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PubMed2004

Indianapolis I3: the third generation Integrated Advanced Information Management Systems.

In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.

Academic Medical Centers↗
PubMed1995

Hospital information management: the need for clinical leadership.

On 12 July the Audit Commission published For Your Information, a well researched report about information and its management in acute hospitals in Britain, how and why it is failing, and steps that clinicians, managers, and the NHS should take to correct this. This article discusses why information management matters to clinicians and considers the problems identified by the Audit Commission--most of which will strike chords with doctors--and possible remedies. Finally, it describes possible routes to administer these remedies and the proposal, recently supported by the BMA Council, for a national centre for health informatics with the goals of educating and enthusing clinicians about informatics, empowering them to participate in local and national information management decisions; exploring how information can be used to improve patient care and outcomes; and evaluating clinical information systems and helping to realise their benefits.

Communication↗
PubMed2002

The protection of individuals by protecting medical data in EHRs.

The paper discusses the changes in the delivery of Healthcare and the ways in which individuals need to be protected by protecting their Electronic Health Records. A Code of Ethics is needed for health Information Professionals, Data Protection and Security issues need to be taken more seriously. Health Informatics needs to address the issues of safety in the delivery of Healthcare so that it provides solutions to healthcare safety problems rather than increasing the problems to be addressed.

Computer Security↗
PubMed2004

Setting the public agenda for online health search: a white paper and action agenda.

BACKGROUND: Searches for health information are among the most common reasons that consumers use the Internet. Both consumers and quality experts have raised concerns about the quality of information on the Web and the ability of consumers to find accurate information that meets their needs. OBJECTIVE: To produce a national stakeholder-driven agenda for research, technical improvements, and education that will improve the results of consumer searches for health information on the Internet. METHODS: URAC, a national accreditation organization, and Consumer WebWatch (CWW), a project of Consumers Union (a consumer advocacy organization), conducted a review of factors influencing the results of online health searches. The organizations convened two stakeholder groups of consumers, quality experts, search engine experts, researchers, health-care providers, informatics specialists, and others. Meeting participants reviewed existing information and developed recommendations for improving the results of online consumer searches for health information. Participants were not asked to vote on or endorse the recommendations. Our working definition of a quality Web site was one that contained accurate, reliable, and complete information. RESULTS: The Internet has greatly improved access to health information for consumers. There is great variation in how consumers seek information via the Internet, and in how successful they are in searching for health information. Further, there is variation among Web sites, both in quality and accessibility. Many Web site features affect the capability of search engines to find and index them. CONCLUSIONS: Research is needed to define quality elements of Web sites that could be retrieved by search engines and understand how to meet the needs of different types of searchers. Technological research should seek to develop more sophisticated approaches for tagging information, and to develop searches that "learn" from consumer behavior. Finally, education initiatives are needed to help consumers search more effectively and to help them critically evaluate the information they find.

Community Participation↗
PubMedDate not supplied

Nursing informatics: a Victorian survey.

Interviews of selected personnel from a stratified random sample of Victoria's public and private acute care hospitals provided data about current computer systems implementation in nursing departments. Key informants were asked about their hospitals' present level of computerisation and plans for the future. The study found that stand-alone microcomputers are currently driving systems development in nursing. This strategy limits nurses' ability to access data, diminishes their influence in decision-making and undervalues the contribution of nursing information to interdisciplinary health care.

Forecasting↗
PubMed2026

Malaria-GENOMAP: a web-based tool for exploring genomic variation of malaria parasites.

