My research in informatics has been in the areas of process and quality improvement. These areas are crucial because the development and use of any information system ultimately has to serve an improvement purpose for individuals, organizations, communities, and the society. While simple automation can be useful to a certain extent, obtaining significant improvements by leveraging information systems is not so straightforward (see the healthcare.gov example). It requires an interdisciplinary community of researchers and practitioners to take an evidence-based approach to the development and evaluation of information systems. Ignoring this perspective can result in, at best, minimal improvements or no significant change; it can possibly result in project failures, waste of valuable resources, or even disastrous consequences for individuals and the society.
In the US, an area of national priority and challenge for information systems and technology has been the health care industry. As mentioned by Sisko et al., the health spending is projected to grow 1.1 percentage faster than the economy till 2023 corresponding to 19.3 percent of the gross domestic product in the US. The aging population, who typically needs a higher level of care contributes to these costs. The 2010 Census reported 13 percent of the United States (US) population to be 65 or above with the projections for 2020 and 2030 rapidly reaching to 16 and 19.3 percents, respectively. Despite the high demand for utilization and high costs, the quality of care in the US needs much improvement too. According to a press release by the Commonwealth Foundation, the US ranked the last among 11 developed countries in terms of the quality of care.
Arguably, effective and efficient development and use of information systems can address the issues with the quality of care, healthcare costs, and health outcomes. For these purposes, the US administrations have supported the health information technology by creating the Office of the National Coordinator for Health IT (ONC). With the HITECH Act, incentives were provided to healthcare providers for Electronic Health Records (EHR) adoption. Since 2008, many governments and organizations have invested considerable amount of resources in health information technology. Yet, in biomedical informatics, decision making is hard, information needs of individuals and teams are non-trivial, and supporting the workflows of individuals and teams is a challenge. Interoperability has both inherent and accidental difficulties. Delivering solutions, while ensuring the privacy and security of patients' health information, requires careful analysis and trade-off decisions. Recently, a coalition of organizations wrote a letter to Karen De Salvo of ONC to express their concerns about the current trajectory of EHR certification and stressed a need to create an entirely new certification program. This letter is just another evidence showing that deriving benefits from informatics have been a struggle.
Together with my students and colleagues at the University of Maryland Baltimore County and other organizations, I conduct research on the intersection of health services and biomedical informatics by taking a socio-technical perspective towards understanding how process and quality improvement can be achieved via the development and adoption of information systems in health care. For this purpose, we have been involved in a number of areas:
- Home Healthcare Informatics
- Health Information Privacy and Security
- Health Data Analytics and Big Data
- Quality Assurance and Performance Improvement
- Biomedical Software Engineering
To support evidence-based research and practice, an emprical approach to research based on data collection, analysis, and interpretation is followed. A variety of qualitative, quantitative, and mixed methods have been adopted in our research projects. Over years, we used many statistical learning techniques, data mining, interviews, focus groups, and surveys. We have also developed a number of software products for our research and industrial partners and for our own use. Particularly, software engineering, databases, and user interface development are among the technical areas of strength.