Student paper competition focuses on medical informatics.
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A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole.
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In this paper, we describe a U.S. Army concept to monitor soldier physiologic status and provide computer-based medical support to increase the likelihood of soldier survival on the battlefield. Supported by an underlying platform of complex wearable computerized systems, the "Warfighter Physiological Status Monitoring" (WPSM) concept consists of an array of biosensors embedded in the soldier's uniform integrated with a database management system and a decision support system that will provide assistance in casualty prevention and casualty management. We discuss the main components of the WPSM, its present status, key requirements and outstanding challenges, and near- and far-term research directions.
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This report describes a new simplified judgment system which enables users to register appropriate judgment rules with ease and to apply them to a wide variety of medical problems. The rule utilized in this system is 3-AND-3-OR, quite a simple one. By applying this judgment rule to the data of as many as 60 items, judgment results of the individual on each item is given by four different grades or categories, namely: 1) normal, 2) borderline, 3) abnormal, and 4) severe. As many as 20 types can be obtained simultaneously. The simplicity of the algorithm allows medical users who are not the experts in computer technology to use this system on a DOS-based personal computer.
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This paper describes an approach to the evaluation of health care information technologies based on usability engineering and a methodological framework from the study of medical cognition. The approach involves collection of a rich set of data including video recording of health care workers as they interact with systems, such as computerized patient records and decision support tools. The methodology can be applied in the laboratory setting, typically involving subjects "thinking aloud" as they interact with a system. A similar approach to data collection and analysis can also be extended to study of computer systems in the "live" environment of hospital clinics. Our approach is also influenced from work in the area of cognitive task analysis, which aims to characterize the decision making and reasoning of subjects of varied levels of expertise as they interact with information technology in carrying out representative tasks. The stages involved in conducting cognitively-based usability analyses are detailed and the application of such analysis in the iterative process of system and interface development is discussed.
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