MOTIVATION: Malaria, caused by Plasmodium parasites, imposes a significant public health burden. While Plasmodium falciparum remains the primary target of elimination strategies due to its high mortality rate, lesser-known species such as P. malariae, P. vivax, and P. knowlesi continue to contribute to substantial human morbidity. Genomic approaches, including whole-genome sequencing, offer powerful tools for understanding the biology, transmission, and emerging drug resistance of these neglected Plasmodium species. However, there is an urgent need for informatic tools to summarize and visualize the high-dimensional and complex genomic data generated. RESULTS: We developed Malaria-GENOMAP, a user-friendly web-based tool, which integrates genomic variant data, such as allele frequencies, with geographical maps and chromosome-wide to gene views for in-depth exploration. The tool includes variation from P. knowlesi (n = 139), P. malariae (n = 158), P. ovale curtisi (n = 36), P. ovale wallikeri (n = 47), P. simium (n = 38), and P. vivax (n = 1359). It enables the investigation of population structure, geographic associations of mutations, and putative drug resistance markers, offering valuable insights for malaria control efforts. AVAILABILITY AND IMPLEMENTATION: Malaria-GENOMAP is available online at https://genomics.lshtm.ac.uk/malaria-genomaps.

Internet↗
PubMed1999

Published criteria for evaluating health related web sites: review.

OBJECTIVE: To review published criteria for specifically evaluating health related information on the world wide web, and to identify areas of consensus. DESIGN: Search of world wide web sites and peer reviewed medical journals for explicit criteria for evaluating health related information on the web, using Medline and Lexis-Nexis databases, and the following internet search engines: Yahoo!, Excite, Altavista, Webcrawler, HotBot, Infoseek, Magellan Internet Guide, and Lycos. Criteria were extracted and grouped into categories. RESULTS: 29 published rating tools and journal articles were identified that had explicit criteria for assessing health related web sites. Of the 165 criteria extracted from these tools and articles, 132 (80%) were grouped under one of 12 specific categories and 33 (20%) were grouped as miscellaneous because they lacked specificity or were unique. The most frequently cited criteria were those dealing with content, design and aesthetics of site, disclosure of authors, sponsors, or developers, currency of information (includes frequency of update, freshness, maintenance of site), authority of source, ease of use, and accessibility and availability. CONCLUSIONS: Results suggest that many authors agree on key criteria for evaluating health related web sites, and that efforts to develop consensus criteria may be helpful. The next step is to identify and assess a clear, simple set of consensus criteria that the general public can understand and use.

Evaluation Studies as Topic↗
PubMed1999

Innovative multidisciplinary research in environmental epidemiology: the challenges and needs.

The ability of epidemiology to determine the relationships between health and environmental insults has become exceedingly difficult. The multifactorial nature of disease and the diversity of the insults, which include biologic, physical, social and cultural factors, combined with genetic susceptibility, suggest the need to develop better models of multidisciplinary epidemiologic investigation. This paper highlights the needs of an environmental epidemiologic team, discusses ways to incorporate new ideas across disciplines and to integrate constructs and paradigms of social, ecological, cultural and population determinants with individual-based exposure assessments. Innovation will be the key to the survival and increasing importance of epidemiology in addressing the public health needs of the future, but what are the ways to enhance and encourage creativity in environmental epidemiology? The process of self-renewal and continuing education will be highlighted. Additionally, the complexity of the problems and the need for clear supervision and control of multidisciplinary research efforts require a forum of communication and an 'information-processing approach' beyond those in traditional epidemiologic studies. New approaches in data management and medical informatics must be incorporated into the epidemiologic investigative framework. Methods to be included should focus on opportunities for computer-supported sharing of ideas. Such capabilities minimise the geographic distances and the disparate knowledge and training of the investigators and bring the team closer to the objectives and functions inherent in multidisciplinary investigation.

Databases as Topic↗
PubMed2003

Informatics systems to assess and apply clinical research on dental restorative materials.

Dental biomaterials are used clinically for one or more of the following purposes: to restore function, to enhance esthetics, and to prevent or arrest demineralization of tooth structure. Studies of the clinical performance of restorations and prostheses made from these materials have generally focused on quality assessment and survival statistics. Data from these studies should provide probabilities of specific treatment outcomes that are useful for practicing dentists. However, the utility of these data is limited by the lack of national and international standards for assessing these clinical outcomes. Standardized approaches toward clinical informatics and treatment-decision analysis are urgently needed to minimize the variability of clinical outcomes reported in publications associated with direct and indirect restorative materials used for dental restorations and prostheses.

Clinical Trials as Topic↗
PubMed2005

The israeli virtual national health record: a robust national health information infrastructure based on a firm foundation of trust.

