Skip to main content
SpringerLink
Log in

Informatics

  • Chapter
  • First Online:
Oncologic Emergency Medicine

  • 2298 Accesses

Abstract

Clinical informatics is the study of information technology as it applies to clinical care within the health system. The American Medical Informatics Association (AMIA) considers informatics when used for healthcare delivery to be essentially the same regardless of the health professional group involved. Clinical informatics is concerned with information use in healthcare by clinicians. Clinical informatics includes a wide range of topics ranging from clinical decision support (CDS) to visual images; from clinical documentation to provider order entry systems; and from system design to system implementation and adoption. In this chapter, our goal is to introduce the reader to some new and old concepts that will allow the user to assess information and knowledge in order to meet the needs of healthcare professionals and patients. The reader will be able to characterize and evaluate information technology, so that they are better able to refine clinical workflow processes, develop new processes, implement those processes, and refine clinical decision support systems. Knowledge of these elements will aid providers in clinical care of their patients. In this chapter, we discuss workflow, clinical decision support, information technology systems, and communication and then conclude with a brief discussion of cancer research and registries.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Clinical Informatics | AMIA [Internet]. AMIA.org. 2020 [cited 22 Jul 2020]. Available from: https://www.amia.org/applications-informatics/clinical-informatics.

  2. Gardner RM, Overhage JM, Steen EB, Munger BS, Holmes JH, Williamson JJ, Detmer DE, AMIA Board of Directors. Core content for the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):153–7.

    Article  Google Scholar 

  3. Nemeth C, Cook R, Woods D. The messy details: insights from the study of technical work in healthcare. IEEE Trans Syst Man Cybern Syst Hum. 2004;34(6):689–92.

    Article  Google Scholar 

  4. What is workflow? | AHRQ Digital Healthcare Research: informing improvement in care quality, safety, and efficiency [Internet]. Digital.ahrq.gov. 2020 [cited 22 Jul 2020]. Available from: https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/workflow.

  5. Franck R. The explanatory power of models: bridging the gap between empirical and theoretical research in the social sciences. Boston: Kluwer Academic; 2002. p. 309.

    Book  Google Scholar 

  6. Carayon P, Karsh B-T, Cartmill RS, et al. Incorporating health information technology into workflow redesign--summary report. (Prepared by the Center for Quality and Productivity Improvement, University of Wisconsin–Madison, under Contract No. HHSA 290-2008-10036C). AHRQ Publication No. 10-0098-EF. Rockville: Agency for Healthcare Research and Quality. October 2010. Available from: https://digital.ahrq.gov/sites/default/files/docs/citation/workflowsummaryreport.pdf.

  7. Institute of Medicine (US) Committee on Quality of Health Care in America. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington (DC): National Academies Press (US); 2000.

    Google Scholar 

  8. Finnell J, Dixon B. Clinical informatics study guide. Cham: Springer International Publishing; 2016.

    Book  Google Scholar 

  9. Lopetegui M, Yen PY, Lai A, Jeffries J, Embi P, Payne P. Time motion studies in healthcare: what are we talking about? J Biomed Inform. 2014;49:292–9.

    Article  Google Scholar 

  10. Tory M, Moller T. Human factors in visualization research. IEEE Trans Vis Comput Graph. 2004;10(1):72–84.

    Article  Google Scholar 

  11. Jordan B. Ethnographic workplace studies and CSCW. In: Shapiro D, Tauber M, Traunmüller R, editors. The design of computer supported cooperative cork and groupware systems. Amsterdam: Elsevier; 1996. p. 37–9.

    Google Scholar 

  12. Karsh B, Alper S. Work system analysis: the key to understanding health care systems [Internet]. Agency for Healthcare Research and Quality; 2020. Available from: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Karsh.pdf.

  13. Clinical Decision Support | HealthIT.gov [Internet]. Healthit.gov. 2020 [cited 22 Jul 2020]. Available from: https://www.healthit.gov/topic/safety/clinical-decision-support.

  14. Expected value [Internet]. En.wikipedia.org. 2020 [cited 22 Jul 2020]. Available from: https://en.wikipedia.org/wiki/Expected_value.

  15. Expected utility hypothesis [Internet]. En.wikipedia.org. 2020 [cited 22 Jul 2020]. Available from: https://en.wikipedia.org/wiki/Expected_utility_hypothesis.

  16. Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econometrica. 1979;47(2):263–92.

