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PubMed1998

What is done, what is needed and what is realistic to expect from medical informatics standards.

Medical informatic experts have made considerable progress in the development of standards for orders and clinical results (CEN, HL7, ASTM), EKG tracings (CEN), diagnostic images (DICOM), claims processing (X12 and EDIFAC) and in vocabulary and codes (SNOMED, Read Codes, the MED, LOINC). Considerable work still remains to be carried out. Abstract models of health care information have to be created, to cover the necessary domain, and yet be simple enough to assimilate, implement, and manage. This requires a high degree of abstraction. Enormous amounts to develop standardized vocabulary are still required to complement such a model, and to define the subsets that apply to given contexts.

Computer Communication Networks↗
PubMed2004

Medical informatics at Heidelberg/Heilbronn: status-evaluation-new challenges in a specialised curriculum for medical informatics after thirty years of evolution.

After reporting on characteristics, structure and contents of the specialised informatics-based curriculum for medical informatics (MI) at the University of Heidelberg/University of Applied Sciences Heilbronn, the paper describes the development during the last 5 years, and in particular a complementary health care oriented postgraduate program in 'Health Information Management' (IM). Furthermore, it outlines results of a study among the MI graduates, which aims to assess their job situation and to evaluate the curriculum from their viewpoint and so establishes a summary of 30 years of experience with the program. Finally, the paper discusses new challenges of the program, considering the results of the study, perspectives of health care provision in the next decade, content changes to be focused on and the growing competition in the field of programs for medical informatics.

Computer-Assisted Instruction↗
PubMed2004

Teaching of medical informatics in UME-21 medical schools: best practices and useful resources.

OBJECTIVES: Information-based decision making is important to modern medical practice. This report identifies learning objectives, teaching innovations, and student outcomes for teaching medical informatics (MI) in medical schools that participated in the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project. METHODS: Project reports by the UME-21 schools were analyzed, and curricular content was classified in terms of the five categories for MI literacy adapted from the Medical School Objectives Project. Student self-assessments of adequacy of exposure to MI were reviewed. RESULTS: Teaching methods included demonstrations, lectures, small-group tutorials, hands-on labs, and task-based assignments. The curriculum was taught during the first 3 years of medical school with medical librarians participating. Content examples in the five categories of medical literacy were: "Role of the Lifelong Learner" (accessing, evaluating, and using information and databases), "Role of Clinician" (obtaining patient information, using decision support), "Role of Educator/Learner/Communicator" (accessing information for patient education, student-teacher communication, studying Web-based cases, making presentations, accessing on-line course information), "Role of Researcher/Evaluator" (documenting patient encounters), and "Role of Manager" (using drug formularies and clinical guidelines). Seniors exposed to the UME-21 curriculum reported higher levels of exposure to MI than did untrained seniors 2 years earlier; however, seniors at non-UME-21 schools reported equally high levels. CONCLUSIONS: UME-21 schools developed creative materials for teaching students to use computers for learning, communication, and searching for information. Outcome measures suggest that MI has become an important curriculum topic in most medical schools.

Computer Literacy↗
PubMed1995

Integrating medical informatics into an undergraduate medical curriculum.

his paper outlines a rationale for medical schools to integrate medical informatics into their curricula. The approach used in the problem-based undergraduate curriculum at Dalhousie University School of Medicine is presented in three areas: organizational structure, implementation, and curriculum development. Seven goal areas defined to guide the curriculum development process are described.

Computer Literacy↗
PubMed2003

Informatics united: exemplary studies combining medical informatics, neuroinformatics and bioinformatics.

OBJECTIVES: Medical informatics, neuroinformatics and bioinformatics provide a wide spectrum of research. Here, we show the great potential of synergies between these research areas on the basis of four exemplary studies where techniques are transferred from one of the disciplines to the other. METHODS: Reviewing and analyzing exemplary and specific projects at the intersection of medical informatics, neuroinformatics, and bioinformatics from our experience in an interdisciplinary research group. RESULTS: Synergy emerges when techniques and solutions from medical informatics, bioinformatics, or neuroinformatics are successfully applied in one of the other disciplines. Synergy was found in 1. the modeling of neurophysiological systems for medical therapy development, 2. the use of image processing techniques from medical computer vision for the analysis of the dynamics of cell nuclei, and 3. the application of neuroinformatics tools for data mining in bioinformatics and as classifiers in clinical oncology. CONCLUSIONS: Each of the three different disciplines have delivered technologies that are readily applicable in the other disciplines. The mutual transfer of knowledge and techniques proved to increase efficiency and accuracy in a manifold of applications. In particular, we expect that clinical decision support systems based on techniques derived from neuro- and bioinformatics have the potential to improve medical diagnostics and will finally lead to a personalized delivery of healthcare.

