Pediatric Informatics: Computer Applications in Child Health (Health ...

2 Informatics and Pediatric Health Care 7
(the management of medical data and knowledge as they relate to the health of
individuals, families, communities, and populations).
Clinical informatics, the focus of this book, has been in existence for over 30 years.
In the past decade, it has received increasing interest as the adoption of health IT
tools have been promoted as a solution to improve patient safety, efficiency, and cost
effectiveness. Pediatric informatics, a subset, can be defined as “clinical informatics
that advances child health,” and as such, is a translational field, in that it transforms
results from information science and technology into new methods and tools for
diagnosis, therapy, and prevention and into general pediatric practice. 11 The increasing
availability of IT environments that allow rapid development of operational tools
and the progressive adoption of computational tools into health care infrastructures
have facilitated the translation of pilot projects into successful production-level
applications without extensive technical expertise by clinical innovators.
IT functions that can improve quality and safety in health care include: speeding
and organizing access to longitudinal personal health data and related information,
standardizing and streamlining communication and transactions, automating tracking
and auditing, providing decision support and clinician guidance, translating
evidence into practice, and reusing clinical data for practice and public health planning.
IT functions that can improve the efficiency and cost-effectiveness of care
include: standardizing and automating documentation, reducing clerical and transcription
errors, coordinating care services, and improving the accuracy of charge
capture. To take advantage of these IT functionalities, health care systems must
have a common infrastructure that spans and connects many health institutions and
entities (hospitals, physician offices, pharmacies, laboratories, etc.) to enable realtime
data sharing, as advocated by the IOM 12 and other leaders in health care.
However, as there is great promise, there are also caveats to disseminating information
technology in health care. First, technology must solve the problems for which
it was intended. Although there may be evidence that a particular technology will
improve safety, its inappropriate implementation may have unintended and/or hazardous
consequences. Second, sufficient planning and resources must be allocated to
assure a viable and sustainable deployment. The business plan for a technical solution
must include pragmatic considerations for its continuation and growth. Third, clinician
and cultural resistance to adopting new technologies can be strong, especially if
applications unproven in practice are associated with high financial investments and
require major organizational and behavior change. Past bad experiences with specific
applications may cause practitioners to question and oppose the adoption of health IT.
Thus, clinical informatics goes beyond the realm of IT alone and into its interactions
with people, organizations, and processes as they affect health outcomes.
2.4 Pediatricians’ Role in Health Information
Technology Adoption
As advocates for children, pediatricians should be very interested in health information
technology and its adoption into practice for several reasons.