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PubMed1998

Health or uni-disciplinary informatics initiatives--why are we where we are today?

This paper looks at the development of health informatics from a segregated uni-disciplinary beginning to an environment in which multi-disciplinary health informatics and uni-disciplinary work co-exist reasonably harmoniously. However, the paper considers some of the catalysts and inhibitors which have made the transition not as smooth or wide ranging as the technological developments could have supported. Organisational and cultural factors appear to have played a part in the migration as it has emerged. Identification and understanding of the key issues may help in progressing health informatics towards a mature state.

History, 20th Century↗
PubMed1998

Setting a national research agenda in nursing informatics.

An active program of research assures the development and evaluation of nursing informatics solutions to the challenges of contemporary patient care. Experts in nursing informatics research participated in a two-part electronic mail survey of research priorities. Priorities identified included formalization of nursing vocabularies, design and management of databases for nursing information, development of technologies to support nursing practice, use of telecommunications technology in nursing, patient use of information technology, identification of nurses' information needs, and systems modeling and evaluation. Many of these priorities are similar to those advanced in the 1993 US PHS NINR PEP Report on Nursing Informatics. Additionally, the findings suggest the need for greater emphasis on the application of emerging technology to nursing practice problems, and the expansion to consider patients as direct users of information systems.

Data Collection↗
PubMed1999

Impact of medical informatics on medical education.

In recent years, medical informatics has become a well-recognized branch of medicine. It is a multidisciplinary science that combines information technology and various specialties of medicine. The impact of medical informatics on medical education is advancing along with the rapid developments in computer science. Departments of medical informatics or similar divisions have appeared in schools of medicine in Taiwan in the past 5 years. At National Taiwan University College of Medicine, we offer curricula in basic computer concepts, network concepts, operating systems, word processing, database and data processing, computer media resources, multimedia computer statistics, intelligent health information systems, medical diagnostic support systems, and electronic medical record systems. Distance learning has also been favorably accepted on this campus. Recently, we proposed the concept of a virtual medical campus, which will break the physical barriers of time and space. We expect this revolution to influence every aspect of medicine, especially medical education.

Education, Medical↗
PubMed2000

Applied medical informatics and computing skills of students, residents, and faculty.

BACKGROUND AND OBJECTIVES: Little is known regarding the applied medical informatics and computing skills of family practice residents and faculty, yet such information is critical when planning a medical informatics curriculum. We conducted a survey at our institution to collect this information. METHODS: An applied medical informatics and computing skills survey was administered to 93 first-year medical students, 42 family practice residents, and 14 family medicine faculty. Responses were compared between groups before and after stratification by age and gender. RESULTS: A total of 92% of students, 100% of residents, and 79% of faculty responded. Faculty had the highest rate of computer ownership (91%), followed by students (86%) and family practice residents (79%). Students and interns had the highest overall confidence using computers, followed by faculty and then senior residents. Faculty, students, and junior residents were significantly more confident than senior residents in their ability to perform several specific tasks, such as conducting a MEDLINE search. Residents perceived lack of money and time as barriers to improving their skills. CONCLUSIONS: Current senior residents may require remedial training to graduate with the computer skills specified in curricular guidelines. While upcoming medical students and interns will demand more advanced training, faculty may not have the skills to provide it.

Adult↗
PubMed2000

Continuing educational needs in computers and informatics. McGill survey of family physicians.

OBJECTIVE: To describe family physicians' perceived educational needs in computers and informatics. DESIGN: Mailed survey. SETTING: General or family practices in Canada. PARTICIPANTS: Physicians (489 responded to a mailing sent to 2,500 physicians) who might attend sessions at the McGill Centre for CME. Two duplicate questionnaires were excluded from the analysis. METHOD: Four domains were addressed: practice profile, clinical CME needs, professional CME needs, and preferred learning formats. Data were entered on dBASE IV; analyses were performed on SPSS. MAIN FINDINGS: In the 487 questionnaires retained for analysis, "informatics and computers" was mentioned more than any other clinical diagnostic area, any other professional area, and all but three patient groups and service areas as a topic where improvement in knowledge and skills was needed in the coming year. Most physicians had no access to computer support for practice (62.6%); physicians caring for neonates, toddlers, or hospital inpatients were more likely to report some type of computer support. CONCLUSIONS: Family physicians selected knowledge and skills for computers and informatics as an area for improvement in the coming year more frequently than they selected most traditional clinical CME topics. This educational need is particularly great in small towns and in settings where some computerized hospital data are already available.

