The Blessings and Limitations of Clinical and Public Health Information in Health Informatics

This essay explores the blessings and limitations of clinical and public health information in the field of health informatics. It discusses how these domains are improving healthcare and the challenges they face. The essay also highlights the importance of training healthcare professionals and the need for cost-effective solutions in implementing health informatics in rural areas. Future research directions are also discussed.

Running head: HEALTH INFORMATICS
Health Informatics
Name of the Student
Name of the University
Author Note

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Title
The blessings and limitations of clinical information and public health information in
the domain of health informatics
Overview
The domain of Health Informatics (HI) is on the cusp of its main promising period till
date, entering into a new revolution where advanced technology is planning to handle Big
Data, bringing out unparallel growth potential for the growth of information access in
healthcare. Big Data along with Data mining are helping to understand the main aim of
diagnosing, effective treatment, active helping and simultaneous healing of patients as per
their needs in healthcare. The end goal in this field is overall improvement in the healthcare
delivery and improving the level of satisfaction and quality outcome of the end-users or the
patients. HI is an amalgamation of information science and computer science in the domain
of healthcare. There are various domains of research under the umbrella of Health
Informatics like Bio-informatics, Image informatics (neuro-informatics), Public Health
Informatics (PHI), Clinical informatics (CI) and Translational Bio-informatics (TBI)
(Herland, Khoshgoftaar and Wald 2014).
The following essay will focus on the PHI and CI and the research conducted so far in
PHI in the domain of data acquisition, data storage, retrieval and analytics by using the data
mining technology. In doing so the essay attempts to highlight how PHI and CI are helping to
bring change in the quality improvement in healthcare and the associated challenges of HI
creating a barrier in comprehensive implementation of the same.

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Definition of Key terms
Clinical informatics (CI): It deals with making predictions, which help the physicians
to make faster, better and person centred decisions based on the clinical priority of the client.
The CI deals directly with the patients’ data (Herland, Khoshgoftaar and Wald 2014).
Public Health Informatics: It deals with the data mining and data analysis of the population
data and thus helping to get a medical insight of the health demographics. The PHIs data is
gathered either from the traditional means (excerpts from the hospitals) or gathered from the
population or from social media (Herland, Khoshgoftaar and Wald 2014).
Key research Findings
PHI in effective management of the chronic disease
The effective documentation of the population based information in generating PHI is
helpful in effective management of the chronic diseases. The systematic review conducted in
this domain highlighted that mHealth tool that is the tool design by the use of the mobile
technology helps in effective incorporation of the public health data as per the differing
demographic parameters. This generation of the public health data not only helps to get an
overview of the disease prevalence and associated morbidity and mortality, but also helps to
get a detailed insight about disease progression. These data are important in generation of the
disease prevention and disease awareness policy program and thus helping to reduce the rate
of occurrence of the chronic diseases. Further research must be undertaken in the domain of
understanding and improving the mHealth tools in order to overcome the specific barriers to
adherence (Hamine et al. 2015).

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Social Media and PHI
Social media is regarded as a valuable tool in the domain of disease surveillance
toolkit in order to improve the ability of the public health professionals for the early detection
of disease outbreak. However, social media like Facebook, Twitter, Myspace and microblogs
to support data mining in PHI has certain gaps and biases. Despite having potential for
success, there are limited studies on the interventions and on the use of social media in
practice. Further research is required to be undertaken for identifying opportunities to employ
social media data in disease surveillance (Charles-Smith et al. 2015).
CI in clinical decision making
The research conducted by Simpao et al. (2014) highlighted that healthcare systems
have leveraged Big Data for overall quality and performance improvements by the use of the
analytics – systematic use of the data that is combined with the qualitative and quantitative
analysis in order to aid in the decision making process. The CHIs can be effectively used
under the various aspects of the healthcare including the predictive risk assessment of the
patients, support in the clinical decision making, effective monitoring of the patient under the
home health setup and subsequent resource allocation based on the needs of the patients.
Simpao et al. (2014) also highlighted a special focus on the visual analytics in the domain of
the analytic technique with a diverse domain of health care and research applications and thus
bridging the gap between the medical practice and information sciences.
The study conducted by Beeler, Bates and Hug (2014) highlighted that clinical health
informatics helps to provide the clinical decision support system in order to link with the
patient data with the electronic knowledge base for improving the decision making process.
The study also revealed that clinical decision support tool designed with the patient centred
date helps in assisting the healthcare professionals in the domain of medication dosing
support. The software also provides point-of-care alert and reminders for the timely

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administration of medication along with proper display of the medication management in
order to avoid the chances of medication error. The use of the patient-centred data encrypted
in the CHI system have helped to avoid the chances of deep-vein thrombosis, increase used of
vaccinations and adherence to the medication management guidelines.
Shen et al. (2015) conducted a research in the domain ontology and CHI. The aim of
the research was to highlight the methodological steps along with tools about combined
operation of case-based reasoning (CBR) and multi-agent system in order to explore the
ontological application of CHI and support to clinical decision making. The analysis of the
results highlighted that CHI data helps to provide proper information in the diagnosis,
prognosis, therapeutic monitoring and treat based on multi-agent architecture. The CHI
mainly extracts similar cases encrypted in the database and use to information in order to
generate a customised treatment plan. Such customised treatment plan based on experience
data with the help of matching approach helps to improve the overall outcome of care.
Limitations associated with HI
Resource and Infrastructure limitations
The research conducted by Al Nuaimi et al. (2015) ighlighted that there are several
financial and structural hurdles experienced by the developing countries during the
comprehensive implementation of the HIs in the form of CHIs or PIs (e-Health Programs).
The reason behind this is the infrastructure that is required to support this kind of
implementation is poorly developed and irregularly distributed. Few of the examples of the
difficulties include lack of proper electric supply and poor internet access. The situation is not
same in all the countries moreover, disparities also remain within different states of the same
country and the conditions are extremely poor in the rural areas.

