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PubMedDate not supplied

How can usability measurement affect the re-engineering process of clinical software procedures?

As a consequence of the dramatic improvements achieved in information technology standards in terms of single hardware and software components, efforts in the evaluation processes have been focused on the assessment of critical human factors, such as work-flow organisation, man-machine interaction and, in general, quality of use, or usability. This trend is particularly valid when applied to medical informatics, since the human component is the basis of the information processing system in health care context. With the aim to establish an action-research project on the evaluation and assessment of clinical software procedures which constitute an integrated hospital information system, the authors adopted this strategy and considered the measurement of perceived usability as one of the main goals of the project itself: the paper reports the results of this experience.

Evaluation Studies as Topic↗
PubMed2002

How to find out burning problem of telemedicine?

Sample of 177 cited papers from Current Contents in year 2001 containing word 'telemedicine' as a keyword, and/or in title and/or in abstract. Most of papers were coming from Journal of Telemedicine & Telecare, International Journal of Medical Informatics and Telemedicine Journal & E-Health. Titles and abstracts were analysed statistically by using Sphinx Lexica as a tool and lexical statistics and lexical analysis as methods. Environment/neighbourhood of words potentially reflecting evaluation in telemedicine, enabled to make synthesis: evaluation or similar words were mentioned in connections with programs and plans of telemedicine application in the whole, with economic issue (minimizing, low-cost, reducing cost), with ICT evaluation, quality, and scarcely with methodology and criteria for evaluation.

Medical Informatics↗
PubMed2005

Distance learning at biomedical faculties in bosnia & herzegovina.

Increase and development of distance learning technologies over the past decade has exposed the potential and the efficiency of new technologies. Benefit and use of contemporary information technologies is the area where medical informatics got the most on understanding and importance. Definition of distance learning as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies(ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. In this paper authors described activities on introduction of distance learning in teaching process at Medical faculty, University of Sarajevo, Bosnia and Herzegovina. Internet was not really meant to be a means of human communication at first; but the clearly the Net become a main piece of human communication.

Bosnia and Herzegovina↗
PubMed1996

The role of standards in a dynamic area.

It proves difficult to achieve a good measure of security in medical informatics applications. A number of reasons for this are analyzed. It is argued, that standardisation will help in solving this problem to a certain extent, but a more complete solution is possible when this is used in close conjunction with legal instruments (e.g. EU directives) and advice of a less strict nature, like guidelines. On the whole, a pragmatic step-by-step approach is needed, although there are signs that the general environment for these developments is improving.

Computer Literacy↗
PubMed1993

Philosophies for the design and development of clinical decision-support systems.

Little significance is attached by medical informatics workers to the many practical issues which affect the development of clinical decision-support systems. We examine the current state of research in clinical decision-support, the characteristics and motivations of developers, and the perceptions of intended end-users. Factors which adversely affect the success of systems are highlighted and pointers to good practice discussed. We then propose a coherent approach to system development, consisting of requirements analysis, software design, implementation, testing, evaluation and maintenance.

Computer Systems↗
PubMed2005

An ontological approach to modelling tasks and goals.

Current approaches to modelling plans and processes in AI are limited by current understanding of "goals" and "intentions". We discuss this question in a medical context, viewing goals as clinical objectives and plans and processes as collections of tasks to achieve those objectives. The specific context for this discussion is the CREDO project, which aims to develop a comprehensive approach to supporting complex treatment plans and care pathways and provides an opportunity to carry out an extensive investigation of the key problem of formalising goals in medical informatics and AI generally. A review of 222 clinical services required in the management of breast cancer has yielded a systematic classification of tasks involved in breast cancer care and a similar classification of the clinical goals associated with these tasks. A six-component model of goal structure is proposed based on these ontological analyses. Although the model has been derived from a corpus of examples from medicine many of the issues encountered, and the solution proposed, appear to be relevant to other domains.

Artificial Intelligence↗
PubMed1987

Medical applications of computers: an overview.

In this review computer applications in medicine are discussed from the point of view of the levels of information processing as suggested by van Bemmel. Applications are presented and research directions indicated. The purpose of this review article is to give an overview of the field of medical informatics. A structural approach is followed in discussing the subjects of communication, databases, complex calculations (including signal analysis and image analysis techniques), pattern recognition and expert systems. The role the computer system plays in relation to the physician is discussed. It is stressed that computers cannot replace the physician, because computer systems use programs, that are of a scientific nature. This means that only certain aspects are taken into account and that one abstracts from individuality. Therefore, computers are unable to give advice about individual patients regarding their future.

Database Management Systems↗
PubMed1996

Introduction of new technologies to the medical undergraduate curriculum.

