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PubMed2002

A message model designed by EDISANTE WG 11.

WG 11 is one of the Working Groups of the EDISANTE Association. First, his mission was to define message models with two parts: The envelope of the message, including a header, the characteristics of the transmitter, of the receiver, and of the patient concerned. The contents of the message, including medical data which could be exchanged between different middleware. This second part was halted by the " Réseau Santé Social", public network for all the healthcare professionals, who want to have a structured content for his "medical message format". The prupose of EDISANTE is essentially to promote the use of EDI in health care. In a second time, this association decide to include work about envelope in a larger domain concerning all exchanges in medical domains, so the GT 11 centred his action on content.

Computer Communication Networks↗
PubMed1997

Computerized health assessment and education for adolescent HIV and STD prevention in health care settings and schools.

This report summarizes a number of computer applications from a decade of experience with computerized adolescent health assessments and automated health education in a large health maintenance organization, military adolescent clinics, detention facilities, health fairs, and public schools. Feedback from over 5,000 adolescents is given for patient responses to and acceptance of computerized health assessments and preferences for automated health education modalities, including multimedia. Implications of the computerized approach to assessment of adolescent health risk behaviors and the provision of automated health education and HIV/STD prevention are considered in terms of efficiency, reliability, and access to health screening and educational services.

Adolescent↗
PubMed1994

Development of standards and data quality control.

Health care expenses represent 6 to 10% of the Gross National Product in most European countries. This budget exceeds by far those devoted to Defence or Education. The rising cost of health care concerns all governments. In each country of the European Community, measures were and will further be taken in order to increase efficiency in the delivery of health care. Recent advances in information technology offer new opportunities to collect, process and exchange data to document health practices. In Belgium the Ministry of Public Health collects uniform medical summaries for all acute care hospital inpatients, while detailed health care activities are documented for each patient through a very precise billing system. The use of Minimal Clinical Data and Minimal Nursing Data Sets in hospitals became mandatory four years ago. The fundaments for any data collection is reliability, no matter what the preconceived aim was.

Belgium↗
PubMed2003

Open Source in the European Union: a future way for health applications?

Since 1999, the Open Source movement has aroused the interests of different players of the Information Society. M. E. Liikanen, European Commissioner for Enterprise and Information Society, has publicly expressed an interest for more security through the use of Open Source software. Municipalities deployed desktops and servers based on Open Source software in Spain, France, Austria and Belgium. Some health professionals see in this movement a way of obtaining better software, more secure and interoperable. This presentation explores the context and economical considerations at the basis of the Open Source movement, its rationale in a research programme publicly financed and some of the challenges ahead. It concludes on the observations that Open Source is high on several agendas but needs to quickly become an economical activity to deliver its promises.

Computer Security↗
PubMed1999

Role of clinical trials informatics in the NCI's cancer informatics infrastructure.

A Web-enabled Cancer Informatics Infrastructure (CII) will enable faster, better clinical trials, ultimately improving cancer care. To create the CII, the National Cancer Institute is forming public-private partnerships and building on existing activities. Key innovations include development of standards for cancer patient information and clinical research, management of patients using disease specific "clinical states" and use of drag and drop electronic protocol authoring.

Breast Neoplasms↗
PubMed2000

Continuing education meets the learning organization: the challenge of a systems approach to patient safety.

Since the release of the report of the Institute of Medicine on medical errors and patient safety in November 1999, health policy makers and health care leaders in several nations have sought solutions that will improve the safety of health care. This attention to patient safety has high-lighted the importance of a learning approach and a systems approach to quality measurement and improvement. Balanced with the need for public disclosure of performance, confidential reporting with feedback is one of the prime ways that nations such as the United States, Canada, the United Kingdom, and Australia have approached this challenge. In the United States, the Quality Interagency Coordination Task Force has convened federal agencies that are involved in health care quality improvement for a coordinated initiative. Based on an investment in a strong research foundation in health care quality measurement and improvement, there are eight key lessons for continuing education if it is to parlay the interest in patient safety into enhanced continuing education and quality improvement in learning health care systems. The themes for these lessons are (1) informatics for information, (2) guidelines as learning tools, (3) learning from opinion leaders, (4) learning from the patient, (5) decision support systems, (6) the team learning together, (7) learning organizations, and (8) just-in-time and point-of-care delivery.

