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PubMedDate not supplied

A national agenda for public health informatics: summarized recommendations from the 2001 AMIA Spring Congress.

The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes-that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health.

Computer Security↗

PubMedDate not supplied

Implementation and evaluation of a medical informatics distance education program.

OBJECTIVE: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area. DESIGN: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation. MEASUREMENTS: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions. RESULTS: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students. CONCLUSION: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented.

Data Collection↗

PubMedDate not supplied

Leadership in nursing informatics.

Nursing informatics is a 21st century science with great potential for improving the quality, safety, and efficiency of health care. Perinatal, neonatal, and women's health nurses have an opportunity to contribute and lead in informatics. Leaders must learn about current informatics issues from essential resources, including the literature, professional organizations, and education programs, to develop successful strategies for innovation, collaboration, and implementation. Most important, nurses must be accountable for humanizing the use of technology using a nursing model.

Computer User Training↗

PubMed2005

Public health informatics: the nature of the field and its relevance to health promotion practice.

The purpose of this article is to introduce the relatively new field of public health informatics and provide examples of how informatics is currently being applied to health promotion activities. Additionally, the article illustrates how informatics is well positioned to play a central role and is likely to be central to disease prevention, health education, and health promotion as it will be practiced in the future.

Health Behavior↗

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↗

PubMedDate not supplied

The evolution of definitions for nursing informatics: a critical analysis and revised definition.

Despite the fact that nursing informatics is entering its third decade as a specialty within nursing, many definitions still exist to describe the field. This paper offers a rationale for a definition for nursing informatics and a critical analysis of past definitions. An organizing framework of technology-oriented, conceptual, and role-oriented definitions is used to critique these definitions. Subsequently, a revised definition is proposed. This evolutionary definition integrates critical concepts from past work and adds components that are currently missing--patients, information communication, information structures, and decision making. A separate role specification for informatics nurse specialists is provided.

Medical Informatics↗

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↗

PubMedDate not supplied

A national education strategy to develop nursing informatics competencies.

Advances in the sophistication of information and communication technologies offer nursing practitioners opportunities for better information management, more complete documentation of their work, and knowledge development to support evidence-based nursing practice. However, a nursing culture that recognizes and adopts the contributions of technology to practice is required to take advantage of these opportunities. The nature of this change suggests a shift in emphasis from specialists in Nursing Informatics (NI) to NI being integrated into all four domains of nursing practice. The magnitude of change required on individual, organizational and professional levels points to the need for Nursing Informatics education strategies on a national level. Recognizing the role and history of NI specialists, defining NI and the required NI competencies are necessary first steps in developing such a plan. Expanding and adapting the educational infrastructure required to support this initiative follows. A working committee at the national level with representatives from a number of stakeholder groups is currently working on a National Nursing Informatics Project to address these issues. This article summarizes key points of an initial discussion paper.

Canada↗

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↗

PubMed2004

Professional values and informatics: what is the connection?

General practitioners (GPs) need to feel that they are doing a good job in providing care of high quality in a humane manner - that they are "good" doctors. The General Medical Council booklet Good Medical Practice is full of imperatives, but short on values that are the determinants of behaviour. Much has been written on doctors' professional values in the past decade, but it is not easy for individual GPs and teams to define their own values and consider to what extent they live up to them. Values and informatics, at first glance, might seem to have little in common, or even to be mutually antipathetic, and this is possible within the limitations of current technology. However, providing high-quality care involves the application of knowledge, evidence and guidelines, as well as auditing outcomes. For all these tasks, informatics provides the essential means of discovering whether we, as individuals and teams, are living up to our espoused values so that they become values-in-action that drive behaviour. Application of advanced informatics has the potential to improve and measure diagnostic and therapeutic skills. Technical advances are impressive, but their application lags. The next logical step would seem to be a comprehensive and easy-to-use knowledge-based decision support (KBDS) system in a convenient format. Locally based KBDS could facilitate self-audit and provide a step towards the ideal of a "self-organising system" requiring little external audit.

Humans↗

PubMedDate not supplied

Evidence-based patient choice and consumer health informatics in the Internet age.

In this paper we explore current access to and barriers to health information for consumers. We discuss how computers and other developments in information technology are ushering in the era of consumer health informatics, and the potential that lies ahead. It is clear that we witness a period in which the public will have unprecedented ability to access information and to participate actively in evidence-based health care. We propose that consumer health informatics be regarded as a whole new academic discipline, one that should be devoted to the exploration of the new possibilities that informatics is creating for consumers in relation to health and health care issues.

Access to Information↗

PubMed2006

Reengineering clinical research with informatics.

