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The purpose of the paper is to present both the processes and the results of a task force organized to recommend nursing informatics competencies for practicing nurses, nurse administrators, nurse teachers and nurse researchers. The competencies are designed to be useful in preparing nurses for their specific roles. The criterion for inclusion of a specific informatics competency statement was task force consensus.
The purpose of this paper is to share the results of a conceptual model application in informatics management and re-engineering. This theoretical construct is a four phase problem solving process shell which has distinct actions, descriptions, and deliverables with evaluation as an ongoing bridge. The process shell was used as a tool for a retrospective assessment of Nursing Informatics developmental waves and for prospective planning of the re-engineering wave. The authors feel this tool can be an invaluable guide for development, an instrument for planned change, and a paradigm for strategic planning.
One of the most ancient of sciences, anatomy has evolved over many centuries. Its methods have progressively encompassed dissection instruments, manual illustration, stains, microscopes, cameras and photography, and digital imaging systems. Like many other more modern scientific disciplines in the late 20th century, anatomy has also benefited from the revolutionary development of digital computers and their automated information management and analytical capabilities. By using newer methods of computer and information sciences, anatomists have made outstanding contributions to science, medicine, and education. In that regard, there is a strong rationale for recognizing anatomical informatics as a proper subdiscipline of anatomy. A high-level survey of the field reveals important anatomical applications of computer sciences methods in imaging, image processing and visualization, virtual reality, modeling and simulation, structural database processing, networking, and artificial intelligence. Within this framework, computational anatomy is a developing field focusing on data-driven mathematical models of bodily structures. Mastering such computer sciences and informatics methods is crucial for new anatomists, who will shape the future in research, clinical knowledge, and teaching.
One of the hallmarks of a mature discipline is a varied and robust body of literature describing the research activities of the discipline. Medical informatics has rapidly become an accepted scientific discipline, having emerged from two long established disciplines (medical and computer science). This study looks at one form of scientific communication as a descriptive indicator of the maturity of medical informatics as a discipline. Conference proceedings were selected because they represent one of the first means of communication within a discipline in a semiformal format. Findings confirm that conference papers report research, development, and application projects across a wide range of topics; identify a possible trend toward increased funding; and show widespread use of empirical and quantitative research and analytical techniques. Deficiencies in the conference papers are also discussed.
Medical informatics is the science of information processing and the creation of information processing systems in medicine and health care delivery. Its methodological approach is based on the area specific applicability of a multidisciplinary theory of engineering and managing computerized information systems related to its empirical object. This paper gives a systemic view of the health care system, representing the empirical object of medical informatics.
Medical informatics has the potential to revolutionize patient care by providing every physician with rapid, easy access to the entire medical knowledge base. However, many changes are needed in the way systems are designed and physicians are trained before this potential can be realized. It is the shared responsibility of the medical informatics community, professional societies, academic organizations, and practitioners to accept the challenge of turning the power and promise of modern computer technology into useful tools for the care of patients.
This article provides an overview of how functional genomics is likely to impact on the pathology laboratory and highlights how informatics and tissue banking will greatly facilitate the molecular age of medicine. Important aspects of functional genomics in the post-genome era, including the roles of laser capture microdissection, DNA- and complementary DNA-based microarrays, proteomic methods, collaborative human tissue banking, tissue microarrays, and pathobioinformatics in the modern pathology laboratory are discussed. The role of mass spectroscopy in the analysis of RNA, DNA, and protein and its impact on the clinical laboratory, particularly in cost-effectiveness and time savings, are evaluated. This article explores how laboratory information systems (LISs) and the devices that feed them information may need to be modified to adapt to greater volumes of data for the new testing modalities that require understanding sophisticated fluorescence detection methods and image processing. Emerging genomic testing methods and their impact on pathology laboratory testing, especially in the area of molecular classification of neoplasms, are examined. The role of the tissue bank in the modern pathology laboratory as an archive of control normal tissues, as well as subsamples of the spectrum of progressive neoplastic states, is discussed in light of its critical importance to the molecular classification of cancer. Establishing a database that combines structured reports in pathology LISs and construction of tissue banking information systems will provide a rich resource for pathology departments. The article discusses a hypothetical resource, such as the Shared Tumor Expression Profiler, that would provide access to well-characterized tissue-based research resources for clinicians and researchers. Last, the article emphasizes how LISs can prepare for these changes, and how training pathologists in pathology informatics and bioinformatics (pathobioinformatics) is critical to ensure pathology's overall leadership role in the post-genome era.
Healthcare informatics research is a scientific endeavor that applies information science, computer technology, and statistical modeling techniques to develop decision support systems for improving both health service organizations' performance and patient care outcomes. The analytical strategies include (1) the formulation of a data warehouse for exploration, (2) data mining, (3) the application of confirmatory statistical analysis, (4) simulation via an interface with computer and information system technologies, and (5) translational research. Healthcare informatics research will help to direct evidence-based strategic management.
Access and effective management of medical information have become increasingly important in the practice of medicine today. Computer technology is developing to achieve this goal. This had led to the emergence of a new specialty, medical informatics, the basic science of the use of computers in medicine. Areas of patient care to which medical informatics has been applied include history taking, medical records, medical data base information retrieval, test performance, test result retrieval, decision support, patient monitoring, medical education, quality assurance and utilization review, medical research, and medical office and financial management. It is important that these applications become integrated with existing medical information systems and that physicians take a leading role in developing and maintaining these systems.
