The Next Revolution: The Role of Informatics in Improving Health Care

Medical Informatics

Slide Presentation by Eduardo Ortiz, M.D., M.P.H. (Text Version)

On July 25, 2001, Eduardo Ortiz, M.D., M.P.H., Senior Service Fellow at the Agency for Healthcare Research and Quality (AHRQ) made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "Medical Informatics."

This is the text version of Dr. Ortiz's slide presentation. Select to access the PowerPoint® slides (30 KB).

Slide 1

Medical Informatics

• "Medical informatics is the application of computer technology to all fields of medicine—medical care, medical teaching, and medical research." Morris F. Collen, 1977.
• "Medical informatics is the scientific field that deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making." M.S. Blois and Edward H. Shortliffe, 1990.

Slide 2

Medical Informatics

• Deals with all aspects of understanding and promoting the effective organization, analysis, management, and use of information in health care (American Medical Informatics Association Web site).
• Improves and optimizes use of health care information to improve decision making.

Slide 3

Examples of Medical Informatics Tools

• Desktop and laptop computers.
• Handheld wireless devices (e.g., PDAs).
• Networks.
• Databases.

Slide 4

Examples of Medical Informatics Applications

• Electronic medical records.
• Electronic order entry.
• Automated reminders.
• Computerized expert systems.
• Electronic mail.
• Telemedicine.
• Digital imaging.
• Voice recognition.

Slide 5

Safety

Computerized order entry systems can reduce medication errors:

• Improve drug prescribing.
• Improve drug dosing.
• Drug-drug interactions.
• Drug allergies.

Bates, et al. JAMA 1998;  Bates, et al. J Am Med Inform Assoc 1999;  Teich, et al. Arch Intern Med 2000.

Slide 6

Effectiveness

Computerized reminders can improve compliance with recommended guidelines:

• Increase preventive services.
• Increase use of appropriate medications.
• Increase use of other interventions.

Hunt, et al. JAMA 1998;  Shea, et al. J Am Med Inform Assoc 1996.

Slide 7

Quality of Care

Computerized decision support can improve quality:

• Prevention of venous thromboembolism.
• Use of antibiotics.

Durieux, et al. JAMA 2000;  Teich, et al. Arch Intern Med 2000; Evans, et al. N Engl J Med 1998.

Slide 8

Costs

Electronic medical records with decision support can reduce costs:

• Reducing medical errors and adverse events.
• Recommending equally effective but less costly alternative interventions.
• Reducing the use of inappropriate tests.
• Reducing the ordering of redundant tests.

Teich, et al. Arch Intern Med 2000;  Bates, et al. JAMA 1998;  Glaser, et al. Proc Healthcare Information and Management Systems Society Annual Conf 1996.

Slide 9

Outcomes vs Process Measures

• Most studies have evaluated process measures.
• Many studies have demonstrated improvements in process measures using decision support systems.
• Few studies have assessed patient outcomes.

Slide 10

Patient Centered Care

• Information.
• Communication.
• Shared decision making.

Slide 11

Other Technologies

• Wireless devices.
• Automated data capture and transmission.
• Smart cards.
• Bar coding.
• Smart automated medication dispensers.
• Interactive patient decision support.
• Computer simulation for education and training.

Slide 12

Barriers

• Lack of technology infrastructure.
• Lack of standards.
• Cultural barriers:
  • Evidence-based medicine.
  • Tradition.
  • Resistance to change.
• Complexity of medicine.
• Workflow issues.
• Human factor issues.

Current as of August 2001

Internet Citation:

Ortiz, E. Medical Informatics. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 25, 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/informat/ortiztxt.htm

Return to Web Conference
State & Local Policymakers
AHRQ Home Page