Next Step of Health Informatics Ed ti d R hEducation and Research

in Thailandin Thailand

Nawanan Theera-Ampornpunt, MD, MS (Health Informatics)Faculty of Medicine Ramathibodi Hospital

PhD Candidate in Health Informatics Uni ersit of MinnesotaPhD Candidate in Health Informatics, University of Minnesotahttp://www.slideshare.net/nawanan

August 21 2010

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Thailand License. http://creativecommons.org/licenses/by-nc/3.0/th/

August 21, 2010

Session Outline• Introduction about the field• Thailand’s research in ICT in healthcareThailand s research in ICT in healthcare• Thailand’s educational landscape in ICT

& h lth i f ti& health informatics• National policy and strategies for ICTat o a po cy a d st ateg es o C

& informatics workforce development, research and educationresearch, and education

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IntroductionIntroduction

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What Is Informatics?• The discipline focused on acquisition,

storage, and use of information in a g ,specific setting or domain (Hersh, 2009)

• Scientific study of information(Bernstam et al, 2010)( e s a e a , 0 0)

• How is it different from computer science?p

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What Is Informatics?

K l dKnowledge

Knowledgeg

management

Information (Data + Meaning)

Informatics(Data + Meaning)

ComputerData

Computer Science

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What’s Health Informatics?• Formerly known as “Medical Informatics”

(this term is being retired)• Health Informatics = Biomedical Informatics• Informatics in biomedicine and healthInformatics in biomedicine and health

– Personal health and wellbeing– Health careHealth care– Public health (epidemiology, policy, environment)– Biomedical researchBiomedical research– Education of health professionals

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What’s Health Informatics?

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Shortliffe, 2002

Informatics & Other Fields

Social Sciences (Psychology,

Sociology, Linguistics, Law

& Ethics)

Statistics & Research Methods

Cognitive & Decision Science

& Ethics)Medical

Sciences & Public Health

Engineering Management

Biomedical/Health

Computer & Information

Library Science, InformationHealth

InformaticsInformation

ScienceInformation

Retrieval, KM

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Information Is Everywhere

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Why Health Informatics?• Information is at the heart of biomedicine• Health care is not simplep

– People’s business– Biological organisms vs. engineered machinesg g g– Uncertainty in medicine– Life and death– Complex and heterogeneous nature of information &

knowledge

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Fundamental Theorem

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Friedman, 2009

The Role of Informaticians

I want a system that helps me make DDx, warns me when I’m about to make a mistake, like

giving Aminoglycoside to a patient with CRF, reminds me when I forget to follow CPG for

DM patients, and most importantly, don’t get between

me and my patients!

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The Role of Informaticians

Not a problem, Doc! I will first need to understand what DDx

I want a system that helps me make DDx, warns me when I’m about to make a mistake, like

to understand what DDx, Aminoglycoside, CRF, CPG, DM are, and then I’ll start writing UMLand design the ER Diagram I’m

giving Aminoglycoside to a patient with CRF, reminds me when I forget to follow CPG for

and design the ER Diagram. I m thinking about using a web app

with AJAX. I believe we’ll need to migrate from MySQL to some otherDM patients, and most

importantly, don’t get between me and my patients!

migrate from MySQL to some other DBMS, and ideally a Linux web server. It will probably need SSL

too. What do you think?y

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The Result

Washington Post (March 21, 2005)g ( , 5)

“One of the most important lessons learned to date is that the complexity of human change management may be easily underestimated”

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Langberg ML (2003) in “Challenges to implementing CPOE: a case study of a work in progress at Cedars-Sinai”

The Role of Informaticians

Medical Technical Language Language

Knowledge of Clinical Reasoning &

Knowledge of Key Technical Issues

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gHealthcare Processes Relevant to Health Care

The Result

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Key Areas in Health Informatics

• Clinical applications– Electronic Health Records (EHRs)– Computerized Physician Order Entry (CPOE)– Clinical Decision Support Systems (CDSSs)– Personal Health Records (PHRs)– Health Information Exchange (HIE)

• People & Organizational Issues in Informatics• StandardsStandards• Privacy & Security of Health Information

Cli i l R h I f ti17

• Clinical Research Informatics

Current Workforce• ~10-15 clinicians with strong IT experience who

can be considered “thought leaders”• 2 MD/PhD in Information Science/Informatics• 2-3 PhD or Post-Doc in Health Informatics2 3 PhD or Post Doc in Health Informatics• 3 MD & 1 Pharm + Masters in H/M Informatics

Other clinicians with some IT/informatics training• Other clinicians with some IT/informatics training(unknown #)

• IT management & staff (not trained in informatics) (unknown #)

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• Estimated needs: 1 per 50-60 staff (Hersh, 2008)

Educational Opportunities

• Certificates• Undergraduateg

– ICT/Engineering with health care focus– MD with some informatics backgroundg– Electives

• MS/PhD in Health InformaticsMS/PhD in Health Informatics– Integrate students with health & IT backgrounds

• MD/MS & MD/PhD in Health InformaticsMD/MS & MD/PhD in Health Informatics• Fellowship in Health Informatics?

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Next?• What are the active areas of research at the intersection

of ICT and healthcare?Success factors/issues?– Success factors/issues?

• What are the landscape of currently available curricula in ICT and informatics?ICT and informatics?

• How to establish a high-quality academic program in health informatics in Thailand?ea o a cs a a d

• Who sets the national policy in the area of ICT & informatics?

• What should be the strategies for moving the country’s informatics education & research forward?

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ReferencesB EV S i h JW J h TR Wh i bi di l• Bernstam EV, Smith JW, Johnson TR. What is biomedical informatics? J Biomed Inform. 2010 Feb;43(1):104-10.

• Friedman CP. A "fundamental theorem" of biomedical informatics. J Am Med Inform Assoc. 2009 Apr;16(2):169-70.

• Hersh W. A stimulus to define informatics and health information technology BMC Med Inform Decis Mak 2009;9:24technology. BMC Med Inform Decis Mak. 2009;9:24.

• Hersh W. Health and biomedical informatics: opportunities and challenges for a twenty-first century profession and its education. Yearb Med Inform. 2008:157-64.

• Shortliffe EH. JBI status report. Journal of Biomedical Informatics. 2002 Oct;35(5-6):279-802002 Oct;35(5 6):279 80.

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