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Health Informatics and Research Applications

Health Informatics and Research Applications. IHRTP Summer Research 1:30 - 2:30 @ Room 1613A, Veterans Memorial Bldg. Health Informatics.

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Health Informatics and Research Applications

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  1. Health Informatics and Research Applications IHRTP Summer Research 1:30 - 2:30 @ Room1613A, Veterans Memorial Bldg.

  2. Health Informatics Scientific field that deals with understanding the meaning and use of health information to support clinical care, health services administration, research and teaching. Health Informatics Program, Dalhousie University “Biomedical Informatics touches on all basic and applied fields in biomedical science and is closely tied to modern information technologies, notably in the areas of computing and communication.” Shortliffe, Dean, Faculty of Medicine, University of Arizona

  3. Environment of Supported Practice People Technology Information

  4. Pointing the Way: Competencies and Curricula in Health Informatics • Covvey, Zitner and Bernstein, Oct 2001 http://informatics.medicine.dal.ca/files/PointingtheWay.pdf • Types of health informaticians • Applied – solution deployers • Research and Development – create new capabilities and produce new professionals • Clinicians with Health Informatics competence • 21 informatics-relevant challenges faced by clinicians, ranging from maintaining information currency to technology assessment

  5. What Health Informaticians Do Develop • Decision support tools • Information systems and tools • Nova Scotia: A Lab for the Development and Evaluation of Canadian Health Information Systems http://informatics.medicine.dal.ca/nslab.html • Shared Care Informatics for concurrent review and appropriateness of hospital care

  6. What Health Informaticians Do Research • Information collection, storage, analysis • Model formulation and knowledge translation • Clinical Pragmatics – practical data entry, retrieval and presentation for clinical tasks • Health Outcomes – Structured Discharge Summaries to link activities with results

  7. What Health Informaticians Do Support learning for health and health care • HealthInfoRx: lifelong learning for chronic disease patients and their caregivers • Training and tools for a systematic review • Knowledge translation • Put research findings and the products of research into the hands of practitioners • Use research knowledge to inspire people to think and/or act differently

  8. Healthcare Information Technology • Drugs and Devices are approved using Health Technology Assessment methods • Healthcare IT decision-making • Cost-Benefit Analysis • Process of Selection and Articulation of Needs • What features are needed to provide a supportive environment for health care delivery • Effective Healthcare IT – making the practice of Evidence-based Medicine a reality

  9. Clinical Decision Support 1. Speed is Everything 2. Anticipate Needs and Deliver in Real Time 3. Fit into the User’s Workflow 4. Little Things Can Make A Big Difference 5. Recognize that Physicians Will Strongly Resist Stopping 6. Changing Direction is Easier than Stopping 8. Ask for Additional Information Only When You Really Need It 7. Simple Interventions Work Best 9. Monitor Impact, Get Feedback and Respond 10. Manage and Maintain Your Knowledge-based Systems Bates et al., JAMIA 2003

  10. e-Prescribing Example MOXXI (Tamblyn et al., JAMIA 13(2)) • lack of integration of electronic prescribing systems was barrier to physician adoption Functions needed to improve patient safety • Display patient demographics • Retrieve and display all currently active drugs • Alerts for relevant prescribing problems • Integration of e-prescriptions with pharmacy • Discontinuations sent to dispensing pharmacies • Monitor patient adherence/treatment outcomes

  11. Benefits

  12. Thank You and Contact Information Grace Paterson, PhD, 494-1764 Email: Grace.paterson@dal.ca David Zitner, MD, MA, 494-3802 Email: David.zitner@dal.ca Website: http://informatics.medicine.dal.ca Offices on 2nd Floor Tupper Link

  13. Discussion • Why can't we track the fate of all waiting patients? • Why do Wal-Mart and Costco have better models to support just-in-time purchasing and the epidemiology for sales compared to our existing health care system? • Why did we fail to track waiting times so that it is a crisis today? • Why do Baker, Norton et al.* report an unacceptably high error rate in Canada (arguably twice the proportion of preventable death, disability and dysfunction) compared to the United States? • Why can health services administrators make changes to the way health care is delivered (for example, reducing the number of emergency rooms) without the kind of rigorous analysis and ethics review required for scientific studies? *(The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada – CMAJ • May 25, 2004; 170 (11). doi:10.1503/cmaj.1040498 http://www.cmaj.ca/cgi/content/full/170/11/1678?ijkey=5d4a7269c591dc9816a1eec9c0afed72bae4a209

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