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History of Informatics

BMI 6010/NURS 6810
by

John Hurdle

on 14 August 2013

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Transcript of History of Informatics

Objectives
While we’re learning, have some fun

Take a brief look at the history healthcare informatics

Sometimes, things change for the better
A brief history of
healthcare informatics informatics

Why bother with history in technical fields?
'Those who cannot remember the past are condemned to repeat it.'
G. Santayana
Historical note about
MUMPS
Created in the Age of Minicomputers
Octo Barnett MD, internist, MGH, late 1960s
Created a programming language designed for medicine, tailored to minicomputers 8Kb RAM (…eek!)
Integrated DB language into programming language (first and only so far as I know...)
Historical note about
MUMPS 2
Hierarchical database, reflecting medical hierarchies
Very efficient, B-trees database
Simple commands, one data type: text
Only the third computer language standard by ANSI after FORTRAN & COBOL
Core of the VA CPRS system, EPIC
(in short, it won)
Our historical themes
Information: how clinicians/librarians find
what they need

Hardware: the computing platforms in use

Software: the programming platforms in use

Communication: how clinicians/librarians communicate with information systems
Healthcare informatics is littered with good ideas badly implemented <repeat…as needed>
Late 70s-90s
1960s-70s
Mid 1990s-Present
1960s-70s
Late 70s-90s
Mid 1990s-Present
1960s-70s
Late 70s-90s
Mid 1990s-Present
1960s-70s
Late 70s-90s
Mid 1990s-Present
A reminder about names
Clinical Informatics
aka Healthcare Informatics
aka Medical Informatics
Informatics supporting clinicians and patients in care process
Biomedical Informatics ~ Big Umbrella
Bioinformatics
Biomolecular informatics coupling w/ math working in biology
Public/Population Health Informatics
Informatics applied to populations
Translational (bio)Informatics
Informatics to speed research to bedside
Clinical Research Informatics
Informatics supporting researchers
in the research process
The Vendor Space
First dominated by big companies: IBM, SMS (mainframes) --> good start/flopped

Then by smaller companies with niche products, like RIS, LIS, ADT (mini-computers) and by home-grown (some say "home-groan") systems --> good start/many flopped, some didn't

Best of Breed (DoD)
Today, there are hundreds of vendors, even "cloud based" systems (Internet)
Some acronyms you'll hear a lot:

EHR: electronic health record
aka electronic medical record (EMR)

CPOE: computerized provider order entry

HIE: health information exchange

RHIO: regional health info organization

Bad implementation often arises from faulty system evaluation and human factors, which we will cover in fture lectures.
Full transcript