Health informatics

Health informatics or medical informatics is the intersection of information science, medicine 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.

Subdomains of (bio)medical or health informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, and bioinformatics, and pharmacy informatics.

Aspects of the field

 * architectures for electronic medical records and other health information systems used for billing, scheduling or research
 * decision support systems in healthcare
 * messaging standards for the exchange of information between health care information systems (e.g., through the use of the HL7 data exchange standard) - these specifically define the means to exchange data, not the content
 * controlled medical vocabularies such as the Standardized Nomenclature of Medicine, Clinical Terms (SNOMED-CT), Logical Observation Identifiers Names and Codes (LOINC) or OpenGALEN Common Reference Model - used to allow a standard, accurate exchange of data content between systems and providers
 * use of hand-held or portable devices to assist providers with data entry/retrieval or medical decision-making

Development
Medical informatics began to take off in the US in the 1950s with the rise of the microchip and computers.

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

Since the 1980's the coordinating body has been the International Medical Informatics Association (IMIA)

Medical informatics in North America
The earliest use of computation for medicine was for dental projects in the 1950's at the United States National Bureau of Standards by Robert Ledley.

The next step in the mid 1950s were the development of expert systems such as MYCIN and  INTERNEST-I. In 1965, the National Library of Medicine started to use MEDLINE and MEDLARS. At 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 at Massachusetts General Hospital in Boston. 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 descendent of this system is being used in the United States Veterans Affairs hospital system.

In the United States in 1996, HIPAA regulations concerning privacy and medical record transmission created the impetus for large numbers of physicians to move towards using EMR software, primarily for the purpose of secure medical billing.

In the US, progress towards a standardized health information infrastructure is underway. In 2004, the US Department of Health and Human Services (HHS) formed the Office of the National Coordinator for Health Information Technology (ONCHIT), headed by David J. Brailer, M.D., Ph.D. The mission of this office is to achieve widespread adoption of interoperable electronic health records (EHRs) in the US within 10 years. For more information regarding federal initiatives in this area, see QIOs.

European health informatics
In the United Kingdom, moves towards registration and regulation of those involved in Health Informatics have begun with the formation of the UK Council for Health Informatics Professions (UKCHIP)

The UK has also contracted out to several vendors for a National Medical Informatics system that divides the country into six regions and is united by a central electronic medical record system nicknamed "the spine". National Programme for IT in the NHS

In 2005, 40% of UK citiizens have more or less extensive clinical records and their prescriptions generated on 4000 installations of one system (EMIS) written in 'M' (MUMPS as was). The other 60% predominantly have records stored on assorted SQL or file-based systems.

The Eurpoean Commission's preference, as exemplified in the 5th Framework, is for Free/Libre and Open Source Software (FLOSS) for ehalthcare.

Australian health informatics
Although there are a number of informatics organisations in Australia, The Health Informatics Society of Australia (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 an incorporated company. The membership comes from across the informatics spectrum that is from students to corporate affiliates. HISA has a number of branches (Queensland, New South Wales and Western Australia) as well as special interest groups such as nursing (NIA), pathology, aged and community care, industry and medical imaging (Conrick, 2006)