retrieve the data, and an ability to perform
analytics based upon the type of information one hopes to generate. The ability to link data provides us the
ability to ask important questions such as, “How many ERCPs were performed
in-house this month?”, “What is the average age of clients diagnosed with lung
cancer?”, and “How much does it cost to perform a cholecystectomomy?”
As a scientist and
oncology nurse, I am particularly interested in advances made in
chemotherapies, biotherapies, and cancer genomics. There is a vast amount of information
generated in cancer research and the delivery of healthcare to those impacted
by cancer. In order to make significant
advances, however, it is necessary to make higher-level connections between
disease states and non-disease states.
In other words, what is different?
What changes do we see? What causes uncontrolled proliferation in one
cell and not the other? How can we
exploit this information to provide better health outcomes? In order to make these significant advances,
we must be able to mine the data we generate.
Healthcare informatics is the goose that laid the golden egg.
I was once part of
a start-up biotechnology company in San Diego (watch the video if you want to get a better understanding of what I did and where the company is today). In brief, we collected nucleic acids (genetic
material) from environmental sources around the world. Once purified, we would clone the genetic
information into expression hosts, like E.
coli, and look for gene products of biotechnological significance. The myriad of sample sources, whether a hot
spring in Costa Rica or a deep sea vent at the bottom of the ocean, combined with thousands of
genes, and gene products discovered from those sample sources, created a mountain of data that would remain useless
unless it could be stored and retrieved to facilitate research and development.
As one of the bioprospectors responsible for the collection, generation,
and storage of genetic information, I was given the opportunity to work on an
intracompany database. Essentially, we
needed to create a platform that would allow us to mine the reams of data we
were generating. Data and the scientific
advances we made were the life-forces of our company. If we discovered a commercially viable gene
product (i.e, an enzyme that could be used in laundry detergents to break down
fat stains on clothes or an anti-tumor compound) we needed to be able to go
back to the original source of that material in order to conduct further
studies. Knowing where we collected that
sample, how it was purified, the genetics of the expression host, and where it
was stored was critical. Developing the
database, coming up with a standardized language, and providing a user-friendly
platform gave us this ability. Without
this ability, our company could not stay in business. Advances in cancer research and the delivery
of healthcare are also dependent upon this ability. We must be able to mine the data we generate
in cancer research in order to provide the highest level of care that leads to
better health outcomes for clients.
Certainly,
healthcare informatics is meant to provide a system whereby critical client
information is stored and retrievable in a useable format to provide the best
care available to clients. But, it is
not limited to the delivery of care directly to the client. It starts long before a client enters the
hospital, the urgent care clinic, or the physician’s office. It starts when we start asking “How can we
provide better health outcomes?”
References
Kudyba, S. (2010,
April 19). What is healthcare
informatics? Retrieved from http://youtu.be/pzS--PaGC9o
Sewell, J. &
Thede, L. (2013). Informatics and nursing: Opportunities and challenges (4th
ed.). Philadelphia, PA: Wolters
Kluwer Health / Lippencott Williams & Wilkins
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