ISC471/HCI 571 Isabelle Bichindaritz1 Introduction to Health Information Systems 8/27/2012.

1ISC471/HCI 571 Isabelle Bichindaritz

Introduction to

Health Information Systems

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Agenda• Introduction to course

– Course description– Learning objectives– Topics– Schedule– Evaluation

• Biomedical information and information systems

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Course Description • Course description

The course is an introduction to technologies and practices in medical, health, and biological information systems. Topics include terminology, data sets, relational, and distributed databases, privacy, computer and network security, web services, human-computer interaction, and emerging trends. Students engage in projects which apply computing and information technologies to one or more areas of these information systems.

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Learning Objectives

• HCI 571 introduces students to biomedical information systems concepts and skills. Upon successful completion of the course, the students will be able to:– Articulate institutional, social, and cultural aspects of the

health care environment, as well as discuss ethical and legal issues associated with the medical field.

– Read and analyze scientific publications in information technology applied to biomedical information systems.

– Specify and evaluate computer security criteria for biomedical web services, and relational database applications.

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Learning Objectives

• HCI 571 introduces students to biomedical information systems concepts and skills. Upon successful completion of the course, the students will be able to:– Use their acquired knowledge of health care data sets to code

data, construct relational databases, write queries for report generation, and analyze data.

– Apply concepts and practices from artificial intelligence, human-computer interaction, data visualization, web technologies, and simulations to medical information systems.

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Topics• Healthcare system and health information management

profession.• Human resource management and operational

management.• Resource planning.• Patient privacy and legal constraints.• Health informatics technologies.• Health data concepts and methods.• Electronic health records.• Classification systems and coding.

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Topics• Information security.• Health information management.• Data summarization with statistics.• Data analysis.• Information systems evaluation.• Artificial intelligence and decision-support systems in health

sciences.• Simulation science and robotics in medicine.• Human-computer interaction, new media, and visualization in

medicine.• Internet and associated technologies in health sciences.

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ClassworkCLASS WORK AND EVALUATION

Undergraduate students

bi-weekly assignments or deliverables due, and

two midterms.

The last assignment takes the form of an explanatory article of the data analyses achieved in previous assignments. Some of the assignments involve analytical skills, writing competence, or light programming.

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ClassworkCLASS WORK AND EVALUATION

Graduate students

In addition to the assignments for undergraduate students, the coursework involves:

a project with milestones

an in-class technical presentation

a writing portfolio (containing all non-project related assigned writings)

active participation.

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GradingUndergraduate students

Labs/assignments: 40%

First midterm: 20%

Second midterm: 20%

Explanatory article: 10%

Participation: 10%

Graduate students

Labs/assignments: 20%

Project: 30%

Portfolio: 30%

Presentation: 10%

Participation: 10%

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11

Information Principles and Information Systems

Agenda

Introduction to the information age / era

What is information ?

What is informatics ?

What are information systems ?

Examples of information systems

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ISC471/HCI 571 Isabelle Bichindaritz

The Information Era• Why is information important?

– Rate of increase in the amount of information is exponential [Kurzweil 2005]• Youtube hosts 100 M videostreams a day• Number of shared MP3 songs is greater than 1 billion• Number of traffic surveillance cameras in London is 200,

they send 64 trillion bits a day to command centers• Number of Internet users is 1,966 M or 28.7% of world

population• New digital information in 2006: 161 billion Gigabytes,

this is 3 M times the information created in books.

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The Information Era• Why is information important?

– Some of the largest datamarts • eBay - 5 petabytes of user data (40 terabytes per day)

10,000’s users millions of queries per day 100’s of databases

• Walmart – 2.5 petabytes of data• Dell – 1 petabyte of data• Google uses a crawler with 850 terabytes of data• France’ Social Security stores insurance data of 60 M

people and accumulates 100 Terabytes of data (100,000,000,000,000) every 18-24 months and Caisse Nationale des Allocations Familiales (CNAF) stores 4 Terabytes.

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The Information Era

• Why is information important?

– Rate of increase in the amount of information is exponential [IDC 2007]

• Total amount of digital information in the world reached 281 billion gigabytes (GB) in 2007 (281 exabytes).

• This represents 45 GB of digital information per person.

• The overall size of digital information exceeds the world storage capacity, so that not all can be saved.

