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PubMedDate not supplied

A survey of medical informatics in Belgium.

The Belgian Society for Medical Informatics (MIM) organized a survey in 1986 in order to assess the present state of development of medical informatics in Belgium. Questionnaires were sent to hospitals, laboratories, private practitioners and pharmacists, as well as to social security organizations and software industries. The response rate was higher in hospitals (93%) than in any other category. Results showed a large number of computerized hospitals (93% of general acute care hospitals and 91% of psychiatric hospitals). There has been a sharp increase (+ 15%) in computerization of the admission, accounting and billing procedures since 1985, most likely in relation with administrative rules issued by the Belgian Government. The same trend (+ 20%) has been observed for computer applications in clinical laboratories, between 1984 and 1985. There is almost one computer terminal for ten beds in the hospitals with more than 200 beds in 1986. This figure exemplifies the present trend to on-line access to data. Computerized instrumental aids to medicine such as text processing, imaging or computerized interpretation of signals have known a rapid extension during recent years, although less comprehensive than administrative applications in hospitals and in social security organizations. The present state of other applications in medicine (general practice, pharmacy, etc.) was more difficult to assess as those information systems remain more pinpointed. In all medical fields, there appears to be a new rise in computer programs offered by software companies.

Belgium↗
PubMedDate not supplied

[Computer-assisted documentation and therapy planning in pediatric oncology--introduction of a nationwide solution].

In Pediatric Oncology in Germany, 90% of the patients are treated according to multicenter clinical trials, which means an enormous effort for documentation in the participating clinics. In order to enable multiple use of data for patient records as well as for clinical trials a computer-based documentation system for pediatric oncology (DOSPO) is being developed, which can be used nationwide. DOSPO currently comprises a minimum basic data set, which represents the common core of all multicenter trials and which has been approved by the German Society for Pediatric Oncology and Hematology (GPOH). It is intended to enhance the documentation by specific items of each clinical trial. Functions for computer-aided chemotherapy planning and medical report writing have already been implemented in the documentation system. Various centers in Germany are currently validating the system in routine use.

Child↗
PubMed1998

Preparing for the third millennium: the views of life informatics.

The chief aspects of this paper are the condition of the birth of life informatics and its tasks, basic concepts, principles, and structure. There are three phases of combining informatics with medicine: product, technological, and theoretic application of which the goals are respectively the informatization of numerical and word processing, data of medical treatment, and the knowledge of medicine. While reached the third phase we have dealt with two types of biological information, physical and nonphysical, i.e., body information (i.e., the information about body's components and structure), and life information (i.e., the information about life codes and life programs). Life informatics is a main branch of bioinformatics. It is a new member of the medical informatics family, and as such is younger than health informatics, nursing informatics, and dental informatics. It's task is to assist biologists and medical doctors to recognize and interfere the human life information procedure just as they are doing well with human body's matter and energy system. Its basic concepts are life information, life information medicine, and life information therapy. Its most important principles are information materialism, general informatics, and information determinism. Its main branches are biomolecule, cellular, organic, individual, and social informatics. In the third millennium, the life informatics will be a leading discipline in biology, medicine and informatics, which will gradually influence modern philosophy and other humanities.

Biology↗
PubMed1991

A collaborative institutional model for integrating computer applications in the medical curriculum.

The introduction and promotion of information technology in an established medical curriculum with existing academic and technical support structures poses a number of challenges. The UNC School of Medicine has developed the Taskforce on Educational Applications in Medicine (TEAM), to coordinate this effort. TEAM works as a confederation of existing research and support units with interests in computers and education, along with a core of interested faculty with curricular responsibilities. Constituent units of the TEAM confederation include the medical center library, medical television studios, basic science teaching laboratories, educational development office, microcomputer and network support groups, academic affairs administration, and a subset of course directors and teaching faculty. Among our efforts have been the establishment of (1) a mini-grant program to support faculty initiated development and implementation of computer applications in the curriculum, (2) a symposium series with visiting speakers to acquaint faculty with current developments in medical informatics and related curricular efforts at other institution, (3) 20 computer workstations located in the multipurpose teaching labs where first and second year students do much of their academic work, (4) a demonstration center for evaluation of courseware and technologically advanced delivery systems. The student workstations provide convenient access to electronic mail, University schedules and calendars, the CoSy computer conferencing system, and several software applications integral to their courses in pathology, histology, microbiology, biochemistry, and neurobiology. The progress achieved toward the primary goal has modestly exceeded our initial expectations, while the collegiality and interest expressed toward TEAM activities in the local environment stand as empirical measures of the success of the concept.

Academic Medical Centers↗
PubMedDate not supplied

The challenge of meeting patients' needs with a national nursing informatics agenda.

Information has become a capital good and is focused on outcomes. Clinical guidelines are being developed to standardize care for populations, but patient preferences also need to be known when planning individualized care. Information technologies can be used to retrieve both types of information. The concern is that nurses are not adequately prepared to manage information using technology. This paper presents five strategic directions recommended by the National Advisory Council on Nurse Education and Practice (Department of Health and Human Services, Division of Nursing) to enhance nurses' preparation to use and develop information technology. The recommendations are 1) to include core informatics content in nursing curricula, 2) to prepare nurses with specialized skills in informatics, 3) to enhance nursing practice and education through informatics projects, 4) to prepare nursing faculty in informatics, and 5) to increase collaborative efforts in nursing informatics. The potential impact of these strategic directions on patients is discussed.

Computers↗
PubMed1993

Quality assurance for respiratory care services: a computer-assisted program.

