Health Informatics: Practical Guide

Citation

Hersh, W. (Ed.). (2022). Health Informatics: Practical Guide (8th ed.). Lulu.com.

Chapter Summary

The eighth edition has 23 chapters on about 450 pages, written by Hersh and a group of contributing authors from academic medical centres, health systems and industry. Hersh's preface says the content was almost completely redone from the seven earlier editions led by Robert Hoyt, and that it roughly follows the introductory course Hersh teaches at Oregon Health & Science University and in the AMIA 10x10 programme. The two chapters in the publisher's sample open with learning objectives and close with a conclusion, annotated additional readings and an extensive reference list.

Chapter 1: Introduction to Biomedical and Health Informatics

Defines informatics and its subfields (clinical, imaging, public health, consumer health, clinical research informatics and bioinformatics) and argues that biomedicine is an information science. A large part of the chapter describes the informatics workforce: typical job titles, the competency frameworks published for health informatics and for the clinical informatics subspecialty, professional certifications, and organisations and resources for further study.

Chapter 2: A Short History of Biomedical and Health Informatics

A brief history from Ledley and Lusted's 1959 paper on modelling diagnostic reasoning, through early electronic record systems, the National Library of Medicine, the Human Genome Project, the web and the Institute of Medicine reports, to the HITECH Act. It also covers the backlash against electronic records (clinician burden, poor interoperability), the 21st Century Cures Act and SMART on FHIR, and the effects of COVID-19.

Chapter 3: Computing Concepts for Biomedicine and Health

The preface presents this chapter as the essential computing background: informatics is not centrally about technology, but its students need a working grasp of computing concepts before the applications chapters.

Chapters 4–5: Electronic Health Records; Standards and Interoperability

Chapter 4 covers what the preface calls perhaps the most central application of the field, the electronic health record and the clinical data held in it. Chapter 5 turns to one of the field's main challenges: standardising data so that it can be exchanged and used across systems.

Chapters 6–8: Data Science and Artificial Intelligence; Clinical Decision Support; Natural Language Processing

Chapter 6 reviews what data science and AI have and have not achieved in health and healthcare. Chapter 7 describes the current status and future directions of clinical decision support, and Chapter 8 surveys natural language processing, needed because so much clinical information is recorded as text.

Chapter 9: Safety, Quality, and Value

Examines the role of informatics in the safety, quality and value of healthcare.

Chapters 10–13: Health Information Exchange (HIE); EHR System Selection and Implementation; Telemedicine and Telehealth; Health Information Privacy and Security

A group of chapters on running clinical systems in practice: exchanging information across organisational and business boundaries, choosing and implementing an electronic record system, the rapid growth of telemedicine and telehealth, and the privacy and security of health information.

Chapters 14–16: Information Retrieval (Search); Clinical Research Informatics; Translational Bioinformatics

The preface marks these as moving beyond direct patient care. Chapter 14 covers search systems used by clinicians, researchers and patients; Chapter 15 shows how informatics supports clinical and translational research; Chapter 16 deals with genomics and other omics and their impact on health and healthcare.

Chapters 17–21: Nursing Informatics; Consumer Health Informatics; Public Health Informatics; Evidence-Based Medicine; Imaging Informatics

Five chapters on focused areas: the role of nurses and informatics, the patient or consumer as a user of informatics, informatics in public health, the use of the best evidence in clinical decisions (a topic the preface notes is not included in every introduction to the field), and imaging.

Chapters 22–23: Ethical Issues in Health Informatics; Human-Computer Interaction

The book closes with the ethics of informatics and with human-computer interaction.

Key Concepts

Chapters 1–3: Foundations

• Biomedical and health informatics (BMHI): the discipline concerned with using information, aided by technology, to improve individual health, healthcare, public health and biomedical research.
• Subfields of informatics: clinical, imaging, public health, consumer health, clinical research and bioinformatics, each defined by where informatics is applied.
• Informatics workforce and competencies: the roles held by people who work in informatics and the published knowledge and skills they need, including the clinical informatics subspecialty and professional certification.
• HITECH Act and 21st Century Cures Act: the US laws that drove adoption of electronic records and later tried to correct its problems, including information blocking and weak interoperability.

