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PubMedDate not supplied

Approaches to the construction of a medical informatics glossary and thesaurus.

In a project concerned with establishing a glossary and thesaurus for the medical informatics domain, various approaches to the task have been investigated. The developers take the view that a glossary should be a coherent system of terms, reflecting a coherent system of concepts that underlies a body of knowledge about a domain. A framework for the conceptual analysis of the concepts/terms underlying the domain has been developed. The emphasis of this framework is on how the concepts relate together. This work has given an important insight into how the practical task of establishing well-structured vocabularies for a field can be better achieved. An eclectic approach to term selection was adopted. Criteria for assessing what constitutes good definitions for concepts in a field were examined. Using all these approaches glossaries, thesauri and domain models of the medical informatics field are being developed. Another aspect of our work of particular interest is the development of attributed definitions from which inheritance patterns can be defined.

Data Collection↗
PubMed2006

Romanian medical informatics and professor Jan H. van Bemmel's support--Dr. Honoris Causa bestowed by Victor Babes University.

OBJECTIVE: The development of medical informatics education in Romania, starting from Timisoara, was strongly influenced by the support offered generously by Professor Jan H. van Bemmel, in a period when the imposed political conditions limited contacts between Western and Eastern countries. We tried to present here some of the most significant actions and events related to this long lasting collaboration. METHODS: The evolution of the relations between the Departments of Medical Informatics from Medical University in Timisoara and Erasmus University in Rotterdam is described in chronological order. RESULTS: Professor van Bemmel found appropriate ways to offer his support, adapted to each historical period. He started by sending books, journals and software, continued with support for attending conferences and then extended to more active collaborations. CONCLUSION: In 2006 professor van Bemmel was the keynote speaker of the EFMI Special Topic Conference held in Timisoara and was awarded the title of 'Doctor Honoris Causa' of the Victor Babes University of Medicine and Pharmacy.

Curriculum↗
PubMed1994

Recommendations for medical informatics training in The Netherlands.

In this contribution recommendations for education and training in Medical Informatics as they have been formulated end 1987 by the Subcommittee Medical Informatics of the Royal Netherlands Academy of Arts and Sciences are described. The current situation of education and training is presented and compared with the recommendations. It is concluded that not all recommendations have yet been followed up.

Medical Informatics↗
PubMed1997

Education and training in medical informatics, statistics and epidemiology in EuroMISE.

The paper gives information on education and training covered by the Joint European Project (JEP) entitled 'Education in the Methodology Field of Health Care, EuroMISE (European Education in Medical Informatics, Statistics and Epidemiology)', that has been running for 3 years (1993-1995) under the umbrella of the European TEMPUS-PHARE programme. Training and education in EuroMISE consists of three overlapping methodological branches: Medical informatics (MI), medical statistics (MS) and epidemiology (E). The teaching scheme has been developed in cooperation between 11 universities in the European Union and Charles University in Prague (four medical faculties, the Faculty of Mathematics and Physics and the Faculty Hospital) together with the Academy of Sciences of the Czech Republic (Institute of Computer Science). The paper shows EuroMISE targets, structure of EuroMISE courses and conferences and gives further views to the future in this field of education.

Congresses as Topic↗
PubMed2005

Publication trends and impact factors in the Medical Informatics literature.

We survey the "evolution" of the field of Medical Informatics by describing trends in volume(quantity) of Medical Informatics-indexed publications, identifying major journals of publication and their focus areas and presenting trends in impact factor scores during the 1994-2003 period. Changes in total impact-scores suggest an increasing trend of publication in journals of higher impact.

Bibliometrics↗
PubMed2005

On geography and medical journalology: a study of the geographical distribution of articles published in a leading medical informatics journal between 1999 and 2004.

BACKGROUND: Studying the contribution of individual countries to leading journals in a given discipline can highlight which countries have the most impact on that discipline, and also give some idea about the geographical outreach of those journals. This paper examines the number of countries that contributed articles to one leading medical informatics journal, Medical Informatics & the Internet in Medicine, and the amount of their contributions between 1999 and the first half of 2004. METHODS: The PubMed citations of all indexed articles from the chosen journal (n = 128) were retrieved online (up to Volume 29, Number 2/June 2004 issue, the latest indexed issue as at 28 January 2005). The country of corresponding author's affiliation for each retrieved citation was recorded. The five-year-and-half corpus of abstracts retrieved from PubMed was further explored using MetaCarta Geographic Text Search http://www.metacarta.com/. RESULTS: The examined journal has an international outreach, with authors from 24 countries, spanning four continents, contributing to the journal during the studied period. The journal is dominated by a very large number of articles from Europe (81.25% of all articles counted in this study), and in particular from the UK (15.63%) and Greece (15.63%). There were no contributions from Africa or South America. CONCLUSION: A detailed discussion and interpretation of these results and ideas for future analyses are provided. MetaCarta can prove very useful as a bibliometric research tool.

