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What is Health Informatics?
Health Informatics is an interdisciplinary and inter-professional field of scholarship that applies computer, information and cognitive sciences to
promote the effective and efficient use and analysis of information to improve the health of society. The role health informatics plays in modern
health care continues to expand with the spectrum of providers making growing use of computer-based information systems. The application of health
information technology (HIT) is an integral component of practice in all areas of care, across all delivery settings. The expanded use of HIT is
seen as critical to overcoming the "quality chasm" identified by the Institute of Medicine (IOM). In a ringing call for change, the IOM stated that
"There must be a renewed national commitment to building an information infrastructure to support health care delivery, consumer health, quality
measurement and improvement, public accountability, clinical and health services research and clinical education." The need for knowledge at the
point of care and evidence-based care is self-evident. The NIH Roadmap's re-engineering of clinical research, NCI's caBIG endeavor to build an
informatics infrastructure to support seamless collaborative science and CTSA's designation of biomedical informatics as a core areas are all rooted
in the science of informatics and its enabling of interdisciplinary research.
The nation's and the health care community's response to these calls has led to a dramatic increase in the visibility of health informatics. The
President's 2004 State of the Union Message called for widespread adoption of electronic health records (EHR) within 10 years. HHS established the
Office of the National Coordinator for Health Information Technology (ONCHIT) headed by Dr. David Brailer. Within 3 months he put forth a Strategic
Framework to achieve the vision of a "...health care industry that is consumer-centric and information-rich, in which medical information follows
the
consumer, and information tools guide medical decisions." In the context of this discussion we would substitute the term "health" for "medical" to
reflect its relevance to the entire AHC. Dr. Brailer has estimated that investments on the order to $200 billion will be required to fully implement
this vision on a national scale.
The reality however, is that most health care professionals in practice today have had little training that either enables them to understand and
cope with the onslaught of HIT developments or to guide and control the use of those technologies in their profession. This need has been officially
recognized in Dr. Brailer's presentations at the recent national meetings of the American Medical Informatics Association, the AAMC, and the AACN
concerning the urgent need to train health professionals in health informatics skills and knowledge.
The Academic Health Center is now ideally positioned to respond to these national priorities both in terms of developing an interdisciplinary,
inter-professional cadre of health informatics experts and in providing the educational and research environment to prepare both practicing and newly
trained physicians, nurses, dentists, pharmacists, public health practitioners, and veterinarians. Moreover, the call for informatics specialists as
well as more informatics scientists builds on a strong University base which includes the existing health informatics program with its 29 year
tradition of informatics training, the newly installed Dean of Nursing, the newly hired Director of the Health Science Libraries, and the explosion
of informatics research and development in all of the schools of the AHC. It is now time to establish an interdisciplinary, interprofessional center
in the AHC that supports a critical mass of informatics faculty and students, provides the coordinating capacity to leverage existing and potential
partners within the health care systems in the State, and fosters technologic innovation opportunities with private sector partners such as those
comprising Medical Alley. Now is the time to make the University of Minnesota the premier center for interprofessional health informatics in the
country.
Opportunities
Research funding opportunities for the field have increased significantly in the last three years and are expected to continue to grow at the federal
and state levels. The Agency for Healthcare Research and Quality (AHRQ) has devoted $138M in the last two years to studying and implementing HIT.
The National Library of Medicine with a FY2005 Budget of $384M funds investigator initiated projects in the area of health informatics. ONCHIT will
be funded at the $75M level for the coming year. The NIH roadmap initiative that focuses on re-engineering the clinical research enterprise will
have $120M to distribute in the upcoming fiscal year and has recognized that methods and systems of health informatics are critical to the clinical
research enterprise. CMS, as mandated by the Medicare Modernization Act of 2003, is funding demonstration projects focused on improving health care
quality and is encouraging the use of information systems to achieve that goal. The Connecting Communities for Better Health initiative administered
through HRSA has allocated $6.8M to improve community health systems through health information exchange. Finally the State of Minnesota is actively
interested in HIT and has commissioned an official advisory committee on eHealth that is expected to make recommendations for major state funding of
health informatics initiatives within the next few years. By building a strong health informatics research base, the University will position itself
as a leading research institution in the area and will be highly competitive for these funding initiatives. Moreover, this research activity will
enhance the capacity for the University of Minnesota to be seen as a key knowledge and innovation resource for the State.
The successful, widespread implementation of HIT requires a knowledgeable, well trained cadre of professionals at several levels. All students in
our professional programs should graduate with the knowledge and skills necessary to optimize information technology use in their chosen professions.
Practicing professionals require the means to update their skills to take advantage of, as well as lead the implementation of HIT. And we need to
create a new generation of scholars (i.e., researchers) who will contribute to our understanding of how health information can be used to make better
health decisions, create more effective and efficient clinical and clinical research processes, and discover new health knowledge. The National
Library of Medicine Training Grant with its 28 year history and 15 fellowships illustrates the existing educational strength that can be brought to
bear. This grant already marks the University of Minnesota as being among the select universities in the field that includes Harvard, MIT, Stanford,
University of Washington, Columbia, Vanderbilt, Pittsburgh and the University of Wisconsin. Since health informatics is interdisciplinary by nature,
the AHC and its respective schools are well positioned and incented to offer high-quality, comprehensive programs of education and research
training.
An example of potential programmatic collaborative opportunities and synergies is presented by the CTSA initiative. That initiative requires
biomedical informatics as one of its key functions. The proposed Center can assist by taking the responsibility for this function and working to
provide the necessary faculty resources to execute its informatics related research and training activities. Examples of what could be accomplished
are constructing systems that connect research subjects in the community back to University data collection centers, constructing clinical trials
information systems to facilitate research and training clinical scientists in knowledge management skills.
In addition, the private sector plays a pivotal role in the development and deployment of HIT throughout our nation.s health care system. It
comprises the employers of our graduates, the providers of care, the vendors of information systems, the licensors of our ideas, and the consumers of
our research findings. Our region represents a hotbed of medical and health related innovation ranging from medical devices to patient care systems.
We need to take advantage of the potential partnerships that are available by working with the private sector.
The AHC already has a rich portfolio of examples of faculty partnering in health informatics activities. It should be self-evident that faculty
across schools are already involved in active collaborations and that the necessary faculty resources,
expertise, research projects and teaching resources already exist to form the foundation for this center. Assembling these faculty members and
supporting them with a Center structure will create that vitally important, but elusive critical mass that can propel the University of Minnesota to
a position of prominence in health informatics.
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modified on April 9, 2007