In the introduction to Guide to Medical Informatics, the Internet and Telemedicine Enrico Coiera

makes the following summary of the scope of medical informatics:

"These then, are the challenges for medicine. Can we put together rational structures for the way clinical evidence is pooled, communicated, and applied to routine care? Can we develop organizational processes and structures that minimise the resources we use, and maximize the benefits delivered? And finally, what tools and methods need to be developed to help achieve these aims in a manner that is practicable, testable, and in keeping with the fundamental goal of health care – the relief from disease? The role of medical informatics is to help develop a rational basis to answer these questions, as well as to help create the tools to achieve these goals."

The value of this summarization of the scope of informatics is that it stresses the utility of information, not the means by which information is processed. Information Technology is one of the tools to be used in Informatics, not the central focus of the subject. Information Technology has developed from scratches in the mud to papyrus, to bookshelves, to libraries, to computer networks and electronic searching. There is no reason to believe that this development will cease. All orthopaedists are interested in the appropriate use of orthopaedic information to help them treat their patients successfully. All orthopaedists have a stake in orthopaedic informatics.

Because Orthopaedic Informatics is a young subject we can define the subject broadly. Orthopaedic Informatics (OI) is the study of the value, exchange and utility of orthopaedic information as it pertains to the treatment of patients. Table 1 shows some of the subjects which fall under this definition

Table 1 Scope of Orthopaedic Informatics

Overall Subject



Exchange of Orthopaedic Information

Electronic Skills

Finding Information



Webpages (creation & editing)



Digital Images (capture & editing)



Electronic Presentations (Powerpoint)



Electronic Medical Records


Orthopaedic Directories

Subject Headings (Definition)


Orthopaedic Teaching

Computer Assisted Learning



Orthopaedics on the Internet






Rare Diseases



Point of care clinical data collection


Patient Education

Needs assessment



Multi-centre studies



Surgeon to Surgeon






Patient to Surgeon



Surgeon to Patient



Open Journals



Innovative Peer Review

Value of Orthopaedic Information

Evidence Based Orthopaedics



Quality Mechanisms


Application of emerging Information Technology in Orthopaedics

Computer Assisted Design and Manufacture CAD/CAM



Digital Radiology

Digital Templating


Computer Assisted Pre-operative Planning

Spatial Frame


Computer Assisted Orthopaedic Surgery CAOS



Computer Diagnosis

Decision Analysis

This definition means that the subject covers (but is not limited to) finding and assessing information, evidence based orthopaedics, the application of novel technology to orthopaedic care and to the changing demands of patient education and medical education and the development of novel methods of contact between orthopaedic surgeons. The introduction of the Internet is changing the information landscape dramatically. It will have an effect on our subject as far-reaching as the introduction of printing. Printing allowed everyone access to general knowledge which had previously been available to very few. The Internet allows everyone access to specialized knowledge and the full realization of the consequences has not yet been appreciated. Orthopaedic Informatics both uses and studies Internet mechanisms for the transfer of orthopaedic information. We were overloaded with information long before the Internet arrived

but it has brought the subject into prominence while at the same time offering mechanisms to organize and filter the flood of new information