Health Informatics and Medical Librarianship in the Philippines

Ayedee Ace Domingo, MDMAHLAP Congress, February 2009, Tagaytay

Health Informatics Management

Health Informatics and Medical

Librarianship in the Philippines• Overview of health informatics

• Trends in health informatics in the Philippines

• The nature of medical data

• Role of medical librarianship in health informatics

• Tools

Health Informatics

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Library and information studies

• (manages)…recordable information and knowledge, and the services and technologies to facilitate their management and use, encompassing information and knowledge creation, communication, identification, selection, acquisition, organization and description, storage and retrieval, preservation, analysis, interpretation, evaluation, synthesis, dissemination and management.

(American Library Association, 1992)

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Health informatics

• study and application of methods to improve the

management of patient data, medical knowledge,

population data and other information relevant to

patient care and community health.

• emphasis on information management rather than

technology.(Wyatt, BMJ, 2006)

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Branches of health informatics

• Bioinformatics

• Clinical informatics

• Consumer health informatics

• Public health informatics

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Bioinformatics

• Use of health informatics methods for

molecular biology

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Example : Drug design

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Clinical informatics

• Use of health informatics in the management

of patients

• Examples : clinical decision support, security

privacy and confidentiality, hospital

information systems

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Example : Electronic health records

• Any information related to the health of the

individual in electronic format for the primary

purpose of providing health care

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Consumer health informatics

• Study and development of systems that

support access to health and lifestyle

information

• Example : telehealth, e-health

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Example : Web portals

• Aggregators of health content

• WebMD, Rxpinoy

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Public health informatics

• Health informatics in public health

• Example : syndromic surveillance, national

health information systems

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Example : POGS ISIS

• Integrated Statistical Information System of

the Philippine Obstetrical and Gynecological

Society

• Electronic statistics on ob and gyn

• 150 hospitals nationwide

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Health Informatics in the Philippines

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Health informatics in the Philippines

• Hospitals

• Universities and medical schools

• Physicians

• Government

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Hospitals

• Hospital information systems –Philippine Heart Center, St. Luke’s, Cardinal Santos,

Asian Hospital–BizBox, Microsoft Amalga

• Radiology information systems–GE Centricity and Siemens (TMC), DR Systems (SLMC)

• Laboratory information systems–TD Synergy

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Example : The Medical City SHAMAN

• Strategic Hospital and Medical Automation

Network

• Hospital information management system of

TMC

• Homegrown, internally developed

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Example : The Medical City SHAMAN6 Core / Multi-mode 1Gbps – 10 Gbps Fiber Optic Cables

Category 6 10/100/1000 Mbps Copper Cables

IBM P-650 Servers w/ AIX5 & Oracle 9i IBM X-Series

Servers w/ Win2K for DNS, PDC, Mail, etc.

P4 PCs, Laptops w/ WinXP, OfcXP & Oracle Clients

Nortel Passport 8500 Core Switch & Edge Switches

PLDTI-Gate

Sub-terrain Black Fiber (Ortigas-loop)

Doctor’s Clinics/Homes

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Universities and Medical Schools

• Integration of health informatics into the

curriculum

• Short courses and elective : DLSU-EAC, UPCM

• MS in Health Informatics : UPCM

• MBA : ASMPH and AGSB

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Physicians

• Electronic patient records and clinic

information systems

• Klinika, Medbrilliance

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Government

• National Telehealth Program–Remote consultation using Internet

• National Epidemic Sentinel Surveillance System–Detection of outbreaks

• Field Health Service Information System–Aggregation of public health data from the RHU

Medical Librarianship and Health Informatics

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Role of the librarian

• In the previous lecture, the librarian is the

“information mediary”

• “Infomediary”

• Same as the physician; the librarian is the

“learned intermediary”.

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A New Model : The Informationist

• Bridges the gap between clinician and patient

• Understands both clinical and information science

• Experts in the practice of retrieving, synthesizing,

and presenting medical information

• Designs, evaluates and improves information

systems(Davidoff, Annals of Internal Medicine, 2000)

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Role of ML in Health Informatics

1. Manage information in health information

systems

2. Provide access to clinicians to evidence-based

information and clinical decision support tools

3. Provide access to patients to easy-to-understand

health information

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Information management in HIS

• Health information systems–Electronic patient records

–Hospital information systems

–Public health information systems

• Skills in organizing and classifying information and

optimizing access

• Help develop policy on technical standards

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Technical standards

• ICD-10–International Classification of Diseases

–Used for billing and epidemiology

• HL7

–Health Level 7

–Used for exchange for health information

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Access to information for EBM and CDS

• “To actually do a good search on Medline you

have to be a biomedical librarian.”

–Enrico Coeira, Professor of Medical Informatics,

University of New South Wales

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Access to information for EBM and CDS

• Every hospital and clinic should have access to good medical information, whether print or online

• Free up physician’s time to care for patients• Give access to the best evidence-based information on

treatment• Provide access to tools for improved clinical decision-

making– Diagnosis (E.g. : GIDEON)– Drugs (E.g. : Epocrates)

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Epocrates

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GIDEON

• Global Infectious Disease and Epidemiology

Network

• Commercial

• Diagnostic aid for infectious diseases

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GIDEON

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Access to health information for patients

• Patient empowerment

• Access to the Internet

• Patient-centered care

• Emphasis on health promotion, rather than treatment

• Greater role of patient education

Tools

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Tools

• The Internet is your library.

• Archive not just books, but also online

resources and software

• I will focus on free (and legal) resources, since

most of the commercial vendors already

surround you.

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Tools

• Online journals–Medline

–www.freemedicaljournals.com (including BMJ,

NEJM)

–Herdin (www.herdin.ph, doh.herdin.ph)

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Tools

• Search engine–Google!

• Advanced tools (e.g. health informatics

filetype:ppt)

• Keywords (e.g. anemia vs. decreased blood)

–RightHealth

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Tools

• References–Emedicine (www.emedicine.com)

–Disease information written by physicians

–Patient education materials

–Continuing medical education

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Tools

• References–WebMD

–Mayo Clinic

–Medline Plus

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Tools

• Software–Portal

• Download.com (www.download.com) (sure to

be virus free)

• Handheldmedicine.ca

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Tools

• Software–Clinical

• Epocrates• Archimedes (medical calculator)

–Research• Epi info• Epi Maps• Google Earth

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Conclusion

• Health informatics is becoming an integral aspect of the delivery of healthcare in the Philippines

• Librarian and information science skills are essential in the development of health informatics in the country.–Organization of health information–Access to reliable clinical information–Access to easy to understand information for patients

Thank you.