Computational Biology↗
PubMed1997

Preparing our future physicians: integrating medical informatics into the undergraduate medical education curriculum.

This paper describes how two medical schools have integrated "medical informatics" into their undergraduate medical education programs with the aim of preparing their students for future practice. It describes the components or elements of the informatics programs, how learning opportunities have been integrated into the curricula, how the informatics programs have evolved, and future directions. The medical schools approached the task of introducing informatics in a parallel way. Following needs identification, similar topic areas, goals, and specific informatics learning objectives were developed. These were used as a basis for implementation and evaluation. In general, the topic areas selected are: computer literacy, communications, information retrieval and management, computer-aided learning, patient management, office practice management, and hospital information systems. Learning opportunities in informatics were integrated for the above goals, in accordance with how the curriculum was organized in each school. These opportunities, and the support activities provided will be described.

Alberta↗
PubMed2004

Evolution of medical informatics in bibliographic databases.

Medical informatics became a medical specialty during the last years and this is evidenced by a great amount of journal articles regarding the subject published worldwide. We compared the presentation of Medical Informatics in two different bibliographic databases: MEDLINE and LILACS (Latin American and Caribbean Literature on the Health Sciences). Previous studies described how Medical Informatics was represented in MEDLINE, but we wanted to compare it to a regional database as LILACS. We search both databases completely (MEDLINE 1966 -2002 and LILACS 1982-2002) using the keyword "Medical Informatics" as MeSH term in MEDLINE and as DeCS term in LILACS, and we added "medical informatics" as text word and analyzed the references obtained as results. We found that MEDLINE properly represents the impact of Medical Informatics in non-Latin-American international journals, but lacks of a considerable amount of articles from this region, while LILACS, although in comparison it is smaller in size, has more articles regarding the subject. So we think that LILACS properly represents the specialty in Latin America and the Caribbean Region.

Bibliometrics↗
PubMedDate not supplied

Design and analysis of controlled trials in naturally clustered environments: implications for medical informatics.

In medical informatics research, study questions frequently involve individuals who are grouped into clusters. For example, an intervention may be aimed at a clinician (who treats a cluster of patients) with the intention of improving the health of individual patients. Correlation among individuals within a cluster can lead to incorrect estimates of the sample size required to detect an effect and inappropriate estimates of the confidence intervals and the statistical significance of the intervention effects. Contamination, which is the spread of the effect of an intervention or control treatment to the opposite group, often occurs between individuals within clusters. It leads to an attenuation of the effect of the intervention and reduced power to detect a difference. If individuals are randomized in a clinical trial (individual-randomized trial), then correlation must be taken into account in the analysis, and the sample size may need to be increased to compensate for contamination. Randomizing clusters rather than individuals (cluster-randomized trials) can eliminate contamination and may be preferred for logistical reasons. Cluster-randomized trials are generally less efficient than individual-randomized trials, so the tradeoffs must be assessed. Correlation must be taken into account in the analysis and in the sample-size calculations for cluster-randomized trials.

Cluster Analysis↗
PubMed2003

Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association.

The Primary Care Informatics Working Group (PCIWG) of the American Medical Informatics Association (AMIA) has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI), to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

Humans↗
PubMed1998

[The concept of practical teaching of medical informatics at the Medical School of Palacký University in Olomouc].

The method and conditions of medical information technology teaching represent a direct reflection of both significant progress of information technology and change in public approach to computer techniques. Over the years, the content of the course has been changed to a large extent. It is a result of the existing wide scale of available program products, modernization of local computer network and information technology classrooms and especially common attempt to availability of Internet. The computer-literacy of students is increasing as well as the number and quality of specialized teaching programs and demands of theoretical subjects of study. However the level of computer-literacy of individual students is getting to be widely different. In answer to this situation our institute reacts by some measures, described here. The aim of this paper is to raise a discussion about them and about this issue and to learn more about the approaches and practise in other institutes. In our opinion, a general integration of the main features of the medical information technology teaching courses at Medical Faculties would be the most effective result.

Czech Republic↗
PubMed1999

A hypergraphic model of medical informatics: curriculum development guide.