Education, Continuing↗
PubMedDate not supplied

The meaning of mental health: a report of two ethnoscientific studies.

The use of the ethnoscientific method in nursing research is demonstrated in an initial study and a replication of that study, utilizing male and female informants. The domain of "mental health" was explored, analyzed, and contrasted within the subculture of the central city resident and the subculture of the psychiatric-mental health professional. To facilitate an understanding of ethnoscience, the method is briefly outlined; then, to illustrate the methodology, data from one informat are presented in depth. A summary of the major similarities and contrasts that emerged from the data of both studies is presented. Implications for nursing of the research and ethnoscience are discussed.

Adult↗
PubMed2006

Comparative Mouse Genomics Centers Consortium: the Mouse Genotype Database.

The Comparative Mouse Genomics Centers Consortium (CMGCC) is a branch of the Environmental Genome Project sponsored by the National Institute of Environmental Health Sciences (NIEHS) focusing upon the identification of human single nucleotide polymorphisms (SNPs) that may confer disease susceptibility within the human population. The goal of the CMGCC (http://www.niehs.nih.gov/cmgcc/) is to make genetic mouse models for human SNPs within cell cycle control, DNA replication and DNA repair genes that may be associated with human pathologies. In order to facilitate information sharing and analysis within the consortium a set of informatics resources have been generated to support the mouse model development efforts. The primary entry point for information about the mouse models developed by the consortium is through the CMGCC Genotype Database (http://mrages.niehs.nih.gov/genotype/), which maintains both a consortium specific and public access display of the available and developing mouse models.

Animals↗
PubMed1993

[Collecting, publishing and searching scientific and research information].

Time of information in which we live resulted in the increase of the amount of the information exponential growth of the new kind of knowledge, flourishing of the familiar ones, and the appearance of the new sciences. Medical (health) informatics occupies the central place in all the segments of modern medicine in the past thirty years--in practical work, education and scientific research. In all that, computers have taken over the most important role and are used intensively for the development of the health information systems. Following activities develop intensively within the area of health informatics: health- documentation, health-statistics, health-informatics and biomedical scientific and professional information. Starting with the fact that in this century and especially after the World War II, great advancement in bio-medical sciences is visible, in Bosnia and Herzegovina, it is clear that as a result of the above increase in scientific research, in the number of scientists, and funds invested in scientific institutions, equipment and documentation, is visible. Innovations and developments in science demand analytic-synthetic processing of scientific information and their utilisation research. This can be realised by collecting sources (documents) for reading, noting, editing, discovering-which is the integral part of scientific developmental research. Scholarly journals as well as the publications that follow the latest events in the world of science, and inform their users in the area of bio-medicine quickly and efficiently, play an important role in the professional literature.

Information Storage and Retrieval↗
PubMed2003

Medical image security in a HIPAA mandated PACS environment.

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.

California↗
PubMed1998

The strategic plans of OTE concerning the development of telemedicine applications based on the Euro-ISDN technology.

OTE SA, the Hellenic Telecommunications Organization, is the major public network operator of Greece and aims to actually promote all services made available through this technology and more peculiarly that of telemedicine. Through its modernization plan in progress, OTE aims at providing wide/range, high/quality competitive services on the basis of customer oriented policies. Its activities cover, besides basic telephony (5.9 million lines), data communications, leased lines, maritime communications and value-added services. The public health service has a lot to profit from efficient use of telecommunications. The greatest challenge the health service is faced with, is the growing gap between the expectations of the population, and the resources that society can set-aside for health purposes. Increasing the level of efficiency and co-operation is therefore the best probable response to the challenge. Telecommunications may contribute to a more effective utilization of resources, typing together those that could be in benefit of the health sectors in the process of implementing a large number of telemedical services.

Greece↗
PubMed1997

The U.S. pediatric cancer clinical trials programmes: international implications and the way forward.

