Sunday, July 16, 2017

Health Informatics and the Role of Standards for exchanging Health Information


Public health informatics is the systematic application of information and computer science and technology to public health practice, research, and learning (1). It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., cognitive psychology and analysis) to public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Though the concept of health IT encompasses the use of technology in the field of health care, health informatics is defining the science, the how and why, behind health IT (2). For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. Health informaticians should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology. The field covers the art and science of healthcare data and information analytics.

For the adoption and uptake of health information technology and digital health, the technical standards and specifications have to be in place to support this technology and is critical to the development and success of a fully functional nationwide health IT ecosystem. Interoperable health information exchange is not a “one-size-fits-all” solution like many other domains. Different providers will have different uses, and the standards and specifications supporting those needs areusually notified by the respective governments.

In India, the Ministry of Health and Family Welfare had notified the Standards for EHR in August 2013, and the second revised version was notified in December 2016 (4). These guidelines provides a set of
recommendations relevant to adoption of electronic health informatics standards in EHR/EMR and other similar clinical information systems. The scope is limited to identifying the standards, their intended purposes
in such systems, followed by a short guideline for implementation approach. With the adoption of these standards properly,the data capture, storage, view, presentation, and transmission will be standardized to levels that will achieve interoperability of both meaning and data contained in the records.
.While earlier hopes were not fulfilled (5-10), now, with Digital India becoming a reality and the National Digital Authority to be set up as an action item included in the National Health Policy - 2017 (11), the importance of Standards in Health Informatics are being recognized gradually. The industry (12) is also looking forward to the establishment of the NDHA, as proposed in the NHP-2017.

Once the NDHA of India is in place, a robust National Digital Health Strategy / Policy, in consultation with all the stakeholders, will ensure the smooth adoption of Digital Health in India.


References:
1. O'Carroll PW, et al. Public health informatics and information systems, Springer, 2002.
2. Savel TG and Foldy S, The Role of Public Health Informatics in Enhancing Public Health Surveillance
https://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a5.htm (Accessed July 17, 2017)
3.  HealthIT.gov, Standards and Interoperability: https://www.healthit.gov/providers-professionals/standards-interoperability (Accessed July 17, 2017)
4. NHP, EHR Standards Helpdesk: https://www.nhp.gov.in/ehr-standards-helpdesk_ms  (Accessed July 17, 2017)
5.Sarbadhikari SN, Gogia SB. An overview of education and training of medical informatics in India. Yearb Med Inform. 2010:106-8. 
6: Sarbadhikari SN. How to make healthcare delivery in India more "informed". Educ Health (Abingdon). 2010 Aug;23(2):456. Epub 2010 Aug 3.
7. Sarbadhikari SN. Applying health care informatics to improve student learning. Med Educ. 2008 Nov;42(11):1117-8. doi: 10.1111/j.1365-2923.2008.03190.x.
8. Sarbadhikari SN. The state of medical informatics in India: a roadmap foroptimal organization. J Med Syst. 2005 Apr;29(2):125-41.
9. Sarbadhikari SN. Health care delivery--the roads not taken. J Indian MedAssoc. 1995 Sep;93(9):329-30. 
10.  Sarbadhikari SN. Medical informatics--are the doctors ready? J Indian MedAssoc. 1995 May;93(5):165-6.
11. MoHFW,  National Health Policy 2017: https://www.nhp.gov.in//NHPfiles/national_health_policy_2017.pdf (Accessed July 17, 2017)
12. NHP-2017 - Industry gives a thumbs up: https://www.cytecare.com/media/national-health-policy-2017-industry-gives-a-thumps-up (Accessed July 17, 2017)


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