Biomedical Informatics

Citation

Shortliffe, E. H., & Cimino, J. J. (Eds.). (2021). Biomedical Informatics: Computer Applications in Health Care and Biomedicine (5th ed.). Springer.

Chapter Summary

This is the fifth edition of the textbook that appeared in its second edition as Medical Informatics: Computer Applications in Health Care and Biomedicine (2001). It was renamed Biomedical Informatics for the third edition and is now edited by Edward Shortliffe and James Cimino. It is a multi-author volume of thirty chapters, each written by specialists in its area, and the contents run from the foundations of the field through the main application areas and policy to a closing chapter on the future of informatics in biomedicine.

Chapters 1–3: Foundations

Chapter 1, "Biomedical Informatics: The Science and the Pragmatics", defines the field. Chapter 2, "Biomedical Data: Their Acquisition, Storage, and Use", covers the data that systems handle. Chapter 3, "Biomedical Decision Making: Probabilistic Clinical Reasoning", treats reasoning under uncertainty, a theme that carries into the decision-support chapter near the end.

Chapters 4–8: People, software, standards and language

Chapter 4, "Cognitive Informatics", and Chapter 5, "Human-Computer Interaction, Usability, and Workflow", look at how people think and work with information systems. Chapter 6, "Software Engineering for Health Care and Biomedicine", and Chapter 7, "Standards in Biomedical Informatics", cover building systems and the standards that let them interoperate. Chapter 8, "Natural Language Processing for Health-Related Texts", addresses extracting information from text.

Chapters 9–11: Bioinformatics, imaging and personal health

Chapter 9, "Bioinformatics", and Chapter 10, "Biomedical Imaging Informatics", cover the biological and imaging ends of the field. Chapter 11, "Personal Health Informatics", turns to tools for individuals.

Chapters 12–13: Ethics and evaluation

Chapter 12, "Ethics in Biomedical and Health Informatics: Users, Standards, and Outcomes", and Chapter 13, "Evaluation of Biomedical and Health Information Resources", address responsible use and the question of whether systems work.

Chapters 14–18: Records, infrastructure, organisations and care

Chapter 14, "Electronic Health Records", leads this group. The others are "Health Information Infrastructure" (15), "Management of Information in Health Care Organizations" (16), "Patient-Centered Care Systems" (17) and "Population and Public Health Informatics" (18), moving from the record to organisations, care delivery and populations.

Chapters 19–24: Care technologies and knowledge systems

Chapter 19, "mHealth and Applications", Chapter 20, "Telemedicine and Telehealth", Chapter 21, "Patient Monitoring Systems" and Chapter 22, "Imaging Systems in Radiology" cover technologies used in care. Chapter 23, "Information Retrieval", and Chapter 24, "Clinical Decision-Support Systems", cover systems that serve clinicians' searches and reasoning.

Chapters 25–30: Education, translational research, policy and the future

Chapter 25, "Digital Technology in Health Science Education", Chapter 26, "Translational Bioinformatics", Chapter 27, "Clinical Research Informatics" and Chapter 28, "Precision Medicine and Informatics" extend the applications to teaching and research. Chapter 29, "Health Information Technology Policy", covers policy, and Chapter 30, "The Future of Informatics in Biomedicine", closes the volume.

Key Concepts

Chapters 1–8

• Biomedical data: acquisition, storage and use of clinical and biological data.
• Probabilistic clinical reasoning: decision making under uncertainty.
• Cognitive informatics and usability: how human cognition and workflow shape system design.
• Standards: the agreements that let systems exchange information.

Chapters 9–18

• Bioinformatics and imaging informatics: informatics for molecular data and for images.
• Evaluation: judging the value of information resources.
• Electronic health records and health information infrastructure: the record and the networks around it.
• Population and public health informatics: informatics applied to groups rather than individuals.

Chapters 19–30

• mHealth, telehealth and patient monitoring: care technologies beyond the clinic.
• Clinical decision support and information retrieval: systems that help clinicians find and apply knowledge.
• Translational bioinformatics, clinical research informatics and precision medicine: informatics at the link between research and care.
• Health IT policy: the policy context for deployment.

Critical Analysis

Strengths

• Breadth in one volume. Thirty chapters take in data, reasoning, human factors, software, standards, ethics and evaluation, then records, care technologies, research informatics, policy and the future.
• Specialist authorship. Each chapter is written by named specialists, such as Hersh on information retrieval and Bates among the authors of the policy chapter, and the editors, Shortliffe and Cimino, contribute to the opening and closing chapters.
• Foundations before applications. Chapters 1 to 13 build concepts such as data, decision making, usability, standards and evaluation before the application chapters rely on them.
• A long-lived reference. The book descends from a text first published as Medical Informatics and has been revised through five editions, so it carries the field's accumulated framing as well as current topics.

Limitations

• Edited volume. A multi-author book varies in style and depth between chapters, and at thirty chapters it works as a reference as much as a course text.
• Reference scale. Thirty chapters by many hands make the volume a reference to dip into; reading it cover to cover is a large undertaking.
• Title and edition change. The earlier Medical Informatics had different chapters, so chapter numbers from older course materials do not match; searching under the older title will not find this edition.

Where It Fits in the Course

Among the course's books, this is the broad, authoritative textbook for the discipline. Enrico Coiera's Guide to Health Informatics and Health Informatics: Practical Guide are shorter, more recent broad introductions and easier first reads. William Hersh's Information Retrieval: A Biomedical and Health Perspective expands one strand, covered here in Chapter 23. Principles of Health Interoperability goes deep on the standards touched on in Chapter 7, and Robert Wachter's The Digital Doctor is a reported account of the digitisation of American medicine, a useful companion to the records and decision-support chapters.

Read this volume after a shorter introduction, or alongside one of the specialised books when a particular chapter needs more depth.

How to Use This Book

The book suits graduate students and professionals in health and biomedical informatics, and researchers who need to understand what computing can do in clinical services and in biomedical research.

A practical plan:

• Core: Chapters 1 to 3, then Chapters 4 to 7 on people, software and standards.
• Next: Chapters 12 and 13 on ethics and evaluation, then the record and infrastructure chapters (14 to 18).
• By interest: Chapters 9 and 10 for bioinformatics and imaging, 19 to 22 for care technologies, 23 and 24 for retrieval and decision support, and 26 to 28 for research and precision medicine.
• Close: Chapters 29 and 30 for policy and outlook.