Medical informatics, as a descriptive, scientific study, must be mathematically or theoretically described. Is it important to define a model for medical informatics? The answer is worth pursuing. The medical informatics profession stands to benefit three-fold: first, by clarifying the vagueness of the definition of medical informatics, secondly, by identifying the scope and content for educational programs, and, thirdly, by defining career opportunities for its graduates. Existing medical informatics curricula are not comparable. Consequently, the knowledge and skills of graduates from these programs are difficult to assess. The challenge is to promote academics that develops graduates for prospective employers to fulfill the criteria of the health care industry and, simultaneously, compete with computer science programs that produce information technology graduates. In order to meet this challenge, medical informatics programs must have unique curricula that distinguishes its graduates. The solution is to educate students in a comparable manner across the domain of medical informatics. This paper discusses a theoretical model for medical informatics.

Computers↗
PubMed1994

Health and medical informatics education.

Health and medical informatics education has meanwhile gained considerable importance for medicine and for health care. Specialized programs in health/medical informatics have therefore been established within the last decades. This special issue of Methods of Information in Medicine contains papers on health and medical informatics education. It is mainly based on selected papers from the 5th Working Conference on Health/Medical Informatics Education of the International Medical Informatics Association (IMIA), which was held in September 1992 at the University of Heidelberg/Technical School Heilbronn, Germany, as part of the 20 years' celebration of medical informatics education at Heidelberg/Heilbronn. Some papers were presented on the occasion of the 10th anniversary of the health information science program of the School of Health Information Science at the University of Victoria, British Columbia, Canada. Within this issue, programs in health/medical informatics are presented and analyzed: the medical informatics program at the University of Utah, the medical informatics program of the University of Heidelberg/School of Technology Heilbronn, the health information science program at the University of Victoria, the health informatics program at the University of Minnesota, the health informatics management program at the University of Manchester, and the health information management program at the University of Alabama. They all have in common that they are dedicated curricula in health/medical informatics which are university-based, leading to an academic degree in this field. In addition, views and recommendations for health/medical informatics education are presented. Finally, the question is discussed, whether health and medical informatics can be regarded as a separate discipline with the necessity for specialized curricula in this field.(ABSTRACT TRUNCATED AT 250 WORDS)

Medical Informatics↗
PubMedDate not supplied

Progress with formalization in medical informatics?

The prevailing view of medical informatics as a primarily subservient discipline in health care is challenged. Developments in both general informatics and medical informatics are described to identify desirable properties of modeling languages and tools needed to solve key problems in the application field. For progress in medical informatics, it is considered essential to develop far more formal modeling languages, modeling techniques, and tools. A major aim of this development should be to expel ambiguity from concepts essential to medicine, positioning medical informatics "at the heart of health care."

Information Systems↗
PubMed2001

Modeling a medical environment: an ontology for integrated medical informatics design.

Modern medical environments have seen an increase in technological complexity and pressures of handling more patients with fewer resources, resulting in higher demands on medical practitioners. Medical informatics designers will have to focus on the problem of organizing medical information more effectively to enable practitioners to cope with these challenges. This article addresses this research problem for the particular area of medical problem solving in patient care. First, we describe a traditional modeling approach for medical reasoning used as a basis for developing some decision support systems. We argue these models may be faithful to what is known about biomedical knowledge, but they have limitations for human problem solving, especially in unanticipated situations. Second, we present an ontological framework, known as the abstraction hierarchy (Rasmussen, IEEE Trans. Man. Cybernetics 15 (1985) 234-243), for integrating patient representations that are faithful to existing biomedical knowledge and that are consistent with what is known about human problem solving. Through an example of a critical event in the operating room, we reveal how this framework can support medical problem solving in unanticipated situations. Third, we show how to use these representations as a frame of reference for mapping medical roles, responsibilities, sensors, and controls in an operating room context. Finally, we provide some insight for medical informatics designers in using this framework to design novel training programs and human-computer displays.

Decision Support Techniques↗
PubMed2004

Curricula in medical informatics.

Education in medical informatics is needed not only for those who want to become specialist in this area but also for health professionals. Since students, depending on the program they are enlisted in, require different types of knowledge and skills in medical informatics, curricula should be adapted to those needs. The curriculum structure also depends on the expert level the students want to attain. This contribution presents the knowledge and skills levels for different groups of students and presents two examples of curricula.

Curriculum↗