The Informatics Institute: why do we need it?
Computer hardware and software have reached levels of performance that permit the creation of computer-based patient records. These devices can automate advice to clinicians about the care of individual patients and give clinicians the means of analyzing patterns of treatment for many patients, by many clinicians, in seconds. We have the tools to replace paper records for health care services with electronic records and to bring the number-crunching powers of computers to bear on the clinical data we place in electronic form. Even payers are demanding that providers produce more information about patients more quickly and in electronic form, and regulators expect that hospitals and health plans will have automated medical record systems in place before they grant them accreditation.
The technologies of computing and communication have already revolutionized the banking, financial services, travel, and airline industries. In the 1990s, they will revolutionize health care services as well and will permit integrated health care systems to emerge, with computer-based patient records moving electronically over regional communication networks between locations of care and into physicians'homes and offices, with primary care services in patients' homes and consultative services in physicians' offices using telemedicine, and with huge clinical databases for quality improvement studies.
What is possible today - computer-based patient records, telemedicine, digital storage and electronic communication of x-rays, robotic fiberoptic surgery, voice recognition for dictation and order entry, radio-frequency local area networks and portable handheld computer terminals for nurses and physicians, and massive clinical databases and expert systems to survey them for opportunities for quality improvement - was not possible five years ago. And the prices continue to plummet as the power of the technologies improves exponentially. Until now, the principal assets of most health care organizations were the paper medical records of their patients. From now on, their principal assets will be computer-based patient records and the information and communication systems on which those records depend for their existence and transportation.
The investments necessary to stay apace of these technological developments are daunting, and the risks of selecting inadequate and incompatible information systems are high. Because technologies are changing so rapidly, the skills of most information systems staffs are not current. They tend to select information systems with older architectures (technologies) that they understand instead of newer systems with more modern architectures that may better meet the needs of their organizations, their affiliated clinicians, and patients. Senior management teams must lead their organizations to select new information and communication systems, working from a common knowledge base of current functional requirements for systems, of information technologies, and of technological trends.
The Informatics Institute will help physician executives lead their senior management teams to learn the state of the art in medical informatics and to share that common knowledge base. Physician executives will inherit the helm of integrated health care systems, and they need to know how to invest wisely in these pervasive and transforming technologies. Informatics will be second only to clinical practice in importance as a discipline for a new generation of chief executives to comprehend when they take office, because successful information management will be the key to a competitive advantage for their organizations.
Guidelines for Authors
The Journal welcomes articles on topics for or about the medical management profession. We encourage prospective authors to call or to submit a brief outline or precis of the article before writing. All materials submitted to the journal are reviewed by at least two persons with expertise in the subject area covered. Any topic that deals with medical management or with health care delivery from a medical management perspective will be considered for the journal.
All manuscripts should be submitted in triplicate. Where possible, a floppy disk, ideally in WordPerfect 5.1 or ASCII format should be sent. Manuscripts and disks will not be returned unless specifically requested. Only original manuscripts are considered. However, a new article that expands on issues raised in other articles, books, or speeches is acceptable. Graphs, charts, photographs, and other illustrations are encouraged. Except for photographs, triplicate copies are required.
Receipt of all manuscripts is acknowledged. The review process requires 4-8 weeks. The editors notify authors of the results of review and of the tentative publication date as soon as it is known. All accepted manuscripts are subject to editorial revision. Edited copy is always submitted for author approval.
For further information on the submission of articles or to submit an article, contact:
Wesley Curry Editorial Director ACPE Suite 200 4890 W. Kennedy Blvd. Tampa, Fla. 33609 813/287-2000
Marshall Ruffin, MD, MPH, MBA, FACPE, is President and CEO of The Informatics Institute. He is also Clinical Information Officer, INOVA Health System, Falls Church, Va.