Health Level 7. A protocol for the interchange of healthcare data.
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Computer Communication Networks↗
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Results for “Medical Informatics”
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Medical EDI message specification and interchange formats.
Assessment of the current medical edi environment learns that "old" interchange formats are being used to represent information of highly complex and quickly evolving nature. Whenever the domain requirements are translated into acceptable messages according to these interchange format specifications, system developers use the latest technologies to implement the messages towards the distorted view imposed by the interchange format constraints. This situation, combined with the fact of coexistence of several interchange formats and the urgent need for more standardised message types, led to the specification of a new meta-syntax, supporting easy message definition and allowing the data-driven conversion between multiple interchange formats. As such, and supported by the development of interchange format independent message descriptions, it may become a tool to support the medical edi needs of the future.
Artificial Intelligence↗
UN EDIFACT--an EDI standard for health care.
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Computer Communication Networks↗
Measuring dissimilarity in online health search activities.
There is growing evidence of the use of the Internet to obtain critical health information as well as increased diversity of user groups. While users of web-based information often report their reliance on healthcare providers for validation of information, it has yet to be determined if this is universally true across all types of information or user groups. In some cases consumers may aggregate in places where they trust web information (relative to provider-based information), such as areas of unsettled diagnostic methods or ambiguous treatment protocols. To date little research has been done to identify and differentiate clusters of health consumers and their similarities related to type of information sought. Data from a study of consumer Web search activity in a post-intervention era serves as a natural experiment, and can identify whether clusters of "digitally underserved groups" persist in the US, following national efforts to eliminate barriers to health information access. This exploratory technology assessment study seeks to differentiate and delineate specific information behaviors, across targeted healthcare subgroups. Doing so allows the design of more effective strategies to promote the use of the Web as a health education and health promotion tool, under the envisioned shared decisionmaking, consumer-centric health information model, critical to the proposed US national health information infrastructure.
Attitude to Computers↗
[Information technology in the health sector of the 90s (I)].
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Electronic Data Processing↗
Information technology for the technologically incompetent.
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Humans↗
Understanding the foundation: the state of generalist search education in library schools as related to the needs of expert searchers in medical libraries.
PURPOSE: The paper explores the current state of generalist search education in library schools and considers that foundation in respect to the Medical Library Association's statement on expert searching. SETTING/SUBJECTS: Syllabi from courses with significant searching components were examined from ten of the top library schools, as determined by the U.S. News & World Report rankings. METHODOLOGY: Mixed methods were used, but primarily quantitative bibliometric methods were used. RESULTS: The educational focus in these searching components was on understanding the generalist searching resources and typical users and on performing a reflective search through application of search strategies, controlled vocabulary, and logic appropriate to the search tool. There is a growing emphasis on Web-based search tools and a movement away from traditional set-based searching and toward free-text search strategies. While a core set of authors is used in these courses, no core set of readings is used. DISCUSSION/CONCLUSION: While library schools provide a strong foundation, future medical librarians still need to take courses that introduce them to the resources, settings, and users associated with medical libraries. In addition, as more emphasis is placed on Web-based search tools and free-text searching, instructors of the specialist medical informatics courses will need to focus on teaching traditional search methods appropriate for common tools in the medical domain.
Curriculum↗
Modeling concepts in medicine for medical language understanding.
Over the past two decades, the construction of models for medical concept representation and for understanding of the deep meaning of medical narrative texts have been challenging areas of medical informatics research. This review highlights how these two inter-related domains have evolved, emphasizing aspects of medical modeling as a tool for medical language understanding. A representation schema, which balances partially but accurately with complete but complex representations of domain-specific knowledge, must be developed to facilitate language understanding. Representative examples are drawn from two major independent efforts undertaken by the authors: the elaboration and the subsequent adjustment of the RECIT multilingual analyzer to include a robust medical concept model, and the recasting of a frame-based interlingua system, originally developed to map equivalent concepts between controlled clinical vocabularies, to invoke a similar concept model.
Artificial Intelligence↗
The retrieval effectiveness of medical information on the web.