In many developed countries, a coordinated effort is underway to build national and regional Health Information Infrastructures (HII) for the linking of disparate sites of care, so that an access to a comprehensive Health Record will be feasible when critical medical decisions are made [1]. However, widespread adoption of such national projects is hindered by a series of barriers- regulatory, technical, financial and cultural. Above all, a robust national HII requires a firm foundation of trust: patients must be assured that their confidential health information will not be misused and that there are adequate legal remedies in the event of inappropriate behavior on the part of either authorized or unauthorized parties[2].The Israeli evolving National HII is an innovative state of the art implementation of a wide-range clinical inter-organizational data exchange, based on a unique concept of virtually temporary sharing of information. A logically connection of multiple caregivers and medical organizations creates a patient-centric virtual repository, without centralization. All information remains in its original format, location, system and ownership. On demand, relevant information is instantly integrated and delivered to the point of care. This system, successfully covering more than half of Israel's population, is currently evolving from a voluntary private-public partnership (dbMOTION and CLALIT HMO) to a formal national reality. The governmental leadership, now taking over the process, is essential to achieve a full potential of the health information technology. All partners of the Israeli health system are coordinated in concert with each other, driven with a shared vision - realizing that a secured, private, confidential health information exchange is assured.

Confidentiality↗
PubMed2006

Global health database.

The Global Health database is available from Ovid Technologies, Inc., and also from CABI Publishing, EBSCO, and DataStar/ DIALOG. This database is really the combination of two others--the Public Health and Tropical Medicine database, formerly produced by the Bureau of Hygiene and Tropical Diseases, as well as human health and diseases information that is extracted from the CAB Abstracts database. This column will provide readers with an overview of the Global Health database, as well as present some searching hints. The Ovid interface will be used.

Databases as Topic↗
PubMed1997

Aims and tasks of medical informatics.

Ten major long-term aims and tasks, so to speak 'grand challenges', for research in the field of medical informatics, including health informatics, are proposed and described. These are the further development of methods and tools of information processing for: (1) diagnostics ('the visible body'); (2) therapy ('medical intervention with as little strain on the patient as possible'); (3) therapy simulation; (4) early-recognition and prevention; (5) compensating physical handicaps; (6) health consulting ('the informed patient'); (7) health reporting; (8) health care information systems; (9) medical documentation and (10) comprehensive documentation of medical knowledge and knowledge-based decision support. Work is, in part, already in progress. To all these aims and tasks medical informatics can and may be should make substantial contributions. Prior to outlining the above aims and tasks, an account is given of the meaning of medical informatics, of the objective it pursues in general and of its achievements so far. The present paper intends to contribute to a broad public discussion of the aims and tasks for research in the field of medical informatics.

Artificial Intelligence↗
PubMed2006

Perceptual structure of the desired functionality of internet-based health information systems.

With the emergence of the Internet, new health information systems are being designed and implemented that focus on coordination between providers, patients, payors and other constituents. While the importance of end user input in identifying the desired functionality of systems has long been recognized, very little work focuses on how users perceive the desired functionalities of these new systems to group together, and the implications of these groupings for the organization of functionalities into program modules and associated user interfaces. In this paper, we advance the construct, user based perceptual structure of desired functionality, in the context of these new coordination-intensive health information systems. Perceptual structure depicts how users perceive different desired system functions to group together. A conceptual framework is advanced which links perceptual structure to two broad categories of components, external coordination and internal coordination, which are related to prospective beliefs about system value. The framework is tested empirically via two field studies conducted by a hospital chain focusing on two major user groups, physicians and office administrators. The setting involves a proposed Internet-based health information system that links various constituencies in the service delivery chain. The empirically generated perceptual structure is found to be largely supportive of its conceptual counterpart. Implications for the design and development of this new class of systems, and public policy implications of such new systems are presented.

Consumer Behavior↗
PubMed2003

A research agenda to advance quality measurement and improvement.

