Nutrition Informatics- What is It 2009

8/14/2019 Nutrition Informatics- What is It 2009

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Nutrition Informatics What is it?What does it mean to you?

Elaine J. Ayres, MS, RDDeputy Chief, Laboratory for Informatics Development

National Institutes of Health, Clinical Center

February 23, 2009University of Maryland


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Key Topics

What is nutrition informatics?

Data and information

Technology Where is the profession?

What are competencies for the field of

informatics?


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Informatics

Informatics includes the science of information,the practice of information processing, and the

engineering of information systems. Informatics

studies the structure, algorithms, behavior, and

interactions of natural and artificial systems that

store, process, access and communicate

information.

http://en.wikipedia.org/wiki/Informatics


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The effective retrieval, organization, storage

and optimum use of information, data and

knowledge for food and nutrition related

problem solving and decision making.Informatics is supported by the use of

information standards, information processes

and information technology.

(ADA Nutrition Informatics Work Group, 2007)

Nutrition Informatics


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The effective retrieval, organization, storage

and optimum use of information, data and

knowledge for food and nutrition related

problem solving and decision making.Informatics is supported by the use of

information standards, information processes

and information technology.

(ADA Nutrition Informatics Work Group, 2007)

Nutrition Informatics


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Data

Raw information that has not beenanalyzed or interpreted

Humans and/or computers can process

data Examples:

Weight

Brand of insulin Grams of carbohydrate in rice


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Information

Transforming data into information Analysis

Interpretation

Comparison Aggregation

Can be displayed graphically

Humans and/or computers can turn data

into information Weight/insulin/CHO in rice = ?


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Knowledge

Trends, patterns, context

Outcomes

Decision support

Artificial intelligence

Research

Humans with computers can efficiently

create knowledge


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Data to Knowledge


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Sources of Data

Printed materials

Electronic

Verbal

Databases

Images Signals

How do you organize?The art of information processing


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Standards


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Standards

Term (a word)

Terminology (a set of terms)

Multiple terminologies developed to meet

specific needs Unified Medical Language System (UMLS)

SNOMED

LOINC

ICD-9 Data transmission standards HL7


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Standard Hierarchy

USDA DatabaseVegetables

Tomato

Tomatoes, red, ripe, raw

WholeCherry

Italian

Plum

OtherNutrients


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Knowledge-Based Terminologies

Defines the relationship between termsrather than just organizing into a hierarchy

Example

Lab test linked to chemical substancemeasured

Medication linked to chemical substance

Diseases linked to body location


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Knowledge-Based HierarchyKnowledge-Based Hierarchy

Includes a traditional hierarchy

Adds concepts such as

Is a ..

Attributes such as chemical composition

Synonyms

Each item is a number not a word

Translation tables link numbers in adatabase


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Knowledge-Based Hierarchy

IS A - VEGETABLE

HAS CHEMICALSTRUCTURE LIKE:

HAS ALLERGANPROFILE LIKE:

HAS GENETIC STRUCTURELIKE:

HAS NUTRIENTCOMPOSITION LIKE:


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Nutrition Resources

Nutrient composition tables

Standardized languages ADA Standardized language

SNOMED Proteomics and genomics data

Chemical composition tablesTHINK BOTH WORDS AND NUMBERS!

Career Tip: Many informaticists havetraining in information science!


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Technology


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Hardware


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Look Familiar?


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Applications

Common tools e-mail, browsers, officemanagement

Query and reporting tools

Statistical analysis Database management systems

Networking and interfaces

Electronic medical records

Nutrition management systems


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The Future?


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Health Information Technology

Health information technology (HIT) allowscomprehensive management of medical information andits secure exchange between health care consumers andproviders. Broad use of health IT will:

* Improve health care quality;* Prevent medical errors;* Reduce health care costs;* Increase administrative efficiencies;* Decrease paperwork; and* Expand access to affordable care.

1) http://www.dhhs.gov/healthit/


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Interoperable Health IT

Interoperable health IT will improve individual patientcare, but it will also bring many public health benefitsincluding:

* Early detection of infectious disease outbreaks

around the country;* Improved tracking of chronic disease management;and* Evaluation of health care based on value enabledby the collection of de-identified price and quality

information that can be compared.



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Electronic Health Record

The Electronic Health Record (EHR) is a longitudinalelectronic record of patient health information generated

by one or more encounters in any care delivery setting.

The EHR has the ability to generate a complete record of aclinical patient encounter - as well as supporting othercare-related activities directly or indirectly via interface -including evidence-based decision support, qualitymanagement, and outcomes reporting.

2) http://himss.org/ASP/topics_ehr.asp


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Electronic Health Record

The Electronic Health Record is thetechnology likely to have the mostprofound effect on the daily work of

physicians and other health careproviders.

3) Blumenthal, D, Glaser, JP NEJM 2007


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Consumer Health IT

Health information technologies can be tools that helpindividuals maintain their health through better managementof their health information.

Health IT will help consumers gather all of their healthinformation in one place so they can thoroughly understandit and share it securely with their health care providers sothey get the care that best fits their individual needs.



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Personal Health Record

Personal Health Record (PHR) acollection of information about anindividuals health and health care, stored

in an electronic format.Personal Health Record System a PHR

with computerized tools that help anindividual understand and manage the

information contained in a PHR.4) DHHS Personal Health Records 2006


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Personal Health Record

Personal Health Records have thepotential to affect the daily lives of patients

by involving them more actively inmanaging their own health.

3) Blumenthal, D, Glaser, JP NEJM 2007


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State of the Union


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Nutrition Informatics Survey

Electronic survey of all ADA members withvalid e-mail (55,063)

Responses 11,223 (20% response rate)

Included students, interns and retirees

80% of respondents work in a dieteticsrelated position

35% work in clinical nutrition .4% work in informatics


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Access to a computer/internet 97.3% have access to a computer at work

91.5% have access to the internet at work

1.3% had no access to a computer or the internet at

work 19% use a PDA

Use of applications 93% use e-mail daily

86% use the internet daily

50% use clinical nutrition applications daily

45% use some form of electronic health record daily

Survey continued


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ADA Standardized Language

44% familiar with ADA standardizedlanguage

Using standardized language in practice 16% using nutrition diagnostic terms

13% using nutrition intervention terms

11% using monitoring and evaluation terms


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Practitioner or Informaticist?

Six areas of practice as defined by ADA:

1. Community Nutrition

2. Clinical Nutrition

3. Consultation and Business Practice4. Food and Nutrition Management

5. Education

6. Research

Is #7 Informaticist?


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Careers in Informatics


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Informatics Competencies

Dietetics Nutrition science Food composition

Food service management Anatomy, physiology, microbiology

Information Processing and Knowledge

Information science Terminology Evidence-based practice Biostatistics Evaluation methodologies

Methods of Informatics Software, hardware and networking

Database systems Human/computer interactions Project management

Huang, QR Health Informatics J 2007; 13: 89-103


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Nutrition Informatics R.D.s

Learn from other professions

Build our own expertise

Develop our own programs

Measure outcomes and value

Do our own research

Be a NIRD !!


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Rome was not built in a day.

Nutrition Informatics- What is It 2009

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