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The Information Era


– Some reasons for the increase

• Growing popularity of digital television and digital cameras (more than a billion worldwide)

• Surveillance systems

• Social networks

• Cloud computing

• Images and videos use the majority of this storage

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The Information Era


– Bill Clinton:

« When I took office, only high energy physicists had ever heard of what is called the world wide web. Now even my cat has its own page »

– Other factors• The border between computerized systems and human systems is

projected to become slimmer and slimmer [Kurzweil 2005] due to robotics, virtual reality and virtual worlds, gaming (serious), nanotechnologies …

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The Information Era


– Consequences

• The sheer amount of digital data and information requires computers for storing and processing it.

• The shift from paper-based information storage to digital storage has changed how we work and often how we relate – not only technical aspects, but organizational, social, and cultural as well.

• Computers as technical beings to be acquainted with.

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The Information Era

• Why is information important ?

– Growth of the Internet

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Table: The size of the Internet in terabytes.

Medium 2002 Terabytes

Surface Web 167

Deep Web 91,850

Email (originals) 440,606

Instant messaging 274

TOTAL 532,897

[How much information 2003]

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The Information Era• Why is information important ?


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The Information Era• Why is information important ?


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The Information Era• Why is information important in healthcare?

– Examples of information use in public health

• Health data are more and more stored on digital media– Electronic medical records (EMRs) and health records (EHRs)

• Data sources and information sources are connected to compose information systems

• Technology is used as a medium for communication of public health information

• Decision support for hospital resource management


Definition of Information

• What are data, knowledge ?– Data are observations, values of parameters– A datum refers to ‘a single obervational point that characterizes a

relationship. It can generally be regarded as the value of a specific parameter for a particular object (e.g. a patient) at a given point in time’ [Shortliffe and Barnett 2006]

– Example: 3.7, 5 ml, 37°, …

– Knowledge is derived from data through ‘formal or informal analysis’ – it is agreed to be true

– Example: The earth is round Normal temperature is 37°C

– Knowledge can be represented and organized in a knowledge base



• The data to knowledge spectrum

– [Pantazzi and Arocha 1991]ISC471/HCI 571 Isabelle Bichindaritz 238/27/2012


• What is information ?– Element of knowledge susceptible to be represented through

conventions with the aim of being stored, processed, or communicated [Journal Officiel of January 17, 1982].

– Any information is characterized by its content, meaning, and form. • Example: Betsy is square

– Content ?– Form ?– Meaning ?

– Information is the communication or reception of knowledge or intelligence [Merriam-Webster].



• What is information ?– Different concepts

• Knowledge obtained from investigation, study, or instruction / Intelligence, news / Facts, data (knowledge, facts).

• What is encoded or communicated by one of two or more alternative sequences or arrangements of something (as nucleotides in DNA or binary digits in a computer program) that produce specific effects (meaning).

• A signal or character (as in a communication system or computer) representing data / something (as a message, experimental data, or a picture) (code, representation).

• A quantitative measure of the content of information; specifically : a numerical quantity that measures the uncertainty in the outcome of an experiment to be performed (informational content).

• The act of informing a person (communication act).– Polymorphic phenomenon and a polysemantic concept



• What is information ?– General Definition of Information (GDI) in

terms of data + meaning [Floridi 2005] .• The General Definition of Information (GDI):

σ is an instance of information, understood as semantic content, if and only if:– (GDI.1) σ consists of one or more data;– (GDI.2) the data in σ are well-formed;– (GDI.3) the well-formed data in σ are meaningful.

• GDI requires a definition of data.



• What is information ?• GDI.1: data are the stuff of which information is made. • GDI.2: “well-formed” means that the data are clustered

together correctly, according to the rules (syntax) that govern the chosen system, code or language being analyzed - broadly (not just linguistically), what determines the form, construction, composition or structuring of something.

• GDI.3: “meaningful” means that the data must comply with the meanings (semantics) of the chosen system, code or language in question.



• Information and communication


Definition of Information Systems

• What is information science?

ISC471/HCI 571 Isabelle Bichindaritz 29

Discipline that deals with the processes of storing and transferring information. It attempts to bring together concepts and methods from various disciplines such as library science,

computer science and engineering, linguistics, psychology, and other technologies in order to develop techniques and devices to

aid in the handling—that is, in the collection, organization, storage, retrieval, interpretation, and use — of information.

[Encyclopedia Britannica]

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Definition of Information Systems • What are information systems?

• An arrangement of information (data), processes, people, and information technology that interact to collect, process, store, and provide as output the information needed to support the organization [Whitten and Bentley 2005].

• Business firms, other organizations, and individuals in contemporary society rely on information systems to manage their operations, compete in the marketplace, supply services, and augment personal lives.

• Can be computerized or not • Often connected with information technology (software,

hardware, networks …)• Example: patient medical records (paper-based, electronic)



• What is systems approach?

