Guide to Health Informatics 2nd Edition
Enrico Coiera
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The Guide to Health
Informatics has been written for healthcare professionals who wish to
understand the principles and applications of information and communication
systems in healthcare.
The text is presented
in a way that should make it accessible to anyone, independent of their
knowledge of technology. It should be suitable as a textbook for undergraduate
and postgraduate training in the clinical aspects of informatics, and as an
introductory textbook for those undertaking a postgraduate career in
informatics.
With the second edition
of the Guide I have kept the essential backbone of the informatics story the
same. We start with foundational chapters explain simply the abstract concepts
that are core to informatics and subsequent chapters are built upon those
foundations. Every chapter has been updated and many have been almost
completely rewritten to reflect the emergence of new ideas and results.
Each chapter now ends
with a new element - questions intended to test the reader’s understanding of
the chapter or stimulate discussion of the material. Not all the answers to the
questions are easy or obvious, and some are specifically designed to challenge.
A new set of chapters
on clinical informatics skills forms Part Two of this book and represents the
major new element in the 2nd Edition. I remain deeply conscious that
practising clinicians need to translate knowledge into action, and in Part Two
I have attempted to identify those clinical activities that are essentially
informatic – communicating, structuring information, asking questions,
searching for answers, and making decisions. Informatics is as much about doing
as it is about the tools we use in the doing, and I hope these new chapters
will, once and for all, establish to clinicians why the study of health
informatics is the foundation of all other clinical activities.
Several new specialist
chapters appear at the end of the book on Bioinformatics and Biosurveillance
and represent areas where there has been a significant surge in research and
development activity since the book was first written in 1996.
The change in title
from medical to health informatics does not represent a major change in
emphasis of the text, but rather should make clearer to readers that the text
is designed to be used by all healthcare professionals, including nurses
and allied health professionals, and not just medical practitioners. When I use
the term ‘clinician’ in this book I am referring to any health care
practitioner directly involved in patient care. I have kept the term electronic
medical record or EMR in the text more as a historical convenience than
anything else, and the discussion of record keeping and its principles is
intended to be applied across all the health professions.
It is said that books
are never finished, but that they are just abandoned. The 1st
edition of The Guide was certainly never finished. Informatics is still
exploring its shape as a principled science, and at some point it is more
important to come to a view of what that shape is, rather than to await perfection.
Unlike a novelist however, the author of a textbook is given the rare privilege
of retelling their story in new editions, and changing one’s mind about what
needs to be emphasised or how the story should unfold.
Finally, it may have
seemed a foolhardy mission for a single author to attempt to write a
comprehensive text on health informatics in 1996. I can assure you that in 2003
the task was significantly greater, and the sense of foolhardiness ever more
present as I struggled to decide what material should come into a core
introductory text, what to exclude, and tried to faithfully extract the major
results form an ever expanding literature. When it came to the bioinformatics
chapter, which covers what has now become a discipline in its own right, I
elected to call in the expert assistance of Zac Kohane rather than carry on
unaided. I am indebted to Zac for providing me the material, drawn from his own
excellent bioinformatics text, which is now assembled as Chapter 29.
My one guiding hope
during this task was that as a single author I could still write with a single
voice and keep the story coherent and simple. Most other informatics texts have
multiple authors and usually suffer because of it. I hope that the clarity of
this text makes up for any limitations in its comprehensiveness. As before, I
hope that readers who find elements of the book they disagree with, or would
like to see improved, take the time to let me know. I may one day contemplate a
third edition!
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ewc@pobox.com ©
Enrico Coiera 1997-2003
updated
10 Oct 03