1. Godin, Michelle EdD, RN, CNA, C, Reviewer

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HEALTH CARE INFORMATICS: AN INTERDISCIPLINARY APPROACH Sheila P. Englebardt, PhD, RN, CAN; Ramona Nelson, PhD, RN, BC Mosby, Inc. 11830 Westline Industrial Dr St. Louis, MO 63146 Telephone: 800-325-4177 Web: Price: $56.95


Health Care Informatics: An Interdisciplinary Approach is an excellent resource for individuals seeking an overview of information systems. The focus is to present information from an interdisciplinary viewpoint rather than from any single discipline. It follows the development of informatics from its theoretical foundations to current and future applications. This book is easy to read and, considering the technical content, is easy to comprehend. The book comprises 23 chapters divided into 6 parts. Each chapter includes an outline, key terms, Web connections, and discussion questions to guide the reader to further explore the content. Additionally, each chapter has an extensive further-reading reference list.


The book begins with a foreword and preface that lay down the foundation of the concept of healthcare informatics. The foreword identifies observations relating to the effect of technology in the current world. The preface defines the term healthcare informatics and the models supporting its use as the framework with the ultimate goal of improved healthcare delivery.


The first part contains 5 chapters all related to the basic understanding of healthcare informatics. Chapter 1 reviews relevant theories of system theory, information theory, learning theory, behavioral theory, and change theory. In this chapter, each theory is explained in terms of human interactions as well as the application to computer systems and their implementation. Chapter 2 discusses skills necessary for information literacy. This chapter outlines well the variety of skill sets called upon to effectively use a computer and apply the information obtained. Chapter 3 discusses the concept of databases. Databases are the foundation of most questions and searches, so this chapter provides the reader with the essential elements for constructing and understanding databases and how to effectively retrieve requested information from the databases. Chapter 4 focuses on specific systems to assist with administrative decision making. The review in this chapter covers all of the various types of information systems one would expect to find to make administrative decisions. Chapter 5 focuses on how the systems benefit clinical decision making. In this chapter, the process of analyzing data and moving into the area of knowledge identification and decision making is explained. In each chapter, there are clear and concise explanations with extensive tables to allow all readers, regardless of their level of computer understanding, to comprehend the content.


The second part contains 5 chapters that review the current state of healthcare information systems.


Chapter 6 explains the organization, structure, and function of an information systems department. Included in this chapter are organization charts, responsibilities, and job descriptions to further identify the roles and areas of responsibilities in supporting a healthcare information system. Chapter 7 reviews the current applications implemented in healthcare systems. This chapter reviews the types of applications found within a healthcare information system. There is also a discussion of the possible constraints that may impede successful use of such a system. Chapter 8 delineates the planning and analysis performed to implement and use an information system in healthcare. Both the identification of the need for strategic planning and the negative effects of lack of planning are discussed. Chapter 9 defines the life cycle of an information system from its birth, viewed as the need, to its maintenance or death when the product may need to be changed or replaced. This chapter traces in detail the entire process of an information system from the planning stage, through the search for a system, to system selection, negotiations, and project plan development. Chapter 10 explores the single application, the electronic health record, identifying factors and forces at the core of its implementation. The electronic medical record is reviewed from its identification of features to the variety of forces involved in the development of standards for its implementation.


Part 3 consists of 3 chapters exploring the effect of technology on communication within the healthcare environment. Chapter 11 outlines the various types of technology communication tools that can be used in a healthcare environment. This chapter reviews the various types of communication technology with the specific applications that can be used within the healthcare environment. Chapter 12 discusses the effect of technology on education from both the consumer and the professional viewpoint. The various methods of electronic education are explored in this chapter, with identification of it potential uses. Chapter 13 analyzes eHealth as an entity and its effect on the healthcare system. This chapter defines the concept of eHealth and explores the trends and requirements for its use and barriers for implementation.


Part 4 contains 3 chapters that explore the social and cultural effect on information technology. Chapter 14 explores the changes that information systems are having on healthcare organizations. This chapter reviews the effect that an organization's structure has on the development of information needs and the possible organizational changes that the resulting information produced might suggest. Chapter 15 studies the interaction and relationship between humans and computers. This chapter explores the need for determining the requirements of computers and includes specific steps for conducting usability assessments to determine the specific requirements for an information system. Chapter 16 discusses the effect information technology has on conducting research. Examples, advantages, and disadvantages of using electronic research methods, as well as ethical implications of conducting research electronically, are reviewed.


Part 5 consists of 4 chapters that investigate the elements that are required for successful healthcare information systems. Chapter 17 identifies the technical standards used for successful integration of information systems. This chapter includes detailed discussions of the major technical standards currently in use not only in the United States but also internationally. Chapter 18 reviews the professional standards for healthcare information systems. This chapter builds on the previous chapter and adds the review of the professional standards and code of ethics necessary for the dissemination of health information. Chapter 19 explores the implication of accreditation and government regulations upon the healthcare information system. This chapter specifically reviews how the different regulatory bodies have an effect on the design and development of information systems in healthcare. Chapter 20 discusses the various elements involved in the care and protection of healthcare information. Access, integrity, availability, privacy, and confidentiality take on a new meaning with information systems. This chapter explores each element moving from paper to electronic record.


The last 3 chapters that make up part 6 review the course of informatics from its distant past, to the present, and toward the future. Chapter 21 looks at the history of healthcare informatics from the pre-1800s to the present. Each date range is filled with the names and inventions, which created the information systems of today. Chapter 22 proposes the type of healthcare informatics educational needs the future may require. This chapter does an excellent job of outlining the forces, principles, and current trends, which will need to be incorporated in the education of future professionals. Chapter 23 presents possible directions to take the technology of tomorrow. It outlines possible uses and implementations and the areas of research in information technology.


As an adjunct faculty who has taught informatics to classes with students of various disciplines I find this book an excellent resource. It covers a complex subject thoroughly, that both the expert and novice informatician would benefit from reading.