The document discusses clinical informatics and how it can improve healthcare. It is presented by Iris Thiele Isip Tan, a professor and chief of the UP Medical Informatics Unit. Clinical informatics uses information and technology to enhance healthcare outcomes, improve patient care, and strengthen the clinician-patient relationship. It can assemble complete patient information, apply medical knowledge, and use decision support and other technologies to improve safety and prevent errors in healthcare delivery.

1. Iris Thiele Isip Tan MD, MSc
Professor 3, UP College of Medicine
Chief, UP Medical Informatics Unit
CLINICAL INFORMATICS

2. What?
Why?
How?
is clinical
informatics
learn
informatics
can
informatics
improve
healthcare

3. It’s not just computers!
Kulikowski et al. J Am Med Inform Assoc 2012;19:931–938.

4. Kulikowski et al. J Am Med Inform Assoc 2012;19:931–938.

5. Kulikowski et al. J Am Med Inform Assoc 2012;19:931–938.

6. Kulikowski et al. J Am Med Inform Assoc 2012;19:931–938.

7. “
Clinical informaticians transform health care by
analyzing, designing, implementing, and
evaluating information and communication
systems that enhance individual and
population health outcomes, improve
patient care, and strengthen the
clinician-patient relationship.
”
– Gardner RM et al JAMIA 2009;16:153-157

8. Gardner RM et al JAMIA 2009;16:153-157

9. Kulikowski et al. J Am Med Inform Assoc 2012;19:931–938.
MSc Health Informatics (UP Manila)
Medical
Informatics
track (UPCM) Bioinformatics
track (CAS)

10. What?
Why?
How?
is clinical
informatics
learn
informatics
can
informatics
improve
healthcare

11. “We are drowning in information
and starving for knowledge.”
Rutherford D. Rogers
http://www.infogineering.net/data-information-knowledge.htm

12. Building a Health
Information Infrastructure
Why electronic health records? by
InfowayInfoRoute https://youtu.be/Lo_3qOejQzI

13. National eHealth Vision Philippines
Photo by Doun, https://flic.kr/p/b5WFRK
By 2020, eHealth will enable widespread access to health care services,
health information and securely share and exchange patient information in
support of safer, quality health care, more equitable and responsive health
system for all the Filipino people by transforming the way information is used to
plan, manage, deliver and monitor health services.

14. IT-enabled
health services
By 2020
Philippine Health Information Exchange
(PHIE) implementation
EMR certification
IT in all public
health facilities
National eHealth Vision

15. Rule VIII. Governance & Accountablity
Sec. 36
All health service providers and insurers are required to
maintain a health information system on enterprise
resource planning, human resource information system,
electronic health records and electronic prescription
log consistent with standards set by the DOH and
Philhealth in consultation with the DICT and the NPC …
RA 11223
Universal Healthcare Act

16. RA 11223
Universal Healthcare Act
Rule VIII. Governance & Accountablity
Sec. 36
PhilHealth shall use its contracts to incentivize the
incorporation of HIS, automation of clinical
information, improvement of data quality, integration
and use of telemedicine, and participation in regional
or national health information networks.

17. Art 4. Sec 3.3 Program Educational Objectives
With additional training, graduates of the MD program
may pursue any of the following careers to include:
• General medical practitioner
• Clinical specialist
• Researcher/Medical Scientist/Innovator
• Health professions teacher
• Health administrator
• Health information manager
• Health economist
• Health policy maker
CHED Memorandum Order 18
Series of 2016

18. Art 5. Sec 6.3 Minimum Curricular Content
The minimum curricular content regardless of the
curriculum design shall include the following:
• Research, evidence-based medicine and medical
informatics
CHED Memorandum Order 18
Series of 2016

19. What?
Why?
How?
is clinical
informatics
learn
informatics
can
informatics
improve
healthcare

20. Patient Safety &
Clinical Informatics
Assemble a
complete picture of
the patient, including
tracking the course
of disease and the
effect of therapies
over time
Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407

21. Patient Safety &
Clinical Informatics
Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407
Assembling the relevant
medical knowledge