The future success of the translational research spectrum depends on the clinical research enterprise's ability to break through the barriers that constrain its productivity. As more basic science discoveries emerge, our ability to effectively translate this knowledge into improved patient care rests squarely on the manner in which we answer clinical questions. Informatics--the science of effective information use--is poised to help advance the conduct of science. However, incorporating informatics into the enterprise comes with its own set of challenges. To harness the benefits of improved information use, it is important to first establish how information flows within research. A thoughtful implementation of informatics--one that factors in social and organizational nuances--will undoubtedly lead to a more efficient and effective clinical research enterprise.

Biomedical Research↗

PubMed2002

Nursing informatics. Applications for long-term care.

Long-term care (LTC) settings, specifically nursing homes, have found it difficult to manage the regulatory process and provide quality resident care without computerization. Clinical information systems in the current health care environment, including LTC, need to provide five functions. These five functions are providing the legal record of care; supporting clinical decision-making; capturing costs for financial purposes; accumulating a database for administrative queries, quality assurance, and research; and supporting data exchange between systems. While computerization may have occurred in LTC, the application of the informatics concepts with nursing standardized languages and financial and database usage may not have occurred. To succeed in the current health care environment, nursing informatics concepts need to be implemented in LTC. As a result, the quality of care for older adults in nursing homes will be improved. The purpose of this article is to identify application for nursing informatics use in the LTC setting.

Databases, Factual↗

PubMed1997

Education and training in health informatics. The IT EDUCTRA Project.

In this contribution the AIM project EDUCTRA and the Telematics Applications Programme IT-EDUCTRA will be described. EDUCTRA has as its aim to investigate what gaps in knowledge health professionals have about health informatics and to provide educational material to fill these gaps. It was believed that a basic understanding of health informatics was present and that educational material should only cover the knowledge necessary for appreciating the products of the AIM programme. It appeared that the knowledge with respect to health informatics was deplorable. Guidelines for curricula were developed to change the situation. In IT-EDUCTRA the necessary course material will be developed.

Curriculum↗

PubMed1998

The roots, values and logic's in nursing informatics.

This paper identifies patterns and tendencies in Nursing Informatics as a phenomenon. The methods have been literature reviews, categorizations and interpretations, looking for characteristic patterns and tendencies. 11 Patterns and 2 main tendencies are identified and the results are discussed in according to make some points on the importance and effects of Nursing Informatics to Nursing when one is developing a Nursing Informatics Curriculum.

Curriculum↗

PubMed1998

The economic implications of users willingness to increase knowledge capital in health informatics.

OBJECTIVE: To develop an economic model of health care professionals demand for knowledge capital in health informatics. DESIGN: Case study with application of the Contingent Valuation Method to develop a small-scale model. SETTING: Specialized clinic at a university Hospital in Sweden. RESULTS: The model displays the economic rationale behind an individual's choice to spend leisure time for obtaining knowledge in health informatics. This decision reduces the total leisure time, but does not increase salary. Instead, it may increase the personal well being by higher satisfaction gained from using information systems and by being recognized as a computer expert. CONCLUSIONS: Individuals have preferences over all uses of time and for activities they can choose to engage in Support of health care staff's investment in health informatics knowledge capital may benefit both the individuals and indirectly the health care organization.

Attitude of Health Personnel↗

PubMed1998

Evaluation as a tool to increase knowledge in healthcare informatics.

The evaluation of information systems is an important topic in Clinical Informatics. It is argued that past evaluations have not been particularly informative in progressing the effective use of IT in healthcare due to their narrow focus. The different roles of evaluation in Clinical Informatics are examined, and the breadth and diversity of the available methodological tool kit highlighted. The aim is to stimulate a greater awareness of the roles and methods of evaluation. Challenges in evaluation which face the Clinical Informatics community are discussed and finally some comments made concerning the way in which evaluation might be made more effective in order to improve our knowledge of how to deliver useful systems into healthcare.

Computer Systems↗

PubMed1998

Health informatics and the humanities.

Researchers and professionals from the Humanities are new within the science of health informatics, where researchers and professionals from the natural sciences have so far de-fined the problems and their solutions. A cross-disciplinary collaboration can be difficult due to factors such as status and competition, to insufficient co-operation qualifications, and due to different definitions of problems. This paper presents examples of differently formulated health informatics problems. Cross-disciplinary collaboration is necessary but collaboration demands openness, curiosity, and readiness from researchers and professionals as well as it demands know-edge of the processes in cross-disciplinary cooperation. Considerations for cross-disciplines were actualized with the foundation in Denmark of the cross-disciplinary institution: The Virtual Centre for Health Informatics.

Cooperative Behavior↗