Health Information Technology and Informatics
Core concepts
Understand the EHR, computerized provider order entry (CPOE), clinical decision support (CDS), health information exchange (HIE), and interoperability standards (HL7, FHIR, DICOM). Know the difference between meaningful use / promoting interoperability and the HITECH Act incentives. Grasp data governance, privacy and security (HIPAA Security Rule for ePHI), consent, and the role of the ONC. Understand clinical informatics roles (CMIO, informaticist), usability, alert fatigue, and the concept of the sociotechnical model. Know the basics of population health analytics, registries, and telehealth infrastructure.
Traps
Alert fatigue is a major safety issue - excessive CDS alerts desensitize clinicians and can increase errors. HIPAA Security Rule applies to electronic PHI; Privacy Rule applies to all PHI. HIE is not the same as an EHR - HIE is the exchange infrastructure. Another trap: confusing DICOM (imaging) with HL7 (clinical messaging) and FHIR (modern API-based exchange). Also, meaningful use is about use of certified EHR technology to meet objectives, not merely adoption.
Worked example / rule of thumb
A hospital implements CPOE with hundreds of drug interaction alerts; clinicians begin overriding them. The correct fix is to tier alerts by severity, implement interruptive alerts only for high-severity interactions, and monitor override rates. Rule of thumb: more alerts ≠ safer care; targeted, high-value alerts reduce harm.
Remember the sociotechnical model: technology alone does not improve care - workflow, people, and policy must align.