The rate at which new educational technologies are introduced is growing at a tremendous pace. This is in large part due to the recommendations of the AAMC Steering Committee on the Evaluation of Medical Education which strongly supported the use of Medical Informatics technologies for education. Some institutions have attempted to implement these technologies; however, a scientific study has not yet been conducted to document their potential benefit. Our attempts to conduct such a study were met with obstacles of resistance from faculty, administration, and students. To overcome these obstacles we have developed a solution which addresses all of the resistance that we encountered. This solution is based upon three premises: 1) adjunct introduction, 2) multicenter studies, and 3) scientific educational benefit analyses.

Attitude to Computers↗
PubMed2003

IMIA Working Conference on Health Information Systems 2002 in Heidelberg--practical HIS experiences.

OBJECTIVES: To give an overview of the scope of commercial Health Information Systems installed in academic centers. METHODS: Six systems presented during the working conference on Health Information Systems of IMIA, the International Medical Informatics Association, are described in a special issue of Methods of Information in Medicine. These contributions shortly summarize the systems' installed base, their functionality, their architecture, as well as site-specific deployment experiences. Specific highlights have been elaborated. CONCLUSION: The role of industrial solutions for Health Information Systems is of increasing importance. Companies have invested in clinical functionality, and significant progress in supporting clinical workflow has been made. Interfaces to connect subsystems are commonly used. Real interoperability, however, is still a challenge. Socio-technical issues are of central importance, and systems still need improved flexibility and adaptability to work practice in health care.

Academic Medical Centers↗
PubMed2005

Instruments to assess the quality of health information on the World Wide Web: what can our patients actually use?

OBJECTIVE: To find and assess quality-rating instruments that can be used by health care consumers to assess websites displaying health information. DATA SOURCES: Searches of PubMed, the World Wide Web (using five different search engines), reference tracing from identified articles, and a review of the of the American Medical Informatics Association's annual symposium proceedings. REVIEW METHODS: Sources were examined for availability, number of elements, objectivity, and readability. RESULTS: A total of 273 distinct instruments were found and analyzed. Of these, 80 (29%) made evaluation criteria publicly available and 24 (8.7%) had 10 or fewer elements (items that a user has to assess to evaluate a website). Seven instruments consisted of elements that could all be evaluated objectively. Of these seven, one instrument consisted entirely of criteria with acceptable interobserver reliability (kappa> or =0.6); another instrument met readability standards. CONCLUSIONS: There are many quality-rating instruments, but few are likely to be practically usable by the intended audience.

Humans↗
PubMed1997

Virtual shelves. II: A unified catalog for a heterogeneous collection.

We describe a unified catalog of traditional and digital resources in medical informatics, using standard cataloging principles (AACR2), schemes (LCC), and coding formats (USMARC). The unified catalog integrates the bibliographic records of physical items in the heterogeneous collection with the bibliographic records of network accessible digital items, using prescribed cataloging formats to new effect. The unified catalog is collections-based. We do not use the MARC 856 field to specify the network location of a digital item. The location of a digital item is determined by mapping its call number through a location guide to a network address. This mapping is strictly isomorphic to the way the shelf location of a physical item is determined within the bounds of a controlled collection.

Book Classification↗
PubMed1995

Healthcare Information Framework.

CEN committee TC 251 Medical Informatics, has set up a project team charged with producing a European pre-standard ENV on Healthcare Information Framework (HIF). The HIF is based on abstraction from a specific information system architecture to a reference architecture and further to a conceptual architectural framework based on serving open, distributed and heterogeneous healthcare enterprises. To specify the suitable healthcare information system architecture modelling of the healthcare enterprise is required. As there is no one method serving all needs, the HIF gives guidance on what aspects to look at in selecting a suitable modelling method. It is expected that the work will be completed by early 1995.

Artificial Intelligence↗
PubMed2003

ICT in health care: sociotechnical approaches.

The importance of the social sciences for medical informatics is increasingly recognized. As ICT requires inter-action with people and thereby inevitably affects them, understanding ICT requires a focus on the interrelation between technology and its social environment. Sociotechnical approaches increase our understanding of how ICT applications are developed, introduced and become a part of social practices. Socio-technical approaches share several starting points: 1) they see health care work as a social, 'real life' phenomenon, which may seem 'messy' at first, but which is guided by a practical rationality that can only be overlooked at a high price (i.e. failed systems). 2) They see technological innovation as a social process, in which organizations are deeply affected. 3) Through in-depth, formative evaluation, they can help improve system design and implementation.

Computer Communication Networks↗
PubMed2001

Information processing in healthcare at the start of the third Millennium: potential and limitations.

