Computers and technology are becoming more and more ubiquitous, with applications in every aspect of life and work. It’s no different in health care, where doctors use electronic health records (EHRs) and other technology every day to document patient visits and communicate with other providers. As the use of technology in the medical world has flourished, so has the field of medical informatics.
The American Medical Informatics Association explains medical informatics as an overarching field of study that combines data science, health information management and data analytics. It is “the intersection between the work of stakeholders across the health and healthcare delivery system who seek to improve outcomes, lower costs, increase safety and promote the use of high-quality services.”
Brian Coleman, DC, is an associate research scientist and lecturer at Yale University with an interest in the application of clinical informatics in pain research. He explained the field like this: “In general, health informatics is about using digital health, computers, data and the principles of computer and information science to advance life sciences, health sciences, health care, health professions education, public health, patient care, anything related to health. It combines a lot of these fields and creates many different avenues for people looking to get involved.”
Before becoming a chiropractor, Dr. Coleman had a background in biomedical engineering and data science, which he then integrated into his health care career during a postdoctoral fellowship in medical informatics at the VA Connecticut Healthcare System. He now works with the Center for Medical Informatics at Yale. “At Yale, most of my work is focusing on the application of informatics tools like machine learning and natural language processing to clinical documentation,” he said.
Adoption of EHRs Led to Increased Use of IT in Health Care
In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted to promote the adoption and use of health information technology. This sparked the adoption of electronic health records (EHRs) across the country, which Coleman said has led to an increase in the use of information technology in health care. “Digital health tools can make our jobs easier, streamline our workflow, improve quality of care for patients and improve remote patient monitoring,” Dr. Coleman said. “That’s the wave of the future, that’s what medicine is moving toward, so I think embracing that is really important.”
“The EHR is a necessary but time-consuming piece of the puzzle in healthcare delivery. It’s the tool, so making it work for you instead of fighting it is always important. Seeing patients, improving your workflow, improving work-life balance — whatever your goal is, informatics can help accomplish that.”
Digital health tools have many applications in clinical practice, and medical informatics research looks at ways to improve them. Dr. Coleman’s research is partly focused on learning as much as possible from EHRs. “The clinic documentation is usually the richest source of what’s actually going on in a clinic visit,” he said. “Pairing that with the data that are collected in structured fields like diagnosis codes and procedure codes allows us to get a more robust picture of what’s going on in an encounter and then use that for research for clinical decision making.”
Researchers might look at data related to the quality of care or a patient’s movement within a healthcare system to learn how to better help future patients. “What is a patient’s care trajectory like when they enter a system with low back pain, how do they move around the system, what are the services they get, and how can we use those data as they accumulate to help predict where they’re going in the future?” Dr. Coleman asks. “It’s kind of forecasting their trajectory in their pain care.”
Developing Role for Chiropractors in Medical Informatics
Dr. Coleman sees an important role for chiropractors as the medical informatics field continues to develop. “As chiropractic care becomes more integrated as part of this larger picture of health care, as we embrace our role within a larger healthcare team from a patient perspective, we’ll continue to move toward more robust health information exchange, connecting data between your office and nearby healthcare systems to help connect the dots for patients,” he said.
“The nice thing about informatics is that it’s extremely interdisciplinary,” Dr. Coleman explained. “If you’re a chiropractor, a dentist, an MD, a DO, an optometrist — it doesn’t matter what your clinical discipline is in informatics. The core tenets cut across all clinical disciplines, so it really is a welcoming community.”
The interdisciplinary nature of medical informatics is even better for patients because it allows for communication throughout a healthcare system and connection with other disciplines, like public health. “Reach out to your local public health department, find out what’s going on in their sphere as far as health information exchange and interconnectedness and how you can get involved,” Dr. Coleman suggested. “That’s the best way we’re really going to grow a network of interconnected health data that expands from hospitals to primary care offices to other healthcare offices, including chiropractic clinics.”
For chiropractors interested in learning more about medical informatics, Dr. Coleman suggests training programs and online resources. There are graduate programs and postdoctoral fellowships available in medical informatics at schools throughout the country, and online resources like Coursera and YouTube offer more information about computer science, programming and informatics.
“Chiropractors are certainly qualified and positioned to get involved in medical informatics,” Dr. Coleman said. “There’s a great opportunity there to improve information exchange and coordination of care for patients, which in a patient-centered care model is the most important thing.”
