Health informatics

Health informatics (also called health care informatics , healthcare informatics , medical informatics , nursing informatics , clinical informatics , or biomedical informatics ) is informatics in health care . It is a multidisciplinary field that uses health information technology (HIT) to improve health care through any combination of higher quality, higher efficiency, and new opportunities. The disciplines involved include information science , computer science , social science , Behavioral science , management science , and others. The NLM defines health informatics as “the interdisciplinary study of the design, development, adoption and application of IT-based innovations in healthcare delivery, management and planning”. [1] It is important to note that the use of biomedicine as a means of acquiring, Health informatics tools including amongst others computers, clinical guidelines , formal medical terminologies, and information and communication systems. [2] [3] It is applied to the areas of nursing , Clinical medicine , dentistry , pharmacy , public health , occupational therapy , physical therapy , biomedical research , and alternative medicine . [4] [ unreliable medical source? ] All of qui are designed to Improve the overall effectiveness of patient care of delivery by Ensuring que la data generated is of a high quality eg year mHealth based early warning scorecard. [5] Physical therapy , biomedical research , and alternative medicine . [4] [ unreliable medical source? ] All of qui are designed to Improve the overall effectiveness of patient care of delivery by Ensuring que la data generated is of a high quality eg year mHealth based early warning scorecard. [5] Physical therapy , biomedical research , and alternative medicine . [4] [ unreliable medical source? ] All of qui are designed to Improve the overall effectiveness of patient care of delivery by Ensuring que la data generated is of a high quality eg year mHealth based early warning scorecard. [5] An mHealth based early warning scorecard. [5] An mHealth based early warning scorecard. [5]

  • The international standards on the subject are covered by ICS 35.240.80 [6] in which ISO 27799 : 2008 is one of the core components. [7]
  • Molecular bioinformatics and clinical informatics have converged into the field of translational bioinformatics .

Sub specialities

Healthcare informatics includes the subspecialties of clinical informatics, pathology informatics , imaging informatics , [8] and pharmacy informatics [9] [10] [11] [12] [13] [14]

It also includes public health informatics , community health informatics , home health informatics , nursing informatics , medical informatics , consumer health informatics , clinical bioinformatics , and informatics for education and research in health and medicine.

Healthcare informatics

Clinical informatics

Clinical informatics is concerned with the use of information in health care by and for clinicians . [15] [16]

Clinical informaticians, Also Known As clinical informaticists, transform health care by analyzing, designing, Implementing, and Evaluating information and communication systems That Enhance individual and population health outcomes, Improve [patient] care, and Strengthen the clinician-patient relationship. Clinical use informaticians Their knowledge of patient care combined With Their understanding of informatics concepts, methods, and health informatics tools to:

  • Health care professionals and patients,
  • Characterize, evaluate, and refine clinical processes,
  • Develop, implement, and refine clinical decision support systems, and
  • Lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems.

Clinicians Collaborate with other health care and information technology professionals to Develop health informatics tools qui Promote patient care That is safe, efficient, effective, Timely, patient-centered, and equitable. Many clinical informaticists are also computer scientists.

In October 2011, the Board of Medical Specialties ( ABMS ), the organization overseeing the certification of specialist MDs in the United States, announced the creation of MD-only physician certification in clinical informatics. The first examination for board certification in the subspecialty of clinical informatics Was offert in October 2013 by the American Board of Preventive Medicine (ABPM) with 432 passing to Become the inaugural 2014 class of Diplomats in clinical informatics. [17]

Fellowship programs exist for physicians who wish to become a board-certified in clinical informatics. Physicians must have graduated from a medical school in the United States or Canada, or a school located elsewhere that is approved by the ABPM. In addition, they must complete a primary residency program such as Internal Medicine (or any of the 24 subspecialties recognized by the ABMS) and be eligible to become licensed to practice medicine in their fellowship program. [18] The fellowship program is 24 months in length, with fellows dividing their time between Informatics rotations, didactics, research, and clinical work in their primary specialty.

Integrated data repository

Example IDR schema
Achilles tool for data characterization of a healthcare dataset

One of the fundamental elements of biomedical and translational research is the use of integrated data repositories. Survey conducted in 2010, defined “integrated data repository” (IDR) as a data warehouse, incorporating various sources of clinical data to support queries for a range of research-like functions. [19] Integrated data repositories are complex systems developed to solve a variety of problems, and most importantly convenient and flexible query. [20] Development of the field of clinical informatics to the creation of large data sets with electronic health record data with such data genomic data. Types of data repositories include operational data stores (ODSs), clinical data warehouses, clinical data marts, and clinical registries. [21] Operational data stores established for the purpose of extracting, transferring and loading before creating warehouse or data marts. [21] Clinical registries repositories have long been in existence, but their contents are archaic. [21] Clinical data stores and clinical data warehouses are considered fast and reliable. Though these are the major challenges facing the organization, it still faces challenges and barriers. One of the most important issues in this paper is the need for a more rigorous approach to the evaluation of chemicals. [22] Some research resources do not require individual IRB approval, example CDWs with data of deceased patients have been de-identified, and its use does not require institutional review board (IRB) approval. [22] [19] [21] [20] However, privacy sensitive data may be explored by researchers when shared through its metadata and services. [23] Another challenge is data quality. Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] (IRB) approval. This document is a preview generated by EVS [22] [19] [21] [20] However, privacy sensitive data may be explored by researchers when shared through its metadata and services. [23] Another challenge is data quality. Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] (IRB) approval. This document is a preview generated by EVS [22] [19] [21] [20] However, privacy sensitive data may be explored by researchers when shared through its metadata and services. [23] Another challenge is data quality. Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] [22] [19] [21] [20] However, privacy sensitive data may be explored by researchers when shared through its metadata and services. [23] Another challenge is data quality. Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] [22] [19] [21] [20] However, privacy sensitive data may be explored by researchers when shared through its metadata and services. [23] Another challenge is data quality. Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24] Methods that adjust for bias. Tools that examine data quality (eg, point to missing data). [24]

Clinical research informatics

Clinical research informatics (CRI) is a subfield of health informatics that tries to improve the efficiency of clinical research by using informatics methods. Some of the problems tackled by CRI are: creation of data warehouses of healthcare data That can be used for research, carrier of data collection in clinical trials by the use of electronic data capturesystems, streamlining ethical approvals and Renewals (in US the Responsible Entity Is the local institutional review board .

