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At least 793 records · Page 44Linked to original sources
PubMed1990

Variables influencing career choices of graduates of informatics programs funded by the National Library of Medicine.

Graduates of the National Library of Medicine-supported Medical Informatics (MI) training programs were studied to determine the variables influencing their choices of an academic or nonacademic career. More than 60% of the available population of trainees (171 of 272) were studied in 1986 and four of the nine variables measured by means of a questionnaire were significant in differentiating the choices the students made. The training programs located in a private institution, with the majority of the faculty from the medical school and with a small number of trainees who already had the M.D. or Ph.D. degree, generated the highest proportion of graduates seeking academic careers. Discriminant analysis was done to determine whether a combination of variables would discriminate between those who chose academic careers and those who did not. It indicated that the status of the institution (public or private); the entry degree of the trainee; and the productivity of the training program faculty were sufficient to correctly classify 75.3% (67 of 89) of the students who chose academics and 71.9% (59 of 82) of those who did not. There is now a baseline of data that can be used in future studies.

Career Choice↗
PubMed1992

Iliad's role in the generalization of learning across a medical domain.

Medical informatics could facilitate more effective analysis and use of clinical knowledge by means of expert systems. To be most effective, such systems should be constructed in a manner which is consistent with physicians' cognitive processes. Our past five years' work with a system called Iliad indicates that it provides effective medical training and education. The current research extends our previous work by using a wider array of training and test cases. We also evaluated whether training on specific cases could generalize to improved testing performance on related cases, which featured similar complaints and pathophysiologic mechanisms, but different final diagnoses. In their junior internal medicine clerkship, students (n = 100) completed 1300 Iliad training cases covering 48 diagnoses. The findings indicated improved problem solving on the specifically trained cases as well as the generalization cases. We discuss a possible training model for expert systems such as Iliad.

Computer-Assisted Instruction↗
PubMed2002

Training in health informatics in Brazil.

Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We report on five initiatives of the Brazil/USA training program in health informatics. The main goal of this program is to train professionals in establishing medical informatics programs in Brazilian universities and major healthcare facilities.

Brazil↗
PubMed2006

Systematic planning of patient records for cooperative care and multicenter research.

PURPOSE: The purpose of this paper is to introduce a method for systematically planning patient records for structured data entry that can be used in cooperative environments (e.g. cooperative care, multicenter trials) in a way that enables multipurpose use and shared data entry. METHODS: Design research, formal logic. RESULTS: The method suggests five steps: analyze the prevailing documentation infrastructure, provide terminology management system (TMS), provide documentation management system (DMS), plan the logical architecture, provide all necessary tools. CONCLUSIONS: The era of eHealth enables cooperative care and collaborative documentation. This can only be efficient if a multiple use and shared entry of data is realized. The task of the medical informatics community is to plan these environments systematically especially in complex environments which are enabled by emerging technologies.

Biomedical Research↗
PubMed2003

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↗
PubMed1996

Medical records and other stories: a narratological framework.

A new model of the medical record is introduced which can incorporate context, structure, process and use of the medical record within a single narratological framework. It is claimed that the analysis of narrative and, in particular, the study of the story metaphor can provide a theoretical model which provides coherence within the broad discipline of Medical Informatics. It is argued that this framework maintains different levels of abstraction, is useful for teaching and clinical practice, and that its concepts can be readily understood by those in both lay and technical healthcare professions.

Communication↗
PubMed1994

An international health/medical informatics programs database.

The University of Maryland at Baltimore has established a database of health/medical informatics programs worldwide. Since 1991, IMIA's Working Group on Education and Training in Medical Informatics has provided guidance on critical issues of policy and purpose. At the Heidelberg/Heilbronn Working Conference in 1992 on Health/Medical Informatics education, representatives to WG1 and participants made suggestions regarding database intent, structure, and attributes.

Databases, Factual↗
PubMed1995

Recognizing nursing informatics.

In our climate of economic uncertainty, readily accessible and reliable information is essential for cost effective decision making and forward planning in an efficient and effective manner. Information systems are widely used in the business industries to achieve the above. The state hospitals in South Africa have also realized the need for functional information systems. Where does this leave the division of nursing? This division usually comprises at least one third of the hospital establishment with very specific and often complex needs. The nurse managers at all levels have to plan, predict, forecast, monitor, and control in a similar manner to the business industries. What makes their decisions more critical is that they are dealing with human lives. A nursing informatics section with specially trained nurses will have to become an integral part of nursing, to enable nursing to keep abreast of the increasing demand for accurate and timely information for effective decision making. This paper will evaluate the importance of recognizing the need for an informatics section to evolve within the division of nursing, rather than within the general department of medical informatics.

Attitude to Computers↗
PubMed1994

Health care professional workstations: where are we now? ... where should we be tomorrow?

