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Medical informatics in healthcare organizations: a survey of healthcare information managers.

OBJECTIVE: To assess the medical informatics needs of healthcare organizations and the work roles for informaticists in those organizations. METHODS: A 128-item survey was developed and administered as a structured interview to thirty-two information managers in eighteen organizations. The survey included items about medical informatics training, prior work experience, skills for informaticists, and programming proficiency. RESULTS: There was a strong preference for informaticists with prior clinical work experience and an understanding of healthcare. Project management and data warehousing were highly rated skills. Informaticists were expected to know about healthcare processes, clinical guidelines, and outcome management. They were not expected to be expert programmers. CONCLUSION: There is a role in healthcare organizations for interdisciplinary workers who understand clinical medicine, healthcare management, information technology, and who can communicate and work effectively across these organizational boundaries.

Administrative Personnel↗

The Brazilian National Health Informatics Strategy.

This paper describes the Brazilian National Strategy for the development of the national Health Informatics Infrastructure. An overall description of the use of IT in the Brazilian Health scenario is presented with emphasis on the federal initiatives by DATASUS, the informatics division of the Ministry of Health. The national health card project is discussed and the strategies to establish interoperability among systems are presented. The adopted standards and methodologies used are also discussed.

Brazil↗

On conceptualization of a decision support system in health informatics.

A decision support system can be approached from two major disciplinary perspectives, those of information systems science (IS) and artificial intelligence (AI). We present in this study an extended ontology for a decision support system in health informatics, which is founded on experience from related research fields as well as being informed by our case studies. The ontology emphasises the need to cover environmental and contextual variables as an integral part of a decision support systems development methodology. With the addition of these variables, the focus in decision support systems development shifts from a task ontology towards a domain ontology. The results of this study help the system developers to take the system's context into account through the set of defined variables that are linked to the application domain. These variables explicate relevant constructs and present a vocabulary for a decision support system. However, applying the ontology requires a more thorough analysis of the domain and therefore more qualified resources for systems development. This indicates the need to focus more on education and training in health informatics.

Artificial Intelligence↗

A survey of academic and industry professionals regarding the preferred skillset of graduates of medical informatics programs.

Identification of the skills needed by graduates of medical informatics masters degree programs is needed so that students will know what is desired in the workplace and curriculum designers can assure that courses cover relevant areas. We conducted a mail survey of representatives of the informatics job market to discover what they think is most important. A survey instrument was designed after analyses of job ads and curricula in the U.S. and interviews with representative employers. The survey was mailed to 1000 randomly selected members of AMIA and HIMMS plus EMR vendors. Respondents were asked to rank skills and groups of skills according to perceived utility. The results indicate higher rankings for organizational and interpersonal skills than for more technical credentials. Statistical analysis indicates the existence of relatively few underlying constructs to the skill list.

Data Collection↗

Student-centered distance learning in health and medical informatics.

Learning and teaching of health and medical Informatics is currently supported by web based material, which in the main has been derived from traditional texts. Aided by contributions from the expert community, the web site of the handbook of Medical Informatics has been developed to incorporate increased interactivity (with question and answers related to each section). This approach has proved beneficial to both student and teacher. To further increase the interactivity of the WWW we investigate the suitability of authoring tools for developing complex simulations and interactive tutorials, using an example from the area of quantitative decision support (Bayes Theorem). We propose that these tools provide a suitable platform for the preparation and delivery of collaboratively produced HMI courses, which address open and distance learning and pedagogic issues.

Bayes Theorem↗

Training in medical informatics: combining onsite and online instruction.

The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of on-site and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.

Brazil↗

Evaluation of the outcomes of a multi-professional education programme in health informatics.

A multi-professional continuing education programme on healthcare information systems was designed on the basis of the IMIA WG 1 recommendations for teaching health informatics. This paper presents the outcomes of the education programme on the basis of the participants' (n=19) narrative assessments and a questionnaire. According to the results, the participants were very satisfied with their personal learning outcomes and they felt that the programme content was useful for their duties at work. They regarded that particularly the multi-professional group had given them many ideas and rewarding discussions. The learning arrangements were assessed very successful and the learning methods rewarding. In conclusion we suggest that it is important to include different professions--healthcare and technical--into the same continuing education programmes in health informatics, and to include real life-like team projects. The validity of the results to undergraduate education programmes should be studied.

Education, Continuing↗

Medical informatics education: an alternative pathway for training informationists.

Recognition of the growing complexity of health information needs has led to a call for the creation of a new health care professional, the informationist. Controversy exists as to the role of such individuals and what their training should be. A library science degree, augmented with clinical background or experience, is one pathway. Another to consider is training in medical informatics. With the right coursework, individuals trained in medical informatics should be equally well qualified to assume the role of informationists.

Career Choice↗

A UK operational practitioner view--some challenges of health informatics are trans-national.

OBJECTIVE: To explore the relevance of catalysts and inhibitors to the achievement of an inclusive identity for health informatics; particularly from an operational perspective in the UK. METHODS: Consideration of the different dimensions of health informatics, as practiced in a working healthcare delivery environment; specifically commenting on the synergy and disjunctions with academic and scientific practitioners in the some domain. RESULTS AND CONCLUSIONS: There appear to be common ground and internationally applicable issues across the domain. Recognizing the differences and similarities will contribute towards harmonisation of the field and its ultimate elevation to a mature discipline and profession.