CRI is a fairly new branch of informatics and has a growing pains as any up and coming field does. Some issues CRI faces the ability for the statisticians and the computer system to design a system to support the development of a new system. Researchers and the informatics team have a difficulty coordinating plans and ideas in order to design a system that is easy to use for the research team. The lack of funding can be a hindrance to the development of the CRI. Many organizations that are performing research are struggling to get financial support to conduct research,

Common data elements (CDEs) in clinical research

Ability to integrate data from multiple clinical trials is an important part of clinical research informatics. Initiatives, such as PhenX and Patient-Reported Outcomes Measurement Information System . CDE initiatives, for example, electronic case report forms .

Human bioinformatics

Translational bioinformatics

With the completion of the human genome and the recent advent of high throughput sequencing and genome-wide studies Association of single nucleotide polymorphisms, the fields of molecular bioinformatics, biostatistics, statistical genetics and clinical informatics are converging into the emerging field of translational bioinformatics . [25] [26] [27]
The relationship entre bioinformatics and health informatics, while conceptually related under the umbrella of biomedical informatics, [28] Has not always-been very clear. The TBI community is specifically motivated with the development of approaches to identify linkages between fundamental biological and clinical information.
Along with complementary areas of emphasis,

Translational Bioinformatics (TBI) is a relatively new field in the year 2000 when human genome sequence was released (Tenenbaum, 2016). The commonly used definition of TBI is lengthy and could be found on the. [30] In simpler terms, TBI could be defined as a collection of colossal amounts of health related data (biomedical and genomic) and translation of the data into individually tailored clinical entities (Tenenbaum, 2016). Today, TBI is categorized into four major themes that are briefly described below:

  1. Clinical big data
    Clinical big data is a collection of electronic health records are used That for innovations. The evidence-based approach that is currently practiced in medicine is the best way to achieve better outcomes for patients. As CEO of California-based cognitive computing firm Apixio, Darren Schutle, explains that the care can be better fitted to the patient if the data could be obtained from various medical records, merged, and analyzed. (Marr, 2016). It is also known as the “
  2. Genomics in clinical care
    . Currently, the most vigorous area of ​​using genomics is oncology. The identification of genomic sequencing of cancer may determine the sensitivity and resistance during oncological treatment processes (Tenenbaum, 2016).
  3. Omics for
    drug discovery and repurposing The drug repurposing is an analgesic drug. (Tenenbaum, 2016, p.37). In this paper, we present the results of the study of the molecular signatures in a patient’s disease.
  4. Personalized genomic testing
    In the USA, several companies offer direct-to-consumer (DTC) genetic testing . The company that performs the majority of testing is called 23andMe. Utilizing genetic testing in health care raises many ethical, legal and social concerns; One-of-a-kind questions about the healthcare provider. The documented examples of incorporating such information into a healthcare-care system are presented in the Tenenbaum, 2016.

Computational health informatics

Computational health informatics is a branch of computer science that deals with computational techniques that are relevant to healthcare. Computational health informatics is also a branch of health informatics, but is orthogonal to much of the work going on in health informatics because computer scientist’s interest is mainly in understanding fundamental properties of computation. Health informatics, on the other hand, is a concern for the intervention of computers. The health domain provides an extremely wide variety of problems that can be tackled using computational techniques, And computer scientists are attempting to make a difference in medicine by studying the underlying principles of computer science that will allow for meaningful (to medicine) algorithms and systems to be developed. Thus, computer scientists work in computational health informatics and health scientists working in medical health informatics combine to develop the next generation of healthcare technologies.

Using computers to analyze health data has been around since the 1950s, but it was not until the 1990s that the first sturdy models appeared. The development of the internet has helped develop computational health informatics over the past decade. Computer models are used to examine various topics such as how to exercise affects obesity, healthcare costs, and many more. [31]

Examples of projects in computational health informatics include COACH project. [32] [33]

Informatics for education and research in health and medicine

Clinical research informatics

Clinical research informatics (CRI) is an amalgamation of clinical and research informatics. (Katzan & Rudick, 2012). In this paper, we present the results of the study. (Kahn & Weng, 2012). In this paper, we describe the evolution of the transitional process and the evolution of the transitional process. (Katzan & Rudick, 2012). Evolution of CRI was very important in informatics and there was an extraordinary increase in the scope of clinical and translational science advances. Clinical research informatics takes the core foundations, principles, and technologies related to Health Informatics, And apply these to clinical research contexts. [34] As such, CRI is a sub-discipline of health informatics, and interest and activities in CRI have increased greatly in recent years given the overwhelming problems associated with the explosive growth of clinical research and information. [35] CRI supports, including:

  • More efficient and effective data collection and acquisition
  • Improved recruitment into clinical trials
  • Optimal protocol design and efficient management
  • Patient recruitment and management
  • Adverse event reporting
  • Regulatory compliance
  • Data storage, transfer, [36] processing and analysis
  • Repositories of data from completed clinical trials (for secondary analyzes)


Worldwide use of computer technology in medicine began in the early 1950s with the rise of the computers. [37] In 1949, Gustav Wagner established the first professional organization for informatics in Germany. [38] The prehistory, history, and future of medical information. [39] Specialized university departments and Informatics training programs in the 1960s in France, Germany, Belgium and The Netherlands. Medical informatics research units Began to Appear During the 1970s in Poland and in the US [38] since then the development of high-quality health informatics research, education and infrastructure has-been a goal of the US and the European Union.

