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Information Technology Offers Better Health Care

   Portland, Ore.

OHSU expert in medical informatics publishes article in JAMA

The growing field of medical informatics can improve the quality and cost-effectiveness of the health care system, says William R. Hersh, M.D., one of the world's leading experts in the field and a professor at the Oregon Health & Science University School of Medicine. His article, "Medical Informatics: Improving Health Care Through Information," will be published in JAMA, the Journal of the American Medical Association, on Oct. 23.

Medical informatics is information technology as applied to health and biomedicine. "Health care is an information science," writes Hersh, who also heads OHSU's Division of Medical Informatics and Outcomes Research. He will deliver a public lecture Monday, Oct. 21, on how the field has evolved.

The all-knowing physician who could derive a diagnosis and prescribe a treatment just by looking at a patient is a beloved stereotype. But if such a person ever existed, it was far in the past. Today, not only is the science of medicine increasingly complicated, but so is the health care system itself, with its myriad specialists, ancillary care providers, technologies, and business regulations. The quantity of information required to function in this system has long surpassed the ability of any one physician to manage it all alone.

Hersh identifies two types of information clinicians need: patient-specific (generated in the care of patients) and knowledge-based (the scientific basis of health care, including research studies). He also cites several challenges to be resolved before medical informatics is more widespread, such as standardizing terminology, assuring the confidentiality of records, convincing hospitals and clinics to maintain complex computer networks, and simply overcoming resistance to change.

Electronic medical records will make patient-specific information more widely available. Paper records remain the norm, although they can be illegible or misplaced. But they're easier for busy clinicians who don't want to take time to enter information into a computer. Yet electronic records save time later because of fewer errors and the ability to access information quickly.

OHSU has an international reputation in the academic discipline of medical informatics, with more students than any similar program in the world. The university has awarded about 30 master's degrees in medical informatics since 1998 and has 60 students currently enrolled. A Ph.D. degree program is expected to begin next fall, and a postdoctoral fellowship has existed since 1992.

In addition, OHSU was among the first to offer a distance-learning program in medical informatics. About 200 students from around the world currently take the distance-learning classes, which lead to a Graduate Certificate. Graduates of OHSU's programs find work with hospitals and clinics, health product vendors and manufacturers, and other universities.

OHSU is establishing a Center for Information Analysis and Decision Support to make it easier for scientists and clinicians to obtain relevant medical information. For example, a researcher could query a database as to how patients with heart failure have been treated in internal medicine clinics, and the result might lead to a hypothesis for a clinical trial.

"The impact of medical informatics will certainly grow," Hersh writes in JAMA. "The imperatives of improving documentation, reducing error, and empowering patients will continue to motivate use of information technology in health care."

Hersh is secretary of the American Medical Informatics Association, a member of the editorial board of the association's journal and a fellow of the American College of Medical Informatics. He is the author of the forthcoming Information Retrieval: A Health & Biomedical Perspective, the second edition of a book he published in 1996.


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