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The Next Revolution: The Role of Informatics in Improving Health Care
Slide Presentation by Eduardo Ortiz, M.D., M.P.H. (Text Version)
On July 25, 2001, Eduardo Ortiz, M.D., M.P.H., Senior Service Fellow at the Agency for Healthcare Research and Quality (AHRQ) made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "Medical Informatics."
This is the text version of Dr. Ortiz's slide presentation. Select to access the PowerPoint® slides (30 KB).
- "Medical informatics is the application of computer technology to
all fields of medicine—medical care, medical teaching, and medical research." Morris
F. Collen, 1977.
- "Medical informatics is the scientific field that deals with the storage,
retrieval, and optimal use of biomedical information, data, and knowledge
for problem solving and decision making." M.S. Blois and Edward H.
- Deals with all aspects of understanding and promoting the effective organization,
analysis, management, and use of information in health care (American Medical
Informatics Association Web site).
- Improves and optimizes use of health care information to improve decision
Examples of Medical Informatics Tools
- Desktop and laptop computers.
- Handheld wireless devices (e.g., PDAs).
Examples of Medical Informatics Applications
- Electronic medical records.
- Electronic order entry.
- Automated reminders.
- Computerized expert systems.
- Electronic mail.
- Digital imaging.
- Voice recognition.
Computerized order entry systems can reduce medication errors:
Bates, et al. JAMA 1998; Bates,
et al. J Am Med Inform Assoc 1999; Teich, et al. Arch Intern
Computerized reminders can improve compliance with recommended guidelines:
use of appropriate medications.
use of other interventions.
Hunt, et al. JAMA 1998; Shea, et al.
J Am Med Inform Assoc 1996.
Quality of Care
Computerized decision support can improve quality:
of venous thromboembolism.
- Use of antibiotics.
Durieux, et al. JAMA 2000; Teich, et
al. Arch Intern Med 2000; Evans, et al. N Engl J Med 1998.
Electronic medical records with decision support can reduce costs:
medical errors and adverse events.
equally effective but less costly alternative interventions.
the use of inappropriate tests.
the ordering of redundant tests.
Teich, et al. Arch Intern Med 2000; Bates,
et al. JAMA 1998; Glaser, et al. Proc Healthcare Information
and Management Systems Society Annual Conf 1996.
Outcomes vs Process Measures
- Most studies have evaluated process measures.
- Many studies have demonstrated improvements in process measures using decision
- Few studies have assessed patient outcomes.
Patient Centered Care
- Shared decision making.
- Wireless devices.
- Automated data capture and transmission.
- Smart cards.
- Bar coding.
- Smart automated medication dispensers.
- Interactive patient decision support.
- Computer simulation for education and training.
- Lack of technology infrastructure.
- Lack of standards.
- Cultural barriers:
- Complexity of medicine.
- Workflow issues.
Current as of August 2001
Ortiz, E. Medical Informatics. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 25, 2001. Agency for Healthcare Research and Quality, Rockville, MD.
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