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Biomedical subjects

B Cesnik

Publications and source records attributed to B Cesnik.

At least 19 recordsLinked to original sources
PubMed2000

A three-tier clinical information systems design model.

Modern health care institutions are often multi-site organisations that implement heterogeneous information management systems interacting with distributed databases. Advances in treatment modality/technology and rapidly changing information technology create increasing demand for changes/redevelopment of many health information applications. These features spawn the need for solutions to (a) guarantee data exchange across different types of applications and database management systems, and (b) reduce the costs of systems development and modification. This paper explores the concept of 'middleware services' as a solution to achieve these goals. It reports on the successful application of a component-based 3-tier system architecture to develop a computerised clinical pathways management system. The implementation experience confirms a number of significant benefits of the 3-tier structure including, reusability, flexibility, significant reduction in costs and efforts of systems development, and provision of easy, open migration pathway for future change of technology and system redevelopment.

Critical Pathways↗
PubMed1999

The future of health informatics.

Whatever a future vision for health informatics entails, it must take into account the evolving nature of the field, a growing trend towards primary and preventive care and the explosive growth in global networking as exemplified by the Internet. While, historically, storage and retrieval of data has been the main target for information systems development, the need to capture knowledge itself is becoming the focus for development. In parallel, education in health informatics for tomorrow's healthcare professionals is now essential. The Asia Pacific Association for Medical Informatics (APAMI) is a regional group of the International Medical Informatics Association (IMIA). While the newest of the IMIA regional organizations, its growth and activities in the Asia Pacific region aim to advance health informatics. Its triennial conferences act as a means of promoting and monitoring the growth of our field in this region, APAMI itself is a part of the future of health informatics.

Asia↗
PubMed1998

Improving clinical pathway design: lessons learned from a computerised prototype.

Increasing costs of health care, fuelled by demand for high quality, cost-efficient health care has propelled hospitals to restructure their patient care delivery systems. One such effort is the adaptation of an engineering project management methodology, the critical path method (CPM), as a tool to organise, standardise and improve the quality of healthcare delivery and hence patient outcomes. However, the two-dimensional nature and the size of paper impose severe limitations on the manual clinical pathways currently in use by hospitals. This paper analyses these inherent limitations and discusses some of the problems encountered in an attempt in early 1996 to create an electronic care map planner (CMP) based on the precedence diagramming method (PDM) model. It also reports on a current project to create a computerised clinical pathway tool to resolve the identified problems.

Cost-Benefit Analysis↗
PubMed1998

Modelling computerised clinical pathways.

Since the mid 1980s, paper clinical pathways have been used in defining the road map of patient care. They have been used with varying degree of success for providing more cost-effective healthcare and helped to establish quality improvement models for healthcare delivery. Many attempts have been made to produce electronic versions of the paper clinical pathways in order to maximise benefits of the paper based systems. However, all paper systems are designed based on linear sequential model with little decision support capability. Current electronic versions of the paper systems produce only minimal improvements on the functionality of their paper counterparts. A state-transition information model (STIM) grounded in the Object Oriented system design paradigm is used to reconceptualise a computerised clinical pathways design. A computerised clinical pathways prototype is currently being developed based on this STIM model. The prototype will demonstrate improved functionality: better information management and decision support capabilities.

Computer Simulation↗
PubMed1998

Methodology for developing educational hypermedia systems.

Hypermedia has the potential to greatly enhance teaching. It can, however, be difficult to develop hyperdocuments which provide medical students with the full benefit of the technology. We wish to resolve this problem by providing a methodology for creating educational hypermedia systems with specific emphasis on the medical domain, but applicable across disciplines. This paper examines some of the specific issues involved in educational hypermedia, and outlines a series of practical guidelines, drawing together the disparate disciplines necessary to the development process. We illustrate the methodology with our own experience in creating and updating the HIV Hypermedia Medical Education Software over a period of two years.

Computer-Assisted Instruction↗
PubMed1995

A model for connecting doctors to university based medical resources through the Internet.

Medical Students and academics at large universities have access to rich and varied information resources. These resources tend not to be available from off campus sites. We have been running a trial to connect practicing doctors to some of the medical resources that are available within our university. We are using the Internet to facilitate this process. In doing so, a large number of non academic, but very practical problems have had to be solved. We examine in particular the roles that Internet service providers and Internet information providers play in such a project. In particular we describe the factors used in advising users on external service providers, and why we as part of a university have chosen not to fulfil the internet service provision role ourselves.

Australia↗
PubMed1995

Designing interfaces for medical information management systems.

Poor interface design has adversely affected the integration of technology into medical environments. This paper discusses the importance of good interface design in medical information management systems. We will illustrate the advantages of approaching interface design in a user-centered manner, by describing the interface design process of the Curriculum Database for the Faculty of Medicine, Monash University. We believe that a consultative design process can make the difference between software success and failure.

Attitude to Computers↗
PubMed1995

The Internet and its role in teaching medical informatics to undergraduates.

Training medical informatics students in the use of tools that may assist their future careers is only one component of what we feel is required of a successful course. Leaving students with a sense of what these tools can actually do for them, and how they can be applied in daily work and research, is the most important goal. We discuss how the Internet, with its wealth of information and interconnections between individuals, can be used to involve students, thus leaving them with the motivation and skills to achieve this longer term goal once they have left our course.