Medical Informatics↗

Web-based informatics education: lessons learned from five years in the trenches.

Duke University has a five-year history with high-quality and clinically oriented informatics web-based nursing informatics education. This paper highlights an overview of instructional methods used and pedagogical considerations for both students and faculty. To do the job well, faculty workload for web-based instruction has been more than double the time and effort required for teaching an on-campus course. Results suggest that virtual teamwork is difficult but possible for highly motivated students. Committed to excellence, Duke's program finds that most students do well in achieving their goals and achieving Duke's high standards of academic rigor, however some students are not successful with on-line courses.

Computer-Assisted Instruction↗

Distributed medical informatics education using internet2.

The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy.

Education, Distance↗

Reflections on an arranged marriage between bioinformatics and health informatics.

OBJECTIVE: To compare the discussions of two workshops held during 2001 by two Canadian organisations, HEALNet, a Network of Centres of Excellence for research in health information applications, and Genome Canada, a national research funding agency for genomics and proteomics, in collaboration with the Institute of Genetics of the Canadian Institutes of Health Research, to examine strategic research development in Health Informatics and Bioinformatics respectively. METHODS: Invited workshops with structured debate. Concept analysis of preparative material and debates. RESULTS: A predominantly common set of concepts was discerned from both workshops. Analysis of published definitions showed an inability to distinguish a definition that would suggest that health informatics and bioinformatics are separate disciplines. In both workshops there was evidence of deep concerns of identity, the lack of clear structures to support research funding as well as uncertainty in distinguishing between service and research. CONCLUSIONS: Many deep issues currently inhibit the recognition and funding of research in health and bioinformatics in Canada and elsewhere. Some of these issues are common to both health and bioinformatics. The overlap in prevailing definitions, research concerns and methodological content in the respective domains suggest that common research needs should be better identified and reinforced for the benefit of both.

Biomedical Research↗

Establishing an agenda for biomedical informatics.

OBJECTIVE: To describe potential areas of collaboration between Medical Informatics (BI) and Bioinformatics (BI) and their effects on planning future work in both disciplines. METHODS: Some reflections on the objectives and rationale underpinning MI and BI are given, and preliminary results from the BIOINFOMED workgroup, supported by the European Commission, are introduced. RESULTS: Applications from both subfields suggest topics for sharing and exchange between the subfields within the emerging field of Biomedical Informatics. CONCLUSIONS: We suggest how the nature and degree of collaboration between the sub-disciplines can impact future work in molecular medicine.

Biomedical Research↗

[Medical informatics as a complementary method in medical education].

The practice of the decision making at the bed side especially highlights the place to be devoted to medical informatics both at the pre- and post-graduate levels. Still in a relatively recent past, say the 50s-60s, most of the medical educational efforts were delivered when watching and then imitating the medical behaviour of an older physician. The medical educators were aware that besides the formal lessons related to selected chapters of medical textbooks, there were an obvious need for better training in the ability to make sound clinical judgements. If this ability has been considered only as an artful and intuitive process neither subjected to theoretical analysis nor to be captured in a formal quantitative model, now things have changed to such an extent that it becomes broadly shared that a science of medical decision making can be reasonably founded and this threefold: 1) Upon a formulated logic, 2) The probability theory, and 3) A value theory. The first gives the hand to artificial intelligence (AI) technics, the third to medical information data bases dealing either with patients (like in hospital information systems) or with literature like MEDLINE or electronic "cookbooks". Basically the probabilistic theory is based here upon a priori probabilities related to patients informations and data and opens the way to bayesian decision making. After this little summary it is stressed that educational informatics in medicine would appear either very central or very marginal, if not optional.

Computer-Assisted Instruction↗

Comparison of health/medical informatics curricula against multiple sets of professional criteria.

This poster expands on a methodology presented at the 2003 International Medical Informatics Association (IMIA) Conference on Education by analyzing the match between four graduate informatics programs to both the IMIA Working Group for Education (WG1) recommendations and the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS). Similarities and differences among the programs and criteria are described.

Curriculum↗

Visualizing AMIA : a medical informatics knowledge domain analysis.

Medical Informatics has been described as having a "long and delayed adolescence" which continues to "find itself in search of self-definition", and the AMIA Symposium Proceedings have been viewed as an indicator of trends in the field. This pilot study investigated the feasibility of applying a knowledge domain visualization approach to clarifying the domain of medical informatics based on the AMIA publications. Document co-citation analysis (DCA) is combined with Pathfinder Network Scaling (PFNET), visualization, and animation to develop a 3-D knowledge landscape.

Bibliometrics↗

Medical informatics and institutional strategy.

Programs in medical informatics can help academic medical centers make effective use of information technology. But to achieve the greatest strategic benefits from these programs, an institution must forge proper linkage between informatics and its overall effort to deploy computing in research, education and patient care. Here we explore this linkage and the ways in which it can be established and managed.

Education, Medical↗

[Current issues of medical informatics].

Due to the modern high standards of information technologies it is only natural to promote our medical care and to ensure a new quality of clinical services. Information technologies should be introduced into the medical field with due respect to clearly predetermined principles. Analyzed in the paper are the key reasons for a huge number of problems occurring in the sphere of medical informatics; optimal methods of medical-informatics introduction are defined.

Delivery of Health Care↗