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Reviewer: Bruce Ivan Blum
This major, long-awaited overview of medical informatics clearly satisfies the need for a comprehensive introduction to this field. Intended for use as a textbook for a course in medical computing applications, the book is equally valuable for health care specialists who wish to learn about the technology and for computer professionals with a desire to gain insight into medical applications. The book presumes no medical or computer background. It stresses the underlying concepts and focuses on learning about computer applications in medical care, critiquing existing systems, and understanding the evolving developments. This work is a large, multi-author (28 contributors) text, and the editors have done a fine job of integrating the materials. Each chapter begins with a list of questions that identify its pedagogic objectives and concludes with an annotated list of suggested readings and a set of questions for discussion. The chapters complement and reference each other. Thus, the reader has the benefit of both the breadth of experience possible only in a multi-author text and the unified perspective of some careful editors. The book's 20 chapters are divided into three sections. The first section introduces recurrent themes in medical informatics. As one might expect, the first chapter provides a motivating example, a historical introduction, and a definition of medical informatics. The next chapter explores how computer technology affects the acquisition, storage, and use of medical data. In addition to exploring the obvious impact on the medical record, the authors also consider the implications of coding and interpretation. The next chapter in this section provides a review of medical decision making with an emphasis on probabilistic medical reasoning. It provides an outstanding primer on probability assessment in the diagnostic process, the application of Bayes's theorem, and the management of bias and uncertainty. The final two chapters of the first section address technical issues. Chapter 4 offers a readable introduction to computer hardware and software. Naturally, the emphasis is on the familiarization of concepts. Most of the material is oriented to the tools appropriate in medical applications. Following the general introduction, sections cover data acquisition, signal processing, communications, and networking. The last of these chapters contains a summary of system design and evaluation concepts. In addition to reviewing typical software engineering issues, it also examines procurement concerns such as make-or-buy. Part 2 of the book is devoted to medical computing applications, and it represents the heart of the text. Chapters discuss medical record systems, hospital information systems, nursing information systems, laboratory information systems, pharmacy systems, radiology systems, patient monitoring systems, information systems for office practice, bibliographic retrieval systems, clinical decision support systems, clinical research systems, computers in medical education, and health assessment systems. The material builds on the concepts introduced in the first five chapters. Each topic is covered in admirable detail, and numerous cross references connect the chapters. The final section, “Medical Informatics in the Years Ahead,” consists of but two chapters. The first deals with health care financing and technology assessment, and the second speculates about the future of computer applications in health care. Both provide brief, effective examinations of some larger issues that affect the progress in medical informatics. The book contains a glossary and a unified set of references. Medical informatics has advanced considerably in the past 15 years, and we are fortunate to have a textbook that establishes a baseline of our understanding at the start of the 1990s. While the main use of this book will be to introduce health care professionals to computer applications, it also serves as a useful survey for computer professionals interested in working in this field. The book is carefully organized and comprehensive in its coverage. It should be the definitive resource for some time to come.
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Health care informatics has emerged as a diverse and important new field of study. The field can be very broadly defined as the science that addresses how best to use information to improve health care. The field includes the four areas of .
Health informatics has led to many changes in the health service delivery system. Awareness of health informatics is important and crucial to modern physicians. In general today there is a lack of awareness and understanding of health informatics among .
