Engineering Grand Challenges - Advancing health informatics

February 19, 2008

Yesterday, we talked about the grand challenge to engineer better medicines. Today, lets look at a related topic; advancing health informatics.

First of all, health informatics probably means different things to different people. In my mind, health informatics is only really useful if it not only benefits the individual, but also our overall understanding of medicine. The challenge identifies health informatics as the acquisition, management and use of information in health, with the purpose of enhancing the quality and efficiency of medical care and response to public health emergencies. All are topics that have been referred to often here, whether it be in the field of telemedicine, or infectious disease management.

The information challenges facing human health are enormous, stemming from ineffective, and more importantly, inconsistent health information systems. In addition, privacy concerns and a mistrust of the medical establishment only amplifies some of the concern in the field of health informatics. It is absolutely imperative that healthcare systems the world over reach a standard that allows health-related information to be transmitted and shared efficiently and securely.

The part I don’t understand is the distributed system, unless the challenge refers to the cloud which we will inevitably move towards. That is not a healthcare informatics challenge specifically, but a general trend towards distributed data and how that data moves. What is important is that the healthcare systems of tomorrow grow with our shift towards distributed systems and not get locked down in silos.

Perhaps the most critical part with be the healthcare record, and how those records are maintained and distributed. While the article refers to privacy and security, it does not address the issues of content ownership and data portability. Who owns someones medical data? How does it move from one system to another? What parts can a physician have access to? What are the dangers of a system controlled by the user (I am assuming that we will end up with user controlled access to information).

I found it curious that the article quotes Russ Altman. What we need is semantic interoperability and information extraction from healthcare record, allowing machines to process information and flag risks and allowing physicians to make informed decisions that will be critical if we are to move towards personalized medicine.

Telemedicine will be absolutely critical to tomorrows medicine. But are we willing to live in a world with implantable sensors and health monitoring? I feel technology should absolutely be used if the end result is better health, but the ethics and privacy concerns of individuals need to be addressed before we get there. I just don’t trust the establishment enough, but the community as a whole can come up with appropriate guidelines.

Last but not the least, there is the issue of vigilance, whether it be post-marketing vigilance of drugs, vigilance against epidemics, or terrorist attacks. Information technology is absolutely critical in all those areas.

All in all, I can’t disagree with much of what is written in the piece, although there isn’t much depth there. The fact remains that technology, especially information technology is going to play a huge role in the future of healthcare. This includes the need to manage vast quantities of data from multiplexed assays, from personal health records and to improve health by gathering vast quantities of global health data and constantly minind it for trends. There will be data from embeddable sensors, from adverse event databases, and from disease monitoring resources. Are we ready for that world? Can we make it so that there is only a minor healthcare divide? Those questions are beyond the scope of those challenges, but any success in solving the health informatics problem is meaningless without answering the broader issues.

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Jean Roberts 8 months ago 1 point
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Deepak - FYI - There are a number of initiatives in the UK to mature the profession of Health Informatics (HI) - both spreading the word on key issues (see www.bcshif.org) and recognising Health Informaticians as professional (see www.ukchip.org) - amongst many other sites of related interest.
To us, the impact of informatics on 'health' involves all clinical and management roles, in operational care, tactical management, strategic planning, commercial service and product provision and academia (both research and teaching). To write commentary focussing only on the medics is to 'miss a trick' - for HI to be as beneficial as possible must encompass all the above, any other divides are artificial ... especially as the health domain is convergent with that of social care (moving towards generic welfare) and the stakeholder groups are widening and getting deeper to include the citizen also.
The UK plays a strong role in the international HI field through the world body IMIA and the European (EFMI) - but those are another dimension to the overall, synergistic and supportive HI field!

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