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Professional qualification of German physicians in medical informatics.

In addition to the medical education in the Federal Republic of Germany which includes a compulsory Medical Informatics course there exists a formal program for professional qualification of physicians in Medical Informatics. After two years of clinical practice and 1.5 years of professional training at an authorized institution, a physician may receive in addition to the medical degree a "supplement Medical Informatics". The qualification requirements are described in detail. Physicians with the additional Medical Informatics qualification perform responsible tasks in their medical domain and serve as partners for fully specialized Medical Informatics experts in the solution of practical Medical Informatics problems. The formal qualification is available for more than 10 years, has become increasingly attractive, and is expected to grow with respect to future Medical Informatics developments.

Education, Medical, Continuing↗

A vocabulary for medical informatics.

The terminology in medical informatics is evolving rapidly. The organizers of MEDINFO and SCAMC have used different sets of keywords to index their documents. Recognizing the limitations of this approach, members of those organizations joined with the National Library of Medicine in the creation of a better terminology for medical informatics. A hierarchical structure was placed on the terms to produce a thesaurus typical of the sort often used in the indexing and retrieving of documents. The building of this thesaurus began with an automatic merging of the thesaurus used by the Association of Computing Machinery and the Information Sciences component of the "Medical Subject Headings." This product was pruned by eliminating terms not related to those in the MEDINFO keyword list or not in the medical informatics literature. Further refinement of the thesaurus resulted from extensive discussions among the authors of this paper. The first major application of this terminology has been to the indexing of the articles in "MEDINFO-86 Proceedings." Major components of this medical informatics thesaurus also have been incorporated into the "Medical Subject Headings." This paper describes the process of preparing the thesaurus and presents an evaluation of its coverage of the "MEDINFO-86 Proceedings."

Abstracting and Indexing↗

"Medical informatics in a medical research facility. An interactive multimedia presentation". Diabetes as a model.

This interactive demonstration provides a model for integrating information in a medical facility. By the use of networking computers, diagnostic data and scientific data are shared between geographically-separated clinical and research units. Data collected in a patient database in the outpatient clinic is sorted on specified qualifying criteria and the resulting subset further analyzed for research studies. To show the process of patient selection from a general database to a diabetes database, and further selection to a subset of diabetes, i.e., Diabetic Neuropathy, the authors used HyperCard. Firstly, HyperCard provided us with a flexible design allowing for both vertical and horizontal progressions. Because we wanted to include an educational component on diabetes and its complications, this flexibility was important. At any point in the demonstration, the viewer is able to access more information nested in several levels. Secondly, we wanted to be able to import a variety of programs that are used to translate diagnostic data into scientific data that is analyzed and prepared for publication in a medical textbook or journal. According to Douglas Adams, author of "Pathways and Relationships", HyperCard occupies the same niche in the evolution of software as human beings do in the evolution of life. "It's the fact that we are unspecialized but infinitely adaptable that has been our success as a species. In the same way, HyperCard is unspecialized but can turn its hand to any kind of task. And if the task is beyond it, HyperCard can use the phone, go for a ride on Excel, or go out and find a powerful graphics tool or sophisticated wordprocessing program!"

Academies and Institutes↗

[Medical informatics].

The fundamentals of medical informatics education are described on the basis of the current understanding of its aims and tasks. The use of a system in medical decision making is pointed out together with its basic characteristics. The significance of the introduction of information systems into the health system is presented as well as the perspectives of their further development in the future. The principles of medical informatics education are presented as well as the present situation in medical informatics education in the world and in this country with a view of the future.

Humans↗

Integrated medical informatics with small group teaching in medical education.

National Taiwan University College of Medicine (NTUCM) introduced small groups of teaching and basic-clinical integrated courses for medical students in 1992. By using computer network and multimedia techniques, this study tried to overcome barriers to learning in small group teaching. The Department of Medical Informatics of NTUCM established campus networking and computer classrooms and provided Internet and intranet network services including mail, netnews, bulletin board systems (BBS), world wide web (WWW), gopher, ftp and local file servers. To implement an interactive learning environment, the authors first tried mail lists, newsgroups and BBS. Next an integrated learning system prototype on the WWW was developed to provide functions including online syllabus, discussion boards simulated to BBS, online talk, interactive case studies, virtual classroom with video on demand (VOD) and Internet medical resources. The results showed that after the medical students completed the required course of medical informatics and had good network access using a network to communicate with each other became a daily practice. In the future, the system will extend to the tutoring of clinical practice and continuing medical education. The authors expect a national medical education network and more international cooperation and exchange.

Curriculum↗

Critical dimensions in medical informatics.

