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PubMed2006

Health check for Latvia: opportunities for information professionals in a new democracy.

BACKGROUND: This paper outlines developments in medical information in Latvia since independence from the former USSR in 1991, and analyses the health information gap faced by professionals. OBJECTIVES: To explore international initiatives and co-operation in health information provision in Latvia; to describe the activities of Latvian medical librarians at national, regional and international level; to look at health information provision by specialist information centres; and to discuss the role of librarians in health information provision in public libraries. METHODS: An extensive search was made of databases and medical library and health information centre staff were interviewed; a questionnaire survey of librarians was carried out. RESULTS: International initiatives and co-operation by medical librarians have extended their services at national, regional and international level. Health information portals exist, with online contacts and links to smaller health centres and organizations, but rarely employ qualified librarians or information professionals. Ninety-three per cent of public librarians had provided health information, with 79% using the Internet. The most popular sources of health information were magazines, books, local pharmacies and the Internet, but mostly for healthy lifestyle, not medical problems. CONCLUSIONS: E-health and medical informatics are high government priorities. Medical librarians are actively involved in these initiatives.

Databases as Topic↗
PubMed2006

Research trends of nursing informatics in Korea.

In order to examine the research trends of Korean nursing informatics over the past 10 years starting from 1995 when the Journal of Korean Society of Medical Informatics started being published, to 2004, nursing informatics related studies were searched for on information search websites such as the National Digital Library, Korean Nurses Association, Korean Society of Medical Informatics, KoreaMed, and MedRIC. As a result of it, specified research trends were identified about Korean nursing informatics.

Humans↗
PubMed1995

The evaluation of computer knowledge and skills of medical students: a three-year comparison.

In 1991, four hundred and forty three (443) first-fourth-and final-year students from the Monash University, Faculty of Medicine were surveyed to seek details of previous computer use [1], knowledge of computer concepts, individual computer skills, perceived usefulness of computers in medicine, and the level of interest in further education on medical computing. his poster will demonstrate the comparison of statistics obtained in the first questionnaire (1991) with the results of the same questionnaire that is currently being distributed and analyzed (1994 -1995). As a response to the first study, Medical Informatics as an optional subject was introduced in 1992 to first, second, and third year medical students. Medical Informatics is currently being developed for inclusion as a compulsory subject for first year students in 1995, taking into account the results of both the first and second survey.

Computer Literacy↗
PubMed1999

Methodological approaches of health technology assessment.

In this era of evolving health care systems throughout the world, technology remains the substance of health care. Medical informatics comprises a growing contribution to the technologies used in the delivery and management of health care. Diverse, evolving technologies include artificial neural networks, computer-assisted surgery, computer-based patient records, hospital information systems, and more. Decision-makers increasingly demand well-founded information to determine whether or how to develop these technologies, allow them on the market, acquire them, use them, pay for their use, and more. The development and wider use of health technology assessment (HTA) reflects this demand. While HTA offers systematic, well-founded approaches for determining the value of medical informatics technologies, HTA must continue to adapt and refine its methods in response to these evolving technologies. This paper provides a basic overview of HTA principles and methods.

Humans↗
PubMed2005

Trends in Evaluation Research 1982 - 2002: A Study on how the Quality of IT Evaluation Studies Develop.

During the last years the significance of evaluation studies as well as the interest in adequate methods and approaches for evaluation has grown in medical informatics. In order to put this discussion into historical perspective of evaluation research, we conducted a systematic review on trends in evaluation research of information technology in health care from 1982 to 2002. The inventory is based on a systematic literature search in PubMed.In the first step of our inventory, we concentrated on describing long-term developments in questions, approaches, setting, methods and criteria of IT evaluation studies as described in the abstracts of the identified 1.035 publications. We found some signs of a maturation of evaluation research in medical informatics. However, these findings are only based on study abstracts that do not give sufficient information to assess the quality of studies in more detail.In a second step of our inventory, we are now looking at the quality of IT evaluation studies in health care, describing in more detail study design and assessing 10 quality indicators. For this second step, we analyse a randomized sample of 105 evaluation full papers in more detail. Besides more descriptive details on study design, the results will show whether IT evaluation studies are credible, and how their quality changed in the last 20 years. An interim analysis of the first 64 papers shows a stable quality of IT evaluation studies over the last 20 years.

Delivery of Health Care↗
PubMed1996

Current status of mechanical ventilation decision support systems: a review.

