Preface to 3rd Edition
This book is written for healthcare professionals who wish to understand the principles and applications of information and communication methods and technologies in healthcare. The text is presented in a way that should make it accessible to anyone, independent of prior technology knowledge. It is suitable as a textbook for undergraduate and postgraduate training in the clinical aspects of informatics, and as an introductory textbook for those pursuing a postgraduate career in health and biomedical informatics.
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. Those with a background in information and communication technology should find the book a valuable introduction to the diverse applications of technology in health, as well as summarize the unique challenges of this domain.
With the third edition of the Guide I have kept the essential backbone of the informatics story the same as in previous editions. Part One contains foundational chapters that explain simply the abstract concepts that are core to informatics. Subsequent chapters then built upon those foundations. Part Two contains a set of chapters that explore all the main themes of the book from the perspective of informatics skills. Practising clinicians must understand how to communicate effectively, structure information, ask questions, search for answers, and make robust decisions. Informatics is as much about doing as it is about the tools we use and these chapters make clear why the study of health informatics is the foundation of all other clinical activities.
We return to each of these information and communication system themes in later chapters, taking a more technological focus. The book has a strong emphasis on demonstrating what works and what does not work in informatics. I have created a new evaluative framework based on the value of information that runs through the book, to help understand why some classes of intervention appear to work so much better than others. Each chapter ends with 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.
Health informatics has undergone many changes since the appearance of the second edition in 2003. New themes have emerged, and new methods and technologies have been adopted. Old ideas have fallen by the wayside. The third edition is thus significantly longer than earlier editions and contains six major new chapters. The chapters cover Implementation, Information System Safety, Social Networks and Social Media Interventions, Model Building for Decision Support, Data Analysis and Scientific Discovery, Clinical Bioinformatics and Personalized Medicine, and Consumer Informatics. The new chapters are extensive and focus as much as possible on basic concepts and principles, rather than simple narrative descriptions of the topics. All the old chapters have had overhauled, most of them significantly restructured, updated and extended. There are very many new sections within the updated chapters, covering diverse topics including health information exchanges, M-health, patient consent models, natural language processing and even augmented reality. Several old chapters have been deleted or merged.
It seemed a foolhardy mission for a single author to write a comprehensive text on health informatics in 1996 or even 2003. In 2014 the task took on Quixotic proportion as I debated which material should appear into an introductory text, and what should be excluded. My rule of thumb was to include wherever possible basic principles and organizing structures as a priority, and only include information which was likely to have a long half-life. The research base of our discipline grows rapidly, and it is very easy to create chapters that date quickly.
As always the balance is between creating an introductory work which has some longevity and explores the core concepts needed to understand our discipline with a single and unified voice, or writing an encyclopedic multi-author work that tries to do everything, but has too many voices, becomes out of date quickly, and overwhelms students. At least for this edition I think we have still managed to keep the book to a ‘single voice’ overview – although I have had many expert colleagues help me with sourcing, writing and structuring the material and checking what has been written. I hope that the clarity of this text makes up for any limitations in its comprehensiveness.
© Enrico Coiera 1997 – 2014
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