Abstract
It is claimed that seeds of ‘medical informatics’ were sown in 1960s.From this time until the 1990s experts have described the discipline as emerging. This perennial state of advancement can be dedicated to the pioneers of medical informatics who constantly realign its frontiers as the need changes for the rapid developments in the techniques pertaining to organization, processing, management and use of information. During this evolution, researchers and practitioners have made notable attempts to define medical informatics. As a result, today we have a noteworthy collection of peer-reviewed definitions of medical informatics. These definitions not only enlighten us with different perspectives and applications of medical informatics but they also provide a measure of the proliferation of this domain’s content. Many of these definitions of medical informatics are unique and explanatory in their respective inferences and contexts. Hence, collectively they can form a larger picture of medical informatics. Lack of clarity about a domain can prove to be counterproductive for new entrants and may also deflect their energies into relatively unrewarding directions. In order to throw light on various perspectives of ‘medical informatics’ and to understand the evolving meaning of the domain, we carried out a systematic review of formal definitions of medical informatics. An analysis was also performed by mapping 36 peer-reviewed definitions with MeSH (Medical Subject Headings) descriptors relevant to medical informatics. We believe that this research would serve as a handy and an informative resource and may also catalyze further research.
TopIntroduction
It may be impossible to overlook the influencing role that computers have had on almost all the domains of life – ranging from education through commerce to amusement. This influence is even more pronounced in safety and security critical domains like aerospace and banking. Medicine being a safety as well as a security critical domain is no exception. The booming diffusion of information technology and the emphasis on evidence-based medicine, force the health sector to be an information-intensive industry which desperately hankers for information-driven decisions. Of late, computers and communications technologies have become integral components of medicine and have secured commanding positions in information management in medicine. The is evident from a diverse set applications of computers in medicine, be it hospital information management, patient records, clinical examinations and decision support systems, measurement of physiological parameters, diagnosis, treatment, public health or education computers are omnipresent (Shortliffe, Perreault, Wiederhold & Fagan, 1990; Musen, 2002) and today computers are acting as common thread in the healthcare delivery chain by linking wards to their departments, departments to their hospitals and hospitals to their administrators and branches. In tune with the evolution of information and communications, newer and innovative applications have been joining this technological bandwagon within medicine. Medical informatics is a composite domain that surrounds management of information in medicine. It was perhaps bound to emerge as a discipline primarily because medicine had started to exploit the demanding and extraordinary capabilities of computers to better meet its complex information needs. Currently, medical informatics is a mature discipline and is continually evolving (Patel & Kaufman,1998). We feel as the discipline matures, there is a need to consolidate past outcomes primarily to educate future practitioners and researchers.
In this era of systems engineering medical informatics is stretching its boundaries and conquering newer boundaries. Today, practitioners of medical informatics include technologists, engineers, clinicians, service providers, regulatory agencies, academicians, professional bodies etc. and their applications of medical informatics are disruptive. For example some of these practitioners have mutually exclusive applications where as others have overlapping applications. This brings with it, to the domain, a wealth of knowledge and promise of further evolution. Because of the many areas of discordance between systems we now have a spectrum of definitions of informatics, yet this in a way reaffirms the dynamism and the continuing evolution of the domain but still there are considerable idiosyncrasies in medical informatics that hamper communication (Patel & Kaufman,1998) and in certain instances researchers have expressed their concern over the clarity about the very identity of medical informatics (Nagendran, Moores, Spooner & Triscott, 2000; Maojo, Iakovidis, Martin-Sanchez, Crespo & Kulikowski, 2001; Musen, 2002). Interestingly for many clinicians, medical informatics is poorly understood and remains only vaguely equated with computers (Karlinsky, 1999).
During its evolution, numerous attempts have been made to define the field and in many cases these attempts have topped-up existing definitions with some additional details. Since there is no universally accepted definition for medical informatics, the field is evolving in its very own language of communication and in some form is striving for a common ground. Keeping in mind the scope of the domain, it would be meaningful to have a consolidation of existing definition which encompasses, if not all, at least the major components that make up medical informatics. In this paper we have attempted to throw light on various aspects highlighted by researchers and practitioners. This review presents the list of peer-reviewed definitions followed by a qualitative analysis and discussions on the data gathered. This research tries to confirm that the meaning of medical informatics varies with the context in which the term has been used. It is expected that the outcome of the research shall propagate the domain of medical informatics further and the application of this knowledge shall eventually facilitate better quality of life for the populace on our planet.
Key Terms in this Chapter
Computer: Is a machine for manipulating data according to a list of instructions.
Information Technology: Is “the study, design, development, implementation, support or management of computer-based information systems, particularly software applications and computer hardware.”
Information Science: Is an interdisciplinary science primarily concerned with the collection, classification, manipulation, storage, retrieval and dissemination of information. Information science studies the application and usage of knowledge in organizations, and the interaction between people, organizations and information systems. It is often (mistakenly) considered a branch of computer science. It is actually a broad, interdisciplinary field, incorporating not only aspects of computer science, but also library science, cognitive, and social sciences.
Knowledge: Is (i) facts, information, and skills acquired by a person through experience or education; the theoretical or practical understanding of a subject, (ii) what is known in a particular field or in total; facts and information or (iii) awareness or familiarity gained by experience of a fact or situation. Philosophical debates in general start with Plato’s formulation of knowledge as “justified true belief” .
Information Systems: Is the discipline concerned with the development, use, application and influence of information technologies. An information system, following a definition of Langefors, is a technologically implemented medium for recording, storing, and disseminating linguistic expressions, as well as for drawing conclusions from such expressions.
Health Care (Healthcare): Is the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical, nursing, and allied health professions.
Methodology: Is (i) the analysis of the principles of methods, rules, and postulates employed by a discipline” or (ii) the development of methods, to be applied within a discipline or (iii)a particular procedure or set of procedures.
Science: Refers to any systematic methodology which attempts to collect accurate information about reality and to model this in a way which can be used to make reliable, concrete and quantitative predictions about future events and observations. In a more restricted sense, science refers to a system of acquiring knowledge based on the scientific method, as well as to the organized body of knowledge gained through such research.
Decision Support Systems: Are a class of computer-based information systems including knowledge based systems that support decision making activities.
Information: Is the result of processing, manipulating and organizing data in a way that adds to the knowledge of the receiver. In other words, it is the context in which data is taken.