• Systems thinking consists in considering how parts influence one another to form the whole.

• Example: ecosystems.

• Based on the idea that the whole is more than the parts.

• Parts can not only be described in isolation but in the relationships they entertain with other parts and systems.



Definition of Information Systems• What is Informatics?

• “The systematic application of information and computer science and technology”

• Bioinformatics application to biology• Medical informatics application to medicine• Enviro-informatics application to environmental sciences …

• Computer science refers to the automatic processing of information with computers (in French, Italian, Spanish: informatique).

• In terms of science, it is “the science of information processes and their interactions with the world” (Denning 2005). There is a debate around computer science as a science / an engineering discipline. 328/27/2012



33[Shortliffe 2010]8/27/2012



34[Shortliffe 2010]8/27/2012



• Informatics example: what is Public Health Informatics ?

• Public Health informatics refers to the application of informatics to public health and to the entire healthcare system (health information infrastructure) [Yasnoff et al. 2006].

• Population level informatics for • Medical care of populations.• Environment monitoring for health risks due to biological,

chemical, and radiation exposures (natural and man-made such as bio-terrorism agents).

• Threat detection from the food supply, water systems, driving conditions etc.

• Natural or man-made disaster assistance.

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• Informatics example: what is Public Health Informatics?

• “The systematic application of information and computer science and technology to public health practice, research, and learning”

• [O’Carroll and the Public Health Informatics competencies Working Group 2002]

• Informatics has an information science connotation while information systems has a business connotation (in English, less so in European countries)




• The health information system dimensions

• [A framework for health care and life sciences]378/27/2012



• Example of organization: Public Health Informatics in the US

• Centers for Disease Control and Prevention (CDC)• Coordinating Center for Health Information and Service (CCHIS)

• National Center for Health Marketing (NCHM)• National Center for Health Statistics (NCHS)• National Center for Public Health Informatics (NCPHI)

Creation of 5 centers of excellence in Public Health Informatics funded by CDC (University of Washington, University of Utah, Johns Hopkins University, New York City Health Department, and Harvard Medical School)

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• Example of organization: Public Health Informatics in the US

• Informatics Competencies for Public Health Professionals (available at http://www.nwcphp.org/docs/phi/comps/phi_print.pdf)

Patrick W. O’Carroll, MD, MPH and the Public Health Informatics Competencies Working Group

• Three classes of informatics competencies are defined relative to – in public health practice -

• The use of information • The use of information technology• The management of information technology.

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http://www.nwcphp.org/docs/phi/comps/phi_print.pdf



• Related disciplines

• Medical informatics / Biomedical informatics core themes• Standards• Terminology• Usability• Demonstrated value

• Informatics (applied IT / information/people/technology / domain problem-solving / transform information into knowledge)

• Elie Wiesel: “But how does one transform information into knowledge, knowledge into understanding, understanding into sensitivity”.

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• Medical informatics

• Clinical informatics• Patient specific information versus knowledge-based information• Electronic medical records• Information retrieval• Decision support system

• Health administration informatics• Evaluation, acquisition, and implementation of information

technology systems in support of all administration and clinical functions

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• Public health informatics

• Four key principles [O’Carroll 2003]• Applications of information science and technology that promote the

health of populations as opposed to the health of specific individuals• Applications that prevent disease and injury by altering the conditions or

the environment that put populations of individuals at risk• Applications that explore the potential for prevention at all vulnerable

points in the causal chains leading to disease, injury, or disability• Public health informatics reflects the governmental context in which

public health is practiced.

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• Public health informatics

• Growing importance of information in public health• Information intensive field subject to the growth of information

• Publication of “the future of public health” in the US Institute of Medicine in 1988, re-centering public health around assessment, policy development, and assurance – all areas for which information is key [O’Carroll 2003]

• Growth in managed care

• The information technology revolution

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• Public Health Informatics

• Public health informatics is characterized by• Focus on populations• Study of environmental factors• Orientation to prevention• Not limited to clinical settings and encounters• Governmental context.

• Public health three core functions• Assessment – monitoring health status and disease outbreaks and

epidemics• Policy development – such as seat belt use• Assurance – assuring that health services are provided to achieve

agreed upon goals

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Examples of Information Systems

• Information systems

• Health care information systems

• Hospital information systems

• Clinical information systems

• Medical insurance information systems

• Pharmaceutical information systems

• …


ISC471/HCI 571 Isabelle Bichindaritz1 Introduction to Health Information Systems 8/27/2012.

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