Chapters 4–9: Clinical Data and Its Use

• Electronic health record (EHR): the record of patient care and the clinical data in it, the book's central application.
• Interoperability: the ability of systems to exchange data with shared meaning, which depends on standards.
• Clinical decision support and natural language processing: computer support for clinical decisions and the processing of clinical text.

Chapters 10–23: Systems, Settings and Specialties

• Health information exchange: moving patient data between organisations.
• Telehealth: delivering care at a distance.
• Evidence-based medicine: finding and appraising the best evidence for clinical decisions.
• Translational bioinformatics: bringing genomic and other omics data into health and healthcare.

Critical Analysis

Strengths

• Breadth in one volume. Twenty-three chapters cover the field from definitions and history to records, standards, AI, decision support, telehealth, privacy, research informatics, public health, imaging and ethics, so a single book can carry a whole survey course.
• Built around a long-running course. The preface ties the structure to an introductory course taught for three decades to about 5,000 students. The sequence is foundations first, then clinical systems, then research and the specialised areas, which is a teachable order.
• Practical orientation to the profession. The sample chapter spends real space on job roles, competencies, certification and professional organisations, useful to students who are deciding whether to work in informatics.
• Pointers onward. Each sampled chapter ends with an annotated list of additional readings and a long reference list, and the preface states this as a deliberate aim: a big-picture view with copious references for deeper study. The publisher's site also keeps an errata list, and an instructor resource is available to teachers who request it.

Limitations

• Overview rather than depth. With about 20 pages per chapter, topics such as standards, NLP and data science are introduced rather than taught. Readers who need to build systems will need specialist texts.
• United States focus. The sampled chapters frame the field through US institutions and policy: AMIA, AHIMA and HIMSS certifications, the ACGME subspecialty, the HITECH and Cures Acts. Readers elsewhere will need to translate the policy material to their own system.
• Dated in fast-moving areas. The preface is dated July 2022. The data science and AI chapter therefore predates the wave of large language model tools that followed later that year, and policy chapters reflect the situation at that time.
• Small known errors. The publisher's errata page lists a few production faults, including missing text in a figure in Chapter 4 and a duplicated bullet list in the critical-appraisal section of Chapter 20; readers should check the list.

Where It Fits in the Course

This is the natural first textbook in the course list: a structured survey of the whole field with a chapter for each major application. Wachter's The Digital Doctor is a natural companion rather than an alternative. It is a reported, narrative account of what happened when US medicine adopted electronic records, and it gives the human side of the material in Chapters 2, 4, 7, 9 and 23. Reading it alongside or just before this book makes the policy and safety chapters concrete.

Coiera's Guide to Health Informatics is a broad course text with an Australian and international perspective, built around models of information, communication and decision-making; it suits a second pass after this book, or replaces it for students outside the United States. Benson and Grieve's Principles of Health Interoperability takes the subject of Chapter 5 much further into messaging standards, FHIR and clinical terminologies. Hersh's own Information Retrieval: A Biomedical and Health Perspective is the full-length treatment of the topic of Chapter 14. The Shortliffe-led Medical Informatics is a larger, systems-oriented textbook for readers who want more depth on clinical data, decision support and human factors.

How to Use This Book

The book suits students from either clinical or technical backgrounds starting a first course in health informatics: medical and nursing students, biomedical engineering and computing students, and health IT staff. No specific prerequisites are needed. The preface ties the content to an introductory graduate course, so undergraduates should expect a professional rather than a school-level register.

A practical reading plan:

• Core: Chapters 1–5 in order. They set up the vocabulary, history, computing background, electronic records and standards on which everything else depends.
• Second block: Chapters 6–9 (data science and AI, decision support, NLP, safety and quality), then Chapters 10–13 on exchange, implementation, telehealth and privacy.
• Choose by interest: Chapters 14–21 can be read in any order. Clinicians may start with evidence-based medicine and information retrieval; engineers with imaging and translational bioinformatics; nursing and public health students with their own chapters.
• Finish with: Chapters 22–23 on ethics and human-computer interaction, which read well after the clinical systems chapters.

Where a chapter opens with learning objectives, as the sampled ones do, use them as a checklist: after reading, try to answer each one in a few sentences without looking back. The additional readings list is the place to go when a chapter only opens a topic. For areas that change quickly (AI, interoperability rules, telehealth policy), check recent sources for what has happened since 2022, and consult the errata page before relying on the affected figure and list.