Department of Medical Informatics & Clinical Epidemiology

About: What is Medical Informatics?

William Hersh, MD
Professor and Chair
Department of Medical Informatics & Clinical Epidemiology
Oregon Health & Science University

We are in an era of uncontrolled health care costs, compromised patient safety, and a lack of utilization of information technology applications that have the potential to improve the situation. We are also on threshold of great new scientific advances in genomics and related disciplines. The discipline that focuses on the acquisition, storage, and use of information in health and biomedicine is called medical informatics. The purpose of this Web page is to define the discipline and provide an overview of its contributions. My preferred working definition of medical informatics is as follows:

Medical Informatics
The integrative discipline that arises from the synergistic application of computational, informational, cognitive, organizational, and other sciences whose primary focus is the acquisition, storage, and use of information in the health/biomedical domain.

A recent defining event for the field was the establishment of the Office for the National Coordinator for Health Information Technology (ONCHIT), with David Brailer, MD, PhD at its helm. A key step for this office was the publication of its strategic framework, The Decade of Health Information Technology: Delivering Consumer-Centric and Information-Rich Health Care. Other important recent reports have been published by the Connecting for Health initiative of the Markle Foundation.

Others define medical informatics differently, and many quibble over the adjective(s) that precede the word informatics. (For example, should it be Biomedical? Health? Bio-? Nursing? And so forth.) Some other definitions of medical informatics and related terms can be found at:

• http://www.amia.org/history/what.html
• http://www.amia.org/inside/faq/#3
• http://www.amia.org/inside/faq/#1
• http://www.bmis.org/what_is_mi.html
• http://www.bisti.nih.gov/CompuBioDef.pdf
• http://www.veranda.com.ph/hermant/definitions.htm

I have published a paper in Journal of the American Medical Association (JAMA) on medical informatics that defines the field and describes its motivations, applications, and future directions. The citation for the paper, including the URL at JAMA, is:

Hersh, W. (2002). Medical informatics - improving health care through information. Journal of the American Medical Association, 288: 1955-1958. jama.ama-assn.org/cgi/content/extract/288/16/1955.
(Those unable to access the JAMA site can contact me for a reprint.)

I have also produced a voice-over-PowerPoint lecture overview of medical informatics which uses the Flash plug-in. The lecture, which lasts about one hour and is divided into five segments, can be accessed from the links below:

• Segment 1/5
• Segment 2/5
• Segment 3/5
• Segment 4/5
• Segment 5/5
• Handout of all slides plus references cited

There are a number of books written about the field as a whole and various aspects of it. Many of these are part of the Health Informatics series of Springer-Verlag. Some major books include:

• Shortliffe, E. and Perreault, L., eds. (2000). Medical Informatics: Computer Applications in Health Care and Biomedicine. New York. Springer-Verlag.
• Hersh, W. (2003). Information Retrieval: A Health and Biomedical Perspective (Second Edition). New York. Springer-Verlag. http://www.irbook.org/
• Baxevanis, A. and Ouellette, B. (2001). Bioinformatics: A Practical Guide to the Analysis of Genes and Proteins, Second Edition. Hoboken, NJ. Wiley-Interscience.
• O'Carroll, P., Yasnoff, W., et al., eds. (2002). Public Health Informatics and Information Systems. New York. Springer-Verlag.
• Ball, M., Hannah, K., et al., eds. (2000). Nursing Informatics: Where Caring and Technology Meet. New York. Springer Verlag.

There are a number of organizations concerned with medical informatics:

• American Medical Informatics Association - www.amia.org
• National Library of Medicine - www.nlm.nih.gov
• Agency for Healthcare Quality and Research - www.ahrq.gov
• International Medical Informatics Association - www.imia.org
• Health Information Management Systems Society - www.himss.org
• Association of Medical Director of Information Systems - www.amdis.org
• American Health Information Management Association - www.ahima.org
• eHealth Initiative - www.ehealthinitiative.org
• Medical Library Association - www.mlanet.org

Much can be learned about a discipline through its history. There are some excellent resources covering the history of the field:

• AMIA History of Medical Informatics Web site - http://www.amia.org/history/
• Collen, M. (1995). A History of Medical Informatics in the United States 1950-1990. Bethesda, MD. American Medical Informatics Association.
• Miles, W. (1982). A History of the National Library of Medicine: The Nation's Treasury of Medical Knowledge. Bethesda, MD. U.S. Department of Health and Human Services.

• A list of US universities offering formal programs
• A list of international training programs
• A list of training programs funded by the National Library of Medicine
• Information about our program at Oregon Health & Science University

If you are contemplating a career in the field, particularly in operational settings, you might want to check out the following book:

Hersher, B.S. and Hodges, L.B. (2004). Career Success in Healthcare Information Technology, Chicago. HIMSS.

Some important documents about medical informatics education include:

• Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics, from the International Medical Informatics Association Working Group on Education
• Pointing the Way: Competencies and Curricula in Health Informatics, from Dominic Covvey et al.

This page maintained by William Hersh, MD. All views are his own.