McCoy A B, Wright A, Eysenbach G, Malin B A, Patterson E S, Xu H, Sittig D F
Center for Healthcare Quality & Safety, The University of Texas, Health Science Center at Houston (UTHealth), 6410 Fannin St., UTP 1100.43, Houston, TX 77030, USA. E-mail:
Yearb Med Inform. 2013;8:13-9.
The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in clinical practice.
In this review, we present recent evidence on clinical informatics in the United States covering three themes: 1) clinical informatics systems and interventions for providers, including EHRs, CPOE, CDS, and health information exchange; 2) consumer health informatics systems, including personal health records and web-based and mobile HIT; and 3) methods and governance for clinical informatics, including EHR usability; data mining, text mining, natural language processing, privacy, and security.
Substantial progress has been made in demonstrating that various clinical informatics methodologies and applications improve the structure, process, and outcomes of various facets of the healthcare system.
Over the coming years, much more will be expected from the field. As we move past the "early adopters" in Rogers' diffusion of innovations' curve through the "early majority" and into the "late majority," there will be a crucial need for new research methodologies and clinical applications that have been rigorously demonstrated to work (i.e., to improve health outcomes) in multiple settings with different types of patients and clinicians.
自临床信息学领域创立以来的六十年间，其规模已大幅扩展。早期研究聚焦于简单的论证，即诸如电子健康记录（EHR）、计算机化医嘱录入（CPOE）和临床决策支持（CDS）系统等健康信息技术（HIT）在临床实践中是可行的且可能有益。
在本综述中，我们展示了美国临床信息学的最新证据，涵盖三个主题：1）针对医疗服务提供者的临床信息学系统及干预措施，包括电子健康记录、计算机化医嘱录入、临床决策支持和健康信息交换；2）消费者健康信息学系统，包括个人健康记录以及基于网络和移动的健康信息技术；3）临床信息学的方法与治理，包括电子健康记录的可用性；数据挖掘、文本挖掘、自然语言处理、隐私和安全。
在证明各种临床信息学方法和应用可改善医疗系统各方面的结构、流程和结果方面已取得重大进展。
在未来几年，该领域有望取得更多成果。随着我们从罗杰斯创新扩散曲线中的“早期采用者”阶段，经过“早期多数”阶段并进入“晚期多数”阶段，将迫切需要新的研究方法和临床应用，这些方法和应用需在多种环境中，针对不同类型的患者和临床医生，经过严格论证证明其有效（即能改善健康结果）。