Adult↗
PubMed2000

A coherent approach to health informatics education: results of the Dutch curriculum project.

From the beginning a coherent approach to health informatics education has been aimed for in our project to develop learning materials. The features are the thematic approach of the contents, the interrelationship of the modules and the didactical approach embedded in the learning materials. Following results have been achieved. Learning materials have been developed for the following themes: healthcare policy and management, delivery of professional care (specific for nursing and allied health), more generic themes such as electronic patient record, clinical decision making, classification and coding of healthcare data and knowledge based systems. Software made available by private companies has been selected for use in the learning modules. In specific cases the available software products did not match the criteria to support the learning materials. In these cases model applications have been developed that can be considered as forerunners for systems in practical use. Already some companies have expressed interest to adapt our home grown products for use in clinical practice. The modules are based on a model curriculum that has been developed by Aarts et al in 1995. New developments in healthcare have prompted modification of the contents of a few modules. For example, a module has been redefined to cover the important issue of logistics in healthcare. The module on patient education has been adapted to take into account the resources available on the Internet. Also, new insights in the effectiveness of computer-based patient education have been taken into account. The module on informatics for disabled persons has been focussed on computer-based aids and is being linked to the EU-project "Impact" aimed at increasing knowledge about assistive technology. However, the model curriculum has proved to be reasonable robust as a base for our project to develop learning materials for health informatics.

Curriculum↗
PubMed2000

Comparison of mailed vs. Internet applications of the Delphi technique in clinical informatics research.

The Delphi technique provides a means of assessing the judgments of groups of experts without the necessity of having these experts meet together. The technique has been used in health care since the mid-1970s, and has just recently become more common in clinical informatics research. As informatics develops as a specialty, it is logical to consider information technology solutions to research as well as clinical practice problems. The overall purpose of this methodology presentation is to compare a mailed vs. Internet application of the Delphi technique for clinical informatics research. Specifically, this presentation will provide: 1) an overview of the Delphi technique, and 2) a methodological comparison of two research applications of the Delphi technique. Results of the studies will be presented elsewhere.

Computer Communication Networks↗
PubMed2001

The Cancer Informatics Infrastructure (CII): an architecture for translating clinical research into patient care.

Today, the clinical trial process remains slow and paper-based. The creation of a Cancer Informatics Infrastructure (CII) can provide the architectural base across the continuum of cancer research and cancer care. Recommendations of a Long Range Planning Committee identified near-term activities for the Office of Informatics at the National Cancer Institute (NCI). These include participating in national standards development; fostering oncology-related terminology and standards, e.g., Common Data Elements (CDEs); and leveraging mainstream informatics and Internet technologies, using the successful Internet model that focuses on facilitating stakeholder participation, sponsoring the CII rather than subsidizing it, and providing a test bed as well as an infrastructure. Diffusion tactics include extending the CII concept beyond its "early adopters" to the wider community through recommendations for the near-term and development of a major document defining next-phase activities.

Clinical Trials as Topic↗
PubMed2003

An author co-citation analysis of medical informatics.

OBJECTIVE: This study presents the results of an author co-citation analysis of the interdisciplinary field of medical informatics. METHODS: An author co-citation analysis was conducted for the years 1994 to 1998, using the fifty most-cited American College of Medical Informatics fellows as an author population. Co-citation data were calculated for every author pair, and multivariate analyses were performed to ultimately show the relationships among all authors. A multidimensional map was created, wherein each author is represented as a point, and the proximity of these points reflects the relationships of authors as perceived by multiple citers. RESULTS AND CONCLUSION: The results from this analysis provide one perspective of the field of medical informatics and are used to suggest future research directions to address issues related to better understanding of communication and social networks in the field to inform better provision of information services.

Authorship↗
PubMed2003

Comparing structural perspectives on Medical Informatics: EMBASE vs. MEDLINE.

Previous bibliometric analyses of Medical Informatics' internal structure used MEDLINE records as the unit of study. EMBASE, a product of Excerpta Medica, carries a wider international scope and offers complementary retrieval results to MEDLINE. Since much medical informatics critical thinking originated abroad and migrated to North America, this difference in coverage may also indicate a different perspective of "what constitutes medical informatics." Using traditional bibliometric and multivariate data analysis techniques, the present work examines EMBASE indexing records for the same 1995-1999 time frame as earlier MEDLINE studies to identify and compare structural features of the field.

Abstracting and Indexing↗
PubMed1992

Supporting collaboration through a nursing informatics curriculum stage II.

