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PubMed2000

Medical informatics and the concept of disease.

This paper attempts to address the general question whether information technologies, as applied in the area of medicine and health care, have or are likely to change fundamental concepts regarding disease and health. After a short excursion into the domain of medical informatics I provide a brief overview of some of the current theories of what a disease is from a more philosophical perspective, i.e. the "value free" and "value laden" view of disease. Next, I consider at some length, whether health care informatics is currently modifying fundamental concepts of disease. To this question I will answer largely in the negative, and I will provide the sketch of some arguments from current research programs in medical informatics why I think this is the case. This argumentation is supported by a detailed account of how the disease profile for beriberi heart disease, used in one of the major medical informatics diagnostic programs, QMR (and its ancestor INTERNIST-1), was developed, and why at least this program essentially follows received views of traditional medicine. The one main exception to the conformity of this program to "received" views of a disease occurs when the program's designers need to fine-tune a disease definition. This fine-tuning is to comport with the expert's perspective on the disease, including his or her epistemic values, as well as the program's other resources for diagnosing components of a disease.

Beriberi↗

PubMed1998

On development of medical informatics education via European cooperation.

In this paper, we show different activities of the European Center for Medical Informatics, Statistics and Epidemiology (EuroMISE Center) of Charles University and Academy of Sciences in the field of medical informatics, statistics and epidemiology education and training. The development of these activities started within the TEMPUS-PHARE project in 1993 and they are continuing with the support of another project, particularly the IT EDUCTRA (Information Technologies Education and Training) (Fourth Framework Programme) project. New approaches using the Internet as well as newly developed programmes are described.

Czech Republic↗

PubMed2005

A current perspective on medical informatics and health sciences librarianship.

OBJECTIVE: The article offers a current perspective on medical informatics and health sciences librarianship. NARRATIVE: The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. SUMMARY: Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as "boundary spanners," incorporating human factors that unite technology with health care delivery.

Humans↗

PubMed2003

Future history: medical informatics in geriatrics.

With deference to Isaac Asimov's The Foundation, which is the inspiration for this series, we briefly describe the "present history" of medical informatics (the application of information technology in medicine) in geriatrics, and then project a "future history" of this same endeavor. The older patient often has multiple acute and chronic problems that require management by a variety of medical professionals in a variety of settings. Proper care necessitates efficient gathering, integration, and management of information by each professional in each setting. As medical informatics evolves, we project that barriers to information exchange (both between providers and between providers and patients) will continue to decrease while the quality and relevance of exchanged information will continue to increase. The nexus of care will be the electronic medical record (EMR), which will shed its current paper chart metaphor and adopt an industrial process metaphor based on tasks and tolerances or goals. The multidisciplinary management of geriatric patients will strike a new balance: doctors, nurses, allied health professionals, family, and patients will all participate in the management of the patient's care. The EMR will coordinate data from a variety of novel sources, including wearable sensors monitoring physiologic parameters, falls, diet, ambulation, and medication compliance. The highly organized data in the EMR will allow explicit decision support for computer-facilitated, evidence-based care; will empower midlevel providers and patients with an increased role in the care plan; and will promote the realignment of care from hospitals/clinics to the patient's home.

Aged↗

PubMed2006

Applied medical informatics for the chest physician: information you can use!

The world of applied medical informatics is changing rapidly. This is the first of a three-part series of articles on applied medical informatics that will bring the practicing chest physician up to date on the structure, function, benefits, and drawbacks of the electronic medical record and all of its components, including the virtual ICU and the daily practice of medicine.

Decision Support Systems, Clinical↗

PubMed1997

Medical informatics in perinatology project AGUSTINA in Argentina.

This paper reviews the development of the field of medical informatics in Latin America. It also describes the preliminary results of a computer-based data management system, named AGUSTINA, which is comprised of maternal and infant data on 6195 deliveries that occurred between June 1990 and December 1995 in a hospital in the surroundings of Buenos Aires, Argentina. These data were fundamental for the instrumentation of preventive community-oriented activities in the area. Finally, this paper describes recommendations for future actions in the area of medical informatics in Latin America.