Objectives of computerized decision support systems for mechanical ventilation are discussed. Questions considered are: Why is computerized decision support for mechanical ventilation important? What parameter(s) should be optimized? What are the differences between a single attribute and a multiattribute value function used for optimization? How is it possible to achieve optimization in clinical practice with existing ventilators? How does one solve the problem of acquiring measurement of data needed for closed loop control? The possibilities and limitations of three existing decision support systems are discussed. 1) Computerized protocols from LDS Hospital in Salt Lake City, Utah, USA. 2) Optimization Program (OPTPROG) developed jointly at the Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland and Medical Intensive Care Unit, Department of Medicine at Karolinska Institute, South Hospital, Stockholm, Department of Medical Informatics Linkoping University, Sweden. 3) Ventilator Therapy Planner (VENT-PLAN) from the Section on Medical Informatics at Stanford University, Palo Alto, California, USA. Strategies leading to an optimal computerized decision support system are proposed. These strategies include development of better measurement methods for blood gases and cardiac output, improvement of man-machine and machine-machine interaction and the selection of optimization criteria. Finally, research directed towards building quantitative, dynamic patient models based on computerized databases of mechanically ventilated patients are discussed.

Algorithms↗
PubMed2003

Hospital information systems: perspectives on problems and prospects, 1979 and 2002.

PURPOSE: To assess progress made in hospital information systems (HIS) since 1979, when the forerunner of the International Medical Informatics Association Working Group on HIS first met. METHODS: A review of the recommendations made in 1979 identified core concerns, which were analyzed in light of the state of the art in 2002. RESULTS: Despite significant changes over the years, the underlying concerns identified in 1979 are still valid today. In 2002 as in 1979, HIS must be integrated into the hospital's organizational structure; financial and economic benefits depend upon using technology as an enabler of improved clinical outcomes; and education and training remain critical to the successful use of technology solutions. The tools available for addressing these concerns have changed enormously. Where there were dumb terminals, there are the World Wide Web and handheld devices. As a result, we are raising our expectations and changing the terms of our discussions. Today the focus is shifting to patient safety, decision support, and evidence-based practice; the concerns voiced in 1979 have become medical informatics cornerstones. New tools and new approaches now available can improve the quality of care. Using them appropriately requires careful planning and education for patients as well as healthcare professionals.

Congresses as Topic↗
PubMed2006

On exemplary scientific conduct regarding submission of manuscripts to biomedical informatics journals.

As the Editors of leading international biomedical informatics journals, the authors report on a recent pattern of improper manuscript submissions to journals in our field. As a guide for future authors, we describe ethical and pragmatic issues related to submitting work for peer-reviewed journal publication. We propose a coordinated approach to the problem that our respective journals will follow. This Editorial is being jointly published in the following journals represented by the authors: Computer Methods and Programs in Biomedicine, International Journal of Medical Informatics, Journal of Biomedical Informatics, Journal of the American Medical Informatics Association, and Methods of Information in Medicine.

Biomedical Research↗
PubMed2003

Evaluation methodology for a medical e-education patient-oriented information system.

This paper describes an evaluation methodology designed for the IMSA (Interactive Multimedia System for Auto-medication) system. IMSA stands in the multidisciplinary field of medical informatics and aims at providing a health care Internet tool for the general public. As far as a medical information system is patient-oriented, issues in understanding content and of human - computer interface usability are key factors to achieve success. The team developing IMSA concentrated part of its work on designing an evaluation methodology to ensure that the system is user-friendly and responds in a way that can be easily understood by the general public. This methodology is built on a three-tier architecture with the user, the evaluator and a set of medical case descriptions. The testing protocol is based on a user trying to run scenarios related to mild clinical signs on the IMSA prototype under the passive presence of an evaluator.

Evaluation Studies as Topic↗
PubMed2006

Human factors engineering for clinical applications.

This position paper advocates the necessity for promoting a Human Factors Engineering (HFE) approach to new clinical applications in the medical informatics domain. We first describe the negative consequences of NOT using HFE methods for such sensitive applications as medication Computerized Physicians Order Entry systems. We then describe rapidly the HF technology and how it would apply to the healthcare domain. The specific and complex problem of the necessary re-engineering of existing applications is then addressed. We conclude on the mandatory cooperative characteristic of any practical HFE project for designing or re-engineering safety-sensitive clinical applications.

Ergonomics↗
PubMed1994

Standardization of medical imaging in Europe: an integrated initiative.

