Exploring the History of Health Informatics

The History of Health Informatics: Milestones, Innovations, & Impact on Modern Healthcare

The healthcare sector generates more data than any other industry. How this data is collected, managed, and used can improve everything from individualized patient care to developing new technologies and healthcare solutions that improve lives. Health Informatics is responsible for all of this.

Table of Contents

Health informatics arose in the 1950s as the need for more efficient patient management systems emerged. Through the decades, the field of health informatics has shifted and changed, and now has the potential to revolutionize health care from birth through to end-of-life care.

The Early Days

The early days of health informatics take us back to the mid-twentieth century. It was in the 1950s that pioneers in the field of health informatics began to study the applications of using new technologies to reduce administrative burdens and streamline the process of storing patient information.

The seeds of health informatics were planted several years before, as early as the 1940s. Still, it wasn’t until nearly a decade later that pioneers realized the potential of emerging technologies for medical informatics.

In the early days, health informatics drastically differed from what we know today. Developments in technology have played a significant role, but the foundation has shifted from simply streamlining medical record-keeping to revolutionizing the patient care experience.

First Uses

The first uses of health informatics were primarily focused on medical administrative procedures. The 1950s and the following decades were transformative years for healthcare as we know it today.

During the 1930s and Great Depression, health insurance was created. [1] This was a first step in changing how, when, and why people in the United States would access healthcare. In general, medical care became more accessible, which created a need for more efficient medical record management systems.

An influx of patients meant that paper medical records were becoming burdensome. The first use of health informatics was to streamline the paper trail that this uptick in accessing medical care created.

Over the next few decades, paper records remained a primary means of medical record-keeping. Still, health informatics made creating backup records, updating patient information, managing hospital admission records, and scheduling easier.

Pioneers

Joshua Lederberg and William S Yamamoto: These two men are considered the first pioneers of medical informatics, with their work in automatic calculation in the 1940s.
Robert S Ledley and Lee Browning Lusted: He was the first medical professional to work with a computer, which led to innovative computing methods. In future years, he will work with another health informatics pioneer, Lee Browning Lusted.
Wilfrid J Dixon: Along with several collaborators, pioneered the development of BMDP (Bio-Medical Data Package) software in 1965 at the University of California, Los Angeles.
Morris F Collen: A prominent pioneer in health informatics who helped develop a tool to record patients’ health status and checkups. He also played an integral role in creating the first comprehensive paid health plans, which led to the development of Kaiser Permanente. [2]
Donald A.B. Lindberg: Served as Director of the National Library of Medicine and was the first president of the American Medical Informatics Association. His career in applying computerized technology to healthcare began in the 1960s.
Clement J McDonald: Developer of the Regenstrief Medical Record System, crucial in bringing about collaborative healthcare through shared information technology.
Other notable names in early health informatics include Octo Barnett, Charles Molnar, Wesly A Clark, and William Hammond.

Key Milestones and Innovations

The First Decade 1955-1965

This decade was the birthplace of the field of health informatics. These years were fueled by developing new technologies and experimenting with them in healthcare. The work of the health informatics pioneers of this era created the foundation on which every future milestone and innovation would be built. [3]

Phase Two 1965-1975

This decade brought about the development of MUMPS, otherwise known as the Massachusetts General Hospital Utility Multi-Programming System. MUMPS, developed under the leadership of Dr. G. Octo Barnett, became a foundation for medical informatics. [4]

During this time, Larry Weed introduced Problem-Oriented Medical Records (POMR) that changed how doctors recorded patient interactions. Rather than simply recording a diagnosis and treatment, POMR “focuses on the patient’s problems, their evolution, and the relation between clinical events.” [5]

This allowed physicians, for the first time, to access a more complete snapshot of a patient’s prior health to make better-informed observations and decisions regarding care.

The Third Decade 1975-1985

The late 1970s and early 1980s stimulated rapid growth and interest in health informatics. Advancements in computer technology emerged, and the necessary technology for health informatics became more accessible. During this phase, there was a noticeable growth in the number of physicians who began adopting the technology. Hospital bedside terminals began to be used for more accurate patient data collection.

Health Informatics Becomes Modernized 1985-1995

This decade saw advancements in how health informatics improved the patient experience outside of medical record sharing. Cadence patient scheduling software was introduced and became widely implemented. [6] EpiCare, the first Windows-based electronic health records software, was released several years later.

