Princess Sumaya University for Technology

The King Hussein School for Computing Sciences

13768 Introduction to Health Informatics
Topic 1: Introduction to Health Informatics

Dr. Ahmad Altamimi

Acknowledgment: Most of these slides have been adopted from Health Informatics by Practical Guide by William R. Hersh,
and Robert E. Hoyt book for our course. Additional slides have been added from the mentioned references in the syllabus
Outline
o Introduction to Health Information Technology.
o Why Health Information Technology?
o Healthcare Data.
o Clinical Data Warehouse.
o What Makes Informatics Difficult?
o Health Information Technology.
Health Information Technology
Why Health Information Technology?
o With the advent of the internet, high-speed computers, mobile technology, etc.
healthcare professionals today have many more tools at their disposal.
o But, technology is advancing faster than healthcare professionals can assimilate it into
practice.
o Therefore, there is a new need for education and translation of emerging technologies
and the data/information they generate into healthcare.
Health Informatics Careers
o Health systems manager.
o Technology consultant for medical institutions.
o Medical Information Analyst.
o Project Manager for Health Systems.
o Director of the digital transformation of health systems.
o Electronic Medical Record Keepers.
o Academic researcher and teacher.
Healthcare Data
Healthcare Data
o The global healthcare information systems market
was estimated at USD 268.1 billion in 2021
and is expected to hit around US$ 528.5 billion by 2030,
poised to grow at a CAGR of 7.8% from 2022 to 2030.
Sources of Healthcare Data
o HealthData.gov makes federal datasets available to healthcare organizations,
developers, and researchers.
o Datasets are available in categories: health, state, national, Medicare, hospital,
quality, community, and inpatient.
o Users can use filters: data type, subject, agency, date updated, coverage period,
collection frequency, geographic area, release date and output format.

See https://healthdata.gov/browse?limitTo=datasets&sortBy=newest&utf8=%E2%9C%93
HealthData.gov
o Community Health Status Indicators o Fourth National Survey of Older
Americans
o Child Growth Charts
o Health Indicators Warehouse
o Health Data Interactive
o Population (census) (CDC)
o Behavioral Risk Factor Surveillance
System (CDC) o Cancer Profiles
o Births (CDC) o Archimedes data modeling and
analytics tool
o Mortality (CDC)
Healthcare Big Data
o Data so large, it can’t be analyzed or stored in one computational unit
o Five Vs: the definition started with three Vs but has increased to five:
1. Volume: massive amounts of data are being generated each minute.
2. Velocity: data is being generated so rapidly that it needs to be analyzed without placing it
in a database.
3. Variety: roughly 80% of data in existence is unstructured so it won’t fit into a database or
spreadsheet. Analyzing such data requires new training and tools.
4. Veracity: current data can be “messy” with missing data and other challenges. Because of
the very significant volume of data, missing data may be less important than in the past.
5. Value: data scientists now have the capability to turn large volumes of unstructured data
into something meaningful. Without value, no information or knowledge can be drawn.
Information Hierarchy
o Data is a raw and unorganized fact that is required to be
processed to make it meaningful.
o Data are symbols representing observations about the
world.
o Data can be aggregated into a variety of formats such as
image files (JPG, GIG, PNG), text files, sound files (WAV,
MP3), or video files (WMV, MP4).
o There is no meaning associated with data; the 5 could
represent five fingers, five minutes, or have no real
meaning at all.
Cont’d
o Information is a set of data that is processed in a meaningful way according to the
given requirement.
o Information is processed, structured, or presented in a given context to make it
meaningful and useful. From information, conclusions can be drawn by humans or
computers. For example, five fingers have meaning in that it is the number of fingers
on a normal human hand.

o Knowledge is information that is justifiably considered to be true. For example, an