Journal Article↗
PubMed2002

Medical informatics: the Pittsburgh experience.

This column reports the results of a survey conducted of medical librarian participants in medical informatics training at the University of Pittsburgh. This small study was undertaken in order to identify issues in training different kinds of library and information science practitioners in medical informatics.

Academic Medical Centers↗
PubMedDate not supplied

Medical informatics in postgraduate training: a way to improve office-based practitioner information management.

Medical informatics has the potential to revolutionize patient care by providing every physician with rapid, easy access to the entire medical knowledge base. However, many changes are needed in the way systems are designed and physicians are trained before this potential can be realized. It is the shared responsibility of the medical informatics community, professional societies, academic organizations, and practitioners to accept the challenge of turning the power and promise of modern computer technology into useful tools for the care of patients.

Ambulatory Care Information Systems↗
PubMed1995

Medical informatics academia and industry: a symbiotic relationship that may assure survival of both through health care reform.

There are often clear lines drawn identifying the demilitarized zone between medical informatics academics and industry. Academics were "pure" intellectuals sequestered in ivory towers that effectively shielded them from the realities of the world. Industry has historically focused on creating effective products that produce financial return to the corporation. Both the paradigms of academia and industry are quickly becoming dinosaurs in the era of health care reform where both medical informatics academia and industry are under increasing pressure to develop and prove that medical informatics has a positive impact on health care both in terms of the quality of care as well as cost. Unfortunately, neither academia or industry alone are going to be able to successfully complete this task. The purpose of this paper is to describe such a collaborative effort that has produced a computerized decision support system for the management of mechanical ventilation in patients with the Adult Respiratory Distress Syndrome (ARDS) that is now installed and supported on three different commercial CIS platforms. This collaborative effort has allowed us to successfully mount a large multi-center clinical trial designed to determine efficacy.

Clinical Protocols↗
PubMed2001

The impact of medical informatics on the confidence of rural physicians caring for patients with chronic hepatitis C viral infections.

OBJECTIVE: The purpose of the present study was to determine whether CD-based medical informatics enhances rural physicians' confidence in the management of patients with chronic hepatitis C viral infections. METHODS: A total of 385 Canadian rural physicians were mailed a CD-based medical software programme that outlines all aspects of HCV care including diagnosis, counselling, treatment and follow-up. Accompanying the CD was a brief questionnaire that addressed physicians' confidence in the following areas: (i) identifying HCV patients in their practice; (ii) laboratory use and interpretation; (iii) patient counselling; (iv) selection of candidates for treatment; (v) sharing treatment delivery; and (vi) providing follow-up. Three months thereafter, the same questionnaire was repeated. RESULTS: Of the 385 mailings, 59 (15%) physicians returned the initial questionnaire and 57 (15%) the follow-up questionnaire. Twenty-five (44%) respondents indicated they had used the CD. Baseline physician confidence was low in three of the six areas addressed. At follow-up, in addition to now being confident in all areas, CD users were significantly more confident than those who had not used the CD. Increases in physician confidence for CD users were approximately 150-300% in the six areas addressed. The value assigned the CD programme was 8/10. CONCLUSION: The results of this study indicate that: (i) rural physicians are uncomfortable in dealing with many aspects of HCV management; (ii) CD-ROM-based medical informatics can significantly enhance rural physicians' confidence in these areas; (iii) approximately 50% of physicians will employ CD-ROM-based medical informatics in their offices; and (iv) physician level of satisfaction with such programmes is high.

Attitude of Health Personnel↗
PubMed1989

Teaching medical informatics: teaching on the seams of disciplines, cultures, traditions.

This paper reviews different concepts of medical informatics and identifies two families of approaches to education in it: a "specialist" approach, whereby medical informatics is taught as a specialization track for established disciplines like medicine, computer science, nursing, engineering, etc., and a "generalistic" approach, whereby it is taught as an integrated discipline incorporating essential traits of the aforementioned disciplines. The pros and cons of these approaches are outlined. The need to accommodate specific requirements of education is emphasized and these are identified, together with an outline of particular challenges that we are facing.

