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PubMed2003

Bioinformatics and medical informatics: collaborations on the road to genomic medicine?

In this report, the authors compare and contrast medical informatics (MI) and bioinformatics (BI) and provide a viewpoint on their complementarities and potential for collaboration in various subfields. The authors compare MI and BI along several dimensions, including: (1) historical development of the disciplines, (2) their scientific foundations, (3) data quality and analysis, (4) integration of knowledge and databases, (5) informatics tools to support practice, (6) informatics methods to support research (signal processing, imaging and vision, and computational modeling, (7) professional and patient continuing education, and (8) education and training. It is pointed out that, while the two disciplines differ in their histories, scientific foundations, and methodologic approaches to research in various areas, they nevertheless share methods and tools, which provides a basis for exchange of experience in their different applications. MI expertise in developing health care applications and the strength of BI in biological "discovery science" complement each other well. The new field of biomedical informatics (BMI) holds great promise for developing informatics methods that will be crucial in the development of genomic medicine. The future of BMI will be influenced strongly by whether significant advances in clinical practice and biomedical research come about from separate efforts in MI and BI, or from emerging, hybrid informatics subdisciplines at their interface.

Biomedical Research↗
PubMed1990

Medical informatics: the substantive discipline behind health care computer systems.

The computer is rapidly becoming an interactive workstation for medical research and for clinical decision-making and it has become a preferred instrument for communication and documentation throughout health care. However, when the attempt is made to use the rigid conventions of information processing to impose order on the characteristically volatile and unpredictable phenomena encountered in the clinical setting, deep seated logical issues are uncovered. This challenge has generated the new field of Medical Informatics, one major goal of which is to formulate computer logics that can properly relate the idealized descriptions of disease, the rules for medical practice and the general guidelines for health care to the intricate diversities encountered in the care of individual patients. The Integrated Academic Information Management System (IAIMS) program of the National Library of Medicine provides the most ambitious environment for research in this new endeavor.

Expert Systems↗
PubMed1982

Training in medical informatics. The use of computers for diagnostic purposes.

Part of a blockcourse on medical informatics is presented; this course is intended for medical students. It is shown how medical students are introduced to the study of the role of computers for diagnostic purposes. The course consists of an oral presentation which introduces the student to the subject, and of practical work on systems in order to more fully comprehend the topics explained in the oral part of the blockcourse. In the oral presentation the student is introduced to various concepts that are used in computer-aided diagnosis. A critical review of the possibilities of computer use for diagnostic purposes is given. A system is presented, with which the student can work interactively. It consists of a database of patients, referred to the hospital because of suspected congenital heart disorder. Bayes' rule and diagnostic tree decision schemes are available to the student to acquaint himself with the subject. The ways he can work with this system are explained. The course is given regularly (every 4 months) to medical students and is well appreciated.

Computers↗
PubMed1995

Reorganization of the information technology program at a United States medical school: is there a lesson for academic medical informatics in Japan?

Reorganization of the information technology program at Baylor College of Medicine commenced with the goal of obtaining a client-focused organization instead of a classically departmental structure. Legacy organizations independently established by request or serendipity had gaps and overlaps in services and could no longer respond to new issues, such as integration of several hospitals, resource sharing of health care delivery, administration of a shared library, and an academic informatics program. The renewal of the information technology program has led to departments of Telecommunications, Enterprise Services, Client Services, and Medical Informatics, and has also allowed cross-departmental projects led by a technology architect. In contrast with that of Baylor, the approach of the Yamaguchi University School of Medicine in Japan may be construed as economic efficiency at the cost of client services. Effective client services by friendly and efficient staff groups is the most important factor for an academic information technology program, if the goal is to reorganize in anticipation of future challenges to the medical center.

Computer Systems↗
PubMedDate not supplied

A descriptive analysis of National Library of Medicine-funded medical informatics training programs and the career choices of their graduates.

The initial 13 National Library of Medicine-supported medical informatics training programs and their graduates were studied to determine the program objectives, trainee selection factors, and curriculum components of the programs and the backgrounds and career choices of the trainees. All 13 programs and over 60% of the available population of trainees were studied. The analysis indicated that 1) the major objective was to train individuals in the applications of computer and information science to medicine: 2) the most frequent selection factor was the MD degree; 3) course work in computer science and a research project were the most common curriculum components; 4) 52% of the graduates selected academic careers; and 5) personal reasons most frequently influenced career choices. There is now a baseline of data that can be used in future studies.

Career Choice↗
PubMedDate not supplied

Medical informatics and clinical decision making: the science and the pragmatics.

