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This textbook begins with an introduction to the US healthcare
delivery system, its many systemic challenges and the prior efforts
to develop and deploy informatics tools to help overcome those
problems. It goes on to discuss health informatics from an
historical perspective, its current state and its likely future
state now that electronic health record systems are widely
deployed, the HL7 Fast Healthcare Interoperability standard is
being rapidly accepted as the means to access the data stored in
those systems and analytics is increasing being used to gain new
knowledge from that aggregated clinical data. It then turns to some
of the important and evolving areas of informatics including
population and public health, mHealth and big data and analytics.
Use cases and case studies are used in all of these discussions to
help readers connect the technologies to real world challenges.
Effective use of informatics systems and tools by providers and
their patients is key to improving the quality, safety and cost of
healthcare. With health records now digital, no effective means has
existed for sharing them with patients, among the multiple
providers who may care for them and for important secondary uses
such as public/population health and research. This problem is a
topic of congressional discussion and is addressed by the 21st
Century Cures Act of 2016 that mandates that electronic health
record (EHR) systems offer a patient-facing API. HL7's Fast
Healthcare Interoperability Resources (FHIR) is that API and this
is the first comprehensive treatment of the technology and the many
ways it is already being used. FHIR is based on web technologies
and is thus a far more facile, easy to implement approach that is
rapidly gaining acceptance. It is also the basis for a 'universal
health app platform' that literally has the potential to foster
innovation around the data in patient records similar to the app
ecosystems smartphones created around the data they store. FHIR app
stores have already been opened by Epic and Cerner, the two largest
enterprise EHR vendors. Provider facing apps are already being
explored to improve EHR usability and support personalized
medicine. Medicare and the Veteran's Administration have announced
FHIR app platforms for their patients. Apple's new IOS 11.3
features the ability for consumers to aggregate their health
records on their iPhone using FHIR. Health insurance companies are
exploring applications of FHIR to improve service and communication
with their providers and patients. SureScripts, the national
e-Prescribing network, is using FHIR to help doctors know if their
patients are complying with prescriptions. This textbook is for
introductory health informatics courses for computer science and
health sciences students (e.g. doctors, nurses, PhDs), the current
health informatics community, IT professionals interested in
learning about the field and practicing healthcare providers.
Though this textbook covers an important new technology, it is
accessible to non-technical readers including healthcare providers,
their patients or anyone interested in the use of healthcare data
for improved care, public/population health or research.
"This book will be a terrific introduction to the field of clinical
IT and clinical informatics" -- Kevin Johnson "Dr. Braunstein has
done a wonderful job of exploring a number of key trends in
technology in the context of the transformations that are occurring
in our health care system" -- Bob Greenes "This insightful book is
a perfect primer for technologists entering the health tech field."
-- Deb Estrin "This book should be read by everyone.​" -- David
Kibbe This book provides care providers and other non-technical
readers with a broad, practical overview of the changing US
healthcare system and the contemporary health informatics systems
and tools that are increasingly critical to its new financial and
clinical care paradigms. US healthcare delivery is dramatically
transforming and informatics is at the center of the changes.
Increasingly care providers must be skilled users of informatics
tools to meet federal mandates and succeed under value-based
contracts that demand higher quality and increased patient
satisfaction but at lower cost. Yet, most have little formal
training in these systems and technologies. Providers face system
selection issues with little unbiased and insightful information to
guide them. Patient engagement to promote wellness, prevention and
improved outcomes is a requirement of Meaningful Use Stage 2 and is
increasingly supported by mobile devices, apps, sensors and other
technologies. Care providers need to provide guidance and advice to
their patients and know how to incorporated as they generate into
their care. The one-patient-at-a-time care model is being rapidly
supplemented by new team-, population- and public health-based
models of care. As digital data becomes ubiquitous, medicine is
changing as research based on that data reveals new methods for
earlier diagnosis, improved treatment and disease management and
prevention. This book is clearly written, up-to-date and uses real
world examples extensively to explain the tools and technologies
and illustrate their practical role and potential impact on
providers, patients, researchers, and society as a whole.Â
"This book will be a terrific introduction to the field of clinical
IT and clinical informatics" -- Kevin Johnson "Dr. Braunstein has
done a wonderful job of exploring a number of key trends in
technology in the context of the transformations that are occurring
in our health care system" -- Bob Greenes "This insightful book is
a perfect primer for technologists entering the health tech field."