A typology of medical informatics applications is proposed around three dimensions: the dimension of care, the dimension of information and knowledge, and the aspects of the computerized society. These dimension can help both to evaluate application or research papers in the field or to derive long term goals for the discipline. In the first dimension medical informatics appears more as a technology driven by external forces such as the general progress of medicine or the integration of economical constraints in the choice of optimal procedures. It is argued that barriers to overcome as well as challenges for future research mainly remain in the two last dimensions.

Artificial Intelligence↗

Evolution of medical informatics societies in the United States.

Medical informatics, the application of computers to medicine, was supported by engineering groups in the 1950s, by biomedical engineering societies in the 1960s, and by medical informatics organizations in the 1970s and 1980s. Because of the highly specialized and technical nature of medical informatics, the dissemination of early articles on the subject was largely dependent on publication of the proceedings and transactions of meetings of professional organizations. The American Medical Informatics Association (AMIA) was recently formed from the merger of three professional organizations, each dedicated to medical informatics: the American Association for Medical systems and Informatics (AAMSI), the American College for Medical Informatics (ACMI), and the Symposium on Computer Applications in Medical Care (SCAMC). An increase in professional interest and activity in medical informatics is anticipated in the 1990s.

Directories as Topic↗

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↗

The medical informatics curriculum at the University of Heidelberg/School of Technology Heilbronn: new developments in its 5th revision.

We report about new developments in the 5th version of the medical informatics program at the University of Heidelberg/School of Technology Heilbronn, reflect our approaches for the revision and discuss our current curriculum in relationship to other curricula in health informatics and medical informatics. The specialised university curriculum for medical informatics at the University of Heidelberg/School of Technology Heilbronn is one of the oldest educational approaches in the field of medical informatics. During more than 25 years approx. 1000 students graduated. The program belongs to the category of dedicated master programs for medical informatics and is based on the concept of medical informatics as a medical discipline of its own. It covers the total spectrum of medical informatics ranging from information systems in health care, biosignal and medical image processing, medical documentation, to information and knowledge processing in medicine. It is a 4.5 years program with a strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. For the 5th version of the Heidelberg/Heilbronn curriculum on medical informatics, having started at winter semester 1997/98, we hope to have reflected the evolution of medical informatics as a separate discipline, moving one step further towards educating medical informatics, and not 'just' medicine and informatics.

Curriculum↗

Developing a reliable medical informatics network.

As medical informatics increasingly places demands on computer resources, healthcare organizations need to plan for and develop fully integrated, enterprisewide communications networks. Healthcare systems should invest in upgradable equipment that is compatible with industry standards and select specialized contractors familiar with the infrastructure required for healthcare networks. The potential for downtime should be minimized through remote diagnostics that assist repair capabilities. The fully integrated network should be supported by staff who are provided with ongoing training and overseen by a knowledgeable network manager.

Computer Communication Networks↗

Visualizing AMIA : a medical informatics knowledge domain analysis.

Medical Informatics has been described as having a "long and delayed adolescence" which continues to "find itself in search of self-definition", and the AMIA Symposium Proceedings have been viewed as an indicator of trends in the field. This pilot study investigated the feasibility of applying a knowledge domain visualization approach to clarifying the domain of medical informatics based on the AMIA publications. Document co-citation analysis (DCA) is combined with Pathfinder Network Scaling (PFNET), visualization, and animation to develop a 3-D knowledge landscape.

Bibliometrics↗

Medical informatics--an interdisciplinary approach.

Medical informatics is the first science that has incorporated all traditional medical disciplines. That progress is possible due to fast development of new technologies, particularly in informatics, as well as due to common needs of all medical disciplines. Information is crucial component of all investigations, and that is why the main goal should be incorporation of information technologies into medical practice. Due to its complexity, medical informatics is interdisciplinary. That is evident through incorporation of different methods, principles, techniques etc., that are used while carrying out the tasks in the field of medical informatics. Implementation of modern technologies, particularly information technologies in medicine, will enable faster data processing; it will reduce expenditures in all branches of medicine (statistics, documentation or documentary etc.). Thus, medical staff will have much more time to devote themselves to primary tasks.

Medical Informatics↗

The Missouri Medical Informatics Thesaurus.

The Missouri Medical Informatics Thesaurus, containing approximately 2,000 sorted terms, arranged within a hierarchical structure, covers the multi-disciplinary medical informatics field more accurately than anything else available. Researchers at the University of Missouri-Columbia developed this thesaurus using the four primary methods of thesaurus construction to assure both literary and user warrant in the final terminology. The thesaurus can also be quickly revised to include the rapidly evolving terminology of the discipline.

Medical Informatics↗

Health care in the information society: what should be the role of medical informatics?

