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PubMed1999

Contemporary issues in medicine--medical informatics and population health: report II of the Medical School Objectives Project.

The Association of American Medical Colleges established the Medical School Objectives Project (MSOP) to set forth program-level learning objectives that medical school deans and faculties can use as guides in reviewing their medical student education programs (initial phase), and to suggest strategies that they might employ in implementing agreed-upon changes in those programs (implementation phase). The publication of MSOP Report I in 1998 concluded the initial phase of the project by presenting 30 program-level learning objectives that represent a consensus within the medical education community on the knowledge, skills, and attitudes that students should possess before graduation from medical school. Report II, published here, is the work of two expert panels that focus on the two interrelated topics of medical informatics and population health for which Report I developed learning objectives. The Medical Informatics Panel identified five roles played by physicians--lifelong learner, clinician, educator-communicator, researcher, and manager--in which medical informatics plays a vital part, and defined one or more informatics learning objectives important for each role (e.g., the successful medical school graduate, in his or her role as a clinician, should be able to retrieve patient-specific information from a clinical information system). The panel then identified ways that schools might implement educational programs to address the various informatics learning objectives and to eventually embed informatics experiences throughout the curriculum rather than relying on an informatics course to achieve some or all of the objectives. The Population Health Perspective Panel developed a consensus definition of "population health perspective" (PHP); chose four types of populations to discuss (e.g., the geographic community); reviewed pressures for and against the implementation of a PHP in the curriculum (e.g., the cross-disciplinary nature of the topic is a barrier); named the fields that encompass training in a PHP (e.g., public health); listed several educational objectives, three principles to govern the design of educational activities, and a number of recommendations; and closed with a list of the knowledge, skills, and attitudes that should be instilled by a successful PHP curriculum.

Education, Medical, Undergraduate↗
PubMed2004

Evaluating consumer informatics: learning from health campaign research.

This paper suggests that some conceptual models used in health communication campaigns as well as the "uses and gratifications" approach might be successfully integrated into the evaluation of consumer informatics. These models and tools are especially pertinent when the desired outcomes of media health interventions are therapeutic changes in public knowledge, motivations, attitudes and patient behavior

Communication↗
PubMed2005

Implementing digital resources for clinicians' and patients' varying needs.

This paper presents an overview of several evidence-based medicine and patient information studies conducted across the UK health service over a 4 year period, investigating clinicians', managers', and patients' perceptions of digital resources (primarily digital libraries) in hospitals, Primary Care Trusts, NHS Direct (patient call centre) and patient groups. In-depth interviews and focus groups are analysed using grounded theory methodologies and through content analysis used to produce quantitative finding. The perceived impacts of three different methods employed for delivering health informatics are presented. The findings highlight some generic issues relevant for health informatics in the UK health sector as well as some specific issues for medical digital libraries. This paper reviews in more detail the issues of medical technology implementation (traditional implementation, on the wards, and intermediaries within in communities). A breakdown of the clinicians' and patients' information journey (information initiation, facilitation and interpretation) is also presented with regard to medical digital libraries and online resources. Broad guidelines derived from these findings are provided for health-informatics deployment.

Adult↗
PubMed1990

[Problems in improving information supply in the public health administration].

F. G. Grigoriev (Soviet Public Health, 1989, No. 2, p. 31-36) raised an issue of the necessity to considerably reduce the amount of annual statistical reporting of curative and preventive institutions. The preparation and drawing up of such a report in its present form require an unjustified lot of time and means. But it is advisable to broaden this task and to solve it as a problem of optimizing the information supply of public health management with allowance made for its present state and prospects of development for the nearest 8-10 years. The problem could be solved by rationally reducing the number of insufficiently informative and duplicating forms of reporting, sections (tables) of annual statistical reports and by a wider introduction of paperless informatics system.

Annual Reports as Topic↗
PubMed2004

Towards clinical bioinformatics: advancing genomic medicine with informatics methods and tools.

OBJECTIVES: To summarize the challenges facing clinical applications in the light of growing research results in genomic medicine and bioinformatics. METHODS: Analysis of the contents of the Yearbook of Medical Informatics 2004 of the International Medical Informatics Association (IMIA). RESULTS: The Yearbook of Medical Informatics 2004 includes 32 articles selected from 22 peer-reviewed scientific journals. A special section on clinical bioinformatics highlights recent developments in this field. Several guest editors review the promises and limitations of available methods and resources from biomedical informatics that are relevant to clinical medicine. Integrated data and knowledge resources are generally regarded to be central and key issues for clinical bioinformatics. Further review papers deal with public health implications of bioinformatics, knowledge management and trends in health care education. The Yearbook includes for the first time a section on the history of medical informatics, where the significant impact of the Reisensburg protocol 1973 on international health and medical informatics education is examined. CONCLUSIONS: Close collaboration between bioinformatics and medical informatics researchers can contribute to new insights in genomic medicine and contribute towards the more efficient and effective use of genomic data to advance clinical care.

Computational Biology↗
PubMed1997

Medical informatics.

Explore the source record for details and available documents.

Computer Communication Networks↗
PubMed2005

Towards new information resources for public health--from WordNet to MedicalWordNet.

