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PubMed1998

Otolaryngology in the information age: enabling technologies for the future of surgery. Enabling technologies for the future of surgery.

Enabling technologies for the future, whether exemplified by endoscopic, minimally invasive, or microdexterity systems or surgical and nonsurgical image-guided procedures, continue with an evolution so rapid that before one change has been accepted and perfected, another even more dramatic change promises to replace it. These information-based surgical and procedural interventions are just now becoming accepted standards of surgical, radiologic, and medical practice, and yet the promise of more advanced technologies blurs even these new boundaries, constantly redefining the concept of "surgery." It is essential that otolaryngologists, as part of the broader spectrum of physicians, understand these changes and prepare to adapt and improve each and every one of their technical and cognitive skills.

Computer Simulation↗
PubMed2001

Metaphors of movement: a visualization and user interface for time-oriented, skeletal plans.

Therapy planning plays an increasingly important role in the everyday work of physicians. Clinical protocols or guidelines are typically represented using flow-charts, decision tables, or plain text. These representations are badly suited, however, for complex medical procedures.One representation method that overcomes these problems is the language Asbru. But because Asbru has a LISP-like syntax (and also incorporates many concepts from computer science), it is not suitable for physicians.Therefore, we developed a visualization and user interface to deal with treatment plans expressed in Asbru. We use graphical metaphors to make the underlying concepts easier to grasp, employ glyphs to communicate complex temporal information and colors to make it possible to understand the connection between the two views (Topological View and Temporal View) available in the system. In this paper, we present the design ideas behind AsbruView, and discuss its usefulness based on the results of a usability study we performed with six physicians.

Decision Making, Computer-Assisted↗
PubMed2006

Pre- and intraoperative processing and integration of various anatomical and functional data in neurosurgery.

A software system is presented, capable of integrating various information sources for neurosurgical procedures. These include anatomical data such as a standard 3D DICOM image stacks, atlas data, as well as functional information (e.g. fmri, MEG, EEG). The system is programmed in C++ using Open GL for visualisation, and was developed in a close cooperation with a neurosurgical department to match existing needs. Preoperatively the data may be combined, registered by a rigid or elastic matching process, enriched by user specified planning information such as annotations or trajectories, and visualised in a standard fashion using different segmentation schemes, interactive rotation, zooming etc. Selected portions of the gathered and generated information may then be exported for neuronavigation input in DICOM or a vendor specific format. Intraoperatively, this information may, on the one hand, be simply used as an integrational part of the routinely used navigational data. On the other hand, the system is also capable of interacting with the navigational system to integrate the actual spatial information of the ongoing procedure into the preoperative data, thus allowing further planning and visualisation beyond the scope of the navigational unit. Furthermore, intraoperatively updated information such as intraoperative MR images or electrophysiological data may be integrated and correlated to the existing information. Ongoing developments comprise redistribution of the relevant data for injection onto the screen of the navigational system or into the optical pathway of the (3D capable) microscope display/ocular. This also includes information about the actual automatically optimized accuracy of the navigation process in relation to the head markers in use.

Humans↗
PubMed1998

The economic implications of users willingness to increase knowledge capital in health informatics.

OBJECTIVE: To develop an economic model of health care professionals demand for knowledge capital in health informatics. DESIGN: Case study with application of the Contingent Valuation Method to develop a small-scale model. SETTING: Specialized clinic at a university Hospital in Sweden. RESULTS: The model displays the economic rationale behind an individual's choice to spend leisure time for obtaining knowledge in health informatics. This decision reduces the total leisure time, but does not increase salary. Instead, it may increase the personal well being by higher satisfaction gained from using information systems and by being recognized as a computer expert. CONCLUSIONS: Individuals have preferences over all uses of time and for activities they can choose to engage in Support of health care staff's investment in health informatics knowledge capital may benefit both the individuals and indirectly the health care organization.

Attitude of Health Personnel↗
PubMed1997

Health online and the empowered medical consumer.

BACKGROUND: Lay health care consumers' emergence as active participants in online health care networks is a powerful new technological pattern that promises to take the American health care system through all stages of cultural adaptation--substitution, innovation, and transformation. Soon everyone will recognize the fundamental changes online health has produced in the way we think and act about health care. A NEW ACADEMIC SUBSPECIALTY: A new subspecialty--consumer health informatics (CHI)--is covering two domains: (1) community CHI resources--the online networks, forums, databases, and World Wide Web sites that anyone with a home computer can access, and (2) clinical CHI resources--programs or systems developed by clinicians, system developers, or health maintenance organizations and provided to selected membership groups or patients. EXHIBITS: Sample communications among online self-helpers within their chat groups, e-mail exchanges, bulletin boards, and USENET newsgroups for chosen health topics show what is on their mind, how they get information, how they use it, and how they correct it. Sometimes, clinicians have observed, lay care offers higher quality than professional care. Lay self-helpers, such as the originator of the Brain Tumor Mailing List, have observed several potential benefits in linking online self-helpers and providers and at a very modest cost. FUTURE DIRECTIONS: In a coming six-level system of information-age health care, patient-consumers may seek what they need in the following order: individual self-care, family and friends, informal self-help networks, the professional as coach, the professional as partner, and the professional as authority.

Adult↗
PubMed1989

Computers in a human perspective: an alternative way of teaching informatics to health professionals.

An alternative way of teaching informatics, especially health informatics, to health professionals of different categories has been developed and practiced. The essentials of human competence and skill in handling and processing information are presented parallel with the essentials of computer-assisted methodologies and technologies of formal language-based informatics. Requirements on how eventually useful computer-based tools will have to be designed in order to be well adapted to genuine human skill and competence in handling tools in various work contexts are established. On the basis of such a balanced knowledge methods for work analysis are introduced. These include how the existing problems at a workplace can be identified and analyzed in relation to the goals to be achieved. Special emphasis is given to new ways of information analysis, i.e. methods which even allow the comprehension and documentation of those parts of the actually practiced 'human' information handling and processing which are normally overlooked, as e.g. non-verbal communication processes and so-called 'tacit knowledge' based information handling and processing activities. Different ways of problem solving are discussed involving in an integrated human perspective--alternative staffing, enhancement of the competence of the staff, optimal planning of premises as well as organizational and technical means. The main result of this alternative way of education has been a considerably improved user competence which in turn has led to very different designs of computer assistance and man-computer interfaces. It is the purpose of this paper to give a brief outline of the teaching material and a short presentation of the above mentioned results.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Computers↗
PubMed2002

Usability assessment study of a web site displaying medical resources on line: the CISMeF.

We present here the usability assessment study of a medical web site dedicated to the Cataloguing and Indexing of French speaking Medical web Sites (CISMeF). We performed a usability inspection using heuristic evaluation and an empirical usability test using a portable lab. The results of the heuristic evaluation show usability flaws along guidance, prompting and legibility ergonomic criteria. The usability test confirms this result and gives some more hints about the severity rating of the problems. From these results, we draw up a set of recommendations for the re-engineering of the Human Computer Interface (HCI). We conclude on the necessity to integrate usability engineering early enough in the projects lifecycle.

France↗
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↗
PubMed2001

Preparing tomorrow's doctors: the impact of a special study module in medical informatics.

BACKGROUND: In response to the call for more informatics teaching in the medical curriculum, an elective special study module has been offered to first-year students at Queen's University since 1997. OBJECTIVES: To assess the impact of a medical informatics course in terms of the use of skills acquired and attitudes held about information technology (IT) in medicine. METHODS: A postal structured questionnaire was sent to all 30 students who took the medical informatics special study module in 1997 and to all 29 students who took the module in 1998, plus an age and sex-matched group of controls in each year. Main outcome measures included attitudes to the role of IT in medicine and declared frequency of use of various software packages. RESULTS: Compared with the control group, those taking the module felt less confident initially with computers. There was a high level of positive attitude to computers in medicine following the course, in both study and control groups. There was a significantly greater use of word-processing (P=0.001) and presentation packages (P=0.0005) amongst third-year students compared with second-year students, but there was no significant difference in this regard between those taking the module and controls. CONCLUSIONS: Students' use of computer technology and IT skills, is more influenced by the demands of the overall curriculum than by undertaking a single module in medical informatics. A special study module may, however, provide valuable support by performing a 'remedial function'. The authors found the module a useful first step in the process of introducing medical informatics to the core curriculum.