This period also saw the formation of the American Medical Informatics Association, along with the significant investment of more than a billion dollars by the US Government into Science Applications International Corporation’s Composite Health Care System for all military healthcare centers.

Bringing Health Informatics Into the Future Late 1990s – Today

Today, we see consistent progress in health informatics, its uses, and technological innovations.

In 2004, the US created the Office of the National Coordinator (ONC) for Health Information Technology to implement the most advanced health information systems technology available. In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) mandated the goals of the ONC.

As stated by the Act, “The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to [healthcare] providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of certified Electronic Health Records (EHRs)” [7]

Nearly nine out of ten physicians with office practices have adopted some electronic health record system [8], and health informatics are widely used for clinical and administrative data sharing.

The Growth Period

More than seventy years since the very first innovations in the field of health informatics, it’s now widely adopted by mainstream medicine. The field continues to grow rapidly, evolving with new technologies that meet the changing needs of patients, healthcare providers, and medical care facilities.

As a society, we’ve reached the point where it’s easy to take the convenience of health informatics for granted. Still, it’s important to step back and acknowledge how the field has improved healthcare in unique situations.

The COVID-19 pandemic was a prime example of this. Health informatics made remote patient management possible and greatly improved patient outcomes.

However, growth periods rarely come without growing pains, and there’s room for improvement.

The Center for Medicare and Medicaid Services (CMS) has proposed policies to expand the accessibility of patient health information and the exchange of healthcare data to improve everything from patient care coordination to patient outcomes. [9]

Ideally, by doing this, costs would be lowered across the board, which is critical as a growing segment of the population reaches the age for Medicare eligibility. CMS benefits the 18.8 percent of the population covered by Medicaid and the 18.7 percent currently covered by Medicare. [1 0]

Development of Health Informatics as a Distinct Field

An article by Purdue Global quotes the book “The History of Medical Informatics in the United States” when it says that health informatics became a distinct field of its own early in its inception in the 1950s. However, it became a unique field of study a decade later in the 1960s. [1 1]

Health informatics has blossomed into an important field with unyielding professional potential in the following decades. A few current careers for those holding a Master’s Degree in Health Informatics include:

Health Informatics Advocate
Public Health Information Officer
Clinical Analyst
Nursing Informatics Specialist
Pharmacy Informaticist
Compliance Officer
Application Analyst
Informatics Manager or Director
Medical Records and Health Information Technician
Health Informatics Consultant
Data Mining Engineer
Data Analytics
Healthcare IT Project Manager

Current Trends

What are the current trends in the field of health informatics? These three areas of focus are where we’re seeing significant advancements.

Big Data Analytics in Health Care: The health informatics sector is looking at more efficient and reliable ways to collect and analyze large datasets, with health-related information from groups as large as thousands of patients. The goal is to develop predictive models by identifying key correlations among these datasets. [1 2]

AI and Machine Learning Applications: AI has been making waves in the healthcare sector, and leveraging what we’re learning from AI and applying health informatics tools can significantly improve patient care and patient outcomes. An interesting article by Fast Company points out AI’s ability to predict lifespan in terminal patients. By taking this data and analyzing it, it’s possible to offer proper end-of-life care, including palliative care, to more people who are in need. [1 3]

Health Informatics in Patient-Centered Care: Health informatics has enabled physicians to improve care through more comprehensive medical records and data. As the capabilities of health informatics continue to grow, so does the trajectory of patient-centered care.

Challenges and Future Directions

Between 2023 and 2031, the expected compounded annual growth rate (CAGR) of the health informatics market is 13%. [1 4] This strong growth is expected to be supported by continued technological progress and increased demands for digitalized data management in every area of the healthcare sector.

We expect to see expansion in data-driven decision-making in all healthcare sectors fueled by advancement in healthcare informatics technology and solutions. This has the potential to transform clinical decision-making as we know it today.

The challenges ahead include developing standardized protocols for data collection and sharing and developing sophisticated frameworks that enable a more seamless data exchange. Data security and patient privacy are critical concerns that must be addressed.

Finally, we can’t underestimate the need for an increased number of data professionals in the health informatics field. We need innovative minds and great thinkers to take it to the next level.

Conclusion

Health informatics is taking us into the future of patient care and health sector innovation. It’s a rapidly growing field that continues to drive forward with new growth and technology. Health informatics has come a long way since its inception in the 1950s. It’s exciting to look into the future and imagine where health informatics will take us.