Well, for English-speaking readers, I think I will have to first define Informatics, a word which although already vernacular has not become of common use in English-speaking countries as it has in the rest of the world - which is surprising, given the worldwide acceptance of the term, and the fact that there is no other word or expression in English with this word's exact (albeit broad) meaning, leading to frequent circumloquies to express the idea. The word Informatics was born in France as l'Informatique, and it seems that it has been first employed by Jean-Dominique Warnier, the French sacred monster of Software Engineering. From French it has spread to other languages - here in Brazil it's hard to find a person on the street who doesn't have at least a vague idea of what Informática is. (There are also versions that the Russians came first with the word informatika, and I don't know who's right.)
Informatics is formally defined as "the science of the rational and automated processing of information." Less formally, Informatics is an umbrella word which encompasses absolutely everything related with computers and information processing, however remotely. Therefore, it comprises all aspects of what is generally known as Computer Science, Information Science, Information Technology, Information Systems and dozens of other related terms about computers, hardware, software, data, information and all the knowledge and technologies used to deal with all these things, in a comprehensive way. And anyone who works professionally with Informatics - from programmers and analysts to systems administrators to microchip engineers to Bill Gates - is called an informatician.
Having said that, it becomes obvious that "Medical Informatics" is Informatics applied to Medicine. Or not exactly so: much to the justified protest of other health professionals such as dentists, nurses, physiotherapists, etc., it is actually used to mean Informatics applied to the health sciences and health care in general (the more appropriate expression Health Informatics, for some more or less obscure reason, is rarely ever seen in practice). This is, of course, a broad definition, and it is intended to be so: Medical Informatics is indeed a vast subject. Health sciences are a set of vast subjects, and Informatics can be applied to all of them, in diagnostic procedures, imaging, decision-support systems, patient records, financial and administrative systems, educational systems (for health-area students, practicing professionals and patients), patient monitoring, accessing health knowledge, etc.
I'm not going to even try enumerating all possible applications of Medical Informatics. But although there are many interesting things being done at the Universities, research labs, health institutions and private companies, the bulk of the global effort in Medical Informatics still goes to rather trivial and conventional information systems for administrative purposes, such as hospital billing or epidemiological statistics. It's mostly what is feasible in a given time and place, and quite often what's most necessary. On the other tip of the spectrum, of course computers and microchips are present in just about every medical technology that appeared in the last two decades. In between lie lots of possible applications, some of which are tremendous successes (for example, access to medical databases on CD-ROM or from the Internet), while others are not of widespread use, for many reasons, ranging from lack of information about MI's possibilities among health professionals (many of whom are still scared to death of computers) to the lack of enough qualified MI professionals to get things going.
And sometimes the problems are just so complex that our present technology is not enough to address them fully. This is the case of computerized patient records, which, in spite of many innovative and efficient partial solutions, haven't yet reached the point where the traditional patient record can be fully stored in computers with the same and total functionality the paper-based record has, while at the same time adding value through the computer's processing capabilities. Not incidentally, one big annual event on this subject is called "Toward an Electronic Patient Record" (I attended the 1996 edition of it, in San Diego, California, USA). Decision-support systems in the medical area have some cases of limited success, but rarely with a functionality and a cost/benefit ratio good enough to justify their widespread use. But there are more successful MI applications. For example, computer connectivity is spreading everywhere, and here it has originated a whole new field of applications called telemedicine, which has been proving to be invaluable in many places and situations where direct health care is either unavailable, or too difficult, or too costly. And Internet is opening up immense possibilities for education and health care itself.
It may be correctly hinted that most problems in Medical Informatics arise from its main subject area: medical and health information. This is incredibly complex, can assume an incredible number of forms, and resists most efforts to be framed within the usual Informatics techniques. A huge amount of research still needs to be done to solve the extremely complex problems of health information processing, and Medical Informatics is a science still in its infancy. But it's a promising child, and I'm proud to be a part of the effort.
There are many good books on Medical Informatics, but most of them are about specific problems and technologies. No book, however, is as comprehensive as Medical Informatics - Computer Applications in Health Care, edited by Shortliffe, Perreault, Wiederhold and Fagan (Addison-Wesley, 1990, ISBN 0-201-06741-2). Being already six years old (a lifetime in this field), the book is already somewhat outdated; it doesn't mention Internet, for example. But this book remains THE reference book in Medical Informatics, giving an excellent overview of MI applications, with a depth suitable for all parties interested, health professionals as well as informaticians. It also bears the quality seal of its main editor, Dr. Edward H. Shortliffe, from Stanford University, who is an MI legend, having contributed, among other things, with MYCIN, a pioneer expert system for the diagnosis of infectious diseases.
Another good source is the Proceedings of the many events in the field, such as MEDINFO, taking place every three years (the last one was in 1995 in Vancouver, Canada, and the next one will be held in August 1998 in Seoul, South Korea), the Symposium on Computer Applications in Medical Care (SCAMC), and the American Medical Informatics Association (AMIA) Spring Congress. As for periodicals, there are many; perhaps the most prestigious is MD Computing, followed by other publications which are usually more technical (such as Methods of Information in Medicine). And, of course, Internet is full of Medical Informatics resources.
It would be useless for me to make a comprehensive list of good Medical Informatics links on the Web - there are too many, and there are already huge and well-maintained index pages for that. But I will list a few useful starting points for those who are interested in the subject. Be warned that some of them are not specifically about Medical Informatics, but general indexes of medical resources on the Web which include references to Medical Informatics sites.
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