| In practicing clinical medicine, computers and | | | | HIPAA contains a section on Administrative |
| programs are often used. These computers and | | | | Simplification which is about the technology plans |
| programs are part of an information system. | | | | that would be used to make data transfer |
| Clinical informatics is the study of such information | | | | simpler. If you have used electronic billing for |
| systems which governs the practice of clinical | | | | services involving health care since October of |
| medicine. Some of the facets of clinical informatics | | | | 2003, you have followed the transaction |
| are data entry, telemedicine, imaging, data display | | | | regulations of HIPAA. Take note that Medicare |
| and decision support. | | | | considers this as a requirement except if you |
| Data Entry | | | | stated you are a small practice in your record. |
| A usual example is of a nurse taking the | | | | There is no doubt that you have known about |
| temperature of the patient. The nurse is using a | | | | the privacy rules that has been in effect since |
| point-of-care device to measure the temperature | | | | April 2003 from business partners, health plans or |
| which will be transmitted to the electronic health | | | | hospitals. |
| record of the patient. | | | | Another way that clinical informatics can affect |
| Telemedicine | | | | you is shown in the IOM report. The IOM report |
| Even with the absence of the physical slides, a | | | | stated that there are about 100,000 medical |
| pathologist in Bethesda can conduct a review of | | | | errors yearly. This concern about medical errors |
| the strange tumor found in a young male in the | | | | was brought to the public. As a response to the |
| rural areas of California. | | | | report, another IOM report came out suggesting |
| Imaging | | | | the use of computerized physician order entry |
| As technology progresses, new models of CT | | | | (CPOE) systems. According to this report, CPOE |
| scanners can have the latest algorithms of | | | | systems would decrease medical errors if this |
| software that can display 3-dimensional images. | | | | technology is implemented. |
| These 3D images could show vital structures' | | | | The third means of clinical informatics affecting |
| reconstruction. | | | | someone is through the National Health |
| Data Display | | | | Information Infrastructure (NHII). The effort of |
| This can be best described by graphs of median | | | | developing a NHII was initiated by Dr. David |
| or even mean values using raw numbers. This will | | | | Brailer, the Office of the National Coordinator for |
| make things easier for a clinician conducting a | | | | Health Information Technology director, who was |
| review. In addition, abnormal vital signs can be | | | | appointed by the Bush administration. The main |
| highlighted. | | | | objective of NHII is to make the patient |
| Decision Support | | | | information anywhere in the country in a digital or |
| Urgency of feedback at the ordering entry time is | | | | electronic format so it can be transmitted from |
| very essential especially about allergies of the | | | | its original storage area to where the patient is |
| patient and interactions amongst drugs. This is | | | | currently being treated if the need arises. It is |
| essential because it has proven to decrease the | | | | noted though that there are clearly no plans for a |
| costs of healthcare as well as the morbidity of | | | | central database containing patient information. |
| the patient. | | | | Implementation for the NHII is targeted to take |
| Clinical informatics can greatly affect an individual | | | | about seven years. To achieve this objective, |
| as shown in the Health Insurance Portability and | | | | financial incentives are under the works to aid and |
| Accountability Act (HIPAA) of 1996. Under the | | | | encourage the acceptance of Electronic Health |
| HIPAA, keeping insurance for employees who | | | | Records or EHRs. |
| changes their jobs would be less troublesome. | | | | |