Early names for health informatics included medical computing, biomedical computing, medical computer science, computer medicine, medical electronic data processing, medical automatic data processing, medical information processing, medical information science, medical software engineering, medical and computer technology. Citation needed ]

The health informatics community is still growing, it is by no means a mature profession, but work in the UK by the voluntary registration body, the UK Council of Health Informatics Professions has suggested eight key constituencies within the domain information management knowledge, ICT, education and research, medical informatics, health records (service and business-related), health informatics service management. NHS, in academia and commercial service and solution providers.

Since the 1970s the most prominent international coordinating body has been the International Medical Informatics Association (IMIA). [40]

In the United States

Even though the idea of ​​using computers in medicine emerged as technology advanced in the early 20th century, it was not until the 1950s that informatics began to have an effect in the United States. [37]

The Earliest use of electronic digital computers for medicine Was for dental projects in the 1950s at the United States National Bureau of Standards by Robert Ledley . [41] During the mid-1950s, the United States Air Force (USAF) carried out several medical projects on its computers while also encouraging civilian agencies as the National Academy of Sciences (NAS-NRC) and the National Institutes Of Health (NIH) to sponsor such work. [42] In 1959, Ledley and Lee B. Lusted published “Reasoning Foundations of Medical Diagnosis,” widely read article in Science , (Computationally). Ledley and Lusted’s article has been influential for decades, especially within the field of medical decision making. [43]

Guided by Ledley’s late 1950s NAS-NRC, and by Nidesh, the NIH undertook the first major effort to introduce computers to biology and medicine. This effort, carried out initially by the NIH’s Advisory Committee on Computers in Research (ACCR), chaired by Lusted, spent over $ 40 million between 1960 and 1964 in order to establish dozens of large and small biomedical research centers in the US. [42]

One early (1960, non-ACCR) was used to quantify normal human movement, as a precursor to scientifically measuring deviations from normal, and design of prostheses. [44] The use of computers (IBM 650, 1620, and 7040) allowed analysis of a large sample size, and of more measurements and subgroups Age and body characteristics. A study co-author was Dean of the Marquette University College of Engineering; Biomedical Engineering.

The next steps, in the mid-1960s, were the development of expert systems such as MYCIN and Internist-I . In 1965, the National Library of Medicine began to use MEDLINE and MEDLARS . Around this time, Neil Pappalardo , Curtis Marble, and Robert Greenes Developed MUMPS (Massachusetts General Hospital Utility Multi-Programming System) in Octo Barnett ‘s Laboratory of Computer Science [45] at Massachusetts General Hospital in Boston , Reviews another center of biomedical computing That Received significant support from the NIH. [46] In the 1970s and 1980s it was the most commonly used programming language for clinical applications. The MUMPS operating system was used to support MUMPS language specifications. As of 2004 , a descendant of this system is being used in the United States Veterans Affairs Hospital system. The Veterans Health Information Systems and Technology Architecture (VistA) . A graphical user interface known as the Computerized Patient Record System (CPRS) allows healthcare providers to review and update a patient’s electronic medical record at any of the VA’s over 1,

During the 1960s, Morris Collen, a physician working for Kaiser Permanente’s Division of Research, developed computerized systems to automate many aspects of multiphasic health checkups. Kaiser Permanente developed during the 1970s and 1980s. [47] The American College of Medical Informatics (ACMI) has since 1993 annually bestowed the Morris F. Collen MD Medal for Outstanding Contributions to the Field of Medical Informatics. [48]Permanent Kaiser

In the 1970s a growing number of commercial vendors began to market and manage electronic medical records systems. However, many health care practitioners use electronic health care records systems. In 1970, Warner Slack, MD, and Howard Bleich, MD, co-founded the academic division of clincal informatics [49] at Beth Israel’s Deaconess Medical Center and Harvard Medical School. Warner Slack is a pioneer of electronic medical history, [50]and in 1977 Dr. Bleich created the first user-friendly search engine for the worlds biomedical literature. [51] In 2002, Dr. Slack and Dr. Bleich were awarded the Morris F. Collen Award for their pioneering contributions to medical informatics.

Computerized systems involved in patient care have led to a number of changes. (Zahabi, Kaber, & Swangnetr, 2015), and the results of the study are presented in this paper. The support for the flow of patient information through various modalities of care.

A patient who has been diagnosed with diabetes and who has been diagnosed with diabetes, (Zahabi, Kaber, & Swangnetr, 2015). Many researchers in the field of healthcare systems have reported a decrease in the quality of healthcare systems. The system however is not perfect and will continue to require improvement. (Zahabi, Kaber, & Swangnetr, 2015). As leaders in the field of medical informatics, the overall provision of healthcare will continue to improve. [53] [54]

Homer R. Warner , one of the fathers of medical informatics, [55] founded the Department of Medical Informatics at the University of Utah in 1968. The American Medical Informatics Association (AMIA) .