Adolescent↗

PubMed2006

Medical informatics education needs information system practicums in health care settings--experiences and lessons learned from 32 practicums at four universities in two countries.

OBJECTIVES: To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics students. METHODS: We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported. RESULTS: Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive. DISCUSSION: It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies.

Austria↗

PubMed2002

Evaluation of medical informatics curriculum at the Rijeka University School of Medicine in Croatia.

This paper presents preliminary results from the study to evaluate the Medical Informatics curriculum at the Rijeka University School of Medicine, Rijeka, Croatia. Evaluation is based on the written anonymous. survey filled out by students after passing the exam. Questionnaire consisted of questions considering basic data (age, gender, study year, etc.), as well as students' opinions and marks on informatics, computer usage and teaching skills during the lessons. In total 459 students from five consecutive generations (from 1996/97 to 2000/01) were evaluated. Collected data define guidelines for teachers to improve organization and contents of curriculum. This study proved that, from one generation to the next, students show more and more interest in Medical Informatics, more of them have their own computer and more of them use Internet and e-mail communication.

Croatia↗

PubMedDate not supplied

Science and practice: a case for medical informatics as a local science of design.

Because scientific research is guided by concerns for uncovering "fundamental truths," its time frame differs from that of design, development, and practice, which are driven by immediate needs for practical solutions. In medicine, however, as in other disciplines, basic scientists, developers, and practitioners are being called on increasingly to forge new alliances and work toward common goals. The authors propose that medical informatics be construed as a local science of design. A local science seeks to explain aspects of a domain rather than derive a set of unifying principles. Design is concerned with the creation, implementation, and adaptation of artifacts in a range of settings. The authors explore the implications of this point of view and endeavor to characterize the nature of informatics research, the relationship between theory and practice, and issues of scientific validity and generalizability. They argue for a more pluralistic approach to medical informatics in building a cumulative body of knowledge.

Computer Systems↗

PubMed2004

Synergy between medical informatics and bioinformatics: facilitating genomic medicine for future health care.

In this paper, we review the results of BIOINFOMED, a study funded by the European Commission (EC) with the purpose to analyse the different issues and challenges in the area where Medical Informatics and Bioinformatics meet. Traditionally, Medical Informatics has been focused on the intersection between computer science and clinical medicine, whereas Bioinformatics have been predominantly centered on the intersection between computer science and biological research. Although researchers from both areas have occasionally collaborated, their training, objectives and interests have been quite different. The results of the Human Genome and related projects have attracted the interest of many professionals, and introduced new challenges that will transform biomedical research and health care. A characteristic of the 'post genomic' era will be to correlate essential genotypic information with expressed phenotypic information. In this context, Biomedical Informatics (BMI) has emerged to describe the technology that brings both disciplines (BI and MI) together to support genomic medicine. In recognition of the dynamic nature of BMI, institutions such as the EC have launched several initiatives in support of a research agenda, including the BIOINFOMED study.

Biotechnology↗

PubMed1995

A citation analysis of medical informatics journals.

Citation analysis is an unbiased, quantitative method for evaluating the usefulness of a particular scientific article, or the journal containing that article, based on the number of citations it receives. We performed a citation analysis of the medical informatics journals and compared them to several general medical and science journals. There was no clear-cut "best" medical informatics journal based on these rankings. Comparison with the general medical and science journals showed that our field is at least an order of magnitude smaller than these fields.

Bibliometrics↗

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.

Journal Article↗

PubMed1998

Teaching medical informatics a la carte: a curriculum for the professional palate.

Health professionals as well as students vary greatly in their appetite for medical informatics and evidence-based medicine. The information professional is challenged by the need for instructional programs that support the use of medical informatics to a diverse audience. For teaching programs to be successfully received, the information professional must be able to offer an adaptable curriculum that can be arranged to meet the differing needs of a wide range of health professionals. The Educational Services Department at New York University Medical Center has designed and implemented a multidisciplinary curriculum that serves as a model for health and information professionals to meet a variety of goals and objectives. This paper describes how the curriculum evolved. It is presented as a menu of offerings that may be coordinated and adapted to meet the varying skills and needs of clinicians, basic scientists, residency training programs, medical student clerkships, and nursing and allied health programs. Informatics programs that may include workshops in basic computer skills, identification of information resources, the structure of information, developing search strategies in support of evidence-based medicine, identifying qualitative journal literature, and critical appraisal of the literature, are easily adapted to any audience and schedule.