The four national paediatric cancer clinical trials organisations in the United States--the Children's Cancer Group, the National Wilms' Tumor Study Group, the Intergroup Rhabdomyosarcoma Study Group and the Pediatric Oncology Group--were formed in 1955, 1969, 1972 and 1979, respectively. Together, the Children's Cancer Group and Pediatric Oncology Group serve as a national registry of nearly all childhood cancers in the United States, provide a national network of communication for researchers, care providers and families of paediatric patients with malignant disease and conduct laboratory investigations and clinical trials of new treatments of cancers in infants, children, adolescents and young adults. Nearly 95% of patients with cancer in the United States who are below 15 years of age are registered by the Children's Cancer Group and the Pediatric Oncology Group and more than half of American children with cancer are entered into at least one trial by a paediatric group. Improved survival of children receiving treatment according to well-defined protocols in specialised children's centres, in contrast to children who received treatment outside of these centres, has been shown for those with acute lymphoblastic leukaemia, lymphoma, Wilms' tumour, medulloblastoma, rhabdomyosarcoma and Ewing's sarcoma. By the year 2000, the overall cure rate for United States children and adolescents with cancer should exceed 85%. To reach this goal, the way forward will depend on international collaboration, implementation of global harmonisation, prevention of the erosion of biomedical research and clinical trials by the managed health care industry, increased public and private financial support and continued recruitment into paediatric oncology of brilliant and dedicated young investigators. The specific challenges ahead include: (1) transferring the knowledge, methodologies and technologies to countries that are less fortunate; (2) conducting multinational clinical trials in conjunction with paediatric cooperative groups in other countries; (3) accessing older adolescent patients who currently do not participate in cooperative group trials; (4) merging clinical trials by adult collaborative groups that overlap with the paediatric groups, as in acute lymphoblastic leukaemia, acute myelogenous leukaemia, Hodgkin's disease, osteosarcoma and germ cell tumours; (5) establishing a stable source of funding for national and international cooperative paediatric cancer clinical trials; (6) creating an informatics system that can link paediatric cooperative group operation centres around the world, and the institutions within each collaborative group; and (7) securing the support of the insurance industry and government in covering clinical trials.

Adolescent↗
PubMed2001

Medicine ethics as a public problem.

Ethics, especially medical ethics, is of a great importance in medical informatics field ethical principles have great importance in confidentiality, security, and access to patient records. This is not as simple problem as it looks in the first sight, and--in that context--it is significant that many jurisdictions have drafted laws in this regard. As medical informatics has been developed, this ethical problem is becoming very important for medical informatics. Many efforts to make fundamental principles "according to which data protection and access to official information could be reconciled" are made. The principles described in this paper are independent of any process, as they are based on ethical principles. It avoids any kind of conflict or misunderstandings. They can be a base for making of an ethical code for informatics in health care delivery. These principles are independent of any particular "laws", and they can serve as to establish uniformity of standards in medical informatics.

Bosnia and Herzegovina↗
PubMed2006

Social marketing: should it be used to promote evidence-based health information?

The implementation of public health knowledge is a complex process; researchers focus on organizational barriers but generally give little attention to the format and validity of relevant information. Primary and secondary papers and practice guidelines should represent valid and relevant sources of knowledge for clinicians and others involved in public health. However, this information is usually targeted at researchers rather than practitioners; it is often not completely intelligible, does not explain what it really adds to existing knowledge or which clinical/organizational context to place it in, and often lacks 'appeal' for those who are less informed. Moreover, this information is sometimes founded on biased research, shaped by sponsors to give scientific plausibility to market-driven messages. A "social marketing" approach can help public health researchers make evidence-based information clear and appealing. The validity and relevance of this information can be explained to target readers in light of their own knowledge levels and in terms of how this information could help their practice. In this paper we analyse the barriers to knowledge transfer that are often inherent in the format of the information, and propose a more user-friendly, enriched and non-research-article format.

Evidence-Based Medicine↗
PubMed2004

Information technology in the future of health care.

Technology advances have changed the face of health care. This paradigm shift blurred the boundaries between public health, acute care, and prevention. Technology's role in the diagnosis, treatment assignment, follow-ups, and prevention will be reviewed and future impact projected. The understanding of shift in our expectation for each aspect of health care is critical so that levels of success are understood. Technology advances in health care delivery will be discussed. Specific applications are presented and explained and future trends discussed. Four applications are defined, and related to categories of technologies and their attributes.

Artificial Intelligence↗
PubMed2005

Primary healthcare information system--the cornerstone for the next generation healthcare sector in Republic of Croatia.