Informatics certifications

Like other IT training specialties, there are Informatics certifications available to help informatics professionals stand out and be recognized. The American Nurses Credentialing Center (ANCC) offers a board certification in Nursing Informatics. [56] For Radiology Informatics, the CIIP (Certified Imaging Informatics Professional) certification was created by ABII (the American Board of Imaging Informatics) which was founded by SIIM (the Society for Imaging Informatics in Medicine) and the American Registry of Radiologic Technologists) in 2005. The CIIP certification requires documented experience working in Imaging Informatics, formal testing and is a limited time credential requiring renewal every five years. The clinical trials, PACS administrator or other radiology IT clinical support role. [57] Certifications from PARCA (PACS Administrators Registry and Certifications Association) are also recognized. The five PARCA certifications are tiered from entry level to architect level. The American Health Information Management Association offers credentials in medical coding, analytics, and data administration, as well as Registered Health Information Administrators and Certified Coding Associates. [58] The five PARCA certifications are tiered from entry level to architect level. The American Health Information Management Association offers credentials in medical coding, analytics, and data administration, as well as Registered Health Information Administrators and Certified Coding Associates. [58] The five PARCA certifications are tiered from entry level to architect level. The American Health Information Management Association offers credentials in medical coding, analytics, and data administration, as well as Registered Health Information Administrators and Certified Coding Associates. [58]

Certifications are widely sought after by employers in health informatics, and overall the demand for certified informatics workers in the United States is outstripping supply. [59] The American Health Information Management Association reports that only 68% of applicants pass certification exams on the first try. [60]

In the UK

The broad history of health informatics has-been captured in the book UK Health Computing: Recollections and Reflections , Hayes G, Barnett D (Eds.), BCS (May 2008) by active Those in the field, Predominantly members of BCS Health and Its form groups. The book describes the path taken as ‘early development of health informatics was unorganized and idiosyncratic’. (1960), radiotherapy (1962), immunization (1963), and primary care (1968) emerge. In the early 1950s, Many of these solutions, even in the early 1970s were developed in-house by pioneers in the field to meet their own requirements. In part this was due to some areas of health services (for example the immunization and vaccination of children) still being provided by Local Authorities. Interesting, this is a situation that the coalition government proposes to broaden to the 2010 strategy; Stating:

“We will have patients at the heart of the NHS, through a decision-making and decision-making process. Make choices about their care. They will have increased control over their own care records. ”

These types of statements present a significant opportunity for health informaticians to come out of the back-office and take up a front-line role supporting clinical practice, and the business of care delivery. The International Federation of Information Processing (1969), which became IMIA (1979). Under the aegis of BCS Health, Cambridge was the host for the first EFMI Medical Informatics Europe (1974) conference and London was the location for IMIA’s tenth global congress (MEDINFO2001).

Current state and policy initiatives


Since 1997, the Buenos Aires Biomedical Informatics Group, a nonprofit group, represents the interests of a broad range of clinical and non-clinical professionals within the Health Informatics sphere. Its purposes are:

  • Promote the implementation of the computer tool in the healthcare activity, scientific research, health administration and in all areas related to health sciences and biomedical research.
  • Support, promote and disseminate content related activities with the management of information and tools they use to do under the name of Biomedical informatics.
  • Promote cooperation and exchange of actions in the field of biomedical informatics, both in the public and private, national and international level.
  • Interact with all scientists, recognized academic stimulating the creation of new instances that have the same goal and be inspired by the same purpose.
  • To promote, organize, sponsor and participate in events and activities for training in computer and information and disseminating developments in this area that could be useful for team members and health related activities.

The Argentinean health system is heterogeneous in its function, and because of the informatics developments a heterogeneous stage. Many private health care centers have developed systems, such as the Hospital Aleman of Buenos Aires, or the Hospital of Buenos Aires, which also has a residence program for health informatics.


Main article: Brazilian Society of Health Informatics

The first applications of computers to medicine and healthcare in Brazil began around 1968, with the installation of the first mainframes in public university hospitals, and the use of programmable calculators in scientific research applications. Minicomputers, such as the IBM 1130, have been installed in several universities, and the first applications were developed for them, such as the hospital census in the School of Medicine of Ribeirão Preto and Patient Master Files, in the Hospital das Clínicas da Universidade de São Paulo , Respectively at the cities of Ribeirão Preto and São Paulo campuses of the University of São Paulo . In the 1970s, Several Digital Corporation and Hewlett Packard minicomputers Were Acquired for public hospitals and Armed Forces, and more intensively used for intensive-care unit , cardiology diagnostics, patient monitoring and other applications. In the early 1980s, with the arrival of cheaper microcomputers , a great upsurge of computer applications in health care, and in 1986 the Brazilian Society of Health Informatics was founded, the first Brazilian Congress of Health Informatics was held, and the Brazilian Journal of Health Informatics was published. In Brazil, Two universities are pioneers in teaching and research in medical informatics, both the University of Sao Paulo and the Federal University of Sao Paulo offer undergraduate programs in MSc and PhD. In 2015 the Universidade Federal de Ciências da Saúde of Porto Alegre , Rio Grande do Sul , also started to offer undergraduate program.


Health Informatics projects in Canada are implemented provincially, with different provinces creating different systems. A national, federally funded, not-for-profit organization called Canada Health Infoway was created in 2001 to foster the development and adoption of electronic health records across Canada. As of December 31, 2008 there were 276 EHR projects under way in Canadian hospitals, other health-care facilities, pharmacies and laboratories, with an investment of $ 1.5-billion from Canada Health Infoway. [61]

Provincial and territorial programs include the following:

  • EHealth Ontario was created as an Ontario provincial government agency in September 2008. It has been plagued by delays and its CEO was fired over a multimillion-dollar contracts scandal in 2009. [62]
  • Alberta Netcare was created in 2003 by the Government of Alberta. Today the netCARE portal is used by thousands of clinicians. It provides access to demographic data, prescribed / dispensed drugs, known allergies / intolerances, immunizations, laboratory test results, diagnostic imaging reports, diabetes registry and other medical reports. NetCARE interface capabilities in electronic medical record products which are funded by the provincial government.

