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HIMSS TIGER Interprofessional Community Global Informatics

HIMSS TIGER Interprofessional Community Global Informatics

HIMSS TIGER Interprofessional Community

Global Definitions

Revised July 2020 | Version 4 Statement of Purpose InformaticsWritten by Hank Fanberg, Timeline FHIMSS, CMPE, University of New Orleans

The purpose of this document is to define Before there was informatics, the science of . At its core global health informatics terminology. core, informatics is a means to solving problems through the use of and The carefully selected definitions and . In the 1970s, those who used science, engineering and technology documentation provide context to their use in medicine recognized the need to agree on a term for this still emerging discipline. by the global HIMSS TIGER (Technology The International Federation forTo Information Infinity Processing’s & (IFIP)Beyond Technical Committee 2020+Number 4 took up the challenge. The term they recommended was informatics. Informatics Guiding Reform) Initiative’s Interprofessional Community. This word is relatively new and global in scale. Its earliest appearance is credited to the German computer scientist Karl Steinbuch in the title of a paper published in 1957. The This document also seeks to be inclusive word also appears in French, Russian, Spanish and English around the same time. For of global terminology needs within the many of these countries, the wordArtificial informatics was Intelligencea synonym for computer & science. Informatics field. As the TIGER community 2010+Informatics is usually used as a compoundMachine term (i.e. , environmental and healthcare workforce continue to grow informatics) and extends far beyond healthcare. The first widely used informatics and expand on a global scale, it is important compound term in the English-speaking world was medical informatics. to include definitions relating to informatics According to Collen the English term „medical informatics“ first appeared in 1974 in that extend beyond geographic borders and the IFIP Medical Informatics Monograph Series, Volume 1, Education in Informatics of regions. Therefore, it is necessary to include Health Personnel. It proposed thatEveryone “medical informatics” as Informaticist be defined as “computer and 2000+information science, engineering and technology in all fields of health and medicine, varying terms referenced for similar concepts applied locally, regionally and nationally to including research, education and practice.” maximize the integration of informatics into The Association of American Medical Colleges (AAMC) stated that “Medical seamless practice, education, research, and informatics is a developing body of knowledge and a set of techniques concerning resource development on a global level. the organizational managementRise of information of standards, in support of medical the research, Web, 1990+education, and patient care. Medicalubiquitous informatics combines computing medical science with several This document was last updated in May technologies and disciplines in the information and computer sciences and provides 2020 by the TIGER International Task Force methodologies by which these can contribute to better use of the medical knowledge who reviewed the previous version, infused base and ultimately to better medical care.” new definitions and concepts, re-confirmed The field of medical informatics, however, was not static. Within ten years they revisited sources, and verified the currency of the 1980+its definition and scope. Precision Medicine definitions. We acknowledge that as the Perhaps this is not all that different from where we find ourselves today. Health care, field of informatics continues to mature, so medicine, and informatics continues to develop and evolve, requiring will the terms defined within this document. the thoughtful reflection of if and how the discipline has changed and to evaluate its As the field evolves, our intention is to tools and scope. Fifty years ago, hospitals were not focused on population health nor have this resource mirror those changes were they performing communityNursing wide health needsInformatics assessments. The capabilities 1970+of the computer industry were still forthcoming - pervasive networking, powerful and to serve as a helpful reference tool for those learning about both informatics and affordable computing and along with the portability factor of mobile informatics competencies. You’ll find these devices – and the Internet, while technically in existence, was still in nascent form. terms referenced on landing pages, in official Today, health care has embraced Artificial , , Augmented documents, and within the TIGER Virtual Reality, blockchain, clinical decisionClinical support, robotics, Informatics digital health and more. It is from Learning Environment (VLE). 1960+this vantage point that the definitionsBiomedical of the various health Informatics informatics disciplines were reviewed. And will continue to be reviewed as that intersection of science, technology

and the healing arts continues to evolve. Before health informatics there was informatics, the science of information. At its core, informatics 1950+ Informatics 2 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Justification for Updating Informatics Definition Terms Written by Hank Fanberg, MBA, FHIMSS, University of New Orleans

