Medical Informatics

Why is clinical informatics important?

• There is currently an information gap:
  • About 50% of indicated care is provided (McGlynn, 2003) while up to one-third of care may not be indicated (PMID: Fisher, 2003).
  • 20% of primary care visits have a guess being made by the physician (calculated from Ely, 1999)
  • 14% of medical inpatients may have improved principle treatments if literature searchers were provided to the physicians (Lucas, 2004)
• Current information strategies are problematic
  • MEDLINE is 16 million articles with over a half million added per year; however, one-third of even the highest impact research studies have results that are eventually attenuated or refuted (Ioannidis, 2005)
  • Searching MEDLINE is very difficult, time-consuming (Chambliss, 1996), infrequently done(Ely, 1999) , and as likely to lead physicians to the incorrect answer as the correct answer (McKibbon, 2006).
  • Textbooks are much easier to use than MEDLINE (Chambliss, 1996; Ely, 1999), but have inconsistent quality (Antman, 1992).
  • Yet UpToDate does not cover everything (PMID 17641755)
• Informatics curricular recommendations by national groups
  • AAMC. Medical School Objectives Project: Recommendations for graduates of medical schools.
  • LCME
  • ACGME. Recommendations for residents (see their recommendation 'c')