I am an Informatician. There are several definitions of this that are, generally, supportive of one another. Albeit, the definition of biomedical informatics is rather unique, as can be seen below.
For example, Wikipedia defines Informatics (not biomedical informatics) as follows:
…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. It also develops its own conceptual and theoretical foundations and utilizes foundations developed in other fields.
The general study of algorithms, structure, behavior and interactions of natural and artificial systems that store, process, access and communication information are all aspects of biomedical informatics, too.
The Free Dictionary provides the following definitions:
…computerized automated delivery and manipulation of information to and by users of computer systems.
…the management of information and knowledge by computers.
…information management; the technology of information storage, retrieval and transmission. Includes on-line access to and editing of data bases, facsimile transmission, optical reading and word processing.
The American Medical Informatics Association has developed a formal definition of Biomedical Informatics:
…Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving and decision making, motivated by efforts to improve human health.
The list goes on, but I think the point is made: the use of biomedical data for knowledge and scientific inquiry, problem solving and decision making. These are definitely aspects and attributes of the definition that apply to me and my background.
I am a member of AMIA, a member of HIMSS (Health Information Management Systems Society), and other organizations that aim to use health information to foster improved care at the bedside. However, when I started my involvement in this whole arena or field of study I knew of neither and some of the societies that are now in full swing were not even born (IHE, for instance).
My involvement in healthcare informatics began in 1990, and the decision to migrate into this field formally occurred after rather a personal tragedy: my mother’s diagnosis with, and ultimate death from, breast cancer. We all have our stories and reasons why we do things in life. This was one that changed my complete direction. I had been working in the aerospace industry for a major defense contractor (later acquired by yet another defense contractor) and had no intention of changing my field. However, mom’s rather sudden diagnosis with a very virulent form of breast cancer combined with the utter helplessness I felt during her illness and the lack of answers I could obtain from her oncologist, caused me to begin to ask the questions about how such seeming inability to assess and forecast was not a major news story. Furthermore, the inability to locate and access data was, to me, unbelievable. After all, weren’t we dealing with people’s lives here? I compared the relative “order” in my field of aerospace engineering–the existence of standards; the ability to link and integrate disparate systems; the ability to collect data and access multiple sources of information, even sources developed by competing contractors, and could not understand why medicine or healthcare in general was “allowed” to continue this way!
Of course, I was naive. I understood that there were major challenges in medicine that remained and still remain unsolved (cancer being one of them). Yet, I was coming at this “problem” from the perspective of an engineer’s brain: diagnose the problem, seek the data, formulate a solution approach, execute the solution.
What I saw in this case (so close to me as it was) was the ability to diagnose the problem, collect some of the causal data, but the processes of formulating an effective solution and executing on that solution were completely beyond the capabilities of everyone involved. At the time, at least, there was “guessing”; there were pockets or sources of incomplete data; not all information could be collected and made available to any given clinical end user, etc. Now, to be fair, had my mother been diagnosed in this day & age I believe she may still be around–some very fundamental advances have been made in the field that would have given her more of a fighting chance. However, back then the key approach was “poisoning” the system (note: I had read Dr. Susan Love’s book on breast cancer at that time). Furthermore, the tools at hand for her oncological team were stored in “silos.” There was not much sharing of information outside of the major medical journals. In addition, the oncological team’s ability to seek independent studies or new research to be able to evaluate or even model or statistically assess the effectiveness of experimental treatments was almost impossible to do.
However, the experience placed a focus like a laser beam in my consciousness in terms of providing the tools and access to data to improve the care and prospects of the patient that has not diminished in me since that time. In the aerospace field, collecting information from multiple sources in order to seek better overall knowledge of the “target” was and is done regularly. Often called “multi sensor data fusion”, I carry this term forward from my former field to comparable use in medicine and healthcare as a metaphor for describing the process of collecting data that may paint a picture of “different sides of the elephant” in order to assemble a more complete view of what is actually happening–in other words, to improve situational awareness around the patient. This aspect of informatics is one that, for me, also motivated the need for better and more complete data (medical device connectivity being one source for this type of information).
During my days in research at PENN, collecting data from multiple sources was key to establishing the situational awareness and conditions around the predictive models I had developed for assessing likelihood to wean from post-operative mechanical ventilation. To accomplish this, rich and complete source data from laboratory to medical device information as well as patient demographics and history were necessary. The conditions that establish the usability of the data, its importance and applicability to the environment are, in a microcosm, what was missing from my mother’s experience and that of her oncological team. The ability to source data–even experimental data–from multiple sources and to have the ability to combine and integrate it effectively for the use in “what-if” analysis was completely missing. However, again, going back to the aerospace engineering analogy, this is frequently done as a method for validating design or determining the best approach or possible effects for dealing with unknown situations.
In summary, medicine is much more complex than “rocket science,” but only because of the unknowns. The field of informatics seeks to place the best possible information in the hands of those who are operating on the front lines of battle–the physicians, principally–who are charged with guiding the treatment. If, in this process, I can assist or make a difference to win the battle for the patient, my life will have been well lived.