Before health informatics there was informatics, of techniques concerning the organizational the science of information. At its core, informatics management of information in support of medical is a means to solving problems through the use research, education, and patient care. Medical of computing and information science. In the informatics combines medical science with several 1970s, those who used science, engineering and technologies and disciplines in the information and technology in medicine recognized the need to computer sciences and provides methodologies agree on a term for this still emerging discipline. by which these can contribute to better use of the The International Federation for Information medical knowledge base and ultimately to better Processing’s (IFIP) Technical Committee medical care.”iv Number 4 took up the challenge. The term they recommended was informatics. The field of medical informatics, however, was not static. Within ten years they revisited its definition This word is relatively new and global in scale. and scope. Its earliest appearance is credited to the German computer scientist Karl Steinbuch in the title of a Perhaps this is not all that different from where paper published in 1957.i The word also appears in we find ourselves today. Health care, medicine, French, Russian, Spanish and English around the computer science and informatics continues to same time. For many of these countries, the word develop and evolve, requiring the thoughtful informatics was a synonym for computer science. reflection of if and how the discipline has changed Informatics is usually used as a compound term and to evaluate its tools and scope. Fifty years (i.e. business informatics, environmental ago, hospitals were not focused on population informatics) and extends far beyond healthcare. health nor were they performing community The first widely used informatics compound wide health needs assessments. The capabilities term in the English-speaking world was medical of the computer industry were still forthcoming informatics.ii - pervasive networking, powerful and affordable computing and communications along with the According to Colleniii the English term “medical portability factor of mobile devices – and the informatics” first appeared in 1974 in the IFIP Internet, while technically in existence, was still in Medical Informatics Monograph Series, Volume nascent form. Today, health care has embraced 1, Education in Informatics of Health Personnel. It , Virtual Reality, Augmented proposed that “medical informatics” be defined as Reality, blockchain, clinical decision support, “computer and information science, engineering robotics, digital health and more. It is from this and technology in all fields of health and medicine, vantage point that the definitions of the various including research, education and practice.” health informatics disciplines were reviewed. And will continue to be reviewed as that intersection of The Association of American Medical Colleges science, technology and the healing arts continues (AAMC) stated that “Medical informatics is to evolve. a developing body of knowledge and a set

3 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Terminology Table of Contents

4 HIMSS | TIGER INTERPROFESSIONAL Definitions

Ambient intelligence is an emerging discipline biology and biochemistry, to medicine and that brings intelligence to our everyday healthcare. While not solely tied to computers environments and makes those environments and , biomedical sensitive to us [humans]. Ambient intelligence informatics has become more reliant on software, research builds upon advances in sensors and artificial intelligence and cloud computing with sensor networks, pervasive computing, and the rise of the biotechnology industry and the artificial intelligence. widespread digitization of personal health data.

Source: ScienceDirect Source: Biomedical Informatics, SearchHealthIT

Ambient intelligence represents a new generation Clinical Informatics is the subspecialty of all of user-centered computing environments and medical specialties that transforms health care systems. These solutions aim to find new ways by analyzing, designing, implementing, and to better integrate information technology into evaluating information and everyday life devices and activities. systems to improve patient care, enhance access

Source: Espinilla, M., Villarreal, V., & McChesney, I. (2019). Ubiquitous to care, advance individual and population health

Computing and Ambient Intelligence. outcomes, and strengthen the clinician-patient relationship.

