The domain of medical informatics has evolved fast since the early 90ies. Until that moment, there had been many developments in information systems to support the infrastructure of medicine. Gradually the awareness emerged that medical doctors and other healthcare professionals (including managers) needed support in education, decision-making, communication and other professional activities. As the focus shifted to information management of the health care professionals, the discipline of 'medical informatics' took further shape.

"Medical informatics is the field that concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research, including the information science and the technology to support these tasks."

The field is very much interdisciplinary, with branches of high applied activities and also involved in fundamental research. Medical informatics currently is a distinct academic entity in most countries, with a strong network between EU countries in particular. And the focus is on medical practice.

The domain of public health informatics seems not yet so clearly defined in the EU. Most of the time, IT in public health (e.g. supporting new surveillance systems), follow standards defined within medical informatics (e.g., LOINC, SNOMED, HL7).

Where medical informatics comes from a predominantly patient-oriented focus, it follows that choices in IT architecture, standards, protocols etc have been made from that perspective (e.g. high requirements for confidentiality. data protection, and accuracy of information of individual diagnostics and diagnosis).

Key requirements from the public health perspective focus on populations rather than individuals and may include timely data access (which can conflict with decisions for data shielding in medical informatics systems) and representativeness for (sub)populations (e.g. high focus on getting continuous and unbiassed samples of information on subpopulations; accuracy of information on individual diagnosis would be much less important). These key requirements could (and probably should) lead to appropriate choices for IT architecture that may be different from those in medical informatics.

Therefore there is a need for building and maintaining a critical mass of public health information experts that are well versed in core activities of public health (e.g. surveillance, outbreak investigations, field epidemiology, public health microbiology, screening) and who are able to use that knowledge in developing IT infrastructure that serves the needs of public health profesionals and that is well integrated in health care systems.

"Public health informatics is the systematic application of information and computer science and technology to public health practice, research, and learning."

The USCDC has developed a 2-year fellowship in public health informatics with the goal of providing training and experience in applying computer and information science and technology to real public health problems. In the EU, the public health informatics is not yet coordinated at the Community level in either development of professional standards or training.

References

• Greenes RA, Shortliffe EH. Medical informatics. An emerging academic discipline and institutional priority. JAMA. 1990 Feb 23;263(8):1114-20.
• William A Yasnoff, J Marc Overhage, Betsy L Humphreys, Martin LaVenture. A National Agenda for Public Health Informatics: Summarized Recommendations from the 2001 AMIA Spring Congress. JAMIA 2001;8:535-545 doi:10.1136/jamia.2001.0080535
• William A. Yasnoff, Patrick W. O’Carroll, Denise Koo, Robert W. Linkins, and Edwin M. Kilbourne. Public Health Informatics: Improving and Transforming Public Health in the Information Age. J Public Health Management Practice, 2000, 6(6), 67–75
• Public Health Informatics Fellowship Programme PHIFP, Centers for Disease Control, Atlanta, Georgia, USA

FEM PAGE CONTRIBUTORS 2007

Editor

Arnold Bosman

Contributors

Patty Kostkova

Arnold Bosman