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PubMed2006

Information Rx: Evaluation of a new informatics tool for physicians, patients, and libraries.

This paper reports selected results from two comprehensive evaluation studies of the Information Prescription (or "Information Rx") Program implementation conducted from 2002-05 by the American College of Physicians Foundation (ACPF) and the U.S. National Library of Medicine (NLM). In this Program physicians are provided with Information Prescription pads, analogous to pads used to prescribe medications, that are used to direct patients to the MedlinePlus web site and its contents that are applicable to a patient's health condition. The results describe the Program's potential to enhance patient education and interpersonal communication from physician and patient perspectives. The findings suggest once physicians adopt the use of an information prescription, they perceive they are providing an additional clinical service that enhances patient education and interpersonal communication. For physicians, participation in information prescription may improve patient communication, encourage information seeking, and lessen the number of poor quality Internet searches that patients frequently self-perform and bring to a doctor's office. Similarly, once patients receive a recommendation from a physician to seek health information on the web, patients may be more comfortable with health seeking on the Internet and discussing their findings with their doctor. The conclusions of the two evaluation studies imply an Information Prescription fosters a dialogue between providers and patients, helps patients use the Internet more effectively and seems to favorably impact patient education. As the medical community and patient advocacy groups continue to emphasize the importance of evidence-based information as the gold standard for accepted care, it can be expected that informatics tools such as Information Rx will come to play an increasingly important role as a vehicle to help identify and access high quality health information on the Internet.

Journal Article↗

PubMed2000

The intersection of health informatics and evidence-based medicine: computer-based systems to assist clinicians.

Evidence-based medicine and health informatics may assist clinicians contend with the current barriers to the integration of evidence-based "best practice" into typical healthcare settings. Computer-based decision support systems can improve the process of care, but whether they improve patient outcomes in a cost-effective manner is uncertain.

Decision Making, Computer-Assisted↗

PubMed1997

Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention.

Clinical Medicine↗

PubMed1996

Health care informatics: the key to successful disease management.

Health services integration and disease state management (DSM) require improved health care informatics systems. Accurate, comprehensive patient information and an integrated data infrastructure are needed for all stages of DSM, from development and implementation of programs to evaluation and continuous program improvement. The lack of an integrated information infrastructure is one of the leading obstacles to achieving a comprehensive electronic patient data system. This article examines initiatives underway to make the computer-based patient record a reality.

Attitude of Health Personnel↗

PubMedDate not supplied

Informatics, imaging, and healthcare quality management: imaging quality improvement opportunities and lessons learned form HCFA's Health Care Quality Improvement Program.

This article examines the use of population-based healthcare data at the interface among radiology, healthcare informatics, and health services research for the purposes of healthcare quality management. To illustrate these concepts, we draw on experience with Health Care Financing Administration's Medicare Health Care Quality Improvement Program (HCQIP). We present two HCQIP efforts that have identified opportunities to improve the delivery of imaging services, specifically studies of the diagnosis and management of congestive heart failure and cerebrovascular disease. The examples demonstrate from a population-level perspective that there are opportunities to enhance the quality of imaging practice by reducing the magnitude of imaging practice variability, implementing evidence-based guidelines, and optimizing the communication of imaging study findings to physicians who are responsible for subsequent diagnostic and therapeutic decisions. Additional research is required in specific clinical domains of radiology to determine if implementation of evidence-based imaging guidelines and enhanced clarity in the interpretation and communication of diagnostic imaging will improve health outcomes.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1997

A collaborative international nursing informatics research project: predicting ARDS risk in critically ill patients.

An international nursing informatics research collaboration between Duke University Medical Center in Durham, North Carolina, USA and Allgemeine Krankenhaus Hospital in Vienna, Austria used data mining techniques called Knowledge Discovery in Databases (KDD) to explore the relationship between clinical data variables and adult respiratory distress syndrome (ARDS) in critically ill patients. Results of the study and logistics of international research collaboration will be presented at NI '97. The conceptual model, data mining methodology, and objectives for the collaboration are described here.

Austria↗

PubMed1997

Informatic support for processing the data regarding the environment factors possibly involved in the etiopathogenesis of insulin-dependent diabetes mellitus ETIODIAB.

Diabetes represents a heterogeneous group of disturbances, which can have a different aetiology, but have in common glucidic, lipidic and proteinic metabolic disturbances. Insulin-dependent diabetes appears in genetically susceptible persons, as an autoimmune disease activated by environment factors. Epidemiological studies performed in different countries, notice the increasing of diabetes cases in the last decades. Therefore the informatic system EtioDiab (from Etiopathological diabetes) has been developed. The purpose of this system is to assist the medical research regarding the environment factors involved in the etiopathogenesis of insulin-dependent diabetes. The system offers the possibility of calculation of many statistic indicators, of graphic representation of the recorded data, of verification of the statistical hypotheses.