Australia↗
PubMed1995

The evaluation of computer knowledge and skills of medical students: a three-year comparison.

In 1991, four hundred and forty three (443) first-fourth-and final-year students from the Monash University, Faculty of Medicine were surveyed to seek details of previous computer use [1], knowledge of computer concepts, individual computer skills, perceived usefulness of computers in medicine, and the level of interest in further education on medical computing. his poster will demonstrate the comparison of statistics obtained in the first questionnaire (1991) with the results of the same questionnaire that is currently being distributed and analyzed (1994 -1995). As a response to the first study, Medical Informatics as an optional subject was introduced in 1992 to first, second, and third year medical students. Medical Informatics is currently being developed for inclusion as a compulsory subject for first year students in 1995, taking into account the results of both the first and second survey.

Computer Literacy↗
PubMed1995

Medical undergraduates using the Internet as an information technology teaching tool.

The use of the Internet as an information resource is increasingly becoming useful as a tool for educators, government, and business sectors alike. The potential to deliver educational material to medical students via the Internet at any time or location is now a realistic option. Medical Informatics is a compulsory subject for all medical students at Monash University. Monash Medical Informatics (MMI), the body responsible for this teaching, considers the use and understanding of Internet resources an important component in the students overall understanding of information technology. Furthermore, the Faculty of Medicine at Monash has, as part of its mission statement, the desire to provide a sophisticated range of information technology resources to its students. his poster will show how the Unit of Medical Informatics teaches medical undergraduates to use the Internet. It will also illustrate some of the technical aspects in the establishment and efficient running of such a student facility.

Computer Communication Networks↗
PubMed1994

Medical data and knowledge management by integrated medical workstations: summary and recommendations.

The health care professional workstation will function as an interface between the user and the patient data as well as an interface pertinent medical knowledge. Appropriate knowledge focus will require the workstation to recognize the concepts and structure of patient data, and understand the scope and access methods of knowledge sources. Issues are organized around five major themes: (i) structure, (ii) reliability and validation, (iii) views, (iv) location, and (v) ethical and legal. Conventional database representations can effectively address data structure and format variations that will inevitably persist in local data stores. The reliability of data and the validation of knowledge are critical issues that may determine the ultimate utility of clinical workstations. Alternative views of patient information and knowledge sources represent the true power of an intelligent data portal, represented by a well-designed clinical workstation. Both data and knowledge are optimally represented in decentralized information networks, although the confidentiality and ownership of this information must be respected. Evolutionary progress toward consistent representations of knowledge and patient data will be facilitated by the establishment of self-documentation standards for the developers of data encoding systems and knowledge sources, perhaps extended from the preliminary model afforded by the Unified Medical Language System (UMLS).

Computer Security↗
PubMed1993

What do medical students know about computers?

OBJECTIVE: To evaluate the computer knowledge and skills of medical students in the first, fourth and final years of the Monash University medical course. DESIGN: Questionnaire. SETTING: Undergraduate medical education. PARTICIPANTS: All first, fourth and final year medical students in the Monash University medical course in 1991. RESULTS: The students in first year were found to have greater computer skills than those in sixth year. There were also significant differences between the sexes, particularly in sixth year, with male students having significantly greater computer skills than female students. CONCLUSIONS: The perceived importance of computing in medicine was high among all students and there was enthusiasm for the development and inclusion of a course on medical computing in the undergraduate curriculum.

Computer Literacy↗
PubMed1988

Human macrophage maturation and heterogeneity: restricted expression of late differentiation antigens in situ.

Terminal maturation of human macrophages is an important step for creation of cell diversity amongst site-specific subpopulations and their functional competence in situ. As monocytes undergo differentiation in vitro, they start to express lineage-restricted antigens specific for differentiation stages beyond the blood monocyte level as detected by monoclonal antibodies of the MAX series. We have analyzed the expression of MAX.1, MAX.2, MAX.3 and MAX.11 on exudate-type macrophages from pleural and peritoneal cavity and the alveolar space, as well as on resident and activated tissue macrophages in cryostat sections of spleen, lymph node, tonsil, liver, gut mucosa, skin, placenta, kidney and bone. It was found that "free" macrophages in serous cavities expressed MAX antigens in a heterogenous pattern, whereas none of the organ-specific tissue macrophages subsets did so (with the exception being the weak label of MAX.2 on Kupffer cells). Only during allograft rejection were infiltrating macrophages found to express MAX antigens but not at sites of "non-specific" inflammation or granuloma formation. However, Cyclosporin A treatment seems to suppress the induction of MAX antigen expression on intragraft macrophages. In addition, freshly harvested MAX-negative exudate macrophages converted to the complete Max+ phenotype on further cultivation. Isolated Kupffer cells were able only to express the MAX.2 antigen in culture but still did not react with the MAX.1 and MAX.3 monoclonal antibodies. Some MAX antigens are co-expressed on glomerular mesangial cells, dendritic reticulum cells and placental cells (MAX.1/.11) as well as on capillary endothelium within tissues of active immune response (MAX.2).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