At no time in the history of medicine has the growth in knowledge and technologies been so profound [Crossing the Quality Chasm: A New Health System for the 21st Century, Institute of Medicine (IOM), 2001. ISBN 0-309-07280-8]. However, healthcare delivery systems today are not able to keep up with the pace. Studies have shown that it takes an average of about 17 years for new knowledge generated by randomized trials to be incorporated into practice [B. Andrew, S. Boren, Managing clinical knowledge for health care improvement, in: Yearbook of Medical Informatics, National Library of Medicine, Bethesda, MD, 2000, pp. 65-70]. It is safe to say that today healthcare systems "have the data, but not information". In order to provide highest quality patient care, Republic of Croatia has started the process of introducing enterprise information systems to support business processes in the healthcare domain. Two major requirements are in focus: to provide efficient healthcare related data management in support of decision-making processes; and to support continuous process of healthcare resources spending optimization. The first initiated project refers to Primary Healthcare Information System (PHCIS) that provides domain of primary care with state-of-the-art enterprise information system that connects General Practitioners, Pediatricians and Gynecologists offices with the Croatian Institute for Health Insurance and Public Health Institute. In the years to come, PHCIS will serve as the main integration platform for connecting all other stakeholders and levels of healthcare (e.g. hospitals, pharmacies, laboratories) into single enterprise healthcare network. This article gives an overview of PHCIS, explains challenges that were faced in designing and implementing the system, and elaborates PHCIS role as the cornerstone for the next generation healthcare provisioning in Republic of Croatia.

Croatia↗
PubMed2004

Stuart Schreiber: biology from a chemist's perspective. Interview by Joanna Owens.

Stuart L. Schreiber is Morris Loeb Professor and Chair of the Department of Chemistry and Chemical Biology at Harvard University, and an Investigator at the Howard Hughes Medical Institute. He founded Harvard's ICCB and directs the NIH-funded Initiative for Chemical Genetics (ICG). He is also a faculty member of the Broad Institute, a joint initiative by Harvard University and MIT that is 'dedicated to leveraging different disciplines to create a new toolkit for genomic medicine'. Following doctoral studies at Harvard University in the laboratory of R. B. Woodward and Y. Kishi, he joined the faculty at Yale University in 1981, where he was promoted to Full Professor in 1986. In 1988, he returned to Harvard, where, in addition to his main roles described above, he is an affiliate of both the Harvard Department of Molecular and Cellular Biology and Harvard Medical School Department of Cell Biology. He is also a member of the Graduate Programs in Biophysics at Harvard University and in Immunology at the Harvard Medical School. In keeping with his multiple roles at Harvard, Schreiber is renowned for taking an integrative and systematic approach to exploring biology. His pioneering work in the field of chemical biology has resulted in the characterisation of many cellular pathways, including (in collaboration with researchers at Stanford University) the identification of the calcium-calcineurin-NFAT signalling pathway. His lab has developed several methodologies including diversity-oriented synthesis (DOS) and in 2003 launched the Chembank public database (), a suite of informatic tools and databases to promote the use of chemical genetics. Schreiber has received many awards and honours including the Tetrahedron Prize for Creativity in Organic Chemistry (1997) and most recently the Society for Biomolecular Screening Achievement Award (2004). He has founded several successful biotechnology firms, including Vertex Pharmaceuticals in 1989, ARIAD Pharmaceuticals in 1991, and Infinity Pharmaceuticals in 2001. He was also founding editor of the journal Chemistry & Biology, which is now in its tenth year of publication.

Biological Factors↗
PubMedDate not supplied

Biomedicine's electronic publishing paradigm shift: copyright policy and PubMed Central.

Biomedical publishing stands at a crossroads. The traditional print, peer-reviewed, subscription journal has served science well but is now being called into question. Because of spiraling print journal costs and the worldwide acceptance of the Internet as a valid publication medium, there is a compelling opportunity to re-examine our current paradigm and future options. This report illustrates the conflicts and restrictions inherent in the current publishing model and examines how the single act of permitting authors to retain copyright of their scholarly manuscripts may preserve the quality-control function of the current journal system while allowing PubMed Central, the Internet archiving system recently proposed by the director of the National Institutes of Health, to simplify and liberate access to the world's biomedical literature.

Authorship↗