Guide to Health Informatics

Citation

Coiera, E. (2015). Guide to Health Informatics (3rd ed.). CRC Press.

Chapter Summary

The book runs to roughly 700 pages and is organised into eight parts, followed by a glossary and references. The publisher's contents list gives part headings and chapter-level headings without chapter numbers, and the groups below follow that order.

Basic Concepts in Informatics: Models; Information; Information Systems

The opening part introduces models, information and information systems as the basic ideas of the field.

Informatics Skills: Communicating; Structuring; Questioning; Searching; Making Decisions

This part concerns what clinicians do with information: communicating, structuring records, asking questions, searching for evidence and making decisions.

Information Systems in Healthcare: Information Management Systems; The Electronic Health Record; Designing and Evaluating Information and Communication Systems; Implementation; Information System Safety; Information Economics

The systems part covers information management systems and the electronic health record, then the life of an information system: its design and evaluation, implementation, safety and economics. The publisher notes that this edition reflects current issues such as nation-scale health information systems and systems safety.

Guideline- and Protocol-Based Systems: Guidelines, Protocols and Evidence-Based Healthcare; Computer-Based Protocol Systems; Designing, Disseminating and Applying Protocols

Treats clinical guidelines and protocols in relation to evidence-based healthcare, the computer systems that deliver them, and how protocols are designed, disseminated and applied.

Communication Systems in Healthcare: Communication Systems Basics; Interlude—the Internet and the World Wide Web; Information and Communication Networks; Social Networks and Social Media Interventions; Telehealth and Mobile Health

Starts from the basics of communication systems, with an interlude on the Internet and the web, and moves to networks, social networks and social media interventions, and telehealth and mobile health. The publisher names the impact of social media among this edition's updates.

Language, Coding and Classification: Terms, Codes and Classification; Healthcare Terminologies and Classification Systems; Natural Language and Formal Terminology

Explains how clinical language is turned into terms, codes and classifications, surveys healthcare terminologies and classification systems, and contrasts natural language with formal terminology.

Clinical Decision Support and Analytics: Clinical Decision Support Systems; Interlude—Artificial Intelligence in Medicine; Computational Reasoning Methods; Model Building for Decision Support, Data Analysis and Scientific Discovery

Covers decision support systems, an interlude on artificial intelligence in medicine, computational reasoning methods and the building of models for decision support, data analysis and scientific discovery. The publisher lists machine learning and discovery systems among the topics updated for the third edition.

Specialized Applications for Health Informatics: Patient Monitoring and Control; Population Surveillance and Public Health Informatics; Bioinformatics; Clinical Bioinformatics and Personalized Medicine; Consumer Health Informatics

The final part turns to application areas: monitoring and control of patients, population surveillance and public health informatics, bioinformatics and its clinical application to personalized medicine, and consumer health informatics.

Key Concepts

Foundations and skills

• Models, information and information systems: the three basic ideas of the opening part.
• Clinical informatics skills: communicating, structuring, questioning, searching and deciding.

Systems, protocols and communication

• Electronic health record: its role among healthcare information management systems.
• Design, evaluation, implementation and safety: the lifecycle concerns of health information systems.
• Guidelines and protocols: evidence-based care expressed in computer-based protocol systems.
• Telehealth and mobile health: communication systems applied to care at a distance.

Language, decision support and applications

• Terminologies and classifications: coding clinical language.
• Clinical decision support: systems and computational reasoning methods that assist clinical decisions.
• Bioinformatics and consumer health informatics: two application areas at either end of the field.

Critical Analysis

Strengths

• Whole-field scope in one volume. The part headings run from concepts and clinical skills through health records, protocols, communication, terminology and decision support to specialised applications, matching the publisher's claim of complete coverage of the area.
• Written for a mixed readership. The publisher aims it at health science undergraduates, clinicians and health service managers, and describes the writing as readable yet sophisticated, making a vast area accessible to non-specialists. A review in IEEE Pulse by Paul H. King, quoted by the publisher without naming the edition, called it comprehensive, timely and readable and judged it suitable as a textbook for an undergraduate biomedical engineering elective.
• Updated for the third edition. The publisher lists social media, nation-scale health information systems, systems safety, augmented reality and surgical simulation, machine learning and discovery systems among the current topics added.
• Student aids. Tables, boxes and chapter summaries are described, together with free online resources: a glossary, references linked to MedLine, multiple-choice questions for self-testing and discussion points for tutorials.

Limitations

• Breadth over technical depth. A survey of this width cannot go deep on every topic. The contents list has no chapter devoted to messaging or interoperability standards, so readers who need to implement HL7, FHIR or SNOMED CT will need a specialist text.
• Self-testing material is online. The multiple-choice questions and discussion points are listed as online resources, not as part of the printed volume.
• Review evidence is limited. The reviews quoted on the publisher's page do not identify the edition they assessed, and no independent review of the third edition was found.

Where It Fits in the Course

Coiera is the broad conceptual foundation among the medical informatics books. Hersh's Health Informatics: Practical Guide is also an introductory survey for clinical and technical readers, built from chapters by specialist contributors, and is the nearest alternative; Coiera is a single-author text that begins from models, information and clinical skills. Wachter's The Digital Doctor is a reported account of what happened when American medicine adopted electronic records and is an easy complement for context rather than a technical text.

Benson and Grieve's Principles of Health Interoperability is the next step for readers who want depth on the standards that let systems exchange data, a topic that Coiera's contents list approaches only through terminologies and coding. Shortliffe and colleagues' Medical Informatics is a systems-oriented text on clinical data, decision support and records, and Hersh's Information Retrieval: A Biomedical and Health Perspective goes deeper into search, one of the skills in Coiera's second part.

How to Use This Book

The publisher presents the book for readers who are not informatics specialists, so no technical prerequisites are implied; familiarity with how hospitals and clinical care are organised will help. Read the first two parts first, since they introduce the ideas about models, information and clinical communication that the rest of the book uses; after that the parts are fairly independent and can be taken in the order a course or project needs.

For a general course, a sensible core is the first two parts, the electronic health record and system design chapters, the language, coding and classification part and the clinical decision support part. Engineers working on clinical systems may add the system safety and implementation chapters. The glossary and the free online question sets are useful for revision, and the interludes on the Internet and on artificial intelligence are a convenient way into those topics.