The Growth of a Field

HIMSS Clinical Informatics Insights

The term “Medical Informatics” was substituted for “Information Systems” by the National Library of Medicine in 1987. I conducted a search using the term “Medical Informatics” as a major search term and found that of all the articles coded to that term, over half have been published since 2006 (see Figure 1). The explosion of articles began around 1985 and again around 2001. While a crude measure of evolution, this nonetheless demonstrates the growth of the field of medical informatics. With the formal designation as a medical subspecialty in 2011 by the American Board of Medical Specialties, clinical informatics has truly made great strides.

As I reviewed some of the titles of articles across this timespan, I found three interesting themes. First, many issues of concern early on, remain concerns. A paper by Anderson worried about the need for a standard vocabulary and building a successful taxonomy. Several articles doubted doctors could efficiently input data into a computer record. The mechanisms of health information exchange were already being raised as exemplified by the paper by Garwin.

Second, many new ideas have emerged that were nonexistent at the time. Cybersecurity is one, especially in the use of research. The linkage of genomics and proteomics to bioinformatics is another recent innovation. The extent of mobile computing and devices would astonish many from that earlier period.

The third item is the very recent development of medical informatics training programs and curriculum (The evolution of a novel biomedical informatics curriculum for medical students; The introduction of a medical informatics course into a medical school curriculum; Health information technology and the medical school curriculum). While a growing number of medical schools have informatics fellowships, the newness of this subspecialty prevents many medical students from being aware of this career opportunity.

Perhaps there is a fourth surprise that, on retrospective contemplation, might not have surprised a visitor from 1968 to the present – the development of the role of the Chief Medical Information Officer and its crucial need to bridge informatics to the other medical specialties. While we have travelled far in a mere 46 years, there’s still a lot of excitement yet to come.

About the Contributor
Dr. Catinella is the Chief Medical Information Officer for The University of Arizona Health Network (UAHN) in Tucson, Arizona. Dr. Catinella is Board Certified in Family Medicine. His career extends across locations in Florida, Indiana and Utah. He has published in the Journal of Rural Health on hospital volumes for rural training programs. He is currently engaged in a roll out of an electronic medical record system at UAHN involving CPOE for two academic medical centers and physical offices.