There are important scientific and pragmatic synergies between the medical decision making field and the emerging discipline of medical informatics. In the 1970s, the field of medicine forced clinically oriented artificial intelligence (AI) researchers to develop ways to manage explicit statements of uncertainty in expert systems. Classic probability theory was considered and discussed, but it tended to be abandoned because of complexities that limited its use. In medical AI systems, uncertainty was handled by a variety of ad hoc models that simulated probabilistic considerations. To illustrate the scientific interactions between the fields, the author describes recent work in his laboratory that has attempted to show that formal normative models based on probability and decision theory can be practically melded with AI methods to deliver effective advisory tools. In addition, the practical needs of decision makers and health policy planners are increasingly necessitating collaborative efforts to develop a computing and communications infrastructure for the decision making and informatics communities. This point is illustrated with an example drawn from outcomes management research.

Artificial Intelligence↗
PubMed2006

Medical informatics and bioinformatics: integration or evolution through scientific crises?

OBJECTIVES: To contribute a new perspective on recent investigations into the scientific foundations of medical informatics (MI) and bioinformatics (BI). To support efforts that could generate synergies and new research directions. METHODS: MI and BI are compared and contrasted from a philosophy of science perspective. Historical examples from MI and BI are analyzed based on contrasting viewpoints about the evolution of scientific disciplines. RESULTS: Our analysis suggests that the scientific approaches of MI and BI involve different assumptions and foundations, which, together with largely non-overlapping communities of researchers for the two disciplines, have led to different courses of development. We indicate how their respective application domains, medicine, and biology may have contributed to these differences in development. CONCLUSIONS: An analysis from the point of view of the philosophy of science is characteristic of established scientific disciplines. From a Kuhnian perspective, both disciplines may be entering a period of scientific crisis, where their foundations are questioned and where new ideas (or paradigm shifts) and a progressive research programme are needed to advance them scientifically. We discuss research directions and trends both supporting and challenging integration of the subdisciplines of MI and BI into a unified field of biomedical informatics (BMI), centered around the evolution of information cybernetics.

Computational Biology↗
PubMedDate not supplied

Medical informatics on the Internet: creating the sci.med. informatics newsgroup.

A Usenet newsgroup, sci.med.informatics, has been created to serve as an international electronic forum for discussion of issues related to medical informatics. The creation process follows a set of administrative rules set out by the Usenet administration on the Internet and consists of five steps: 1) informal discussion, 2) request for formal discussion, 3) formal discussion, 4) voting, and 5) posting of results. The newsgroup can be accessed using any news reader via the Internet.

Communication↗
PubMed1998

[Medical informatics in the training of students, dentists and teachers in dental schools].

Philosophy of training students, physicians, and tutors of dentistry schools in medical informatics and the relevant curricula are discussed. Specialized software for differential diagnosis and treatment of the major stomatological diseases (dental caries, pulpitis, periodontitis, mucosal, periodontal, oral diseases, tumors, rapid methods for AIDS screening, etc.) are presented.

Curriculum↗
PubMed2006

Medical informatics in population health: building Wisconsin's strategic framework for health information technology.

Medicine is increasingly practiced through the application of information sciences. Medical informatics deals with optimal information use within bioinformatics, imaging, clinical, and population health domains. Population health informatics plays an important role in that it critically informs practice in each of the other domains. Proper functioning of health care systems requires an advanced health information network that supports clinical care, personal health management, population health, and research. But this infrastructure does not yet exist in the United States. A number of federal initiatives are underway to address this problem, including the development of a framework for a national health information network and funding for implementation. This network will be facilitated by federal leadership, but public and private partnerships, and state, regional, and local implementation and policy development will play a critical role. In this article, we describe several Wisconsin initiatives that are keys to developing a strategic framework and building the state's electronic health information infrastructure.

Biomedical Technology↗
PubMed1999

Medical informatics educational tasks seen from practical perspective. Tempus-Phare Project CME-02555-96.

This paper tries to synthesize the discussion of a seminar on medical informatics educational tasks held in May 1998 in Sinaia, Romania, within the frame of the Tempus-Phare Project CME-02555-96 entitled "Know How Transfer from University to Industry" and coordinated by the University of Medicine and Pharmacy Timisoara, Romania. Special emphasis was paid to particular features of medical education requirements in East European countries, with particular reference to Romania.

Curriculum↗
PubMed2007

Expanding multi-disciplinary approaches to healthcare information technologies: what does information systems offer medical informatics?

The effective use of information technology (IT) is a crucial component for the delivery of effective services in health care. Current approaches to medical informatics (MI) research have significantly contributed to the success of IT use in health care but important challenges remain to be addressed. We believe that expanding the multi-disciplinary basis for MI research is important to meeting these research challenges. In this paper, we outline theories and methods used in information systems (IS) research that we believe can inform our understanding of health care IT applications and outcomes. To do so, we discuss some general differences in the focus and methods of MI and IS research to identify broad opportunities. We then review conceptual and methodological approaches in IS that have been applied in health care IT research. These include: technology-use mediation, collaborative work, genre theory, interpretive research, action research, and modeling. Examples of these theories and methods in healthcare IS research are illustrated.

Cooperative Behavior↗