A New Field of Health Careers is Helping to Improve Care

James Cimino, MD

Information overload is one of the pervasive constants in modern life. That's especially true in health care. On the plus side, medical knowledge is expanding every day. The challenge is that finding what you need to know when you need it isn't always as simple as doing an internet search. So much is happening that you may not even know the answer exists out there in order to look for it.

Wouldn't it be great if information could make our work easier rather than us having to work so hard to keep up with it? That's what informatics is all about.

It's a game changer in many fields of endeavor. In health care, bioinformatics and its subspecialties--pharmaceutical informatics, nursing informatics, radiology informatics, clinical informatics, research informatics and more--are making it easier to ask the right question to get the right answer at the right time.

For students considering opportunities in health-related professions, there is a tremendous demand for people trained in informatics who also speak the language of health and biology.

What is informatics? It's more than IT.

"Informatics takes a broader view of the problem space to find general solutions that apply to specific tasks," James Cimino, MD, director of the UAB Informatics Institute, said. An internist, Cimino completed fellowships in informatics at Massachusetts General Hospital and Harvard before teaching at Columbia and creating the Biomedical Translational Research Information System at the NIH. He was just presented the 2019 Morris F. Collen Award of Excellence by the American College of Medical Informatics.

As an example of the broader view, Cimino explained how informatics would approach the task of creating a system of alerts and reminders to manage a medical condition.

"Instead of writing a program for each problem, informatics would create a knowledge base that would allow you to add more knowledge as you learn about other problems that might come up," he said. "You build a more general tool that is about representing underlying concepts and knowledge. When you want to ask a new question, you can do that. You don't have to create a new program each time."

It is important for an informaticist to know the meaning of what she is capturing so she can create a more useful tool with future flexibility built in.

"The nature of science and medicine is that when you ask a question and look for the answer, you find later that you have more questions," Cimino said. "If you create a tool that is too specific, it may not be able to look at the data you've gathered and answer those new questions. Informatics is more about building tools capable of answering questions you may not have anticipated yet--and without someone having to re-enter the same data from different sources.

"In clinical informatics, electronic medical records would take a more unified approach. If you want to model what's going on with a patient, you can get a clearer picture of overall health, how it's trending and what needs immediate attention. You create a knowledge base model of the patient. The patient has a blood pressure. The most recent reading is stored with historical data. Next time you have a new application that needs to know that reading, it knows where to look and can automatically retrieve it."

When patients visit their doctors with an acute problem, there may be very little time to go through records to look at the big picture of their health. New interfaces coming on the market have a simple, color-coded dashboard that shows physicians at a glance what health factors need attention and developing trends that need to be intercepted and redirected to help the patient achieve optimum health.

"There is a huge work force shortage of people who have both domain knowledge and training in informatics," Cimino said. "The opportunities in health care informatics can be compared to whether you want to design a car or drive it. For people who want to design the next big informatics tool and do research in informatics and artificial intelligence, the UAB Informatics Institute offers training. Our school of nursing has a track for nurses who want to design or use informatics tools in patient care.

"We're teaching pharmacy students how to use genomic biomarkers in working with physicians to choose the right dose of the medication that's most likely to be effective. Our students may also be involved in creating robotic pharmacy systems. Our medical and research students also learn about informatics tools and how to use them in patient care and science.

"When I design informatics tools for physicians and hospitals, understanding work flow and how to bring information into the work flow at the right point is a key consideration. We have to let physicians know the information is available and how to look for it, make the tool easy to use and the answers relevant to help them help their patients."


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American College of Medical Informatics, Bioinformatics, informatics, James Cimino MD, NIH, UAB Informatics Institute


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