elevated fasting blood sugar level suggests an increased likelihood of diabetes
mellitus.
o Knowledge is really about facts and ideas that we acquire through study, research,
investigation, observation, or experience.
Cont’d
o Wisdom is the critical use of knowledge to make intelligent decisions. For example,
rising blood sugar can indicate diabetes and other secondary causes of
hyperglycemia.
o Wisdom is the ability to distinguish and judge which aspects of that knowledge are
true, right, lasting, and applicable to your life.
Example
o A modern way to convert medical information to knowledge is to use a clinical data
warehouse (CDW).
o EHRs are now a huge source of healthcare data and information. They contain both
structured (coded e.g. ICD-9 codes) and unstructured text (free text or natural language)
o Interpreting free text requires natural language processing (NLP)
Clinical Data Warehouse
Clinical Data Warehouse
o A clinical data warehouse (CDW) is a database system that
collects, integrates, and stores clinical data from a variety of
sources including electronic health records, radiology, and
other information systems.
o Data from EHRs, Radiology, Pathology, etc. are copied into a
staging database where they are cleaned and loaded into
another common database and associated with metadata
(data that describes data).
o Tools can be applied to the data in the CDW, such as simple
descriptive analytics that report the number of patients with
breast cancer, their age, menopausal status, etc. )
Clinical Data Warehouse
o CDWs do a better job of analyzing and reporting aggregate
healthcare data than the average EHR, which tends to focus
on the individual.
o CDWs can be used to evaluate a critical clinical process, and
cost estimates and they can analyze potential solutions.
o CDWs are highly valuable for informatics and evidence-
based medical research.
o CDWs can help track infections and report trends to public
health.
CDW schema (i2b2 platform)
o Informatics for Integrating Biology and the Bedside (i2b2) is a Harvard project used
by many other academic institutions in the US
o The program is open source and modular and incorporates genomic and clinical
information for research purposes.
o Database consists of facts (diagnoses, lab results, etc.) queried by users and
dimensions that describe the facts With this model data can be aggregated from
multiple hospitals.

See https://www.i2b2.org/software/index.html
Cancer data Star Schema
What Makes Informatics
Difficult?
What Makes Informatics Difficult?
o With other industries such as banking, data and information are much closer
(smaller semantic gap). For example, banking data such as $100.50 is close to an
account balance of $100.50. It leaves little leeway for a different interpretation
o In healthcare, there are subjective factors (“I feel sick”) that are difficult to
measure and vary from patient to patient and physician to physician. Lab results
are more objective and easier to interpret.
o It is difficult to model all of healthcare. View the HL7 RIM model on the next slide.
o Biomedical information is difficult due to incomplete, imprecise, vague,
inconsistent, and uncertain information.
o Humans can adapt to this dynamic and vague information but computers can not.
Clinical decision support in EHRs is precise when in reality it might need to be
flexible over time
HL7 Version 3
o The Health Level Seven
Version 3 (V3)
Normative Edition—a
suite of specifications
based on HL7’s
Reference Information
Model (RIM)—provides
a single source that
allows implementers to
work with the full set of
messages, data types,
and terminologies
needed to build a
complete
implementation.
Health Information Technology
Health information technology (HIT)
o Health information technology (HIT) is defined as the application of computers and
technology in healthcare settings.
o HIT is not solely a technical discipline but focuses on the relationship between the
technology and its use in real-world settings i.e. solutions are designed in context,
taking into account the social, cultural, and organizational settings in which
computing, and information technology will be used in healthcare sectors.
o Ideally, health information technology provides the tools to generate information
from data that humans (clinicians and researchers) can turn into knowledge and
wisdom. Thus, enabling and improving human decision-making with usable
information is a central concern of informaticians.
o HIT facilitates the processing, transmission, and analysis of information.
Driving Forces Behind Health Information
Technology
o Increase healthcare efficiency and productivity
o Improve healthcare quality (patient outcomes) resulting in improved patient safety
o Reduce healthcare costs
o Improve healthcare access with technologies such as telemedicine and online
scheduling
o Improve coordination and continuity of care
o Improve medical education of clinicians and patients Standardize medical care.
Reducing Errors
o Order entry systems
▪ Reduce medication errors
▪ Detect potential drug interactions
o Clinical decision support systems
▪ Improve drug dosing
▪ Improve preventive care
▪ Not diagnosis.
Barriers to HIT Adoption
o Inadequate time: Busy clinicians complain that they don’t have enough time to read
or learn about new technologies or research vendors.
o Inadequate information: clinicians need information, not data. Current HIT systems
are data-rich, but information poor.
o Inadequate expertise and workforce: to experience the widespread HIT adoption
and implementation, it will require the education of all healthcare workers.
o High cost to adopt: There is still limited evidence that most technologies will save
money.
o Change in the workflow: Significant changes in the workflow will be required to
integrate technology into the inpatient and outpatient settings.
Barriers to HIT Adoption
o Privacy concerns: different organizations have different privacy rules. In the past
decade, there have been many serious healthcare security breaches and stolen
identities.
o Legal issues: Some laws prevent hospital systems from providing or sharing
technology such as computers and software with referring physicians.
o Behavioral change: a large number of medical personnel will be slow to accept any
information technology innovations and they will be perceived as dragging their
feet.
Health (Medical) Informatics
Medical Informatics
o 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.

Warner, Sorenson and Bouhaddou, Knowledge Engineering in Health Informatics, 1997.