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Lack of comprehensive data in PHI
There is a lack of significant focus on the effective maintenance of e-Health in PHI.
Though IT projects are advocated under the World Health Organisation (WHO) and other
international organisation (Centre of Disease Development and Prevention), only 20
developing countries have joined hand in developing the encyclopaedia of PHIs. But this
global partnership is not dedicated lack of comprehensive participation of the all the members
of the countries is creating gap in maintaining proper public health records (Luna et al. 2014).
Ethical and Legal Consideration and Lack of Trained Nurses
Security issue (privacy and confidentiality) and legal accountability represent a
significant hurdle in the domain of comprehensive implementation of the HI technology. The
HI big data has certain gaps in regulating the privacy and confidentiality of the patient’s
health data and thus creating an ethical barrier (Denecke et al. 2015). Holzinger (2016)
recommended that use of the interactive machine learning would help in effective handling of
the patient data by abiding by legal and ethical consideration. Moreover, interactive machine
learning might also prove to be helpful in increasing the efficiency of the nursing professional
to handle HI interface.
There is also a lack of trained workforce of the healthcare professionals. The lack of
training of the medical workforce is creating a barrier in effective handling of the data. The
general model in order to train the healthcare workforce is based on the parameter if e-
Capacity emerged in the meeting of Bellagio during 2008. This framework is designed to
improve the level of information knowledge, attitudes and skills among the healthcare
professionals. However, comprehensive implementation of this framework for training health
workforce is lagging in developing countries (Brownson et al. 2018). The study conducted by
Darvish et al. (2014) stated that in the area of the fast development of technology, to take
advantage of the health information technology in the overall nursing outcomes and improve

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the quality of healthcare, the empowerment of nurses and proper educational arrangement is
recommended. Both short and long-term goals focusing the target group is important to
achieve the goal.
Future Direction of the Research
Cost effective solution
In order to implement HI in rural and remote areas of the developing countries,
application of the wireless networks is important (Kulkarni and Sathe 2014). Yang et al.
(2015) stated that penetration of mobile phones are increasing every year in the developing
countries such that widespread adoption of the mobile technology for the implementation of
the His might prove to helpful to ameliorate the hurdle of poor infrastructure. However, these
solution might create problems like fragment information and hurdle in project scalability.
Future direction of research will include cost-effective installation of the HI in the domain of
CI and PHI.
Development of Agendas related to HI
Throughout the world, a huge amount of data are collected electronically however, the
information is scattered and thus is not useful in providing assistance in clinical decision-
making. Future development of the HI will require proper implementation of the clear
standards of data in order to provide an optimal value in the domain of PHI and thus helping
to understand the demographic data for any communicable or non-communicable disease
(Scott and Jha 2014).
Training of the Nursing Workforce
Training of the healthcare professionals in HI must be done based on international
standards. U.S National Institutes of Health has development a special training module

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named Training for Global Health Program along with a partnership with eight different
countries. The future research must be conducted in order to understand the level of
effectiveness of this training module in improving the data mining and analysis skills of the
healthcare professionals (Krumholz 2014).
Customising of CHI
The study conducted by Beeler, Bates and Hug (2014) proper that the future direction
of the research in the domain of the CHI system optimization must be directed towards the
combination of the computerised physicians based order entry (CPOE) and clinical decision
support (CDS) system in order to reduce the overall time in handling of the data and reducing
the chances of the detrimental medication error. The specificity of the medication alert must
also be improved along with prioritization of the notifications based on patient-centred care
approach.
Manganello et al. (2017) recommended that self-report health literacy dos not
influence the access of digital technologies. There is firm association with health information
searching and preference for the health information sources. Thus the research must be
conducted in order to consider the need and the preferences of the people where determining
the channels for the dissemination of the health-information.
Patient participation in HI
The research conducted by Valdez et al. (2014) stated that designing of the patient-
centered clinical health informatics applications will help to improve in overall outcome of
the patient care. However, it requires proper understanding along with creating alignment
with patients’ health-related activities. Valdez et al. (2014) proposed that further research is
required to be undertaken in order to generate special theories related to patient work, proper
methods for the accessing of the patient work and information along with technologies for

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translating information of patient work in CHI application design. This will help in the
generation of developing and then deploying consumer-friendly technologies, integrated with
patient’s day-to-day lives.
Summary
Thus from the above discussion, it can be concluded that HI holds prime importance
in the domain of health care system. Two of the important domains of HI are PHI and CI. The
CI aids the healthcare professionals in clinical decision making process by highlighting the
patient’s need. The HI on the other hand helps in the effective management of the chronic
diseases. However, there is a lack of training among the healthcare professionals in effective
data handling along with lack of proper resources for the effective implementation of the HI
in the rural area. The future research is required to be directed in the domain of designing of
the training module for the nursing professionals while discovering cost-effective mode to
implementation of HI in rural or remote areas of developing countries.

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