The 21st century is said to be a century of the information society. We should be aware that continuing progress in information processing methodology (IPM) and information and communication technology (ICT) is changing our societies, including medicine and health care. At the start of the third Millennium we should ask ourselves, what progress can we expect from modern IPM/ICT for healthcare in the coming decade, what concerns does the information society have to face, and what steps have to be taken. These questions were addressed by clinicians, researchers and industrial representatives in a panel discussion at the joint conference ISCB-GMDS-99 of the International Society of Clinical Biostatistics and the German Society for Medical Informatics, Biometry and Epidemiology. Important aspects raised by the panelists and in the subsequent discussion were: (1) the main goal of expanding IPM/ICT should be to further improve quality of care, while maintaining reasonable costs; (2) with the support of modern IPM and ICT the boundaries between inpatient and outpatient care will fade away enabling a more efficient, patient-centered health care; (3) cooperation between health-care professionals will increase; there will be different ways of communication between them and with the patient, including modern ICT and the Internet; (4) society must be concerned with achieving equal opportunities in being informed about and in using new ICT; (5) misuse of data will remain a serious problem and can become an obstacle to progress.

Biometry↗
PubMed1993

Pharmacoinformatics: equations for serum drug assay error patterns; implications for therapeutic drug monitoring and dosage.

Pharmacoinformatics is the area of Medical Informatics concerned with modeling and simulation of the behavior of drugs, and control of such behavior by individualized dosage regimens for each patient to achieve explicitly chosen therapeutic goals. The credibility of serum concentration data is a major factor in such modeling. The present report examines a more precise way of describing the credibility of such data with a collection of polynomial equations, developed from routine survey data of the College of American Pathologists, which improve the description of the credibility of serum level results when compared to the usual practice of describing the assay coefficient of variation in the usual manner and then not using such information either in population pharmacokinetic modeling or in actual therapeutic drug monitoring. These equations can be used until each laboratory can develop its own assay error patterns with its own similar polynomial equations.

Bayes Theorem↗
PubMed1999

The need for evaluation when managing the IMIA.ORG web-site.

The International Medical Informatics Association (IMIA) has built up a web-site to support international scientific exchange and facilitate organizational tasks. Regular monitoring is required to get information on whether the site is actually used and by whom. Main aspects of the evaluation are function, structure and contents. As main evaluation methods the logfile analysis and user questionnaires are used. The number of visits to IMIA's web-site has constantly increased in the last year. In January 1998 the site had 418 visits, in December 1998 there were 6002 visits. The user questionnaire showed that the web-site offers an adequate platform for the members. It is concluded that the members as the main target group are reached by the service and in addition that the growing number of non-members require further development of the public part of the site.

Evaluation Studies as Topic↗
PubMed2006

A new perspective in the promotion of e-health.

This paper proposes a new model that provides assistance in understanding the reasons why individuals would use new ICT (Information and Communication Technologies) to perform a healthcare change in their lifestyle. Achieving a lifestyle change by the use of ICT is a multifold issue that can be broadly addressed by analysing, in parallel two dimensions: the individuals' attitude towards their health condition and their approach and readiness to monitor and change their attitude by the use of ICT. Our work has been to conceive and develop a model that explains the different stages the user is at both in terms of the perception of healthcare and of the use of technology to perform any desired or recommended change. In order to place the user at each dimension a set of questionnaires were designed and implemented. These questionnaires assisted us in understanding what personalised information needs to be provided according to the stage the user is at as well as to other variables (such as age, cultural background, etc). The novelty of this model is that it proposes a general framework that may be applied to the conception, design and evaluation of any e-health application. Moreover, it can be applied to different application targets (medical informatics, public health informatics, etc) and to different audiences (healthy individuals, patients, professionals, etc) as it proposes an enhanced user modelling process by taking into account both healthcare behaviour aspects as well as technological issues, which up to this moment, have not been taken into account and may be part of the explanation of e-health uptake failure in the healthcare field. The application of this model promotes the empowerment of the individuals by providing tailored information, as well as guidance, monitoring, through ICT and it will certainly make an impact on health-related behaviour. Besides, it will allow to understand some of the reasons of the success or failure of different e-health platforms. Overall, this model is likely to provide deeper insights into the process of improving e-health so it can meet ongoing individuals' needs and become an increasingly valued part of health care services.

Health Promotion↗
PubMedDate not supplied

[Design criteria for a computerized clinical database].

The techniques of data management constitute a principal field in medical informatics, both for systems oriented to sole information retrieval, and basic-systems for more sophisticated applications. The operative utility of a data base depends on a careful planning based on foreseen requirements, and on the observance of some methodological rules. Such as, a precised preliminary study for the selection of clinical data to include in the data base, the choice of better tools and methodologies for the data collection and the right programming of software for the management of the archives. The knowledge of these problems allows, in many cases, the programming of computerized data base to use efficiently in the management of clinical information and in the planning of research. These problems, which do not depend on the hardware used, are commonly found in these applications. However, they have to be solved either for the use of large data base in hospital, which run on mainframe, or for the archives of the department, which can be built by every clinician on his own personal computer.

Humans↗