Health Informatics: A Current and Historical Perspective

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, 3b

• The major challenges facing healthcare delivery systems around the world
• The key issue of chronic disease and the critical role informatics can play in managing it
• The potential of electronic health records (EHRs)
• The challenges to the design and usability EHRs
• The twin challenges of EHR adoption and data sharing
• The critical role of patient engagement
• The technologies and tools historically used to achieve that engagement
• Contemporary approaches to patient engagement