What is informatics? When I use that word to describe my research, people have asked “Isn’t that just statistics?” Or, “Oh, that’s all the computers and big data stuff, right?” Clinicians may recognize informatics as anything related to the electronic health record (EHR). My Dad explained to my mother that it meant I was, “Crazy about information.” Well, that might be the most accurate.
It’s easy to start by stating what informatics is not. It’s not just computer science, and it’s not statistics either. Oh yea, and it’s not library science. All of these terms are tools used by clinical informatics professionals, but they do not define the field. One of the major informatics textbooks defines informatics as “the inter-disciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, driven by efforts to improve human health” (1). Since so much of today’s health care information and decision-making occurs through the EHR, computing and EHRs do play important roles in the field of clinical informatics. In short, clinical informatics is the study of technology (primarily computing) and how it can be applied for improved clinical care (2). While there are numerous sub-fields within clinical informatics such as public health informatics or bioinformatics, I like to divide informatics into two broad activities: 1) applied clinical applications and 2) research and development.
In today’s world, the applied side deals primarily with implementation, optimization, and maintenance of the EHR. In most healthcare organizations, the CMIO (Chief Medical Information Officer) directs the work surrounding the clinical use of the EHR. Research and development can include secondary use of EHR data to answer research questions, development of new clinical decision support tools, or study of the human-computer interaction. A newer position arising within academic health centers is the CRIO (Chief Research Information Officer) oversees the infrastructure and services for conducting this type of research.
Clinical Informatics is its own specialty, with its own board certification, and professional organizations like AMIA (American Medical Informatics Association). I recently earned board certified in clinical informatics. Through courses, reading, and our UW study group, I studied a range of topics from computer science, database query languages, network architecture, and ontologies. The certification exam also covered topics like leadership models, change management, strategic and financial planning.
The exam covered a lot of material unrelated to computers, and the leaders in the field emphasize that clinical informatics encompasses more than just computing (3). Certainly, many of the tools that I use to carry out informatics research involve computing like the enterprise data warehouse or machine learning. Much work in clinical informatics aims to assist clinicians in taking better care of patients through the use of computers. Amidst a broader popular media concern about the “artificial intelligence apocalypse” (computers taking over), one of my favorite tenets of clinical informatics, is what some have termed the ‘fundamental theorem’ of informatics. The theorem states that a person assisted by a computer will outperform the person performing the same task without the technology (2). Note that the clinician and his or her judgement is still part of the equation:
- Shortliffe EH, Blois MS. Biomedical Informatics: The Science and the Pragmatics. In: Shortliffe EH, Cimino JJ, editors. Biomedical Informatics. London: Springer-Verlag; 2014. p. 3-37.
- Friedman CP. What informatics is and isn’t. Journal of the American Medical Informatics Association : JAMIA. 2013;20(2):224-6. doi: 10.1136/amiajnl-2012-001206. PubMed PMID: 23059730; PMCID: PMC3638194.
- Kulikowski CA, Shortliffe EH, Currie LM, Elkin PL, Hunter LE, Johnson TR, Kalet IJ, Lenert LA, Musen MA, Ozbolt JG, Smith JW, Tarczy-Hornoch PZ, Williamson JJ. AMIA Board white paper: definition of biomedical informatics and specification of core competencies for graduate education in the discipline. Journal of the American Medical Informatics Association : JAMIA. 2012;19(6):931-8. doi: 10.1136/amiajnl-2012-001053. PubMed PMID: 22683918; PMCID: PMC3534470.