Intro to Medical Informatics
Nature of Medical Data
6.872/HST950
Lecture# 2
1
Implications of Health Care
Organization for Informatics
• Money determines much
– Medicine spends 1- 2% on IT, vs. 6-7% for business
overall, vs. 10-12% for banking
– “Bottom line” rules, therefore em phasis on
• Billing
• Cost control
• Quality control, especially if demonstrable cost savings
• Retention and satisfaction (may be)
– Management by accountants
3
Who Keeps Records?
•Doctor
•Nurse • radiologist
• Office staff, • pharmacist
admissions • patient
• Administrator
• physical therapist
• lab personnel
Outline
• Recall context of current medical practice
• History of medical record keeping
• Organization of medical records
• Computerized medical records
–Why
– Key issues
– Failures and successes
• Current approaches
2
Why Keep Records?
• Basis for historical record
• Communication among providers
• Anticipate future health problems
• Record standard preventive measures
• Identify deviations from the expected
• Legal record
• Basis for clinical research
4
Forms of Clinical Data
• Numerical Measurements • Coded (?) discrete data
– Lab data – Family history
– Bedside measurements – Patient’s medical history
– Home instrumentation – Current complaint
• Recorded signals (e.g., • Symptoms (patient)
ECG, EEG, EMG) • Signs (doc)
– Physical examination
• Images (X-ray, MRI, CAT, – Medications
Ultrasound, Pathology, • Narrative text
…)
• Genes (SNPs, – Doctor’s, nurse’s notes
expression arrays, – Discharge summaries
pedigrees, …) – Referring letters
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Harvard-MIT Division of Health Sciences and Technology
HST.950J: Medical Computing
Peter Szolovits, PhD
