Healthcare Informatics by H. Datta

History and Applications of Healthcare Informatics by Harish Datta, BS Health Sciences ‘17

Dr. Morris F. Collen, one of the founders of Kaiser Permanente, is often regarded as the father of healthcare informatics. Dr. Collen believed that technology was the catalyst to administer effective, inexpensive, and more efficient healthcare. He followed one of the principals in public health: striving for a prevention model of healthcare. In the 1950s and 1960s, Dr. Collen and his team first established a checkpoint and screening system to analyze people’s risk for diseases.  Their objective was to refine a medical system based on providing effective primary and secondary care (Culp, 2013). After establishing this program, Dr.Collen was able to transfer the data collected into a punch card computer system and one of the first electronic medical records was born.  Dr.Collen specifically envisioned the use of computers in healthcare and, as a result, healthcare informatics was created. A computer, being such a powerful tool, could be used to consolidate data from many sources for use in health informatics to shed light on a problem that might impact an individual or a community.

A real-world example of healthcare informatics is reflected in Dr. Brenner’s work with statistical mapping.  In the early 2000s, Dr.Brenner, a family physician, used a technique called “hotspotting”, which he applied to the city of Camden, New Jersey. “Hotspotting” uses public health data to pinpoint areas on a map based on a wide range of criteria, from specific diseases to the number of high-cost patients. If an area has a high prevalence of asthma patients, for example, that area on the map will be more profound than an area that has a few asthma patients. “Hotspotting” is on the forefront of healthcare research in reducing costs, such as preventing hospital readmission, as well as being able to figure out why a certain community is experiencing a significant increase in a disease.

Nonetheless, there are prime opportunities to further utilize healthcare informatics to significantly improve issues such as misuse of the emergency room. Emergency medicine was developed to be a safety net system for people with true emergencies to receive care. The administration of emergency care, including having a fully functional emergency room all year 24/7 with competent staff, is extremely costly. An emergency room having to provide nonemergency care is inefficient and dangerous to those patients who are suffering real emergencies. According to Weinick et al., it is estimated that retail clinics and urgent care clinics could have seen between 13.7 and 27.1 percent of emergency cases that entered emergency rooms during 2010. When a patient is suffering an emergency, Emergency Medical Services (EMS)is usually the first point of contact with medical professionals. With EMS and Volunteer Ambulance Corps across the country beginning to use electronic medical records to file their patient care reports, aspects such as the patient’s past medical history can be used in conjunction with a hospital record to be able to better assess individual situations prior to hospital care. These assessments can alert medical professionals of frequent misusers of the emergency room and prompt alternative medical actions, such as treatment in an urgent care clinic. These healthcare professionals could also be able to provide primary prevention options, situation permitting, so that a patient frequently misusing the emergency room would not have to return.

Dr. Collen once said “I feel that I was born with an interest in data, beginning with my birth date, a series of three consecutive two-digit numbers” and it was this interest in turning data into usable information that forged the way for the field of health informatics (Culp, 2013).  In the scenarios discussed above, technology could be used to engineer a solution to some of the toughest healthcare issues in U.S. Dr. Brenner used statistical mapping in order to administer care for the Camden community, a community that was neglected by traditional healthcare.

Beyond decreasing emergency room misuse, an informaticist would be able to analyze the data and collaborate with public health specialists to devise policies to solve pertinent healthcare issue. Informatics is not simply number and data crunching, but a discipline that can bridge gaps between healthcare data, services and policy.