-- Deb Estrin "This book should be read by everyone. " -- David
Kibbe This book provides care providers and other non-technical
readers with a broad, practical overview of the changing US
healthcare system and the contemporary health informatics systems
and tools that are increasingly critical to its new financial and
clinical care paradigms. US healthcare delivery is dramatically
transforming and informatics is at the center of the changes.
Increasingly care providers must be skilled users of informatics
tools to meet federal mandates and succeed under value-based
contracts that demand higher quality and increased patient
satisfaction but at lower cost. Yet, most have little formal
training in these systems and technologies. Providers face system
selection issues with little unbiased and insightful information to
guide them. Patient engagement to promote wellness, prevention and
improved outcomes is a requirement of Meaningful Use Stage 2 and is
increasingly supported by mobile devices, apps, sensors and other
technologies. Care providers need to provide guidance and advice to
their patients and know how to incorporated as they generate into
their care. The one-patient-at-a-time care model is being rapidly
supplemented by new team-, population- and public health-based
models of care. As digital data becomes ubiquitous, medicine is
changing as research based on that data reveals new methods for
earlier diagnosis, improved treatment and disease management and
prevention. This book is clearly written, up-to-date and uses real
world examples extensively to explain the tools and technologies
and illustrate their practical role and potential impact on
providers, patients, researchers, and society as a whole.
Despite its high cost, the US healthcare system produces
relatively short life spans, and is wasteful, inefficient and has
serious safety and quality issues. While other industries have
surmounted similar challenges by transforming themselves through
information technology, healthcare lags behind. Major reasons are
that our approaches to care delivery and financial incentives were
designed for a bygone era. Beyond that the technology offered to
practitioners has often been overly expensive, poorly designed,
overly proprietary, hard to implement and difficult to use. Spurred
by a unique, one-time Federal stimulus and the new mobile, wireless
and cloud technologies now available, this landscape is rapidly
changing. To succeed going forward practitioners, and those
interested in entering the field, need to understand the new
driving forces and have a basic understanding of contemporary
clinical informatics. Practitioners, in particular, need to
understand the alternative technologies and approaches available
for their use in individual patient care and more continuous
management of their chronic disease patients. To efficiently meet
these needs, this book provides an introduction to the rationale
for care transformation through clinical informatics; its
application to patient care outside of hospitals; and a look at its
future. Key points are illustrated throughout by actual examples of
open source and commercial health IT products and services. While
written with practitioners and students entering the field of
clinical informatics in mind, the book eschews technical
terminology and is easily accessible by the lay reader not
proficient in clinical medicine or information technology."
This extensively revised textbook describes and defines the US
healthcare delivery system, its many systemic challenges and the
prior efforts to develop and deploy informatics tools to help
overcome these problems. Now that electronic health record systems
are widely deployed, the HL7 Fast Healthcare Interoperability
standard is being rapidly accepted as the means to access and share
the data stored in those systems and analytics is increasing being
used to gain new knowledge from that aggregated clinical data, this
book goes on to discuss health informatics from an historical
perspective, its current state and likely future state. It then
turns to some of the important and evolving areas of informatics
including electronic healt\h records, clinical decision support,.
population and public health, mHealth and analytics. Numerous use
cases and case studies are employed in all of these discussions to
help readers connect the technologies to real world challenges.
Health Informatics on FHIR: How HL7's API is Transforming
Healthcare is for introductory health informatics courses for
health sciences students (e.g., doctors, nurses, PhDs), the current
health informatics community, computer science and IT professionals
interested in learning about the field and practicing healthcare
providers. Though this textbook covers an important new technology,
it is accessible to non-technical readers including healthcare
providers, their patients or anyone interested in the use of
healthcare data for improved care, public/population health or
research.
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