As technology transforms how information is accessed, stored and disseminated, the concept of the library changes as well. In its plans for a new building to house both library and computing services, the University of Maryland at Baltimore (UMAB) will give physical form and organizational dimensions to this new concept of the library. UMAB's library of the future will be an 'informatics institution,' designed to accommodate new technologies that support problem-based learning in the health sciences curricula. This new library will embody the concept and the discipline of health informatics.
The discussions of the Tenth Anniversary of the Symposium on Computer Applications in Medical Care (SCAMC) are summarized. Eight different subject areas are addressed: Medical informatics and medical education; Decision making, medical artificial intelligence, modelling and simulations; Image processing, 3-D graphics, and computer networks; Reimbursement policy, legal and regulatory issues; Encoding and representation of medical meaning; Ambulatory medical records systems; Hospital information systems; and Software environments for developing medical information systems. The activities of the 10th SCAMC consisted of Tutorials, Panel Discussions, a Plenary Session, Scientific Demonstrations, and an International Student Paper Competition in Medical Informatics.
In this contribution the AIM Concerted Action Education and Training in Health Informatics (EDUCTRA) is discussed. The activities of the Concerted Action and the results of a survey conducted in 1993 concerning the state-of-the-art of education and training in health informatics in healthcare are presented.
Understanding the role of pathology informatics in patient safety entails an introduction to terminology and projects that have represented efforts to date in this area. The authors provide a short alphabetized introduction to several "buzzwords" and terms related to tools and processes that are used by health care research experts and workers involved in patient safety initiatives. The authors also include short descriptions of key health care research and patient safety projects that are relevant to pathology. They aim to highlight the areas where pathology informatics in all of its flavors (production systems provided by vendors as well as research and development efforts) can play a role in promoting patient safety.
Recent developments in screening technologies and data analysis have been driven by promises that the numbers of new lead compounds will increase. Although many of these promises have become reality, the success of this strategy also depends on the information framework that ties the individual components together. In particular, high-content technologies represent a new force in challenging established informatics frameworks; largely because of their data volume, variety of assay parameters and increased scientific complexity. A successful informatics framework design can be regarded as crucial for new technologies, both in terms of scientific content and information, and process integration across large corporate networks.
Master Classes arose within the performing arts and are now being offered in system sciences. The IPhiE group of faculty from six universities in Europe and the United States has offered Master Classes in health informatics to provide an integrative forum for honors students. Featured are international views of health systems, varied opportunities for student interaction and promotion of informatics professionalism. Five years of experience indicate the success of this concept and suggest changes that will be considered for the future.
Recent developments in biomedical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present a number of challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users, which compromises the culture of safety in the workplace. Because clinical practice is a human endeavor, there is a need for bridging disciplines to enable clinicians to benefit from rapid technologic advances. This, in turn, necessitates a broadening of disciplinary boundaries to consider cognitive and social factors related to the design and use of technology. The authors argue for a place of prominence for cognitive science in understanding nursing factors associated with patient safety. Cognitive science provides a framework for the analysis and modeling of complex human performance. Studies of clinical cognition can meaningfully inform and shape design, development and assessment of information systems. Furthermore, they have a decisive impact on whether information technology has a positive influence on human performance and are especially important in understanding and promoting safe practices. These issues are discussed in the context of clinical informatics with a focus on nursing practice.
OBJECTIVE: To obtain an overview of study designs and study methods used in research evaluating IT in health care, to present a list of quality criteria by which all kinds of reported evaluation studies on IT systems in health care can be assessed, and to assess the quality of reported evaluation studies on IT in health care and its development over time (1982-2005). METHODS: A generic 10-item list of quality indicators was developed based on existing literature on quality of medical and medical informatics publications. It is applicable to all kind of IT evaluation papers and not restricted to randomized controlled trials. One hundred and twenty explanatory papers evaluating the effects of an IT system in health care published between 1982 and 2005 were randomly selected from PubMed, the study designs and study methods were extracted, and the quality indicators were used to assess the quality of each paper by two independent raters. RESULTS: The inter-rater variability of scoring the 10 quality indicators as assessed by a pre-test with nine papers was good (K=0.87). There was a trend towards more multi-centre studies and authors coming more frequently from various departments. About 70% of the studies used a design other than a randomized controlled trial (RCT). Forty percent of the studies combined at least two different data acquisition methods. The quality of IT evaluation papers, as defined by the quality indicators, was only slightly improving in time (Spearman correlation coefficient [rs]=0.19). The quality of RCTs publications was significantly higher than the quality of non-RCT studies (p<0.001). CONCLUSION: The continuous and dominant number of non-RCT studies reflects the various approaches applicable to evaluate IT systems in health care. Despite the increasing discussion on evidence-based health informatics, the quality of published evaluation studies on IT interventions in health care is still insufficient in some aspects. Journal editors and referees should take care that reports of evaluation on IT systems contain all aspects needed for a sufficient understanding and reproducibility of a paper. Publication guidelines should be developed to support more complete and better publications of IT evaluation papers.
Social network analysis comprises a set of research methods that can be used to analyze the relationships among entities such as people, departments, and organizations. The purpose of the analysis is to discover patterns of relationships that affect both individual and organizational attitudes and behavior such as the adoption, diffusion, and use of new medical informatics applications. This paper presents an introduction to the concepts and methods of social network analysis. Several applications to health informatics are described.