Informatics Use in Healthcare
Informatics Use in Healthcare
o Communication o Decision Support
▪ Telemedicine ▪ Reminder systems
▪ Tele-radiology ▪ Diagnostic Expert Systems
▪ Patient e-mail ▪ Drug Interaction
▪ Presentations

o Knowledge management o Information Management

▪ Journals ▪ Electronic Medical Records
▪ Consumer Health information ▪ Billing transactions
▪ Evidence-based medical information ▪ Ordering Systems
Healthcare Information Systems
Healthcare Information Systems
o An information system (IS) is an arrangement of data (information), processes,
people, and information technology that interact to collect, process, store, and
provide as output the information needed to support the organization.

o Healthcare information system (and hospital information system)—a group of

systems used to support and enhance healthcare.
Categories of healthcare Information Systems
o There are two primary categories of healthcare information systems:
1. Administrative Information System contains primarily administrative or financial
data and is generally used to support the management functions and general
operations of the healthcare organization.
o Types of Administrative Information Systems:
▪ Admission, discharge, transfer (ADT) tracks the patient’s movement of care in an
inpatient setting
▪ Registration may be coupled with ADT system; includes patient demographic and
insurance information as well as date of visit(s), provider information
▪ Scheduling aids in the scheduling of patient visits; includes information on patients,
providers, date and time of visit, rooms, equipment, other resources
Categories of healthcare Information Systems
o There are two primary categories of healthcare information systems:
2. Clinical Information System (or clinical application) contains clinical or health-
related information used by providers in diagnosing and treating a patient and
monitoring that patient’s care.
o Types of Clinical Information Systems:
▪ Laboratory information supports collection, verification, and reporting of
laboratory tests
▪ Radiology information supports digital image generation (picture archiving and
communication systems [PACS]), image analysis, image management
▪ Pharmacy information supports medication ordering, dispensing, and inventory
control; drug compatibility checks; allergy screening; medication administration
Categories of healthcare Information Systems
o Types of Clinical Information Systems:
▪ Nursing documentation facilitates nursing documentation from assessment to
evaluation, patient care decision support (care planning, assessment, flowsheet
charting, patient acuity, patient education)
▪ Electronic health record (EHR) facilitates electronic capture and reporting of
patient’ s health history, treatment and outcomes; allows clinicians to
document clinical findings, progress notes, and other patient information;
provides decision-support tools and reminders and alerts
▪ Telemedicine and telehealth supports remote delivery of care; common features
include image capture and transmission, voice and video conferencing, text
messaging
Definitions
Sources of Healthcare Data
o Electronic Medical Records
o Electronic Health Records
o Personal Healthcare Records
EMR Software
o Stands for ‘Electronic Medical Records', is a digitized version of hand-written paper
records maintained at the office of medical specialists.
o Such documents include medical diagnosis, treatment, and prescribed medications
aimed at tracking patient data over time.
o The main advantage of EMR healthcare data is that it helps practitioners to receive
quick access to the patient’s basic vitals, including age, weight, blood pressure, and
so on.
o Based on EMR, medical specialists can provide a more personalized medical
treatment for patients.
o While EMR software solutions could be used within a particular office, doctors can
not share this data with other departments.
Best EMR Systems
EPIC EMR System
EHR Software
o Stands for ‘Electronic Health Records’. The main difference between EHR and EMR
is that HER systems offer much more. EHR systems collect information about
patients from multiple sources, such as hospitals, physicians, labs, and patients.
o Such an approach improves the way patients receive treatment.
EHR Advanced Features
o Patient portals: a secure website through which patients can electronically access
their medical records. Portals often also enable users to complete forms online,
schedule appointments, communicate with providers, request refills on
prescriptions, review test results, or pay bills.
o Electronic prescriptions, transmitted directly to pharmacies, save patients’ time
since all the medicine will be processed while the patient travels to the pharmacy
from the doctor’s office.
o Voice-to-text translation and speech recognition saves doctors’ time rather than
having to manually write patient healthcare information.
o Reporting makes it easy to track revenue projections and provide details on how
many patients have paid or failed to pay their bills.
Best EHR Systems
Cerner EHR System
PHR Software
o Stands for ‘Personal Healthcare Records’. It similar to EHRs or EMRs. However, the
patient is responsible for updating and keeping all data up to date.
o Such data may include past critical information from doctor visits, medical
procedures, medical & lab reports and data, and even family health history. .
PHR System
Which one will work for you?
o If your healthcare facility has specific expertise in particular healthcare services,
such as dentistry, choose Electronic Medical Records.
o In the case of your medical facility including numerous departments, such as labs, X
Rays, emergency, and surgery, and you need to provide seamless transactions of
patient related data across these departments, consider the Electronic Health
Records system.
o If your healthcare organization puts patients first and needs to track their recovery
progress, Patient Healthcare Records is your system of choice.