The World Wide Web has become such an extensive health information repository in the world that it is increasingly difficult to search for relevant medical information. Many search tools have been developed to help users look for relevant health information on the web, but most of them are still not efficient. In this paper, we discuss some available on-line solutions to medical information retrieval and compare the performances of some general and medicine-specific search engines with the MediAgent, which has been developed by the National University of Singapore (NUS) Medical Informatics Programme. Although a number of medicine-specific searching techniques have been developed, the difficulty of finding medical information still remains because medical search engines are generally not as effective as generic search engines. Different from other search tools, MediAgent's efficiency was quite high, taking only an average of 1.5 links to retrieve the answers, but its retrieving effectiveness is not good enough due to the short period of operation. Whilst the MediAgent project cannot claim to have all the solutions, it nevertheless offers a new alternative to system implementation. New techniques need to be explored in order to overcome the issues of medical information retrieval on the Internet.
Humans↗
Evaluating black-boxes as medical decision aids: issues arising from a study of neural networks.
The rigorous evaluation of medical decision aids will be critical to promoting their development, establishing their clinical value and legalizing their use. Many decision aids are transparent in the sense that their internal structure and function can be examined and verified. Some decision aids, however, use complex models of associations in training data to construct 'black-box' systems whose workings are largely impenetrable and inexplicable. The issues surrounding the evaluation of such systems, as exemplified by connectionist (neural network) models, are discussed. For such systems the two major aspects that can be evaluated are the training data from which the system is derived, and its performance on test data. A number of questions about the use of black-box systems as medical decision aids are posed which require consideration by the medical informatics community.
Diagnosis, Computer-Assisted↗
Promoting the usability of online AMIA Symposium Proceedings.
A semi-automatic procedure that extracts metadata from MEDLINE was used to develop a search tool that facilitates online location and (free) access to full-text electronic documents from the Proceedings of the American Medical Informatics Association (AMIA) Annual Symposia (1997-2003). Log file analysis for six months showed steady use of the tool, with most queries originating from hosts in the US (60%), Canada (15.3%), Argentina (10.2%) and Australia (9.6%) for common informatics topics.
Congresses as Topic↗
Informatics as a separate section within a department of pathology.
Departments of pathology should be reorganized to include a separate section of pathology informatics (PI) in addition to the traditional sections of clinical pathology and anatomic pathology. PI is the discipline of medical informatics as practiced within pathology and encompasses a rich mix of activities. The primary role of specialists working in clinical pathology and anatomic pathology would be to create information, whereas that of informaticians in a section of PI would be to add value to the created information by processing it and communicating it to users. The four major benefits associated with a PI section would be as follows: (1) enhanced productivity and efficiency in the development of alignment and impact applications; (2) better management of the information product of pathology and the informaticians themselves; (3) increased political power and influence for pathology; and (4) increased awareness and sophistication on the part of departmental leaders about information processing. Departmental benefits from the proposed organizational change would thus be calibrated in terms of the ability of the revamped department to harness and exploit new information technology.
Clinical Laboratory Information Systems↗
A model curriculum of health care informatics for Dutch higher professional education.
This paper describes the results of a two year project to design a model curriculum of health care informatics for Dutch higher professional education. The core of the curriculum are sixteen modules which cover the broad range of medical informatics and which are closely related to the profiles of the professions involved (nursing, physiotherapy, speech therapy, occupational therapy and dietetics). The curriculum emphasizes the need of using structured data and information to perform tasks in health care delivery and management, for which modern information technology is indispensable. The model curriculum will enable faculty to redesign existing undergraduate programs and to select the contents they see appropriate. In this way we hope that the model curriculum will contribute to an innovative attitude of future graduating health care professionals. A new three year project just has started to develop learning materials using professional health care software based on the sixteen modules of the curriculum.
Curriculum↗
Harnessing the power of an intelligent health environment in cancer control.
