This series of courses begins with an introduction to the US healthcare delivery system, its many systemic challenges and the prior efforts to develop and deploy informatics tools to help overcome those problems. It goes on to discuss health informatics from an historical perspective, its current state and its likely future state now that electronic health record systems are widely deployed, the HL7 FHIR (Fast Healthcare Interoperability Resources) standard is being rapidly accepted as the means to access and share the data stored in those systems and analytics is increasing being used to support clinical research using that aggregated data. It then turns to the impact of FHIR in transforming healthcare with a focus on some of the important and evolving areas of informatics including health information exchange, population health, public health, mHealth and big data and analytics. Use cases and case studies are used in all of these discussions to help students connect the technologies to real world challenges.
Courses under this program: Course 1: Health Informatics: A Current and Historical Perspective
Background on US healthcare, the key current applications of informatics in healthcare delivery
Course 2: Health Informatics: Data and Interoperability Standards
The key standards for representing and sharing healthcare data.
Course 3: Health Informatics: The Cutting Edge
Some of the key focus areas for health informatics research and development
A brief history of the healthcare informatics field emphasizing long recognized key capabilities and the reasons for their slow adoption. An introduction to the Fast Healthcare Interoperability (FHIR) standard and its transformative potential. This is illustrated by an interview with the clinical team developing a FHIR based tool for use in an ICU environment. A survey of the problems and challenges facing healthcare systems around the world and in the US in particular. An introduction of chronic disease and its key role in rising healthcare costs. Alternate care models that show promise of improving healthcare outcomes while lowering cost and their dependency on the use of information technology. The concept of a Learning Healthcare System that continuously improves using informatics to glean new knowledge from actual patient care and feed it back to providers as they take care of future patients. An interview with a team of Emory researchers that are using a FHIR-based tool to help lower the cost of hospital care while improving outcomes. A discussion of electronic medical records, the federal programs to stimulate their adoption and the challenges physicians have in using them. An interview with the lead of the FHIR effort at the major health IT vendor Cerner. A detailed discussion of the rich array of patient-facing informatics tools and approaches used in the past and being increasingly deployed at present. An activity using Microsoft’s Personal Health Record system for patients. A detailed discussion of the complex technical and policy issues surrounding the sharing and exchange of confidential health information. An interview with a Blockchain expert and with an expert on data models for sharing of healthcare information for research,
Once electronic health records and other clinical systems used in patient care are digital, the focus turns to how this health information can be represented and shared using standards. Developing standards that are both sufficiently comprehensive and also implementable in practice is one of the long-standing health informatics challenges in part because of the complexity of the human body and the resultant complexity of patient care. We discuss data and data sharing (interoperability) standards separately but they are inevitably intertwined since the information being shared using interoperability standards is often represented using data standards.
Adopting digital health records and sharing the data they contain is a critical step forward. However, since successful management of chronic disease must involve patients, using informatics tools and systems to engage them is now a major area of focus for academic and industry research and development. Much of our focus so far has been on the care of patients one at a time. Another major area of research and development involves the aggregation of data from large groups of patients to understand population (or public) health issues such as the factors external to traditional medicine that cause disease and that impact on our ability to treat it. Finally, digital health data is increasingly being used for research on methods to deploy predictive analytics to improve the diagnosis and treatment of disease as well as to run hospitals and health systems more cost effectively.