Informatics and Family Medicine

Florida Family Physician
January 1996 / Volume 46 / Number 1

Medical informatics is the field that concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research, including the information science and the technology to support these tasks. [1]

• Telecommunication - Several emerging communication technologies will be essential to patient care in the future. We are quickly moving to a time when physicians will treat patients in their homes and across state lines without leaving the office. Virtual house calls will be common using video teleconferencing and advanced telephone services. Vital signs, blood glucose, and other data will be continuously uploaded to the physician between visits. Wireless networks will allow pocket sized computers to go anywhere and still be connected to patient databases. Robotic surgery (developed by the Department of Defense) will even allow surgeons to operate on patients who are an ocean away. The State is currently considering regulations to grant telemedicine licenses to out-of-state providers. In the near future, your consultant (or competitor) may be telecommuting from California to see patients in Florida.
• The Internet - Patients are already seeking advice, consultation, and referral over the Internet. Hospitals and clinics are busy hanging out their shingles on the information superhighway. Doctors are communicating with their patients and colleagues through electronic mail. The free Physicians Online service, endorsed by the FAFP, is an important step in this direction. In addition to Medline and other databases, Physicians Online now offers an email gateway to the Internet. Internet mail is used by millions of people in over a hundred countries. It has become the preferred communications channel for large communities and organizations. Every member of the Florida Academy should become familier with this important technology. Email is only half the equation however, the World Wide Web is the other. The Web is essentially a huge network of interconnected computers that currently holds over 12 million individual documents. There is a staggering amount of health related information available including journals, textbooks, CME, and patient education. [2] Many medical publications may go paperless in the next few years, including the Florida Family Physician. The World Wide Web is big enough to hold them all!
• User Interfaces - Computer speed and capacity doubles every few years while size and cost steadily diminish. All this horsepower does not necessarily make computers easier to use however. The computer/human interface has not progressed significantly since the introduction of the mouse in the 1980s. Newer technologies such as pen and voice input are beginning to prove themselves in the health care arena. Medical students, residents, and physicians are using small, pen-based computers to automate patient management tasks and access reference materials during clinical encounters. These devices have a distinct edge in patient care settings over their larger, keyboard dependent cousins. Pen input is more natural, silent, and often faster than typing. Combined with wireless networking, pen-based computers may become the ultimate information management tool for physicans.

The fact of the matter is, as Family Physicians, we have to push a lot of information around every day. One author took this idea to the extreme when he said: "In the context of today's so-called information society, Family Practice is information management." [3] Given the magnitude of our task, computers and telecommunication technologies will be essential to our continued success.

References

1. Greenes, RA; Shortliffe, EH. Medical Informatics: An Emerging Academic Discipline and Institutional Priority. JAMA. 1990; 263(8):1114-1120
2. To get a quick look at the World Wide Web, sign up for a free test drive with any of the major on-line services (America Online, Compuserve, or Prodigy). Once you are on the Web, check out these locations:
   • University of Florida Office of Medical Informatics
     http://www.med.ufl.edu/medinfo/
   • National Library of Medicine
     http://www.nlm.nih.gov/
   • Medical Matrix
     http://www.kumc.edu/mmatrix/
     http://web.yahoo.com/mm/
     http://www.slackinc.com/matrix/
   • Computers in Primary Care Discussion List
     http://apollo.gac.edu/
   • University of Iowa Family Practice Handbook
     http://vh.radiology.uiowa.edu/Providers/ClinRef/FPHandbook/FPContents.html
   • American Family Physician Patient Information
     http://indy.radiology.uiowa.edu/Providers/Publications/AmericanFamily/AFPHomePage.html
   • Journal of Family Practice
     http://www.phymac.med.wayne.edu/jfp/jfp.htm
   • OncoLink Cancer Resource
     http://cancer.med.upenn.edu/
   • Physician's Guide to the Internet
     http://www.webcom.com/pgi/