BACKGROUND: In developing a conceptual framework for the design of a national quality measurement and reporting system (NQMRS), the Strategic Framework Board (SFB) recommends that such a system be built on a strong evidence base. OBJECTIVES: To identify critical gaps in the evidence needed for a fully functional NQMRS and to recommend a starting point for the development of a research agenda. RESEARCH DESIGN: Selective review of literature in quality of care measurement and reporting and identification of strategic issues that must be addressed. FINDINGS: There is some limited evidence that measurement and reporting can improve quality. Substantial advances have been made in the science of measurement and reporting but important gaps remain, specifically in (1) measurement methods and tools, (2) uses of quality performance data, (3) organizational and cultural factors, (4) information and informatics, and (5) impact evaluation/research. CONCLUSIONS: To achieve a sustainable research agenda, three strategic issues will have to be addressed: (1) the policy rationale for the research agenda, (2) adequate levels of public-sector funding, and (3) sustainability in a rapidly changing environment.

Biomedical Research↗
PubMed1999

Policy issues relevant to evaluation of interactive health communication applications. The Science Panel on Interactive Communication and Health.

This article provides an analysis of policy-related issues associated with the evaluation of interactive health communication (IHC) applications. These include an assessment of the current health and technology policy environment pertinent to public (government, education, public health) and private (medical care providers, purchasers, consumers, IHC developers) IHC stakeholders and discussion of issues likely to merit additional consideration by these stakeholders in the future.

Community Participation↗
PubMed2006

Biomedical informatics applications for asthma care: a systematic review.

Asthma is a common condition associated with significant patient morbidity and health care costs. Although widely accepted evidence-based guidelines for asthma management exist, unnecessary variation in patient care remains. Application of biomedical informatics techniques is one potential way to improve care for asthmatic patients. We performed a systematic literature review to identify computerized applications for clinical asthma care. Studies were evaluated for their clinical domain, developmental stage and study design. Additionally, prospective trials were identified and analyzed for potential study biases, study effects, and clinical study characteristics. Sixty-four papers were selected for review. Publications described asthma detection or diagnosis (18 papers), asthma monitoring or prevention (13 papers), patient education (13 papers), and asthma guidelines or therapy (20 papers). The majority of publications described projects in early stages of development or with non-prospective study designs. Twenty-one prospective trials were identified, which evaluated both clinical and non-clinical impacts on patient care. Most studies took place in the outpatient clinic environment, with minimal study of the emergency department or inpatient settings. Few studies demonstrated evidence of computerized applications improving clinical outcomes. Further research is needed to prospectively evaluate the impact of using biomedical informatics to improve care of asthmatic patients.

Asthma↗
PubMed2000

Better access to information about clinical trials.

Access to information about clinical trials is important to researchers, health care professionals, and patients. Many have argued for the establishment of clinical trials registries, citing their substantial benefits. Although some registries do exist, it has been difficult to create comprehensive, easily accessible systems. This paper briefly reviews existing registries, discusses the challenges in building registries, and reviews some of their benefits. The paper concludes with a description of a new, extensive Web-based registry called ClinicalTrials.gov (http://clinicaltrials. gov/), which was developed at the National Institutes of Health (NIH) by the National Library of Medicine as a result of recent legislation calling for a comprehensive, publicly accessible registry of clinical trials. The first version of the system became available in late February 2000 and contains information about approximately 5000 trials. The first release contains primarily NIH-sponsored trials, and new trials are regularly added to the system. Subsequent versions will contain information about trials sponsored by other federal agencies and by the private sector. The system was developed in accordance with basic informatics principles, including adherence to standards, usability considerations, and iterative testing and evaluation.

Clinical Trials as Topic↗
PubMedDate not supplied

Information technologies, health, and "globalization": anyone excluded?

Modern information technologies and worldwide communication through the Internet promise both universal access to information and the globalization of the medico-social network s modes of communication between doctors, laboratories, patients, and other players. The authors, specialists in public health and members of an association that aims to create opportunities for access to training in public health in developing countries, warn that the use of the term "globalization" ignores the reality of the "digital divide," that is, the fact that social inequalities may preclude the realization of this promise on a truly global scale.

CD-ROM↗