Attitude to Computers↗
PubMed2000

Medical informatics in healthcare organizations: a survey of healthcare information managers.

OBJECTIVE: To assess the medical informatics needs of healthcare organizations and the work roles for informaticists in those organizations. METHODS: A 128-item survey was developed and administered as a structured interview to thirty-two information managers in eighteen organizations. The survey included items about medical informatics training, prior work experience, skills for informaticists, and programming proficiency. RESULTS: There was a strong preference for informaticists with prior clinical work experience and an understanding of healthcare. Project management and data warehousing were highly rated skills. Informaticists were expected to know about healthcare processes, clinical guidelines, and outcome management. They were not expected to be expert programmers. CONCLUSION: There is a role in healthcare organizations for interdisciplinary workers who understand clinical medicine, healthcare management, information technology, and who can communicate and work effectively across these organizational boundaries.

Administrative Personnel↗
PubMed2001

American Academy of Pediatrics: Task Force on Medical Informatics. Special requirements for electronic medical record systems in pediatrics.

Electronic medical record (EMR) systems, which are usually designed for adult care, must perform certain functions to be useful in pediatric care. This statement outlines these functions (eg, immunization tracking and pediatric dosing calculations) to assist vendors and standards organizations with software design for pediatric systems. The description of these functions should also provide pediatricians with a set of requirements or desirable features to use when evaluating EMR systems. Particular attention is paid to special aspects of pediatric clinical care and privacy issues unique to pediatrics.

Child↗
PubMed1997

Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention.

Clinical Medicine↗
PubMedDate not supplied

Bridging the gap in medical informatics and health services research: workshop results and next steps.

In January 2000, the Agency for Healthcare Research and Quality (AHRQ) and the National Library of Medicine (NLM) cosponsored an invitational workshop entitled "Medical Informatics and Health Services Research: Bridging the Gap." Planned by a small committee of representatives from NLM and AHRQ institutional training centers, the workshop was designed to address the need for education of researchers interested in working at the intersection of the fields of medical informatics and health services research. More than 100 educators and researchers from AHRQ- and NLM-sponsored training programs in medical informatics and health services research participated in the workshop. Through a series of plenary presentations and breakout sessions, the workshop addressed ways of increasing the pool of persons interested, trained, and experienced in addressing specific areas of synergy between the two fields. This paper reports on the results of the workshop.

Curriculum↗
PubMed1989

Medical informatics and education: the profession as gate-keeper.

Modern health care systems, both at the policy as well as the delivery level, are becoming increasingly data-dependent. The profession of Medical Informatics is beginning to emerge as a distinctive discipline that functions as the point of entry of the relevant data into the systems and as the medium of their manipulation. Medical Informatics therefore finds itself in a gate-keeper position: i.e., in the position of someone who effectively controls the use of these data and whose actions set the parameters of what will be done with them. This position, in turn, places special ethical obligations on the profession as a whole as well as on the individual professionals. It is unlikely that the nature of these obligations, or indeed their very scope, will be appreciated without some training in ethics; and it is also unlikely that the ethical problems that arise in the conduct of the profession can be handled smoothly without some ethical education. Medical Informatics, as a profession, should therefore insist that the education of its members involve not only technical parameters but also include some education in ethics. The pay-off for this would come not only in terms of an integrated functioning of the profession as a whole, but also in a much more firmly established legal and social position.

Curriculum↗
PubMed1998

An analysis of 5 years of medical informatics publications.

This study describes an analysis of 1520 papers that were published in six medical informatics journals from 1992 through 1996, and indexed in NLM's MEDLINE. Of retrieved publications the countries of origin were determined, and insight in the subject of the publication was obtained by analysing the used MeSH terms. The main conclusion is that despite the fact that publications in medical informatics stem from a wide international community, scientific recognition can still not be demonstrated by high impact factors of journals.

Abstracting and Indexing↗
PubMed2004

Case-based medical informatics.

BACKGROUND: The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. DISCUSSION: We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and powerful case matching mechanisms), technical solutions are challenging.Finally, we discuss the major challenges for a technical solution: case record comprehensiveness, organization of information on similarity principles, development of pattern recognition and solving ethical issues. SUMMARY: Medical Informatics is an applied science that should be committed to advancing patient-centered medicine through individual knowledge processing. Case-based reasoning is the technical solution that enables a continuous individual knowledge processing and could be applied providing that challenges and ethical issues arising are addressed appropriately.

Decision Support Systems, Clinical↗