This article looks back over four years during which major changes have occurred in healthcare informatics, both technically and from a policy perspective. A remarkable portion of what medical-informatics professionals were proposing in 1989 has subsequently come to pass. Thus, one lesson from reflections on the recent past is that now is the time for us to devise realistic expectations of what we will see happen in the next four years. Possible scenarios for the future are outlined, as are suggestions for how the informatics community might best prepare for what lies ahead.

Computer Communication Networks↗
PubMed2001

The role of clinical informatics in the Agency for Healthcare Research and Quality's efforts to improve patient safety.

In 1998, the Institute of Medicine (IOM) issued a report on medical errors, which estimated that up to 98,000 people die in U.S. hospitals each year from errors. This report raised concerns that medical errors have become a national public health problem that should be addressed in the same manner as other epidemics such as heart disease, diabetes, and obesity. In 2001, the IOM released a follow-up report encompassing a broader range of quality issues. They concluded that the U.S. healthcare system is outmoded and incapable of providing consistent, high-quality care. They outlined a strategy for redesigning U.S. healthcare delivery to achieve safe, dependable, high-quality care, which emphasizes information technology as an integral part of the solution. AHRQ's fiscal year 2001 appropriation included an increase of $50 million dollars for initiatives to reduce medical errors and improve patient safety. AHRQ responded to this mandate by developing a series of research solicitations that form an integrated set of activities to design and test best practices for reducing errors in multiple health care settings. This paper discusses the components of this program and the central role of medical informatics research in the Agency's efforts to improve the safety of medical care in America.

Decision Support Systems, Clinical↗
PubMed2002

Evidence-based medicine: applications in dietetic practice.

Evidence-based medicine has been defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." Evidence-based practice requires the ability to apply knowledge of medical informatics (eg, efficiently searching the medical literature) and clinical epidemiology (eg, being able to critically appraise the literature) to the treatment of individual patients. Being able to apply the principles of evidence-based medicine in the dietetic practice adds to the credibility and value of dietetics professionals, is consistent with the dietetic code of ethics, and is empowering. This article provides an introduction to the history, philosophy, and methods of evidence-based medicine as applied to the dietetic practice. This article focuses on a 5-step process to finding the best evidence to answer clinical questions: (a) formulate the question, (b) search for answers, (c) appraise the evidence, (d) apply the results, and (e) assess the outcome. We describe the 4S methodology-a systematic approach to efficiently finding the best evidence to answer clinical questions involving the use of systems (comprehensive, evidence-based resources), synopses (compilations of structured abstracts of high-quality studies), syntheses (systematic reviews), and studies (original research articles). Particular emphasis is given to a method for critically appraising papers that emphasizes validity, importance, and clinical applicability. Resources (including Web sites) for further learning are provided. J Am Diet Assoc. 2002;102:1263-1272.

Data Interpretation, Statistical↗
PubMedDate not supplied

Lifelong learning: skills and online resources.

OBJECTIVE: Advances in information technology enable the practicing psychiatrist's quest to keep up-to-date with new discoveries in psychiatry, as well as to meet recertification requirements. However, physicians' computer skills do not always keep up with technology, nor do they take advantage of online search and continuing education services. This article describes the rationale for using electronic databases and training, as well as basic computer skills, computer equipment, and important online resources for psychiatrists to meet their continuing education and recertification needs quickly, easily, and conveniently. METHOD: A literature review was performed using PUBMED and Google to find articles related to recertification, physician's technology adoption and computer skills, evidence-based medicine, and basic approaches to lifelong learning using computers and the Internet, and resources for lifelong learning. RESULTS: Psychiatrists are required to master a discrete set of information for board certification, and to maintain that knowledge for recertification. Surveys have shown that although most physicians use computers, the majority use them for personal or business purposes, and not for accessing Continuing Medical Education (CME) programs (1). The Council on Graduate Medical Education requires the acquisition of medical informatics skills for the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project (2). There is a growing body of literature outlining basic computer skills and competencies for physicians to access online textbooks, databases, journals, and CME programs. CONCLUSIONS: Psychiatrists can benefit from learning how to use computers and the Internet to keep current with the advances in the field. Skills now being taught in medical school and residency are equally important for practicing psychiatrists to learn and master.

Clinical Competence↗
PubMed1993

Computer processing of the orthogonal electrocardiogram and vectorcardiogram.

The aim of this contribution was to review the possibilities of presentation of orthogonal ECG signals and to evaluate the progress in computerized electrocardiography achieved in Czechoslovakia. The information about the cardiac electric field in orthogonal electrocardiogrpahy is defined and consequently displayed as a fixed single dipole (vector). The spatial trajectory of vector end-point (spatial vectorcardiographic loop) can be presented in different ways--as orthogonal electrocardiogram, polarcardiogram, planar vectorcardiogram and decartogram, respectively. The advantages of particular methods of presentation, as well as their limitations are discussed. Computer-assisted electrocardiography was introduced in Czechoslovakia in 1974. The original AVA program has been further developed in the Research Institute of Medical Informatics (formerly Research Institute of Medical Bionics). The currently developed system CardioSys allows the utilization of all the possibilities of orthogonal ECG and vectorcardiographic presentation for clinical and epidemiological cardiology as well as for the research.

