Child Welfare Informatics: A New Definition for an Established Practice
Nguyen, Loc H., Social Work
Child welfare, one of the most important arenas of social work, has benefited from advances in information technology in the past two decades (Weaver, Moses, Furman, & Lindsey, 2003). This whole discipline of social work can be captured best through the term "child welfare informatics." Although the term "informatics" may be new to the field of child welfare, it has served the health care field well for many years. The first federal funding of health informatics began in the late 1960s through the precursor of the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services (Fitzmaurice, Adams, & Eisenberg, 2002). There has been an extensive examination of the different fields of health informatics, medical informatics, public health informatics, and nursing informatics (Staggers & Thompson, 2002). In fact, the basis of many social work practices that have combined information technology, social work research, and best practices through areas such as evidence-based practice have their origins in the health sciences fields (Gilgun, 2005).
What is informatics? Staggers and Thompson (2002) provided the following definition, which is specific to nursing informatics but can be generalized to any of the health informatics fields:
Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings. (p. 260)
The field of informatics developed because of the recognition of two significant factors (Rosenbaum Burke, Benevelli, Borzi, & Repasch, 2005): First, a report by the Institute of Medicine noted that thousands of patient deaths a year could have been avoided through more advanced and detailed use of health information (Rosenbaum et al.). Second, there is strong evidence to suggest significant socioeconomic disparities in the outcomes of health care, thereby making information on aspects such as race, ethnicity, language, and other socioeconomic factors a critical dimension of health care itself (Rosenbaum et al.).
More recently, the different fields of health informatics have aggressively moved away from analyzing information after the fact (for example, collecting longitudinal data to conduct epidemiologic studies) to computer-aided decision making to support physician decisions in direct patient health care (Fitzmaurice et al., 2002). This has been done by developing the availability of real-time computer-based medical records across different departments within a health agency, across different health agencies, and even across jurisdictions. Kaiser Permanente has spent $3.3 billion in the past decade to integrate medical records with registration, billing, and other information to enhance patient care and service ("Making Healthy Connections," 2006). This integration allows health care practitioners to access, through locally available technologies, databases that along with decision-support tools minimize potential adverse health outcomes while maximizing patient care.
The most recent push for a nationwide health information network was a concept paper that recommended an integrated system to provide a secure exchange of health information across health care agencies in different jurisdictions through multiple centralized databases (National Committee on Vital and Health Care Statistics, 2006). The authors argued that there would be a number of uses that could provide real-time data as well as reducing potential adverse health effects. For example, if a person is on vacation in a different state and has a medical emergency, the emergency room staff would be able to link into a national centralized database and, on the basis of the information found there, able to avoid certain medications that would cause life-threatening allergic reactions. …