Health informatics is the art and science of collecting, analyzing, communicating, and using health information. A commonly accepted definition states:
"It is the intersection of information science, computer science, and health care. It deals with the resources, devices and methods required to optimize the acquisition, storage, retrieval and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems."1Health informatics is based on information science which is a discipline independent of the implementing technology. Health informatics may use paper or electronic technology to implement information systems. To further clarify, it should be stressed that information systems are not necessarily technology based and conversely that there are many applications of technology to health that do not involve information systems.
The Problems
Creating useful health data has always been problematic due to its complexity and the necessity of collection at the point of contact under often difficult conditions. In many resource poor areas, especially Africa, health data is notorious for being of low quality and out of date, therefore lacking usefulness. Health information systems have been historically based on paper forms which are prone to error during data collection, difficult to analyse, and cumbersome to communicate. They have been difficult to convert to electronic systems due to the lack of informatics expertise of health professionals. An additional complication is that health information systems have generally been designed and 'pushed down' from the top level to meet specific reporting needs that are not necessarily useful to those collecting the data. The difficulty in implementing these in the field and the lack of relevance at lower levels has contributed to poor data quality and an increasing burden of data collection. The result is that the data that is collected is rarely used at lower levels where it could improve the management and quality of health services and is lacking quality at higher levels where it could inform policy and strategy development.
A great deal of effort goes into collecting health data in developing countries. However, often data is not used because it is not available when and where it could make a difference. Health systems have many decision points including direct patient care, management of health services, planning, program monitoring, and evaluation of services.
The key to improving access to data is to have clear definitions and communication protocols.
The Mission
A health informatics group will strive to develop information systems that ensure timely, accurate, actionable information at all levels of the health system. Each group of potential information users from the individual clinician through communities, facilities, districts, national, and international levels have unique needs for health information. Patient care, health services management, planning, strategy, policy and monitoring and evaluation each have unique information requirements. All require appropriate, timely, relevant information at a decision point.
The art and science of health informatics has made steady progress along with improvements in information and communication technology (ICT). Capturing, analyzing, and presenting health information is a complex process and resources for training and implementation in developing countries are limited. The result has been slow adoption of electronic health information systems with a resulting lack of vital information at all levels. However, we now have enough experience and technology has improved to the point where we understand how to design and implement useful health information systems in resource poor environments. An important part of our understanding is built around the complex interactions of information system, user interface, work flow, training, and management.
There is a science to designing health information systems to facilitate the collection of useful information and to ensure that the information can be used over time and distance.
The Benefits
The immediate goal is to improve the use of information to make decisions. Improved health information systems increase the efficiency and quality of health systems performance and this leads to better health.
Data standards improve the communication of information. Information can move quickly and clearly to the decision point. This can be the clinician at the point of care with a patient having current test results and patient history; it can be a manager at the district level deciding where to send immunization teams today; or it can be donors making decisions on grants. The person making the decision has better information to make a timely decision and this improves health.
A health informatics group should work to develop collaborative communities which can customize health information systems from the bottom up as well as provide training and support. Open source software and data standards are a powerful enabling environment that take advantage of state of the art communication networks to improve the development, implementation, and deployment of health information systems. Collaborative communities are more responsive, relevant, and sustainable than the often short term vertical program focus of top down initiatives. Open source software can leverage scarce human and financial resources through re-use and collaborative development. The result here also is better information, better decisions, and better health in a more sustainable environment.
1 Wikipedia www.wikipedia.org/wiki/Health_informatics
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