Bioinformatics is a hybrid science that links Source: Accreditation Council for Graduate Medical Education (ACGME) biological data with techniques for information storage, distribution, and analysis to support Clinical Research Informatics is the rapidly multiple areas of scientific research, including evolving sub-discipline within biomedical biomedicine. As an interdisciplinary field of informatics that focuses on developing new science, combines biology, informatics theories, tools, and solutions to computer science, information engineering, accelerate the full transnational continuum: mathematics and statistics to analyze and basic research to clinical trials, clinical trials to interpret biological data. Bioinformatics is fed by academic health center practice, diffusion and high-throughput data-generating experiments, implementation to community practice, and ‘real including genomic sequence determinations and world’ outcomes.

measurements of gene expression patterns. Source: Clinical research informatics: A conceptual perspective

Source: Lesk, A. M. (2013). Bioinformatics. Encyclopaedia Britannica

Biomedical informatics (BMI) is the branch of health informatics that uses data to help clinicians, researchers and scientists improve human health and provide healthcare. Biomedical informatics is an evolving discipline that has grown along with advances in biomedicine, which applies the principles of the natural sciences, especially

5 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Clinical Surveillance is a systematic, goal- Global Health Informatics is a growing directed process that trends physiological multidisciplinary field that combines research changes in patients, interprets the clinical methods and applications of technology to implications of those changes, and alerts improve [global] healthcare systems and clinicians for timely interventions. outcomes.

Source: Online Journal of Nursing Informatics (OJNI) Source: Dr. Yuri Quintana of Harvard University

Consumer health informatics (CHI) is Health informatics is the interdisciplinary the study of consumer information needs study of the design, development, adoption, and healthcare technologies, as well as the and application of information technology (IT) - implementation of methods of making based innovations in healthcare services delivery, information accessible to consumers. management, and planning.

Source: Consumer Health Informatics: Empowering Healthy-Lifestyle-Seekers Source: U.S. National Library of Medicine

Through mHealth. Health informatics is the discipline that Dental informatics refers to the application of researches, formulates, designs, develops, computer and information science to improve implements, and evaluates information-related dental practice, research, education, and concepts, methods, and tools (e.g., . and communication technology (ICT)) to

Source: The Future of Dental Informatics support clinical care, research, health services administration, and education.

Digital health connects and empowers people Source: Health Information Exchange as a Profession and populations to manage health and wellness, augmented by accessible and supportive also sometimes referred provider teams working within flexible, integrated, to as radiology informatics or medical imaging interoperable and digitally-enabled care informatics, concerns how medical images environments that strategically leverage digital are used and exchanged throughout complex tools, technologies and services to transform care healthcare systems. This subspecialty has gained delivery. wide acceptance and is often seen as a mission-

Source: HIMSS.org critical function in healthcare. Virtually every healthcare clinical discipline depends on imaging eHealth (e-health) is an emerging field in the informatics.

intersection of medical informatics, public health Source: American Board of Imaging Informatics and business, referring to health services and information delivered or enhanced through the Medical informatics is the field that concerns Internet and related technologies. In a broader itself with the cognitive, , sense, the term characterizes not only a technical and communication tasks of medical practice, development, but also a state-of-, a way education, and research, including the information of thinking, an attitude, and a commitment for science and the technology to support these networked, global thinking, to improve health tasks.

care locally, regionally, and worldwide by using Source: Greenes, R. A., & Shortliffe, E. H. (1990). Medical informatics: an

information and communication technology. emerging academic discipline and institutional priority. JAMA, 263(8), 1114-1120.

Source: G. Eysenbach, JMIR Publications

6 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Nursing informatics (NI) is the specialty Pharmacy informatics has grown to be an that integrates nursing science with multiple integral discipline within the clinical informatics information management and analytical sciences domain, centered on the effective management to identify, define, manage, and communicate and delivery of medication related data, data, information, knowledge, and wisdom in information, and knowledge across systems that nursing practice. NI supports nurses, consumers, support the medication-use process.

patients, the interprofessional healthcare team Source: American Society of Health-System Pharmacists (ASHP) and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes. Population Health Informatics (PHI) This support is accomplished through the use of addresses the information technology and information structures, information processes and analytic needs of groups and organizations information technology. responsible for the health management of

Source: Nursing Informatics: Scope and Standards of Practice, 2nd Edition, defined populations.