Database Management Systems↗

PubMed1997

Getting IT into shape--external factors effecting the potential benefits from health informatics.

The introduction of a computer system will not always result in the expected outcomes. Extensive planning must be carried out for a new technological environment, changes in organisational practices and human reorientation. In addition to the specific requirements for the implementation of a particular application system there are more general issues to be considered. There are a number of organisational, technical and human factors which are thought to have affected demands for informatics support to healthcare and to have affected the level of benefits that can accrue from its operation in the healthcare sector of today. Some of the catalysts and inhibitors (positive and negative factors) can be recognised in advance of any specific implementation and the potential risk from their effects can be minimised. This paper considers some of the identified factors and how they are being addressed across Europe.

Data Collection↗

PubMed1997

European standardization in healthcare informatics and the need for increased involvement of healthcare professionals.

This paper gives the background and an introduction to the results and present activities of CEN/TC 251 (European Standardization Committee, Technical Committee on Health Care Informatics). The importance of the involvement of healthcare professionals, e.g. nurses, in the standardization development process is stressed. The paper emphasises the need for increased awareness of the standardization efforts in order to accomplish a higher degree of commitment in healthcare professionals.

Classification↗

PubMed1999

Toward a framework for computer-mediated collaborative design in medical informatics.

The development and implementation of enabling tools and methods that provide ready access to knowledge and information are among the central goals of medical informatics. The need for multi-institutional collaboration in the development of such tools and methods is increasingly being recognized. Collaboration involves communication, which typically involves individuals who work together at the same location. With the evolution of electronic modalities for communication, we seek to understand the role that such technologies can play in supporting collaboration, especially when the participants are geographically separated. Using the InterMed Collaboratory as a subject of study, we have analyzed their activities as an exercise in computer- and network-mediated collaborative design. We report on the cognitive, sociocultural, and logistical issues encountered when scientists from diverse organizations and backgrounds use communications technologies while designing and implementing shared products. Results demonstrate that it is important to match carefully the content with the mode of communication, identifying, for example, suitable uses of E-mail, conference calls, and face-to-face meetings. The special role of leaders in guiding and facilitating the group activities can also be seen, regardless of the communication setting in which the interactions occur. Most important is the proper use of technology to support the evolution of a shared vision of group goals and methods, an element that is clearly necessary before successful collaborative designs can proceed.

Communication↗

PubMed1999

Development of standards for the design of educational software. Standards Committee for Dental Informatics.

The ready availability of computers, combined with the advent of sophisticated software development tools, has resulted in a proliferation of dental instructional software. The quality of these products varies widely. Working Group 5 of the Standards Committee for Dental Informatics has published an initial set of guidelines to help course designers develop high-quality instructional materials. In the future, these guidelines will evolve into standards. This article summarizes the guidelines and considers future actions that may be taken once the standards are in place.

Computer-Assisted Instruction↗

PubMed2000

Database and informatics support for QUERI: current systems and future needs. Quality Enhancement Research Initiative.

OBJECTIVES: Our primary objective is to provide an overview of database and informatics support for the Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI). METHODS: We discuss the role of information technology resources in the QUERI process. We also review current VA information systems and specific databases in terms of strengths and weaknesses for addressing the QUERI goals. A synthesis of the issues and strategies for addressing specific data needs are presented by use of examples from 2 of the QUERI disease modules: Diabetes Mellitus and Human Immunodeficiency Virus. Finally, we discuss issues that need to be considered during development of new information systems to address the needs of clinical quality-improvement efforts. CONCLUSIONS: Quality enhancement in VA health care requires coordination and careful planning among clinical, administrative, research, policy, and information technology leaders to ensure that key clinical process and outcome measures are reliably collected in the VA information systems. As the QUERI progresses, data needs will probably shift from addressing data gaps to developing approaches for feedback and evaluation. Continued and enhanced cooperation among all VHA business processes is vital to the success of the QUERI.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Developing NLP Tools for Genome Informatics: An Information Extraction Perspective.

Huge quantities of on-line medical texts such as Medline are available, and we would hope to extract useful information from these resources, as much as possible, hopefully in an automatic way, with the aid of computer technologies. Especially, recent advances in Natural Language Processing (NLP) techniques raise new challenges and opportunities for tackling genome-related on-line text; combining NLP techniques with genome informatics extends beyond the traditional realms of either technology to a variety of emerging applications. In this paper, we explain some of our current efforts for developing various NLP-based tools for tackling genome-related on-line documents for information extraction task.