    Article  Google Scholar 

  17. Bartolini A, Sheppard JW, Munns TE. An application of diagnostic inference modeling to vehicle health management. 2001 IEEE autotestcon proceedings. IEEE systems readiness technology conference. (Cat. No.01CH37237), Valley Forge; 2001. p. 706–17. https://doi.org/10.1109/AUTEST.2001.949454.

  18. Burns M, Pearl J. Causal and diagnostic inferences: a comparison of validity. Organ Behav Hum Perform. 1981;28(3):379–94.

    Article  Google Scholar 

  19. Heuristics - Explanation and examples — Conceptually [Internet]. Conceptually. 2020 [cited 22 Jul 2020]. Available from: https://conceptually.org/concepts/heuristics.

  20. Pearl J. Heuristics. Reading: Addison-Wesley; 1985.

    Google Scholar 

  21. Harvey N. Use of heuristics: insights from forecasting research. Think Reason. 2007;13(1):5–24.

    Article  Google Scholar 

  22. Kahneman D, Slovic P, Tversky A, editors. Judgment under uncertainty: heuristics and biases. Cambridge: Cambridge University Press; 1982. https://doi.org/10.1017/CBO9780511809477.

    Book  Google Scholar 

  23. Smith HD. Use of the anchoring and adjustment heuristic by children. Curr Psychol. 1999;18(3):294–300.

    Article  Google Scholar 

  24. Levy A, Hershey J. Value-induced bias in medical decision making. Med Decis Mak. 2008;28(2):269–76.

    Article  Google Scholar 

  25. Slovic P, Finucane M, Peters E, MacGregor D. The affect heuristic. Eur J Oper Res. 2007;177(3):1333–52.

    Article  Google Scholar 

  26. Park C, Lessig V. Familiarity and its impact on consumer decision biases and heuristics. J Consum Res. 1981;8(2):223.

    Article  Google Scholar 

  27. Kahneman D, Tversky A. Variants of uncertainty. Cognition. 1982;11(2):143–57.

    Article  CAS  Google Scholar 

  28. Neumann P, Sanders G, Russell L, Siegel J, Ganiats T. Cost-effectiveness in health and medicine. 2nd ed. Oxford UK: Oxford University Press; 2017.

    Google Scholar 

  29. Altman D, Bland J. Statistics notes: diagnostic tests 2: predictive values. BMJ. 1994;309(6947):102.

    Article  CAS  Google Scholar 

  30. Brodersen J, Schwartz L, Heneghan C, O’Sullivan J, Aronson J, Woloshin S. Overdiagnosis: what it is and what it isn’t. BMJ Evid Based Med. 2018;23(1):1–3.

    Article  Google Scholar 

  31. Wyatt J, Spiegelhalter D. Field trials of medical decision-aids: potential problems and solutions. Proc Annu Symp Comput Appl Med Care. 1991:3–7.

    Google Scholar 

  32. Osheroff J, Teich J, Levick D, Saldana L, Velasco F, Sittig D, et al. Improving outcomes with clinical decision support: an implementer’s guide. 2nd ed. Chicago: Healthcare Information and Management Systems Society; 2012.

    Book  Google Scholar 

  33. Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10(6):523–30.

    Article  Google Scholar 

  34. Dorsey E, Topol E. State of telehealth. N Engl J Med. 2016;375(2):154–61.

    Article  Google Scholar 

  35. Turer RW, Jones I, Rosenbloom ST, Slovis C, Ward MJ. Electronic personal protective equipment: a strategy to protect emergency department providers in the age of COVID-19. J Am Med Inform Assoc. 2020;27(6):967–71.

    Article  Google Scholar 

  36. Yoost JL, Starcher RW, King-Mallory RA, Hussain N, Hensley CA, Gress TW. The use of telehealth to teach reproductive health to female rural high school students. J Pediatr Adolesc Gynecol. 2017;30(2):193–8.

    Article  Google Scholar 

  37. Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM. The effectiveness of telemental health: a 2013 review. Telemed J E Health. 2013;19(6):444–54.

    Article  Google Scholar 

  38. Freiburger G, Holcomb M, Piper D. The STARPAHC collection: part of an archive of the history of telemedicine. J Telemed Telecare. 2007;13(5):221–3.

