Preface
Preparing a textbook in Health Informatics it was an initial thought that came into our mind when at late 80's we were developing a postgraduate course in Health Informatics at the University of Athens as an interdisciplinary, inter-University across Europe effort. Even at that time we were thinking that no one faculty could achieve this endevour alone. The initiative came into reality when the European Commission financed our effort to develop curriculum for the area of computer applications in health care. In 1987 six representatives of European organizations met in Athens to discuss the way to achieve a European curriculum at postgraduate level that would allow students from European Universities to study this discipline and receive the Master's degree. One of the main tasks from the beginning of the meeting was to give a name to that discipline. Names such as computer applications in medicine / health care, medical informatics, and all related and current at that time were discussed but only one name remained on the table and had been unanimously approved. That was Health Informatics, which is the discipline that is multi-disciplinary and covers applications of computers in Medicine, Nursing, Dentistry, Pharmacy, and Biology. Specialties of Health Informatics can be considered for example the disciplines of Nursing Informatics, Dental Informatics, or Bio-Informatics. The prevailing term for many years of Medical Informatics now coincides with the new term of Health Informatics. Nowadays, ISO/TC215 and CEN/TC251 both are using instead the term Health Informatics.
The effort of 1987 was successful and from early 1990's the MSc course in Health Informatics started being funded by the European Commission under the Erasmus programme with good acceptance among European students. As a spin-off of that effort two European projects were approved in 1995, IT-Eductra and Nightingale. The IT-Eductra project had as an objective to develop educational material in information technologies that would initiate physicians, nurses and hospital administrators to the advantages of the health informatics discipline. The material would be distributed through a CD-ROM storing all the educational material. The Nightingale project was focusing more on the educational needs of nurses in the field of Nursing Informatics. The outcome of the Nightingale project was to develop multimedia CD-ROMs emphasizing the need of IT technology and developing educational material in nursing informatics, developing a nursing informatics curriculum for undergraduate and postgraduate nursing schools, and publishing a textbook in health informatics with emphasis on nursing applications. This book that you are now reading is the textbook of the Nightingale project.
The book follows the structure of the curriculum of Nursing Informatics as it was approved by the ‘users group’, which was comprised mainly by the representatives of the EFMI WG on Nursing Informatics. There are four sections: Introduction to health care, Data analysis, Health information and Knowledge representation, and Organizational impact.
In the first section introductory notions of health care and nursing are introduced giving the reader the spectrum of the health care in which the technical aspects can be applied. A discipline in order to have scientific basis must be able to define in an appropriate manner the terms it uses in everyday practice. The next two chapters by Saba and Mortensen cover the importance of defining and classifying the terms of Nursing describing all efforts made until today with emphasis on nursing practice. The use of a minimum set of nursing terms in facilitating the health management and nursing research is given in the next chapter.
As Health Informatics deals with all aspects of collection, processing, storage, and exploitation of data, information, and knowledge in the health domain, the next two sections are focused on those streams.
The second section starts with an overview of the data analysis methods, whereas the second chapter discusses more the particular study design methods appropriate for health. A detailed description of the most popular tool in dealing with data analysis, that is statistics, is given on the next chapter. A comparison on the most useful statistical methods especially of the advanced techniques is depicted on this chapter and those techniques used in classification processes are described in a more mathematical formulation in the next chapter.
The core technological issues of health informatics are dealt with in the next section. General definitions are presented by Hasman in the first chapter of this section introducing in a way the next chapters to the reader. The main theme of Health Informatics, the Hospital Information Systems, is presented in the next chapter engulfing the most current information whereas the next chapter gives an example of departmental information for diabetes care. Even if the traditional hospital information systems were dealing only with administrative applications the most recent ones are now focusing on the electronic health record. The following chapter describes the architecture and implementation issues of such a system. An important application of the patient record system with particular importance in this book is the nursing information system chapter. In the next three chapters issues of human interaction, electronic data interchange, and communication issues such as telecare are discussed. An overview of image processing and analysis principles is presented giving the groundwork for imaging techniques for those interested to pursue further. An important chapter follows focusing on the particular area of knowledge representation as occurs in nursing. The final chapter discusses the multimedia technologies as applied in educational software applications in the nursing and health domain.
The introduction of technological innovations in the traditional dominated health care field creates a number of changes and reactions prior and after the implementation especially of the hospital information systems. Those issues are discussed in the following section. The organization of the health care systems differs from country to country and from continent to continent. Those differences are discussed in the first chapter of the fourth section. The next two chapters are dealing with the organizational impact of the health informatics and of technology in the healthcare environment. The fourth chapter discusses the particular nursing issues. One of the major factors for implementing information systems in the healthcare domain is the quality assurance of the medical and nursing procedures. Data protection, confidentiality and security policy is discussed in the next chapter following the description of the communication requirements needed to be ensured among health care professionals. The section closes with discussion for the need in introducing the subject of health informatics in the nursing schools at both undergraduate and postgraduate level. The book ends with a glossary of terms in health informatics as it was compiled by the Nightingale project.
The reader can read the chapters with the order presented by the editors. However, if a particular chapter is of more interest to the reader he can skip previous chapters without any particular gaps, since the authors prepared the chapters based on the independence of authoring, including in each chapter all required elements.
Athens 2001
John Mantas, The Editor