Wednesday, November 30, 2005

Health Informatics 411

This is a post that I made on Medicalblog several weeks ago, but neglected to place it on the RHIO blog.

Health Informatics may be the new “basic science” course that will be a prerequisite for an M.D. Genomics, proteomics, as well as other disciplines have evolved from our fledgling knowledge of genetics and protein biochemistry. As we “drill down” into the cellular architecture and the processing of information health informatics will assist consumers and physicians as well as health institutions alike.

Arthur Grove Ph.D. (former head of Intel) in a recent “Commentary” in the JAMA makes note of several things about medicine and digital tools.

“There are signs that individual consumers may be taking matters into their own hands. The proliferation of companies providing personal health record services10 is an indicationof such a movement. This phenomenon has all the makings of becoming a disruptive technology”

Dr Grove goes on to elaborate,

“Like the computer industry, health care is a largely horizontally organized industry, with the horizontal layers representing patients, payers, physicians, and hospitals, as well as pharmaceutical and medical device companies. Standard ways of interconnecting all these constituencies are crucial. The good news is that the desire to increase internal productivity has led to at least partial deployment of information technology within the companies of many of the participants. Further good news is that the physical means of interconnecting the many participants already exists in the form of the Internet. The bad news is that with the exception of a few, large, vertically integrated health care organizations, in which participants from several layers are contained in 1 organization (as is the case with the Veterans Affairs Administration and Kaiser Permanente), the benefits of electronic information exchange are not necessarily realized by the participants in proportion to their own investment.

The industry faces what is called in game theory the “prisoners’ dilemma” all members have to act for any one member to enjoy the benefit of action.”Amongst these “disruptive technologies” are the movements toward “Open Access” publishing, the demand for immediate publishing of negative results from clinical trials, The gaining popularity of compressed audio and digital files resulting in “podcasts”, “videocasts”, which may replace conventional media such as audiodigest, CDs for CME as other formats much like “beta VCR” and the 8 track audio cassette were relegated to oblivion.Undoubtedly this will decrease the “signal to noise ratio” and perhaps the evolution will be much like the “yellow pages” of our telephone book, where you no longer can find what you are looking for.Search engine algorithms will become critical in cataloging and organizing relevant materials. Six or Twenty billion pages of information become relatively meaningless when lumped together in one data base.On the other hand interconnectivity and open access to many old and new journals enhances the synergism between science disciplines as well as basic and applied science. It will speed the translation of scientific discovery into relevant clinical applications, and perhaps quicken the selection of the “fittest” tools for cure disease and optimize health and treatment.Physicians will need to chose relevant digital tools, and become educated regarding what forms of data storage, sorting, and retrieval methods that will yield cost effective results.

To quote Arthur Grove, once again,

“The health care industry in the United States represents 15% of the gross domestic product, and bearing its cost is a heavy burden on corporations and individuals alike. The mandate for increasing its efficiency—in research, translation, and operations—is clear. History shows that whatever technology can do, it will do. If not here, where? If not now, when?”

Gary M. Levin M.D.
Ref: Corresponding Author: Andrew S. Grove, PhD, Intel Corporation, 2200 MissionCollege Blvd, Santa Clara, CA 95054 (
posted by Gary M. Levin M.D. at 5:18 PM


At 7:36 PM, Anonymous Anonymous said...

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