United States

In 2004, President George W. Bush signed Executive Order 13335 , creating the Office of the National Coordinator for Health Information Technology (ONCHIT) as a division of the US Department of Health and Human Services(HHS). The mission of this office is the adoption of interoperable electronic health records (EHRs) in the US within 10 years. See quality initiatives for more information on federal initiatives in this area.

In 2014 The Department of Education approved an advanced health informatics undergraduate program that was submitted by the University of South Alabama. The Informatics Education Program is designed to provide specific information and education to the health informatics community. The program is housed in the School of Computing in Shelby Hall, a recently completed $ 50 million state of the art teaching facility. The University of South Alabama awarded David L. Loeser on May 10, 2014 with the first Health Informatics degree. The program currently is scheduled to have 100+ students awarded by 2016.

The Certification Commission for Healthcare Information Technology (CCHIT), a private nonprofit group, Was funded in 2005 by the US Department of Health and Human Services to Develop a set of standards for electronic health records (EHR) and Supporting networks, and certify vendors Who Meet them. In July 2006, CCHIT released its first list of 22 certified ambulatory EHR products, in two different announcements. [63]

Harvard Medical School added a department of biomedical informatics in 2015. [64] The University of Cincinnati in partnership with Cincinnati Children’s Medical Center created a biomedical informatics (BMI) and Graduate certificate program in 2015 Began a BMI PhD program. [65] [66] [67] The joint program allows researchers and students to observe the impact of their work on the patient’s bedside.


For more information on this topic, see European Federation for Medical Informatics .

The European Union’s Member States are committed to sharing their best practices and experiences to create a European eHealth Area. The European eHealth Action Plan plays a fundamental role in the European Union’s strategy. Work on this initiative involves a collaborative approach in several parts of the Commission services. [68] [69] The European Institute for Health Records is involved in the promotion of high quality electronic health recordsystems in the European Union . [70]


There are a number of models of health care in each of the countries (England, Scotland, Northern Ireland and Wales) but some bodies like UKCHIP [1] (see below) .


NHS Informatics in England (NPFIT) in the early 2000s, under the auspices of NHS Connecting for Health (Part of the Health and Social Care Information Center as of 1 April 2013). NPfIT is a regional service provider based in Lower Saxony, Germany. The various specific technical solutions were required to connect securely with the NHS ‘Spine’, a system designed to broker data between different systems and care settings. NPfIT fell, the ” Exacerbated by the media and political lambasting of the program. In Liberating the NHS. ” This initiative provided little in the way of innovative thinking, the primary re-stating existing strategies within the Coalition’s vision for the NHS. The degree of computerization in NHS was a high priority for NPFIT, and the program was stagnated further development of the original NPfIT. Tried to deal with a hinterland in the middle. Almost all general practices in England and Wales are computerized under the ‘GP Systems of Choice’ (GPSoC) program, and patients have relatively extensive computerized primary care clinical records. GP system, GPSoC sets relative rigid minimum standard of performance and functionality for vendors to adhere to. Interoperation between primary and secondary care systems is rather primitive. It is the first step in the development of intercultural and intercultural dialogue. Notable successes to date are in the electronic requesting and viewing of test results, And in some areas GPs have access to digital X-ray images from secondary care systems. Scotland has a great location and a great location. Scotland has the GPASS system, which is owned by the State, and controlled and developed by NHS Scotland. GPASS was accepted in 1984. GPs in Scotland but has developed poorly. Citation needed ] Discussion of open sourcing it as a remedy is occurring. GPASS was accepted in 1984. GPs in Scotland but has developed poorly. Citation needed ] Discussion of open sourcing it as a remedy is occurring. GPASS was accepted in 1984. GPs in Scotland but has developed poorly. Citation needed ] Discussion of open sourcing it as a remedy is occurring.


Wales has a dedicated Health Informatics function that supports NHS Wales.


In the Netherlands, health information is a priority for research and implementation. The Netherlands Federation of University Medical Centers (NFU) [71] has created the Citrienfonds , which includes the eHealth and Registration programs at the Source. [72] The Netherlands aussi Has the National Society for Healthcare Informatics organisms (VMBI) [73] and Nictiz, the National Center for standardization and eHealth. [74]

Emerging Directions (European R & D)

The European Commission’s preference, as Exemplified in the 5th Framework [75] as well as pilot projects Pursued Currently, [76] is for Free / Libre and Open Source Software (FLOSS) for healthcare. Another stream of research focuses on aspects of “big data” in health information systems. Biomedical Informatics [77] by Andreas Holzinger.

Asia and Oceania

In Asia and Australia-New Zealand, the regional group called the Asia Pacific Association for Medical Informatics (APAMI) [78] was established in 1994 and now has more than 15 member regions in Asia Pacific Region.


The Australasian College of Health Informatics (ACHI) is the professional association for health information in the Asia-Pacific region. It represents the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere through a commitment to quality, standards and ethical practice. [79] ACHI is an academic institution of the International Medical Informatics Association (IMIA) [80] and a full member of the Australian Council of Professions. [81] ACHI is a sponsor of the e-Journal for Health Informatics, [82] an indexed and peer-reviewed professional journal. ACHI has also supported the ”

ALTHOUGH there are a number of health informatics organizations in Australia, the Health Informatics Society of Australia [84] (HISA) is Regarded as the major umbrella group and is a member of the International Medical Informatics Association (IMIA). Nursing Informaticians were the driving force behind the formation of HISA, which is now a company limited by guarantee of the members. The membership comes from the informatics spectrum that is from students to corporate affiliates. HISA has a number of branches (Queensland, New South Wales, Victoria and Western Australia), as well as pathology, aged and community care, and medical imaging (Conrick, 2006).