OBJECTIVE: To discuss the consequences for medical informatics in encouraging and advancing the development of information processing methodology (IPM) and information and communication technology (ICT) to contribute to high-quality and efficient health care. METHODS: Characterization of the current state of ICT, commenting on literature. RESULTS AND CONCLUSIONS: Medical informatics is the discipline, concerned with the systematic processing of data, information, and knowledge in medicine and health care. Our societies are continuously being influenced by modern IPM and ICT. It can be expected that these developments, leading us into an "information society", will continue. Three factors may significantly influence health care in the near future: the development of the population towards an aging society, progress in medicine, and progress in informatics. The major aims that will have to be achieved are the (1) patient-centered use of medical data, (2) process-integrated decision support, using high-quality medical knowledge, and (3) comprehensive use of patient data for clinical research and health reporting. Medical informatics research is needed on the electronic patient record, modern architectures for health information systems, and medical knowledge bases. In order to adequately pursue the goal of "transforming health care through innovative use of ICT for the 21st century", health care professionals are needed, who are well-trained in medical informatics, respectively health informatics. Medical informatics must offer such educational programs and assure a sufficiently high quality of education.

Delivery of Health Care↗

Medical informatics: once more towards systematization.

Commenting on a paper by Van Bemmel (Medical Informatics, Art or Science? [1]), the following questions are raised: What is the meaning of medical informatics?, How to systematize medical informatics?, is medical informatics an art, a science or a technology?. It is argued that medical informatics is concerned with the systematic processing of data, information and knowledge in medicine and health care, and that medical informatics is not just the application of computers in these fields. Three classifications for medical informatics research and education are presented. It is concluded that medical informatics is a scientific medical discipline, similar to surgery, internal medicine, epidemiology, or microbiology; and that medical informatics has a strong relationship with the health sciences concerning its field of application, and to informatics concerning its methods and tools. It is a cross-sectional discipline, with relevance for virtually all other specialties of medicine and the health sciences. This is the reason for its impact on research and education in these specialties. It also causes that the quality of the processing of data, information and knowledge has a direct and considerable effect upon the quality of health care in practically all these specialties.

Delivery of Health Care↗

Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.

A study was undertaken to test the hypothesis that a core set of medical informatics serials could be identified by using standard bibliometric techniques. All journal articles indexed by the National Library of Medicine between 1990 and 1994 were included. Articles were identified by using the "MEDICAL INFORMATICS" Medical Subject Heading (MeSH) term. Each serial title containing articles was then ranked according to (1) the total number of medical informatics journal articles indexed and (2) the percentage of medical informatics journal articles indexed. Twenty-eight serials had more than 100 articles indexed under the "MEDICAL INFORMATICS" MeSH term. Thirty serials had more than 40% of their articles indexed under the "MEDICAL INFORMATICS" MESH term. A "core" set of fourteen serials had 100 or more medical informatics articles indexed, including more than 70% of all articles they published. The methodology described provides librarians with another tool to use in the difficult task of journal selection. The set of "core" serials identified provides librarians with a ranked list of serials, based on which a medical informatics collection can be developed.

Abstracting and Indexing↗

An approach to policy analysis and development of medical informatics.

There are three grand challenges for medical informatics policy: (1) What is it? (2) What should it be? (3) How can we influence its development? To address these challenges requires: (1) an historical analysis of medical informatics policies in a representative sample of countries. This should include an account of major events, the roles of technology, individuals, culture and social settings. Pioneers have been led by visions of what medical informatics should achieve. The role of these visions and the reactions to unmet expectations thus also need to be analysed; (2) a generally applicable medical informatics policy that places the needs of its stakeholders and clients first. Top priorities are to support quality health care delivery and quality management of health care facilities; (3) an explanation of how policies in medical informatics are created and implemented together with a strategy to guide medical informatics professionals in their lobbying efforts.

Humans↗

The internal challenges of medical informatics.

Haux's [7] basic assumption that the object of medical informatics is: "... to assure and to improve the quality of healthcare as well as the quality of research and education in medicine and in the health sciences ..." is taken as a starting point to discuss the three main topics: What is the meaning of medical informatics (i.e. what should be the main activities of medical informatics to bring maximum benefit to medicine)? What are the achievements and failures of medical informatics today (again considering the impact on the quality of healthcare)? What are the main challenges? Concerning the definition of medical informatics it is argued that one should not hide the link to basic informatics and, for that matter to computers, completely behind abstract definitions. After an analysis of the purposes of the definition of a discipline, a differentiated definition of the scope of medical informatics, rather general when concerning the field of scientific interest, more focused when concerning the practical (constructive) applications, is proposed. Contrasting Haux's chapter on achievements of medical informatics we concentrate on and analyse non fulfilled promises of medical informatics to derive lessons for the future and to propose 'generic' (or core) tasks of medical informatics to meet the challenges of the future. A set of 'internal challenges' of medical informatics to change priorities and attitudes within the discipline is put forward to enable medical informatics to meet the 'external challenges' listed by Haux.

Artificial Intelligence↗