In 1971, when Congress declared "war on cancer," the public's perception was driven by an image of a single cure for a single disease. What researchers have learned since that time is that cancer is a formidable enemy made up of more than 100 different disease etiologies. The war on cancer became a war of the 21st century; a war to be fought on multiple fronts against a diffuse enemy and for which prevention was the most judicious path to victory. To fight this new war on cancer, the National Cancer Institute must seek to harness the power of health informatics to create a supportive environment for transforming science, delivering safe and patient-centric health care, and creating an environment of personal empowerment in public health. Three different types of health informatics applications are implicated: (a) applications in bioinformatics, which are intended to revitalize the engine of scientific discovery; (b) applications in medical informatics, which will create a safer and more effective environment for delivery; and (c) applications in consumer informatics, which will enable individuals to advance the charge of their own ongoing health care over the course of their lives. To keep these applications on track, health care administrators must take a sociotechnical approach to implementation. The new systems must be built into the health care environment in such a way that they support human capacities, provide failsafe backups in the face of cognitive and physical limitations, and support continuous quality improvement.
Computational Biology↗
The hip status: a telemedical application.
Biomedical informatics and biomedical engineering are interdisciplinary sciences that are growing fast and have a significant impact on healthcare delivery. The University Medical Centre in Ljubljana and the Medical Faculty through its institutes have initiated the building of their own telemedicine systems. These systems concern only the medical informatics field. However, in this work a telemedical application that uses a combination of biomedical engineering methods and methods of biomedical informatics is presented. This telemedical application was built at the Department of Surgery and it was named "The Hip Status Application". Its aims are to provide services of preventive medicine and health promotion for people with potential problems with the hip-joint, guidance for people that have already underwent an operation of implantation of hip endoprosthesis, or have in any other way affected hip-joints, remote system consultation for diagnostic purposes, etc. The application is still under evaluation, and it is meant as a start of a new era of engineering-powered telemedical applications at the Department of Surgery following the trends in the most developed countries of the World.
Arthroplasty, Replacement, Hip↗
Evaluating informatics applications--clinical decision support systems literature review.
This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with diagnosis. There also is general consensus that a variety of systems are little used despite demonstrated or potential benefits. In the evaluation literature, the main emphasis is on how clinical performance changes. Most studies use an experimental or randomized controlled clinical trials design (RCT) to assess system performance or to focus on changes in clinical performance that could affect patient care. Few studies involve field tests of a CDSS and almost none use a naturalistic design in routine clinical settings with real patients. In addition, there is little theoretical discussion, although papers are permeated by a rationalist perspective that excludes contextual issues related to how and why systems are used. The studies mostly concern physicians rather than other clinicians. Further, CDSS evaluation studies appear to be insulated from evaluations of other informatics applications. Consequently, there is a lack of information useful for understanding why CDSSs may or may not be effective, resulting in making less informed decisions about these technologies and, by extension, other medical informatics applications.
Decision Support Systems, Clinical↗
Informatics and education in the health professions.
Informatics, the applied use of information science, is undergoing definition and development in the health professions with the encouragement of the National Library of Medicine and other professional organizations. Medical informatics and disciplinary subsets such as nursing and dental informatics look to optimize a growing range of applications ranging from video-disks to expert systems. Recommendations call for the integration of informatics into the education of health care professionals. Academic health sciences centers are developing informatics programs; the University of Maryland Campus for the Professions has convened a task force and a national advisory board on informatics.
Health Occupations↗
The barriers to clinical coding in general practice: a literature review.
Clinical coding is variable in UK general practice. The reasons for this remain undefined. This review explains why there are no readily available alternatives to recording structured clinical data and reviews the barriers to recording structured clinical data. Methods used included a literature review of bibliographic databases, university health informatics departments, and national and international medical informatics associations. The results show that the current state of development of computers and data processing means there is no practical alternative to coding data. The identified barriers to clinical coding are: the limitations of the coding systems and terminologies and the skill gap in their use; recording structured data in the consultation takes time and is distracting; the level of motivation of primary care professionals; and the priority within the organization. A taxonomy is proposed to describe the barriers to clinical coding. This can be used to identify barriers to coding and facilitate the development of strategies to overcome them.
Family Practice↗