Biomedical Informatics

The Field of Bioinformatics

The field of bioinformatics can be divided into three broad categories: clinical informatics, public health/population informatics, and translational bioinformatics. Within each of these are potential theoretical and applied divisions. The aims of each branch, however, is the same: to find better ways to research, share, and use the fast-growing fund of medical knowledge.

Clinical informatics is the umbrella term surrounding the information needs of clinicians, medical staff, and patients. It is a broad term covering both inpatient and outpatient medicine and has been the subject of recent state and federal legislation. There are several areas of research within clinical informatics. The goals of each of these areas are to improve patient care through better information management.

Public health or population informatics is similar to clinical informatics except in scope. Population informatics encompasses biosurveillence, preventative medicine research, and disease incidence data.

Translational bioinformatics includes research on tools for acquiring, storing, analyzing, and sharing information. Although not limited to genetic information, this area includes technologies behind the Human Genome Project (1991–2003) that have allowed for processing and storage of large quantities of genetic data and has led to an explosion of information on gene expression, protein synthesis, and biomarker determination. Much of the rapid growth in our understanding of genetics stems from the development of microarrays. A single microarray (a silicon wafer on which genes or gene fragments are attached) can yield 4,000 to 50,000 measurements of gene expression, and many studies use multiple microarrays. Although the biology behind these technologies is beyond the scope of this entry, research in this area continues with the creation and analysis of large genetic databases to facilitate discovery of linkages between genetic information and disease processes. Several new prognostic tests and pharmaceutical agents have been developed through analysis of these data that target specific genes or gene products.

History of Informatics

Some of the early notable achievements in informatics occurred in the 1960s. The first version of the National Library of Medicine's MEDLARS/MEDLINE bibliographic database was released in 1963. In 1966, Massachusetts General Hospital Utility Multiprogramming System was created in Octo Barnett's laboratory as one of the first systems designed specifically for hospital staff to interact with a clinical database. Several large companies such as IBM, 3M, and Hewlett-Packard created medical systems in the 1970s to 1990s with variable success. From 1982 to 1985, the Veterans Administration (VA) began a project to create a decentralized computer network throughout its hospital system, which in 1994 was renamed VistA (Veterans Health Information System and Technology Architecture). It is the current system used to integrate and manage all the clinical information systems throughout the VA network.

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