Collaboration is at the center of the process used to design, implement and evaluate an integrated informatics curriculum in a baccalaureate nursing program. This paper describes the second stage of a process to design the informatics nursing courses. The challenges to foster faculty collaborative relationships as well as to enhance the course content of all nursing informatics curriculum. A number of strategies were used to develop the collaborative efforts between the faculty and nursing staff in the clinical agencies. Information technology was incorporated into the didactic and clinical portions of courses through the use of creative teaching strategies. Therefore, the faculty have ensured a blend of information, technology, and the clinical care process throughout the curriculum.

Curriculum↗
PubMed2004

Approaches and informatics tools to assist in the integration of similar clinical research questionnaires.

OBJECTIVE: The integration of similar clinical research questionnaires is a complex process that can benefit from informatics approaches and tools that provide a systematic structure for performing mapping and integration. This systematic approach is necessary to address complex issues in integration such as data heterogeneity, differing levels of granularity of questions and responses, and other issues involving semantic differences. Informatics tools and approaches have been successfully applied to various standard clinical vocabulary integration processes but not for questionnaire integration or mapping. METHODS: A systematic approach to questionnaire integration was developed in the context of a collaboration of researchers using Trial/DB, a database designed to support clinical research. This approach was applied to the integration of questionnaires involving breast cancer risk factors from each of three research sites. RESULTS: From 375 questions on the three original questionnaires, we identified 65 concepts that were measured by two or three of the sites. An algorithm was developed and used to formalize the process of mapping questions and answers across the questionnaires. The approach was applied to previously collected data and prospective data in disparate data-base systems to import and merge the data from these three sites into Trial/DB. CONCLUSION: Informatics tools that support a systematic approach to mapping questionnaires can be used throughout the research process from questionnaire integration and creation, legacy data integration to data library maintenance and curation.

Biomedical Research↗
PubMed2004

International training in health informatics: a Brazilian experience.

Technology is transforming not only the practice of health-care but also professional training and educational models. Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We envision that training in health informatics can be better achieved if cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our four-year experience of a Brazil/USA training program and discuss lessons learned during its implementation. Eleven onsite courses, one seminar, and two conferences were developed under this unique initiative, which made possible the collaboration among different countries and distinguished leaders in the field of medical informatics.

Brazil↗
PubMed2002

Training in health informatics in Brazil.

Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We report on five initiatives of the Brazil/USA training program in health informatics. The main goal of this program is to train professionals in establishing medical informatics programs in Brazilian universities and major healthcare facilities.

Brazil↗
PubMed2002

New Czech Postgraduate Doctoral Program in Biomedical Informatics.

In the paper we describe the new Czech program in Biomedical informatics with doctor degree. The agreement on cooperation of Charles University in Prague and Academy of Sciences of the Czech Republic in postgraduate doctoral studies was signed on April 23rd, 1997. The main goal of this agreement has been cooperation in development and running of joint education and training of young researchers. Nowadays there are 19 boards of scientific disciplines in postgraduate doctoral studies in biomedicine, one of them the scientific board on Biomedical informatics established in 2001. The involvement of university teachers and researchers from the EuroMISE center-Cardio in the board of biomedical informatics discipline in the postgraduate doctoral studies of biomedicine and first activities of the board are described.

Czech Republic↗
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↗
PubMed2004

[Free sources for medical informatics teaching].

Important worldwide websites offering medical informatics have been searched through to find freely available web-based sources for teaching of medical informatics at faculties of medicine. The conclusion suggests that a complex system for teaching of the whole field of study does not exist. However, a sufficient offer of specialized articles, model programmes and presentations is available, which can be used for teaching. The author lists a brief characterization of the found sources and the programmes he uses. This computer-aided research is only rough. A more precisely defined searching strategy can help find other sources of specialized subjects useful for medical informatics.

Educational Technology↗
PubMed2005

Incorporating healthcare informatics into the strategic planning process in nursing education.

The purpose of this article is to describe the incorporation of healthcare informatics into the strategic planning process in nursing education. An exemplar from the University at Buffalo, the State University of New York School of Nursing, is interwoven throughout the article. The challenges and successes inherent in a paradigm shift embracing the multifaceted adoption of technology in higher education are illustrated. The paradigm shift that necessitated this change, the need for informatics standards and competencies identified by regulatory agencies and the relationship of the triad mission of the Academy which includes research, teaching and service are then elucidated. Information pertinent to the strategic planning process is described including the use of a strengths, weaknesses, opportunities and threats (SWOT) analysis to facilitate the integration of a healthcare informatics model into a nursing curriculum.

Curriculum↗