ANA 2015 Source: Public and Population Health Informatics: The Bridging of Big Data to

Benefit Communities Nursing informatics (NI) focuses on finding ways to improve information management and Public health informatics (PHI) is the communications in nursing to improve efficiency, application of informatics in areas of public health, reduce costs and enhance the quality of patient including surveillance, prevention, preparedness, care. and health promotion. Public health informatics

Source: Nursing Informatics as a Specialization in India: Present and Future and the related population health informatics, work on information and technology issues from Nutrition informatics is the effective retrieval, the perspective of groups of individuals. Public organization, storage and optimum use of health is extremely broad and can even touch information, data and knowledge for food and on the environment, work and living places and nutrition related problem solving and decision- more.

making. Informatics is supported by the use of Source: American Medical Informatics Association (AMIA) information standards, processes and technology.

Source: Academy of Nutrition and Dietetics Translational Bioinformatics (TBI) is the development of storage, analytic, and interpretive Personal health informatics allows individual methods to optimize the transformation of patients to comprehend and analyse their own increasingly voluminous biomedical data, personal health issues; the consequences, risks, and genomic data, into proactive, predictive, benefits, and alternatives to therapy, treatment preventive, and participatory health.

and management. Information based on these Source: AMIA analyses used by patients in an individual manner empowers them to make informed decisions about their own healthcare. Personal health informatics is also a subset of clinical informatics which differs from consumer informatics by focusing on the individual patient, rather than a “consumer”.

Source: Personal Health Informatics: The Evolving Paradigm of Patient Self Care

7 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Infographics

Biomedical Informatics Education and Research:

Basic research

Health informatics (HI): clinical informatics and public health informatics

Biomedical and structural (imaging) Biomedical informatics. informatics (BMI) education and Molecules, cells, research Patients, individuals, tissues, organs Methods, techniques populations, societies theories

Applied research and practice Informatics in translational science: translational bioinformatics (TBI) and clinical research informatics (CRI).

8 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY Medical Informatics:

Bioinformatics Clinical informatics Imaging informatics

Public health informatics

Clinical Epidemiology Personal Health Records Biostatistics Data Science/Artificial Intelligence

Security/Policy Clinical Data Warehousing

Computer Science Computer Clinical Management Standards/Interoperability

Medical Biomedical Engineering Physics

Population Health Public Health Everyone‘s responsibility Governmental responsibility

• Measure and improve health of entire • Concerned with threats to overall health population of a community based on population health analysis • Reduce health inequalities among group • Depends on another entities • Beyond individual-level focus (e.g., health care delivery system, schools, social services, academia, • Address a broad range of risk factors – legislators, regulators, and justice environment, social structure, resource systems) distribution • Plays a legal regulatory role (e.g., restaurant inspections) Population Health vs. Public Health Informatics Resource: Sripriya Rajamani, Minnesota Department of Health

9 HIMSS | TIGER INTERPROFESSIONAL COMMUNITY HIMSS | MEDICATION MANAGEMENT: WHAT IS NEEDED TO KEEP PATIENTS SAFE?

Acknowledgements The original Informatics Definitions document was published in June 2016 with compilation by the FY16 TIGER Committee Co-chairs, Dr. Marion J. Ball, Michelle Troseth and members. The second edition of the document was updated in June 2017 by the FY17 TIGER Committee Co-chairs, Dr. Mari Tietze, Dr. Victoria Wangia-Anderson and members. The third edition of the document was updated in June 2018 by the FY18 TIGER Committee Co-chairs, Dr. Beth Elias, Dr. Ursula Hübner and members. The fourth edition of the document was updated in March 2020 by the TIGER International Task Force’s Informatics Definitions Work Stream led by Hank Fanberg, Dr. Vitaly Herasevich, Jonathan Pitts and members Toria Shaw Morawski, Alexandrina Maria Ramos Cardoso, Beth Elias, Paulino Souza, and Rafeek Yusef.

For more information, please contact TIGER at [email protected].

Revised June 2020 | Version 4

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