Evolution of Health Care Informatcs

The increasing trend in health informatics has led people to believe this field of study is new and just beginning but in actuality it has been developing since the 1960’s.  Let’s take a look at the following time line to see where this all begins.

 

In the mid 1960’s the group The American Society for Testing and Materials (ASTM) recognized a need for set standards with several areas of health care.  Theses areas included laboratory message exchange, data content, health information system security, and properties relating to electronic health record (“Evolution of Health”, n.d.).  This is the beginning of what we now call Health Information Management. 

By 1965 the College of American Pathologists developed a nomenclature (determined number sequence for disease coding) for pathology which is internationally recognized and currently used.  In 1974 a uniform discharge data set called ‘Uniform Hospital Discharge Data Set (UHDDS) was approved by Health and Human Services (HHS) and recommended by the National Center for Vital Health Statics (NCVHS).  This is a set of items that are based on standard definitions to increase consistent data collection across multiple users which decreases disparities in health care by the collection of consistent and reliable information.  Lynn Thomas (2012) states “unified data governance principles will help promote accuracy and consistency and reduce ambiguity…[and] establish the guidelines that will accurately and fairly represent performance and outcomes of care (para. 4).  This standardization will expose disparities in health care so we can address them and make improvements.   

The American College of Radiology and National Electrical Manufacturers Associations collaborated and recognized a need for a standard digital image format which is currently known as a DICOM image.  This was developed in 1985 which makes sharing electronic images possible without facing incompatibility issues.  This is interesting because this development is considered non-proprietary meaning that no one person owns the rights to the digital format and everyone shares it.  This is a concept of open source software which was initiated by Richard Stallman in 1983 by the development of the GNU Project or free software sharing, which has become vital in the success of implementing health information systems.

In 1987 was the first release of what we all know is Health Level7 (HL7).  This particular development included a variety of message format standards for patient orders, registration and observations reporting and by 1991 the Accredited Standards Committee (ASC) started developing interactive communication standards for the transmission of health claims, financial applications, and administrative transactions (“Evolution of Health”, n.d.).   As these developments matured they have brought us into an era of health information exchange.  There are not many hospitals, clinics, or health care facilities that do not have some sort of electronic exchange.  Most of this is due to the ‘meaningful use’ objectives implemented by the Federal Government.

Meaningful use is a termed dubbed by the Centers for Medicare and Medicaid (CMS) for the establishment of specific criteria to help improve the delivery, safety, and cost of health care through the use of electronic information or computers.   The objectives of ‘meaningful use’ are simple “achieving sustainable improvements in healthcare quality… [while maintaining] vision of better patient care at a lower cost” (“How do we get”, 2011, para. 1).  It is mandatory that health care entities participate in meaningful use measures and the government has a strategic timeline when these measures are to be implemented.

The latest health care initiative starting January 2014 is called blue button.  This is an interactive secure application that allows patients to view, download, and manipulate their health care information.  I have attached a podcast  by Lygeia Ricciardi, Director of the Office of Consumer eHealth at the Office of the National Coordinator for Health IT (ONC) in which she discusses the Blue Button initiative.  As we have followed some of the highlights of the progression of health informatics from the 1960’s through 2014 I hope this has given you an idea of where this technology began and where it is headed but ultimately it is for our safety and improvement of the health care system.  

Chelley Plueger R.T. ®
 

References

American health information management association; AHIMA calls for improved health information governance to unify standards for EHR use. (2012). Information Technology Newsweekly, , 443. Retrieved from http://search.proquest.com/docview/1095551688?accountid=32521

Evolution of health informatics. (n.d). Retrieved from http://www.himss.org/ResourceLibrary/GenResourceReg.aspx?ItemNumber=17863

HOW DO WE GET TO MEANINGFUL USE? (2011). Health Management Technology, 32(4), 10-2, 14, 16. Retrieved from http://search.proquest.com/docview/864536463?accountid=32521

Van Leeuwen, D. (Producer) (2013 , June 04). Using onc's patient engagement podcast. Using ONC's Blue Button to Engage and Empower Patients, Caregivers..and You. [Audio podcast]. Retrieved from http://www.himss.org/files/HIMSSorg/Content/podcasts/patientengagement/20130604_patientengagement.mp3