In the last two decades, WordNet has evolved as the most comprehensive computational lexicon of general English. In this article, we discuss its potential for supporting the creation of an entirely new kind of information resource for public health, viz. MedicalWordNet. This resource is not to be conceived merely as a lexical extension of the original WordNet to medical terminology; indeed, there is already a considerable degree of overlap between WordNet and the vocabulary of medicine. Instead, we propose a new type of repository, consisting of three large collections of (1) medically relevant word forms, structured along the lines of the existing Princeton WordNet; (2) medically validated propositions, referred to here as medical facts, which will constitute what we shall call MedicalFactNet; and (3) propositions reflecting laypersons' medical beliefs, which will constitute what we shall call the MedicalBeliefNet. We introduce a methodology for setting up the MedicalWordNet. We then turn to the discussion of research challenges that have to be met to build this new type of information resource. We build a database of sentences relevant to the medical domain. The sentences are generated from WordNet via its relations as well as from medical statements broken down into elementary propositions. Two subcorpora of sentences are distinguished, MedicalBeliefNet and MedicalFactNet. The former is rated for assent by laypersons; the latter for correctness by medical experts. The sentence corpora will be valuable for a variety of applications in information retrieval as well as in research in linguistics and psychology with respect to the study of expert and non-expert beliefs and their linguistic expressions. Our work has to meet several considerable challenges. These include accounting for the distinction between medical experts and laypersons, the social issues of expert-layperson communication in different media, the linguistic aspects of encoding medical knowledge, and the reliability, volume, and emergence of medical knowledge. The work described here has been tested in a small pilot experiment and awaits large-scale implementation.

Computational Biology↗
PubMed1995

Communication theory and the search for effective feedback.

If messages transmitted to the public, patients and health professionals could be assured of being received, understood and acted on as intended by the senders of messages, there would be little need to focus on communications and feedback. That the physician's office, the healthcare system and the community are littered with messages that 'never got through' attests to the problem of ineffective communications and the absence of effective feedback. Communication theorists, health psychologists and thoughtful health professionals, particularly those working in community hypertension programmes, have developed approaches that improve the probabilities of 'getting the message through'. Theory-based communications with built-in feedback and 'feed-forward' enhance the probabilities of success considerably. This presentation explores these problems using the SMCR model of communication. Differences between linear models and transactional models are discussed. On the assumption that the health message environments of the future will be increasingly complex with highly differentiated target audiences in a rapid paced computer and electronically driven world, 'getting the message through' will become an even greater challenge than in the recent past. Specific steps to change communication approaches in this setting are proposed.

Communication↗
PubMedDate not supplied

Dale Schumacher on strategic quality planning and research. Interview by Joann Grenovich-Richards.

Dale N. Schumacher, MD MPH, is president of the Rockburn Institute, a not-for-profit health services research and consulting organization. Dr. Schumacher has 25 years' experience in the fields of medicine, health services research, and consulting. He spent 3 years in the U.S. Public Health Service, where he coordinated the development of the Sickness Index Profile, an early health status measure. Dr. Schumacher also helped establish the Center for Hospital Finance and Management at The Johns Hopkins Medical Institutions, where he was an associate director. He has held senior management positions or consulted with the Sisters of Mercy Health Corporation, Holy Cross Health System, Alexian Brothers Health System, Catholic Medical Center, and Northwestern Healthcare. Currently, he is senior medical advisor to the National Business Coalition on Health and serves as clinical informatics officer for Crozer-Keystone Health System in Philadelphia. He is a board member at Kaleida Health System, Buffalo, NY. Dr. Schumacher has written more than 40 publications in the areas of medical education, medical care, quality-of-care assessment, healthcare data analysis, and reliability of chart-review data. Dr. Schumacher earned his medical degree from the University of Illinois and his master of public health degree from The Johns Hopkins University School of Hygiene and Public Health, and was a postdoctoral fellow there in the departments of health services administration and epidemiology. He trained at The Johns Hopkins/Baltimore City Hospitals and St. Agnes Hospital. Dr. Schumacher is board certified in internal medicine.

Disclosure↗
PubMedDate not supplied

Electronic health record meets digital library: a new environment for achieving an old goal.

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

Internet↗
PubMed2000

Medical informatics and the concept of disease.

This paper attempts to address the general question whether information technologies, as applied in the area of medicine and health care, have or are likely to change fundamental concepts regarding disease and health. After a short excursion into the domain of medical informatics I provide a brief overview of some of the current theories of what a disease is from a more philosophical perspective, i.e. the "value free" and "value laden" view of disease. Next, I consider at some length, whether health care informatics is currently modifying fundamental concepts of disease. To this question I will answer largely in the negative, and I will provide the sketch of some arguments from current research programs in medical informatics why I think this is the case. This argumentation is supported by a detailed account of how the disease profile for beriberi heart disease, used in one of the major medical informatics diagnostic programs, QMR (and its ancestor INTERNIST-1), was developed, and why at least this program essentially follows received views of traditional medicine. The one main exception to the conformity of this program to "received" views of a disease occurs when the program's designers need to fine-tune a disease definition. This fine-tuning is to comport with the expert's perspective on the disease, including his or her epistemic values, as well as the program's other resources for diagnosing components of a disease.

Beriberi↗
PubMedDate not supplied

The federal role in the health information infrastructure: a debate of the pros and cons of government intervention.

Some observers feel that the federal government should play a more active leadership role in educating the medical community and in coordinating and encouraging a more rapid and effective implementation of clinically relevant applications of wide-area networking. Other people argue that the private sector is recognizing the importance of these issues and will, when the market demands it, adopt and enhance the telecommunications systems that are needed to produce effective uses of the National Information Infrastructure (NII) by the healthcare community. This debate identifies five areas for possible government involvement: convening groups for the development of standards; providing funding for research and development; ensuring the equitable distribution of resources, particularly to places and people considered by private enterprise to provide low opportunities for profit; protecting rights of privacy, intellectual property, and security; and overcoming the jurisdictional barriers to cooperation, particularly when states offer conflicting regulations. Arguments against government involvement include the likely emergence of an adequate infrastructure under free market forces, the often stifling effect of regulation, and the need to avoid a common-and-control mentality in an infrastructure that is best promoted collaboratively.

Delivery of Health Care↗