The successful implementation of PACS (or IMACS) depends on the integration of image and image related data handling systems in an overall hospital information system (HIS) and other departmental information systems (DIS), one of which is radiology information system (RIS). With respect to standardization in the medical imaging field, this integration cannot be looked at separately from the overall prospect of standardization in medical informatics. All relevant standardization work done outside health care should be taken into account. This paper gives an overview of the work within Technical Committee TC 251 'Medical Informatics', of the European Standardization Committee, CEN, with special focus on its Working Group 4 'Medical Imaging and Multimedia'. An indication of the overall framework and relations towards ongoing work is given, with emphasis on short-term targets. The standards to be proposed are collectively called MEDICOM, standing for medical image communication.

Computer Communication Networks↗
PubMedDate not supplied

Addressing organizational issues into the evaluation of medical systems.

New system design and evaluation methodologies are being developed to address social, organizational, political, and other non-technological issues in medical informatics. This paper describes a social interactionist framework for researching these kinds of organizational issues, based on research within medical informatics and other disciplines over the past 20 years. It discusses how effective evaluation strategies may be undertaken to address organizational issues concerning computer information systems in medicine and health care. The paper begins with a theoretical framework for evaluation. It then describes the 4Cs of evaluation: communication, care, control, and context. Five methodological guidelines are given for conducting comprehensive evaluations that address these 4Cs. An example of an evaluation research design that fits the guidelines and was used in an evaluation of an on-line clinical imaging system is discussed. Results of the evaluation study illustrate how this approach addresses organizational concerns and the 4Cs.

Communication↗
PubMed1998

Outcomes management of mechanically ventilated patients: utilizing informatics technology.

This article examines an informatics system developed for outcomes management of the mechanically ventilated adult population, focusing on weaning the patient from mechanical ventilation. The link between medical informatics and outcomes management is discussed, along with the development of methods, tools, and data sets for outcomes management of the mechanically ventilated adult population at an acute care academic institution. Pros and cons of this system are identified, and specific areas for improvement of future health care outcomes medical informatics systems are discussed.

Adult↗
PubMed1998

[Informatics education from the viewpoint of clinical medicine].

Teaching of medical informatics in the 1st medical faculty is compared with teaching of informatics and related curricula in European faculties. Practically in all faculties in the 1st year, a curriculum is situated with formal (mathematical, probabilistic or information and computer based) approach. From a clinical point of view there are two main reasons for situating this curriculum in the first year--it is a good basis for teaching special parts of informatics later directly in preclinical or clinical curricula and teaching informatics is a good occasion how to bring some clinical problems to the first year study and how to motivate students to the study of theoretical medicine.

Curriculum↗
PubMedDate not supplied

Assessment of health information technology: which questions for which systems? Proposal for a taxonomy.

After a brief description of the main domains of application of medical informatics, a typology of questions to be assessed, and of the involved actors, is presented. Dimensions of technology assessment include techniques, medical and health efficacy, economics, sociology, and law and ethics. Barriers to evaluation are analysed. They include barriers related to the domain complexity, human motivation and methodological barriers. Finally categories of solutions and research areas are suggested.

Classification↗
PubMed1997

Five steps from a simple data base to an expert system in nutrition.

The paper describes the experience from the Medical Informatics Department--ITC in the field of the human nutrition. The informatic systems were developed staring from a minimal data base and simple programs. The final versions are expert systems running within complex medical informatic products.

Decision Making, Computer-Assisted↗
PubMed1996

A Web-based architecture for the intelligent management of chronic patients.

We describe a distributed architecture for medical informatics applications, based on the World-Wide Web (WWW) environment. After discussing previous experiences in the application of the WWW for medical purposes, we outline the features of a Common Lisp HTTP server designed to provide access to medical informatics applications using a standard Web browser. As an example of application, we describe a system for therapy planning and revision in the field of insulin-dependent diabetes. The system performs automatic data analysis and interpretation and provides advice on possible adjustments to the therapeutic protocol that the patients are following, taking advantage of the network and multimedia capabilities offered by the WWW for user interaction.

Chronic Disease↗
PubMed1996

The complexity of transactions: a means for assessing interoperability.

Interoperability seems to be a major focal point of the activities within the Informatics Society in general, and the Medical Informatics society in particular. In both Europe and the USA standardization efforts are pursued in order to enable interoperability. However, even if the technical requirements are met, interoperability is sometimes not feasible because the message exchange needed is too complex. This complexity is influenced by at least three factors: the volume of the data to be exchanged, the functionality of the information exchange, and the communication standard adopted.

Computer Communication Networks↗