Academic Medical Centers↗

PubMedDate not supplied

Postdoctoral training in medical informatics: a survey of National Library of Medicine-supported fellows.

The National Library of Medicine (NLM) funds training programs in medical informatics and plans to significantly increase the number of program sites in the future. The authors surveyed all NLM-funded trainees at the nine sites supported in the spring of 1988 to determine their backgrounds, current research interests, and career plans. Forty-three fellows were identified, of whom 39 returned a mailed questionnaire. All but four were physicians (89.7%), 82.1% had at least one year of postdoctoral clinical training, and 61.5% had completed a residency. Seventy-one percent of those completing residency had done so in internal medicine. The most common areas of current research were decision support/decision analysis, knowledge representation, and artificial intelligence. The overwhelming majority of the fellows planned to seek positions in a medical school on completion of their fellowships, and most preferred affiliation with a department of medical informatics or medicine.

Education, Continuing↗

PubMed2006

Medical education and role of medical informatics.

Bosnia and Herzegovina (BiH), as developing country in transition, has to shift from traditional ways of learning to the transformation of the university education in accordance with Bologna process and educational standards in European Union. In the light of these changes authors conducted research at bio-medical faculties in Sarajevo in order to address issues of the education of future physicians and especially role of medical informatics in their under and post graduate studies and continuous medical education. As per given results in this study, current quality of medical education at biomedical faculties, University of Sarajevo, is unsatisfactory due to several reasons and some among others are those traditionally seen as "computer literacy". Problems are determined and recommendations are given for decision makers to support transformation of BiH medical educational system to have physicians, dentists, pharmacists and nurses who possess the knowledge, skills and attitudes required to be competent in medical informatics if they wish to incorporate into their practices systematic approaches for promoting and maintaining the health of defined populations.

Education, Medical↗

PubMed1997

[Medical informatics--decision support systems].

The paper describes medical informatics discipline and deals with decision support systems in more details. It describes the process of decision making using diagnostic and therapeutic decision making cycle and two sources of medical knowledge-scientific and empirical knowledge. It shows different approaches for development of computer supported decision systems and presents some examples of their use in medical practice.

Decision Making, Computer-Assisted↗

PubMed1999

WWW as a teaching resource for introductory medical informatics in primary care.

This pro and contra report assesses the current state of the WWW as a teaching aid for Medical Informatics, using the experience gained from the delivery of a module to a heterogeneous group of health workers enrolled in an MSc/PgDip in Primary Care. The students were expected to act as both information consumers in a directed bibliographic retrieval task and information providers for Primary Care. The students' perceptions as to the usefulness and local relevance of current resources on the world wide web (WWW) are discussed.

Curriculum↗

PubMed1998

Integrating learning contexts in a medical informatics program--preparing for the introduction of PACS.

This paper analyzes the possibilities to extend learning contexts within a one-year medical informatics educational program (MIP) at a Radiology Department in Sweden. The MIP was carried out within a theoretical framework based upon the integration of four learning contexts, which were inspired by Nonaka's theory of organizational knowledge creation. A summary of organizational knowledge creation theory and the ideas behind the learning contexts are presented. The main objective of the study was to investigate what would be the major benefits from the use of various learning contexts in a one-year medical informatics program? The MIP was found to form a basis for better learning conditions by increasing the flexibility, accommodating greater numbers of students as well as offering better possibilities for continuous learning. Evaluation of the MIP revealed that 98% of radiology department staff as compared to 39% of the intensive care unit staff, who had followed the hospital routine program, felt competent enough to independently use the functions of a new medical system. Although there are good reason to believe that the superior confidence for information technology (IT) is due to the integration of learning contexts, it can not be excluded that it may be due to other reasons also.

Education, Medical, Continuing↗