    Article  Google Scholar 

  39. Ness R. Influence of the HIPAA privacy rule on health research. JAMA. 2007;298(18):2164.

    Article  CAS  Google Scholar 

  40. UCLA Medical Center. Doctor’s Admission Orders. Heart Failure Admission Orders. UCLA HF Orders 3 ALLL Units-2003.doc. Accessed 14 Oct 2020.

    Google Scholar 

  41. Cowden D, Barbacioru C, Kahwash E, Saltz J. Order sets utilization in a clinical order entry system. AMIA Annu Symp Proc. 2003;2003:819.

    PubMed Central  Google Scholar 

  42. Grissinger M. Guidelines for standard order sets. P T. 2014;39(1):10–50.

    PubMed  PubMed Central  Google Scholar 

  43. Rider AC, Kessler CS, Schwarz WW, Schmitz GR, Oh L, Smith MD, Gross EA, et al. Transition of care from the Emergency Department to the outpatient setting: a mixed-methods analysis. West J Emerg Med. 2018;19(2):245–53.

    Article  Google Scholar 

  44. National Patient Safety Goals [Internet]. Jointcommission.org. 2020 [cited 22 Jul 2020]. Available from: https://www.jointcommission.org/standards/national-patient-safety-goals.

  45. Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl 1):i85–90.

    Article  Google Scholar 

  46. Wharton University of Pennsylvania. Knowledge @ Wharton. How the mayo clinic built its reputation as a top hospital [Internet]. 2020 [cited 22 Jul 2020]. Available from: https://knowledge.wharton.upenn.edu/article/mayo-clinics-secret-success/.

  47. STAT. Health. Bailey M. Communication failures linked to 1,744 patient deaths in five years, US malpractice study finds. 1 Feb 2016. [Internet]. [cited 22 Jul 2020]. Available from: https://www.statnews.com/2016/02/01/communication-failures-malpractice-study/.

  48. Shannon D. Effective physician-to-physician communication: an essential ingredient for care coordination. Physician Exec. 2012;38(1):16–21.

    PubMed  Google Scholar 

  49. Campbell R. The five rights of clinical decision support: CDS tools helpful for meeting meaningful use. J AHIMA. 2013;84(10):42–7. (web version updated Feb 2016).

    PubMed  Google Scholar 

  50. White M, Babcock F, Hayes N, Mariotto A, Wong F, Kohler B, et al. The history and use of cancer registry data by public health cancer control programs in the United States. Cancer. 2017;123:4969–76.

    Article  Google Scholar 

  51. American Cancer Society. Cancer surveillance programs the United States [Internet]. Cancer.org. 2020 [cited 22 Jul 2020]. https://www.cancer.org/cancer/cancer-basics/cancer-surveillance-programs-and-registries-in-the-united-states.html.

  52. National Cancer Registrars Association. Cancer registry profession [Internet]. Ncra-usa.org. 2020 [cited 22 Jul 2020]. https://www.ncra-usa.org/About/Cancer-Registry-Profession.

  53. Centers for Disease Control and Prevention. National Program of Cancer Registries (NPCR). How Cancer Registries Work. How cancer registries work | CDC [Internet]. Cdc.gov. 2020 [cited 22 Jul 2020]. https://www.cdc.gov/cancer/npcr/value/registries.htm.

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA

    James P. Killeen & Christian J. Dameff

  2. Department of Psychiatry, Clinical Informatics, University of California San Diego, San Diego, CA, USA

    Jeremy S. Bass

  3. Department of Medicine, Clinical Informatics, University of California San Diego, San Diego, CA, USA

    Brian Khan & Nathan Yung

  4. Department of Family Medicine, Clinical Informatics, University of California San Diego, San Diego, CA, USA

    Ammar Mandvi

Authors
  1. James P. Killeen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian J. Dameff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeremy S. Bass
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ammar Mandvi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nathan Yung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James P. Killeen .

Editor information

Editors and Affiliations

  1. Former Professor and Founding Chair (Retired), The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Knox H. Todd

  2. Professor and Chair, Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

    Charles R. Thomas, Jr.

  3. Professor and Chair, Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kumar Alagappan

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Killeen, J.P., Dameff, C.J., Bass, J.S., Khan, B., Mandvi, A., Yung, N. (2021). Informatics. In: Todd, K.H., Thomas, Jr., C.R., Alagappan, K. (eds) Oncologic Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-67123-5_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-67123-5_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-67122-8

  • Online ISBN: 978-3-030-67123-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation