Kathy Sward is fascinated by the Iliad -- not the ancient Greek epic by
Homer, but a computer program used by many medical schools to teach diagnosis
and treatment. Sward is an informatics nurse.
Before Iliad, Sward's computer experience was limited to word processing
and spreadsheets -- pretty average stuff. Now she works with expert system
technology, databases and programming health information systems that will
change the way we view medicine.
Here's how Sward defines health informatics: "It combines the knowledge
of health-care specialists [doctors, nurses, dentists and pharmacists] with
computer science and information handling. People in this field use computers
and multimedia technology to solve information problems for health-care professionals
and consumers."
Dr. James J. Cimino is an associate professor of medicine in the medical
informatics department of Columbia University in New York. He says one of
those problems is that health care is a mess.
"Better management of health information, from recording to storage and
retrieval to multiple uses of data will help everyone -- patients, providers
and society," says Cimino.
He uses a comparison to explain his point. "If my bank kept records like
my hospital -- sorry, can't find your money, it may be in a warehouse or we
might have put it in someone else's account -- I'd keep my money in a mattress,"
he says.
Cimino got started as a pre-med student and became involved in computer
programming science in college. During his residency, he saw problems that
would be well suited to solutions via computer. He found a post-doctorate
fellowship in informatics and has never looked back.
Sward has played a lot of roles in her many years as a nurse. She's worked
as a staff nurse and an intensive care nurse, in administration and in-patient
and staff education. She had a well-rounded nursing background and wanted
more.
"I'd been planning to go to graduate school and was debating between informatics
and a couple of other master's programs."
She had an opportunity to work on a medical informatics project and loved
it. "My experience with the consumer software project made it clear that this
was the field for me. I clearly had a knack for the technology, and I wanted
to learn the background and theory behind the systems we were building."
Health informatics is a relatively new career and Sward says it was a natural
next step for her to take. "Informatics lets me combine my nursing expertise
with my interest in computers," she says.
"A tremendous amount of a nurse's time is spent collecting, documenting
and analyzing information. Informatics gives me the tools and skills to develop
creative solutions to [the] information-handling needs of nurses."
Sward knows her job could improve the quality of care for a lot of patients.
"Instead of documenting clinical care given by me, I help build systems that
allow all kinds of care to be documented more efficiently.
"People sometimes ask me, 'So, you aren't doing nursing anymore?' They
couldn't be more wrong. I didn't stop being a nurse when I began working with
informatics. Doctors in informatics don't stop being doctors, pharmacists
don't stop being pharmacists. Instead of teaching one patient about his or
her condition, I help build systems that teach many patients."
Cimino says there are "so many opportunities, you can always find one [job]
with the right characteristics." Among the opportunities for Cimino have been
teaching medicine and medical informatics, practicing medicine,
building systems and doing original research.
There are many things Sward loves about her job. "It's a thrill when the
team comes together to solve a problem -- when we each put in our parts, run
the program and find it does what we wanted. I really enjoy programming and
debugging. It's a kick for me to work out logic and code, run a program and
have it do what I needed to solve a clinical problem."
Even the more routine content work isn't so bad. "When I need to go line
by line through several thousand lines of text, it can get tedious. Luckily,
we tend to work on several projects at once, so I can break up the tedious
work with more fun projects."
Sward recommends this job to people who like puzzles and problem solving.
"It helps to be creative, maybe even a little offbeat," she says. That's
because it's not unusual for the suggestion that seems most bizarre at first
to end up being the most efficient later.
"Informatics has opened up a larger world for me. Suddenly, my colleagues
aren't just local nurses -- they're doctors, nurses, pharmacists, dentists,
and other professionals, programmers, engineers and networking experts.
"I find informatics people from the university, the [Veterans Administration]
hospital, and other hospital systems sharing ideas with people from software
companies, hardware companies, networking companies and multimedia companies."