Journal Article↗

PubMed2000

Informatics issues in the national dissemination of a computer-based clinical guideline: a case study in childhood immunization.

IMM/Serve is a computer-based guideline that provides patient-specific recommendations regarding childhood immunization. IMM/Serve is currently installed at an estimated 75 sites within the US Indian Health Service (IHS), with plans to extend its use to roughly 150 additional sites nationwide by the end of the year 2000. The dissemination of IMM/Serve within the IHS provides a case study with concrete examples that illustrate the diverse informatics issues that arise in the widespread dissemination of a computer-based clinical guideline.

Child↗

PubMed2001

Information needs of clinical teams: analysis of questions received by the Clinical Informatics Consult Service.

OBJECTIVES: To examine the types of questions received by Clinical Informatics Consult Service (CICS) librarians from clinicians on rounds and to analyze the number of clearly differentiated viewpoints provided in response. DESIGN: Questions were retrieved from an internal database, the CICS Knowledge Base, and analyzed for redundancy by subject analysis. The unique questions were classified into ten categories by subject. Treatment-related questions were analyzed for the number of viewpoints represented in the librarian's response. RESULTS: The CICS Knowledge Base contained 476 unique questions and 71 redundant questions. Among the unique queries, the top two categories accounted for 67%: treatment (36%) and disease description (31%). Within the treatment-related subset, 138 questions (59%) required representation of more than one viewpoint in the librarian's response. DISCUSSION: Questions generated by clinicians frequently require comprehensive, critical appraisal of the medical literature, a need that can be filled by librarians trained in such techniques. This study demonstrates that many questions require representation of more than one viewpoint to answer completely. Moreover, the redundancy rate underscores the need for resources like the CICS Knowledge Base. By critically analyzing the medical literature, CICS librarians are providing a time-saving and valuable service for clinicians and charting new territory for librarians.

Artificial Intelligence↗

PubMed2001

The Patient Informatics Consult Service (PICS): an approach for a patient-centered service.

The Patient Informatics Consult Service (PICS) at the Eskind Biomedical Library at Vanderbilt University Medical Center (VUMC) provides patients with consumer-friendly information by using an information prescription mechanism. Clinicians refer patients to the PICS by completing the prescription and noting the patient's condition and any relevant factors. In response, PICS librarians critically appraise and summarize consumer-friendly materials into a targeted information report. Copies of the report are given to both patient and clinician, thus facilitating doctor-patient communication and closing the clinician-librarian feedback loop. Moreover, the prescription form also circumvents many of the usual barriers for patients in locating information, namely, patients' unfamiliarity with medical terminology and lack of knowledge of authoritative sources. PICS librarians capture the time and expertise put into these reports by creating Web-based pathfinders on prescription topics. Pathfinders contain librarian-created disease overviews and links to authoritative resources and seek to minimize the consumer's exposure to unreliable information. Pathfinders also adhere to strict guidelines that act as a model for locating, appraising, and summarizing information for consumers. These mechanisms--the information prescription, research reports, and pathfinders--serve as steps toward the long-term goal of full integration of consumer health information into patient care at VUMC.

Drug Information Services↗

PubMed2000

Rice at the forefront of plant genome informatics.

As rice genomicsdata continue to accumulate at a rapid rate, are becoming more valuable to warehouse and access large and rigorous data sets. This article gives an overview of available resources on rice bioinformatics and their role in elucidating and propagating biological and genomic information in rice. Of particular focus here is the informatics infrastructure developed at the Rice Genome Research Program (RGP) following an extensive rice genome analysis. The database named INE (Integrated Rice Genome Explorer) integrates the genetic and physical mapping information with the genome sequence being generated in collaboration with the International Rice Genome Sequencing Project (IRGSP). Database links are initially evaluated using an interoperable query tool to explore and compare data across the rice and maize genome databases and potential application to multiple crop database querying. A proposed logistics for interlinking these resources is presented to integrate, manipulate and analyze information on the rice genome. One of the biggest challenges of rice bioinformatics lies in the emerging role of rice as a model system among grass crop species. In view of the importance of comparative genetics in the formulation of new knowledge on plant genomes and genes, comparative bioinformatics remains an essential strategy to gain new insights on the needs and expectations on rice genomics.

Chromosome Mapping↗

PubMedDate not supplied

[Informatics in a surgery department].

In this paper the Authors describe their own experience in applying informatics at the Surgical Division III of Azienda Policlinico Universitario of Messina. After a discussion about existing hardware (LAN of PC) and daily used software (commercial suite) for managing the clinical reports and correlated data (images, medical prescription, reservations, and so on), their conclusion is that a great development on this way will be possible with extension of the services to all the business network and then to WAN as Internet.

Computers↗