Attitude of Health Personnel↗
PubMed1992

Digital patient records and the medical desktop: an integrated physician workstation for medical informatics training.

The Institute of Medicine and others have advocated a shift from a paper-based to an electronic medical record and many authorities have advanced the concept of a physician workstation that can provide access to a wide variety of both clinically and reference oriented medical information. We have developed a working model of an integrated physician workstation based on a graphically oriented "Medical Desktop," for personal computers. This system gives the user access to much of the information necessary for the practice of medicine, by integrating an electronic medical record (notes, orders, consults, lab values, and radiological studies, organized both independently and in a "Visual Chart") with tools such as drug references, clinical manuals, textbooks of medicine, literature searching, expert system decision support, and electronic communication. It contains an on-line help system that facilitates use and allows access to all the systems' capabilities. This system has been used to teach students and physicians the methods and potential of computer-based medical information management to prepare them for the impact of computers in their practices and educate them concerning the imperative for the involvement of all health care providers in implementing these changes.

Computer Graphics↗
PubMedDate not supplied

[Infrastructure of information support to clinical medicine].

Issues are discussed related with designing an effective infrastructure of the information-and-computer support to clinical medicine with regard for the recent achievements in informatics, automated systems, medical equipment and robotics. It is suggested to focus on creating a module-type infrastructure meeting evenly both the trends towards integration and towards autonomy. A scheme of an information infrastructure constructed for Bakulev's National Center for Cardiovascular Surgery of the Russian Academy of Medical Sciences is described.

Algorithms↗
PubMed1997

Challenges for medical informatics in the 21st century.

This paper introduces the topic of this special issue: challenges for medical informatics in the 21st century. This paper discusses the nature of medical informatics. Some descriptions and definitions of medical informatics are reviewed. Then the research aspects of medical informatics are discussed. It is argued that the more mundane aspects of medical informatics like system development and implementation are important and need further consideration, especially concerning social aspects and correctness.

Computer Literacy↗
PubMedDate not supplied

Basic science in digital imaging: storage and retrieval.

This practical discussion reviews the current methods available for digital image storage and retrieval. The organization of digital images is important to allow easy retrieval of the data in the future. Examples of several software programs that will catalogue and retrieve the images are demonstrated.

Diagnostic Imaging↗
PubMed1994

Applications of medical informatics in antibiotic therapy.

The Infectious Disease Society of America is concerned about the excessive and inappropriate use of antibiotics in U.S. hospitals. Applications of Medical Informatics can help improve the use of antibiotics and help improve patient care by monitoring and managing enormous amounts of patient information. Monitoring the duration of every antibiotic ordered in the hospital or keeping tract of the antibiotic susceptibilities for five years are examples of tasks better performed by computers. The impact of computers in medicine is seen by some as disappointing. The computer revolution has not had the impact in medicine experienced by other areas. The acceptance and use of computers by medicine will be evolutionary rather than revolutionary. In 1979, the MYCIN project demonstrated that the computer could aid physicians in the selection of antibiotics. However, MYCIN was never clinically used because physicians were require to enter all patient information into the computer. The development of computerized medical records is an essential step to further the development and implementation of computer-aided decision support. The science of Medical Informatics is still relatively new but is emerging as a distinct academic field. A few hospitals are now installing information systems and have determined that these systems will play an essential role in their ability to survive into the next century. The telephone and the automobile have been recognized as two of the most important tools for improving medical care during the past 100 years. People could more readily get medical care and the time to transmit medical information was greatly reduced through physician use of the telephone and automobile. The computer is a tool that can be used to help physicians manage the great amount of medical information being generated every day. The computer can also alert the physician of patient conditions that need attention. However, it is the physician who must use and apply the computer provided information. Thus, the computer will assist but not replace physicians in providing medical care.

Anti-Bacterial Agents↗