22. REAL-WORLD DATA: Information on health care that
is derived from multiple sources outside typical clinical
research settings, including electronic health records
(EHRs), claims and billing data, product and disease
registries, and data gathered through personal devices
and health applications.
NEJM 2016;375(23):2293-7

23. Patient Safety &
Clinical Informatics
Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407
Assembling the relevant
medical knowledge
Enhance adherence of
clinical practice to tenets of
EBM: prompting adherence to
protocols/guidelines via
computerized order entry

24. Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407
Patient Safety &
Clinical Informatics
Applying timely and
accurate knowledge of
medicine to the patient’s
current condition

25. Clinical Decision Support
Gather & make associations between pieces of information
that may be missed because of sheer volume of data
Bates et al JAMIA 2003;10:523-530

26. Buch et al. Diabet Med 2018;35:495-7.
Clinical guidelines will be
delivered through apps
rather than static documents.

27. Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407
Patient Safety & Clinical Informatics
Information systems to prevent, intercept and
ameliorate harm
Preventing mistakes

28. https://mysugr.com/mysugr-bolus-calculator/
Insulin on board
Blood glucose
Carbs
Previous injections
Carbs/insulin ratio
Insulin correction
factor
Blood glucose
target
MySugr Bolus
Calculator

29. https://www.uni-trier.de/index.php?id=44502&L=2
CASE-BASED REASONING
Problem-solving paradigm in
artificial intelligence
Similar problems tend to
have similar solutions
Case base: collection of
memorized chunks of
experience (cases)
Adaptive systems: new problem
solving experience is retained and
outdated experience is removed

30. Brown D et al. Temporal case-based reasoning for type 1 diabetes mellitus bolus
insulin decision support. Artificial Intelligence in Medicine 2018;85:28-42.
Focus on helping patient directly
(instead of aiding the clinician)
RETAINS all
successful cases
Derives bolus
suggestion from
similar cases

31. Brown D et al. Temporal case-based reasoning for type 1 diabetes mellitus bolus insulin
decision support. Artificial Intelligence in Medicine 2018;85:28-42.
CBR method can be
adopted by insulin
pumps, blood glucose
monitors, PCs and as
a web service

32. CBR service in the cloud opens possibility
of case sharing between subjects
Brown D et al. Temporal case-based reasoning for type 1 diabetes mellitus bolus insulin
decision support. Artificial Intelligence in Medicine 2018;85:28-42.

33. Patient Safety &
Clinical Informatics
Kilbridge PM & Classen DC. JAMIA 2008;15(4):397-407
Assembling the relevant
medical knowledge
Enhance adherence of
clinical practice to tenets of
EBM: prompting adherence to
protocols/guidelines via
computerized order entry
Clinical data mining to
increase understanding of
disease

34. Can we predict individuals’ medical diagnoses
from language posted on social media?
Merchant RA et al. doi.org/10.1371/journal.pone.0215476

35. Can we identify specific markers of
disease from social media posts?
Merchant RA et al. doi.org/10.1371/journal.pone.0215476
SOCIAL MEDIA + EMR

36. Merchant RA et al. doi.org/10.1371/journal.pone.0215476

37. Facebook alone
Demographics alone
Demographics and Facebook
Medical Condition
Prediction Strength
Diabetes!!
Merchant RA et al. doi.org/10.1371/journal.pone.0215476

38. All 21 medical condition
categories were predictable
from Facebook language
beyond chance.
18 categories better
predicted by demographics
+ Facebook language vs
demographics.
10 categories better
predicted by Facebook
language vs demographics.
Merchant RA et al. doi.org/10.1371/journal.pone.0215476

39. Merchant RA et al. doi.org/10.1371/journal.pone.0215476

40. Merchant RA et al. doi.org/10.1371/journal.pone.0215476

41. Merchant RA et al. doi.org/10.1371/journal.pone.0215476

42. SOCIALMEDIOME

43. What?
Why?
How?
is clinical
informatics
learn
informatics
can
informatics
improve
healthcare