Electrocardiography↗
PubMed1993

ARTEMIS: a collaborative framework for health care.

Patient centered healthcare delivery is an inherently collaborative process. This involves a wide range of individuals and organizations with diverse perspectives: primary care physicians, hospital administrators, labs, clinics, and insurance. The key to cost reduction and quality improvement in health care is effective management of this collaborative process. The use of multi-media collaboration technology can facilitate timely delivery of patient care and reduce cost at the same time. During the last five years, the Concurrent Engineering Research Center (CERC), under the sponsorship of DARPA (Defense Advanced Research Projects Agency, recently renamed ARPA) developed a number of generic key subsystems of a comprehensive collaboration environment. These subsystems are intended to overcome the barriers that inhibit the collaborative process. Three subsystems developed under this program include: MONET (Meeting On the Net)--to provide consultation over a computer network, ISS (Information Sharing Server)--to provide access to multi-media information, and PCB (Project Coordination Board)--to better coordinate focussed activities. These systems have been integrated into an open environment to enable collaborative processes. This environment is being used to create a wide-area (geographically distributed) research testbed under DARPA sponsorship, ARTEMIS (Advance Research Testbed for Medical Informatics) to explore the collaborative health care processes. We believe this technology will play a key role in the current national thrust to reengineer the present health-care delivery system.

Computer Communication Networks↗
PubMed2005

Practical Approaches to the Development of Biomedical Informatics: the INFOBIOMED Network of Excellence.

Biomedical Informatics (BMI) is the emerging discipline that aims to facilitate integration of Bioinformatics and Medical Informatics for the purpose of accelerating discovery and the generation of novel diagnostic and therapeutic modalities. Building on the success of the European Commission-funded BIOINFOMED Study, an INFOBIOMED Network of Excellence has been constituted with the main objective of setting a structure for a collaborative approach at a European level. Initially formed by fifteen European organizations, the main objective of the INFOBIOMED network is therefore to enable the reinforcement of European BMI at the forefront of these emergent interdisciplinary fields. The paper describes the structure of the network, the integration approaches regarding databases and four pilot applications.

Biomedical Research↗
PubMed2003

The mantra of modeling and the forgotten powers of paper: A sociotechnical view on the development of process-oriented ICT in health care.

The recognition that restructuring care processes is central to effective and efficient health care will result in the emergence of process-oriented electronic patient records (EPRs). How will these technologies come into being? Within informatics, it is often stated that to informate something, we should first model it. This paper queries whether a detailed modeling of work processes and data flows is the primary step that needs to be completed before such EPRs can be developed or tailored. Building upon a sociotechnical understanding of ICT development, we argue for a reinterpretation of 'models' in such development processes. We do so through a reverse engineering of parts of the paper-based medical record, which has received little attention in medical informatics. In process-oriented EPR design, we argue, modeling should not be conceived as the crucial first step in this design, but rather as an intervention in the organizational change-processes that constitute proper ICT development.

Humans↗
PubMedDate not supplied

"You have to be there": twenty-five years of SCAMC/AMIA symposia.

The AMIA Annual Symposium began life as the Symposium on Computer Applications in Medical Care (SCAMC) in 1977. Inaugurated as a multidisciplinary meeting with multiple sponsors, the Symposium quickly became a force in the development of the field of medical informatics. The authors summarize the 25-year history of the meeting and its proceedings, drawing on information in the printed programs and proceedings and on the personal recollections of some Symposium organizers and attendees. They also present the results of a study of the extent to which Symposium papers have been cited in the journal literature.

Congresses as Topic↗
PubMedDate not supplied

Global healthcare and the flux of technology.

For Medinfo '98, as an exercise in technological forecasting and analysis, we volunteered to project the direction of healthcare informatics into the next century. This paper is an extended discussion of that presentation. We open with the observation that healthcare informatics is merely one of the many endeavors that is following a turbulent but nearly inescapable path into a digital future. Our objective is to describe as best we can the overall geography of the general path we appear to be on, to anticipate some of our future checkpoints along the way, to identify some of the roughest transitional passages as they apply to healthcare, and to present this as one guide among many to those who have offered to do the steering into this exciting, electronic unknown. Emphasis is placed on the growing importance of information networks, the particular nature of complexity as applied to healthcare communications and healthcare itself, and the impact of the rising costs of what is medically possible in a technological age. Certain evident recent changes in computing technology are singled out for their present and expected importance. The whole is considered from a broader organizational perspective to better understand the turbulence of present times, and what medical informatics might address to ameliorate the most onerous healthcare issues.

Computers↗