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A study of collaboration among medical informatics research laboratories.

The InterMed Collaboratory involves five medical institutions (Stanford University, Columbia University, Brigham and Women's Hospital, Massachusetts General Hospital, and McGill University) whose mandate has been to join in the development of shared infrastructural software, tools, and system components that will facilitate and support the development of diverse, institution-specific applications. Collaboration among geographically distributed organizations with different goals and cultures provides significant challenges. One experimental question, underlying all that InterMed has set out to achieve, is whether modern communication technologies can effectively bridge such cultural and geographical gaps, allowing the development of shared visions and cooperative activities so that the end results are greater than any one group could have accomplished on its own. In this paper we summarize the InterMed philosophy and mission, describe our progress over 3 years of collaborative activities, and present study results regarding the nature of the evolving collaborative processes, the perceptions of the participants regarding those processes, and the role that telephone conference calls have played in furthering project goals. Both informal introspection and more formal evaluative work, in which project participants became subjects of study by our evaluation experts from McGill, helped to shift our activities from relatively unfocused to more focused efforts while allowing us to understand the facilitating roles that communications technologies could play in our activities. Our experience and study results suggest that occasional face-to-face meetings are crucial precursors to the effective use of distance communications technologies; that conference calls play an important role in both task-related activities and executive (project management) activities, especially when clarifications are required; and that collaborative productivity is highly dependent upon the gradual development of a shared commitment to a well-defined task that leverages the varying expertise of both local and distant colleagues in the creation of tools of broad utility across the participating sites.

Computer Communication Networks↗

A patient's perspective of medical informatics.

From my viewpoint as a patient, 1. Medical knowledge has expanded to the point that individuals cannot adequately improve quality without the assistance of computer programs. 2. The medical profession must concentrate on why and how computer program projects must be used, not on why they cannot be used. 3. The successful application of computer programs to clinical medicine is dependent mainly on the efforts of individual institutions and people at the local level.

Diagnosis, Computer-Assisted↗

[Medical informatics systems exemplified by the diagnosis of equilibrium disorders].

An interdisciplinary field, namely the differential diagnosis of balance disorders and vertigo, is used to describe how a medical expert system can be developed using modern computer analysis, medical expertise, and human pattern recognition techniques. The advantages, results, and unresolved issues of close cooperation between biomedical engineers and physicians are described. The aim of this cooperation was to ensure that complicated data were presented in simple graphic form and that large amounts of diagnostic data were optimally linked together for the generation of a recommended diagnosis. Similar techniques may usefully be employed in other areas of medicine.

Caloric Tests↗

Integration of telemedicine in graduate medical informatics education.

An essential part of health informatics is telemedicine, the use of advanced telecommunications technologies to bridge distance and support health care delivery and education. This report discusses the integration of telemedicine into a medical informatics curriculum and, specifically, a framework for a telemedicine course. Within this framework, the objectives and exit competencies are presented and course sections are described: definitions, introduction to technical aspects of telemedicine, evolution of telemedicine and its impact on health care delivery, success and failure factors, and legal and ethical issues. The emphasis is on literature review tools, practical exposure to products and applications, and problem-based learning. Given the rapid advances in the telecommunication field, keeping the course material up to date becomes a challenge for the instructor who at the same time aims to equip students with the knowledge and tools they will need in their future role as decision makers to detect a need for, design, implement, maintain, or evaluate a telemedicine application.

Cost Savings↗

Medical affective computing: medical informatics meets affective computing.

"The need to cope with a changing and partly unpredictable world makes it very likely that any intelligent system with multiple motives and limited powers will have emotions." [1] From advisory systems that understand emotional attitudes toward medical outcomes, to wearable computers that compensate for communication disability, to computer simulations of emotions and their disorders, the research agendas of medical informatics and affective computing--how and why to create computers that detect, convey, and even have emotions--increasingly overlap. Some psychiatric and neurological researchers state their theories in terms of actual or hypothetical computer programs. Adaptive intelligent systems will increasingly rely on emotions to compensate for their own conflicting goals and limited resources--emotional reactions about which psychiatrists and neurologists have special insights. DEP2 (Depression Emulation Program 2) is a computer simulation of adaptive depression--learning from explainable patterns of failure in autobiographical memory--that simulates many depressive behaviors. In the terminology of fault-tolerant computing, adaptive depression involves fault detection (triggered by failure), fault location (strategic retreat and failure diagnosis), and fault recovery (return to on-line operation). DEP2 relies on subsystems whose structures and behaviors are based on popular hypotheses about left and right brain hemispheric function during depression and emotion. DEP2 and its predecessors, DEP and DEPlanner, are relevant to psychiatric and neurological informatics, and to the design of adaptive autonomous robots and software agents.

Adaptation, Psychological↗

"Pre-medical" informatics.

Many authors have presented arguments in the recent medical literature discussing the premedical preparation of medical students. Much of this work seems to center upon the need to balance the strong science concentration with an increased emphasis on humanities courses. This paper investigates another potential shortcoming of premedical education, that of information literacy. It defines the problem, argues its existence, and proposes the ready availability of a solution.

Computer Literacy↗