After 20 years, China performed a successful transition from its planned economy to a socialist market economy . Along this change, China’s healthcare system In 2003, the data (released from the Ministry of Health of the People’s Republic of China (MoH)), indicated that the national healthcare-involved expenditure was up to RMB 662.33 billion, which accounted for 5.56% of nationwide gross domestic products. Before the 1980s, the entire health care costs were covered in central government annual budget. Since then, the construct of healthcare-expended supporters began to change gradually. Most of the expenditure was contributed by health insurance schemes and private spending, which corresponded to 40% and 45% of total expenditure, respectively. Meanwhile, the financially governmental contribution was decreased to 10% only. On the other hand, by 2004, up to 296,492 healthcare facilities were recorded in statistical summary of MoH, and an average of 2.4 clinical beds per 1000 people were mentioned as well. [85]

In China
Proportion of Nationwide Hospitals with HIS in China by 2004

Along with the development of information technology since the 1990s, healthcare providers realised that the information could generate significant benefits to their patients. conditions. Therefore, China’s own health informatics system. Most of These Were Arranged resources to construct hospital information system (HIS), qui Was avocation to minimize waste and Unnecessary repetition, subsequently to Promote the efficiency and quality-control of healthcare. [86] By 2004, China had successfully spread HIS through 35-40% of nationwide hospitals. [87] However, The dispersion of hospital-owned HIS varies critically. In the east part of China, over 80% of hospitals constructed HIS, in northwest of China the equivalent was no more than 20%. Moreover, all of the Centers for Disease Control and Prevention (CDC) Rural Above level, Approximately 80% of healthcare above-the rural organizations level and 27% of hospitals over town level-have the Ability to perform the transmission of postponements about real-time epidemic Situation through public health information system and to the analysis of infectious diseases by dynamic statistics. [88] All of the above- mentioned Centers for Disease Control and Prevention (CDC) above rural level, approximately 80% of healthcare organizations above the rural level and 27% of hospitals Public health information system and analysis of infectious diseases by dynamic statistics. [88] All of the above- mentioned Centers for Disease Control and Prevention (CDC) above rural level, approximately 80% of healthcare organizations above the rural level and 27% of hospitals Public health information system and analysis of infectious diseases by dynamic statistics. [88]

China has four thirds in its healthcare system. The first tier is a street health and workplace clinics and these are checks and hospitals in terms of medical billing and act as prevention centers. The second tier is the second level of care. The third tier is provisional and municipal general hospitals and teaching hospitals which provided the third level of care. In a tier of its own is the national hospitals which are governed by the Ministry of Health. The World Trade Organization (WTO), the World Trade Organization (WTO). In 2001, it was reported that China had 324,380 medical institutions and the majority of those were clinics. The reason for this is that the clinics are prevention centers and Chinese people like using traditional Chinese medicine as opposed to Western medicine and it works for the minor cases. China has also been improving its higher education in regards to health informatics. At the end of 2002, there were 77 medical universities and medical colleges. There were 48 college medical colleges that offered bachelor, master, and doctorate degrees in medicine. There were 21 higher medical and educational institutions. Since joining the WTO, China has been working hard to improve its education system and bring it up to international standards. [89] SARS played a large role in China’s rapidly improving its healthcare system. Back in 2003, HIS or Hospital Information System and more than 80% of hospitals had HIS. China has been comparing itself to Korea’s healthcare system and figuring out how it can better its own system. There was a study done that surveyed six hospitals in China that had HIS. The results were that doctors did not use computers as much as it was for administrative purposes. If you have any questions or would like to help us improve our services, please do not hesitate to contact us. In conclusion, all of them agreed or strongly agreed to provide information on the Internet should be utilized.

Standards in China

Collected information at different times, by different participants or systems could frequently lead to issues of misunderstanding, dis-comparing or dis-exchanging. To design an issues-minor system, healthcare providers realised that certain standards were the basis for sharing information and interoperability, however a system lacking standards would impediment to interfere the improvement of corresponding information systems. Given that the standardization for health informatics depends on the authorities, the standardization of events must be involved with In 2003,

In China, the establishment of standardization was initially facilitated with the development of vocabulary, classification and coding , which is conducive to reserve and transmit information for premium management at national level. By 2006, 55 international / domestic standards of vocabulary, classification and coding have been provided in hospital information system. In 2003, the 10th revision of the International Statistical Classification of Diseases and Related Health Problems ( ICD-10 ) and the ICD-10 Clinical Modification (ICD-10-CM) were adopted as standards for diagnostic classification and acute care procedure classification. Simultaneously, the International Classification of Primary Care (ICPC) was translated and tested in China ‘ S local applied environment. [92] Another coding standard, named Logical Observation Identifiers Names and Codes (LOINC), was used for general observation for clinical observation in hospitals. Personal identifier codes were widely used in different information systems, involving name, sex, nationality, family relationship, educational level and occupation. However, these codes within different systems are inconsistent, when sharing between different regions. Considering this wide variety of vocabulary, classification and coding standards between different jurisdictions, the healthcare provider realised that using multiple systems could generate issues of resource wasting and a non-conflicting national standard was beneficial and necessary. Therefore, in late 2003,

