Enabling Knowledge-Driven Health Care

At its core, the practice of medicine is an informationintensive endeavor. Most of what physicians do involves the collection, review, and management of information. Examples of such activities include obtaining and recording patient information, consulting colleagues, reading the scientific literature, planning diagnostic procedures, devising strategies for patient care, interpreting tests, and conducting research. The ever-increasing biomedical knowledge base that must be considered to deliver optimal patient care only adds to the challenges facing medicine today. Successfully addressing these challenges to deliver the best health care possible requires not only the existence of valid and generalizable data sets derived from systematic basic, clinical, and epidemiological research efforts but also the ability to apply the knowledge derived from these research efforts at the point of care. It is easy to understand, therefore, why the field of biomedical informatics, a field that is concerned with collecting, managing, and optimally using information in health care and biomedicine, is critical to the current and future practice of medicine and the study of healthcare outcomes that result from such practice.1,2 Biomedical informatics approaches and related health information technology (health IT) platforms are key to enabling knowledge-driven healthcare and practice improvement initiatives based on a solid research foundation. Similar biomedical informatics approaches and resources are also critical to advancing outcomes research. Indeed, such technologies such as electronic health records (EHRs), clinical data repositories, and research-specific data management systems are already transforming the way we practice medicine and conduct research. This transformation is being further advanced by federally directed funding and research infrastructure development efforts.3,4 In the sections that follow, we provide an overview of how biomedical informatics and health IT processes and tools can affect the conduct of research and the delivery of evidencebased health care from our perspective. Given the current state of development in this area, we introduce a conceptual framework by which clinicians, researchers, and the healthcare community at large can optimally leverage biomedical informatics processes and tools to facilitate outcomes research and drive improvements in healthcare outcomes. We conclude by proposing a course of action intended to support greater collaboration between the clinical, research, and biomedical informatics communities to achieve the goals set forth.