National Standards and Standards
1. Establishing a national health information system
2. Identify the classes, relationships and attributes of national health information framework. Produce a conceptual health data model to cover the scope of the health information framework
3. Logical data model for specific domains, depicting the logical data entities, the data attributes, and the relationships between the entities according to the conceptual health data model
4. Establishment of a statistical system based on a statistical model
5. Circulate the completed health information system
6. Developing a process to maintain and refine the China model


Comparison between China’s EHR Standard and Segments of the ASTM E 1384 Standard

Recently, Researchers from local universities Evaluated the performance of China’s Electronic Health Record (EHR) Standard Compared with the American Society for Testing and Materials Standard Practice for Content and Structure of Electronic Health Records in the United States ( ASTM E 1384 Standard). [93]

China’sEHR standard ASTM E 1384 standard
● H.01 Document identifier, H.02 Service object identifier, H.03 Demographics, H.04 Contact person, H.05 Address, H.06 Contacts ● Seg1 Demographic / Administrative, Seg14A Administrative / DiagnosticSummary
● H.07 Medical insurance
● H.08 Healthcare institution, H.09 Healthcare practitioner ● Seg4 Provider / Practitioners
● H.10 Event summary ● Seg5 Problem List, Seg14A Administrative / Diagnostic Summary
● S.01 Chief complaints ● Seg14B Chief Complaint Present Illness / Trauma Care
● S.02 Physical exam ● Seg9 Assessments / Exams
● S.03 Present illness history ● Seg14B Chief Complaint Present Illness / Trauma Care
● S.04 Past medical history ● Seg5 Problem List, Seg6 Immunizations, Seg7 Exposure to Hazardous Substances, Seg8 Family / Prenatal / Cumulative Health / Medical / Dental Nursing History
● S.05 Specific Exam, S.06 Lab data ● Seg11 Diagnostic Tests
● S.07 Diagnoses ● Seg5 Problem List, Seg14A Administrative / Diagnostic Summary
● S.08 Procedures ● Seg14E Procedures
● S.09 Medications ● Seg12 Medications
● S.10 Care / treatment plans ● Seg2 Legal Agreements, Seg10 Care / Treatment Plans and Orders, Seg13 Scheduled Appointments / Events
● S.11 Assessments ● Seg9 Assessments / Exams
● S.12 Encounters / episodes notes ● Seg14C Progress Notes / Clinical Course, Seg14D Therapies, Seg14F Disposition
● S.13 Financial information ● Seg3 Financial
● S.14 Nursing service ● Seg8 Family / Prenatal / Cumulative Health / Medical / Dental Nursing History, Seg14D Therapies
● S.15 Health guidance ● Seg10 Care / Treatment Plans and Orders
● S.16 Oven diagnostic methods in Traditional Chinese medicine ● Seg11 Diagnostic Tests

The table above demonstrates details of this comparison, which shows some areas of improvement for future revisions of EHR Standard in China. Detailedly, these deficiencies are listed in the following.

  1. The lack of support for privacy and security. The ISO / TS 18308 specifies “The EHR must support the ethical and legal use of personal information, which may be culturally or legally specific” ( ISO 18308: Health Informatics-Requirements for an Electronic Health Record Architecture, 2004). However this China EHR Standard did not achieve any of the fifteen requirements in the subclass of privacy and security.
  2. The shortage of support on different types of data and reference. Considering only ICD-9 is a reference in which China’s external coding systems, other similar systems, such as SNOMED CT in clinical terminology presentation, can not be considered for Chinese specialists, which could lead to internationally-deficient information.
  3. The lack of more generic and extensible lower level data structures. China’s wide and complex EHR Standard was constructed for all medical domains. However, the specific and time-consuming attributes of clinical data elements, value sets and [94]

Hong Kong

In Hong Kong a computerized patient record system called the Clinical Management System (CMS) has-been developed by the Hospital Authority since 1994. This system has-been Deployed at all the locations of the authority (40 hospitals and 120 clinics). It is used for up to 2 million transactions daily by 30,000 clinical staff. The comprehensive records of 7 million patients are available on-line in the electronic patient record (ePR). Since 2004 radiology image viewing has been added to the ePR, with radiography images from any HA site being available as part of the ePR.

The Hong Kong Hospital Authority Placed Particular Attention to the governance of clinical systems development, with input from clinicians Hundreds of being white incorporated through a structured process. The health informatics section in the Hospital Authority [95] has a close relationship with the information technology department and clinicians to develop the healthcare systems for the organization to the service to all public hospitals and clinics in the region.

The Hong Kong Society of Medical Informatics (HKSMI) was established in 1987 to promote the use of information technology in healthcare. The eHealth Consortium has been formed to bring together both private and public sector healthcare professionals and healthcare professionals in Hong Kong. [96]


Main article: Indian Association for Medical Informatics

EHCF School of Medical Informatics eHealth-Care Foundation


Since 2010, the Ministry of Health (MoH) has been working on the Malaysian Health Data Warehouse (MyHDW) project. MyHDW aims to meet the diverse needs of timely health information provision and management, and acts as a platform for the standardization and integration of health data from a variety of sources (Health Informatics Center, 2013). The Ministry has embarked on introducing the electronic Hospital Information System (HIS) in several public hospitals including Serdang Hospital, Selayang Hospital and University Kebangsaan Malaysia Medical Center (UKMMC) under the Ministry of Higher Education (MOHE).

A hospital information system (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. As an area of ​​medical informatics, the aim of hospital information system is to achieve the best possible support of patient care and administration by electronic data processing. HIS plays a vital role in planning, initiating, organizing and controlling the operations of the subsystems of the hospital and thus provides a synergistic organization in the process.

New Zealand

Health informatics is taught at five New Zealand universities. The most mature and established program has been offered for over a decade at Otago. [97] Health Informatics New Zealand (HINZ), is the national organization that advocates for health informatics. HINZ organizes a conference every year and also publishes a journal- Healthcare Informatics Review Online .

Saudi Arabia

The Saudi Association for Health Information (SAHI) was established in 2006 [98] to work under direct supervision of King Saud bin Abdulaziz University for Health Sciences to practice public activities, develop theoretical and applicable knowledge, and provide scientific and applicable studies. [99]

Post Soviet countries

The Russian Federation

The Russian healthcare system is based on the principles of the Soviet healthcare system. The current government healthcare system consists of several directions:

  • Preventive health care
  • Primary health care
  • Specialized medical care
  • Obstetrical and gynecologic medical care
  • Pediatric medical care
  • Surgery
  • Rehabilitation / Health resort treatment

One of the main issues of the post-Soviet health care system was the absence of the united system providing optimization of work for medical institutes. Efficiency of medical workers may also have doubtful because of the paperwork administering or lost book records.

Along with the development of the information systems IT and healthcare departments in Moscow agreed on design of a system that would improve public services of health care institutes. Tackling the issues appearing in the existing system, the Moscow Government ordered that the design of a system would provide simplified electronic access to public clinics and automate the work of medical workers on the first level.

The system designed for That Purposes Was called Expired EMIAS (United Medical Information and Analysis System) and presents an electronic health record (EHR) with the majorité of other services set in the system That marriages the flow of patients, contains outpatient card integrated in the system , And provides an opportunity to manage and manage medical records. Besides, the system contains information about the medical institutions and various doctors.

The implementation of the system in 2013 with the organization of a computerized database for all patients in the city, including a front-end for the users. EMIAS was implemented in Moscow and the region and it is planned that the project should be extended to most parts of the country.


For more details on this topic, see Health Law .

Health informatics law deals with evolving and sometimes complicated legal principles as they apply to information technology in health-related fields. It addresses the privacy, ethical and operational issues that invariably arise when electronic tools, information and media are used in health care delivery. Health Informatics, Health Care and the Interaction of Information. It deals with the circumstances under which data and records are shared with other fields or areas that support and enhance patient care.

As many healthcare systems are making an effort to have patient records more readily available to them via the internet, it is important that providers implement security in order to ensure that patients’ information is safe. They have to be able to ensure confidentiality, integrity, and security of the people, process, and technology. Since there is also the possibility of payments being made through this system, it is vital that this aspect of their private information will also be protected through cryptography.

The use of technology in health care settings has become popular and this trend is expected to continue. Various healthcare facilities, electronic health records (EHRs), computerized charting, etc. [100] The growing popularity of healthcare information technology and the escalation in the amount of information that can be exchanged and transferred electronically increased the risk of potential infringement in patients’ privacy and confidentiality. [101] This concern triggered the establishment of strict measures by both policymakers and individual facilities to ensure patient privacy and confidentiality.

One of the federal laws on the protection of the health of the patient is the health insurance system. [102] HIPAA gives patients the autonomy and control over their own health records. [102] Furthermore, selon the US Department of Health & Human Services (nd), this law Enables patients to do the Following: [102]

  • Allows patients to view their own health records
  • Patient permits to request for a copy of their own medical records
  • Modify any incorrect health information
  • Provide patients with the right to know what to do
  • Patient Grants the right to request and access their health information

Leading health informatics and medical informatics journals

Impact Factors of scholarly journals publishing digital health (ehealth, mhealth)

Computers in Biomedical and Research, published in 1967 was one of the first dedicated journals to health informatics. Some additional early journals include Computers and Medicine published by the American Medical Association, Journal of Clinical Computing, published by Gallagher Printing, Journal of Medical Systems, published by Plenum Press, and MD computing, published by Springer-Veriag. In 1984, Lippincott published the first nursing specific newspaper titled, Journal Computers in Nursing which is now known as Computers Informatics Nursing (CIN) Journal. [103] Today, there are many health and medical informatics journals. As of September 7, 2016, there are roughly 235 informatics journals listed in the National Library of Medicine (NLM) catalog of journals.

  • Journal of Medical Internet Research
  • JMIR mHealth and uHealth
  • JMIR Medical Informatics
  • JMIR Human Factors
  • JMIR Public Health & Surveillance
  • Journal of the American Medical Informatics Association: JAMIA
  • International Journal of Medical Informatics
  • Implementation Science
  • Medical Image Analysis
  • Medical Decision Making
  • Journal of Biomedical Informatics
  • BMC Medical Research Methodology
  • Artificial Intelligence in Medicine
  • CIN: Computers Informatics Nursing
Main article: List of medical informatics journals

Related concepts

  • Bioinformatics
  • Clinical coder
  • Clinical documentation improvement
  • Continuity of care record (CCR)
  • Diagnosis-related groups
  • eHealth
  • Electronic health record (EHR)
  • Electronic medical record (EMR)
  • Health information exchange (HIE)
  • Health information management (HIM)
  • Hospital information system
  • Human resources for health (HRH)
  • International Classification of Diseases (ICD)
  • Medical coding
  • Neuroinformatics
  • Nosology
  • Nursing documentation
  • Personal health record (PHR)
  • Public health informatics

Standards / frameworks and governance

  • Health Metrics Network
  • HL7
  • Fast Healthcare Interoperability Resources (FHIR)
  • Integrating the Healthcare Enterprise
  • Omaha System
  • openEHR
  • xdt


  • Datafly algorithm

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