At present, the principal advantage of computer-assisted quality assurance is the acquisition of quality assurance date without resource-consuming chart reviews. A surveillance program like the medical director's alert may reduce morbidity and mortality. Previous research suggests that inadequate oxygen therapy or failures in airway management are important causes of preventable deaths in hospitals. Furthermore, preventable deaths tend to occur among patients who have lower severity-of-illness scores and who are not in ICUs. Thus, surveillance of the entire hospital, as performed by the HIS medical director's alert, may significantly impact hospital mortality related to respiratory care. Future research should critically examine the potential of such computerized systems to favorably change the morbidity and mortality of hospitalized patients. The departments of respiratory care and medical informatics at LDS Hospital have developed a computer-assisted approach to quality assurance monitoring of respiratory care services. This system provides frequent and consistent samples of a variety of respiratory care data. The immediate needs of patients are addressed through a daily surveillance system (medical director's alert). The departmental quality assurance program utilizes a separate program that monitors clinical indicators of staff performance in terms of stated departmental policies and procedures (rate-based clinical indicators). The availability of an integrated patient database allows these functions to be performed without labor-intensive chart audits.

Hospital Bed Capacity, 500 and over↗
PubMedDate not supplied

Informatics in radiology (infoRAD): NeatVision: visual programming for computer-aided diagnostic applications.

A free visual programming-based image analysis development environment for medical imaging applications called NeatVision was developed to provide high-level access to a wide range of image processing algorithms through a well-defined, easy-to-use graphical interface. The system contains over 300 image manipulation, processing, and analysis algorithms. For more advanced users, an upgrade path is provided to extend the core library with use of the developer's interface, giving users access to additional plug-in features, automatic source code generation, compilation with full error feedback, and dynamic algorithm updates. NeatVision was designed to allow users at all levels of expertise to focus on the computer vision design task for computer-aided diagnostic (CAD) applications rather than the subtleties of a particular programming language. The environment allows the designers of image analysis-based CAD techniques to implement their ideas in a dynamic and straightforward manner. Both NeatVision standard and developer's versions can be downloaded free of charge from the Internet and can run on a variety of computer platforms.

Diagnosis, Computer-Assisted↗
PubMed2004

Synergy between medical informatics and bioinformatics: facilitating genomic medicine for future health care.

In this paper, we review the results of BIOINFOMED, a study funded by the European Commission (EC) with the purpose to analyse the different issues and challenges in the area where Medical Informatics and Bioinformatics meet. Traditionally, Medical Informatics has been focused on the intersection between computer science and clinical medicine, whereas Bioinformatics have been predominantly centered on the intersection between computer science and biological research. Although researchers from both areas have occasionally collaborated, their training, objectives and interests have been quite different. The results of the Human Genome and related projects have attracted the interest of many professionals, and introduced new challenges that will transform biomedical research and health care. A characteristic of the 'post genomic' era will be to correlate essential genotypic information with expressed phenotypic information. In this context, Biomedical Informatics (BMI) has emerged to describe the technology that brings both disciplines (BI and MI) together to support genomic medicine. In recognition of the dynamic nature of BMI, institutions such as the EC have launched several initiatives in support of a research agenda, including the BIOINFOMED study.

Biotechnology↗
PubMedDate not supplied

Medical computing over the World Wide Web: use of forms and CGI scripts for constructing medical algorithm Web pages.

The development of the World Wide Web has led to an explosion of educational and clinical resources available via the Internet with minimal effort or special training. However, most of these Web pages contain only static information; few offer dynamic information shaped around clinical or laboratory test findings. In this report we show how this goal can be achieved with the design and construction of Medical Algorithm Web Pages (MAWP). Specifically, using Internet technologies known as forms and CGI scripts we demonstrate how one can implement medical algorithms remotely over the Internet's World Wide Web. To use a MAWP, one enters the URL for the site and then enters information according to the instructions presented there, usually by entering numbers and other information into fields displayed on screen. When all the data is entered, the user clicks on the SUBMIT icon, resulting in a new Web page being constructed "on-the-fly" containing diagnostic calculations and other information pertinent to the patient's clinical management. Four sample applications are presented in detail to illustrate the concept of a Medical Algorithm Web page: Computation of the alveolar-arterial oxygen tension difference using the alveolar gas equation; Computation of renal creatinine clearance; drug infusion calculation (micrograms/kilogram/minute); Computation of the renal failure index.

Algorithms↗
PubMed2005

Recent advances in natural language processing for biomedical applications.

We survey a set a recent advances in natural language processing applied to biomedical applications, which were presented in Geneva, Switzerland, in 2004 at an international workshop. While text mining applied to molecular biology and biomedical literature can report several interesting achievements, we observe that studies applied to clinical contents are still rare. In general, we argue that clinical corpora, including electronic patient records, must be made available to fill the gap between bioinformatics and medical informatics.

Abstracting and Indexing↗
PubMed2006

An object-oriented framework for medical image registration, fusion, and visualization.

An object-oriented framework for image registration, fusion, and visualization was developed based on the classic model-view-controller paradigm. The framework employs many design patterns to facilitate legacy code reuse, manage software complexity, and enhance the maintainability and portability of the framework. Three sample applications built a-top of this framework are illustrated to show the effectiveness of this framework: the first one is for volume image grouping and re-sampling, the second one is for 2D registration and fusion, and the last one is for visualization of single images as well as registered volume images.

Algorithms↗
PubMed2005

Toward personal eHealth in cardiology. Results from the EPI-MEDICS telemedicine project.

Despite many attempts to improve the management of acute myocardial infarction, only small trends to shorter time intervals before treatment have been reported. The self-care solution developed by the European EPI-MEDICS project (2001-2004) is a novel, very affordable, easy-to-use, portable, and intelligent Personal ECG Monitor (PEM) for the early detection of cardiac ischemia and arrhythmia that is able to record a professional-quality, 3-lead electrocardiogram (ECG) based on leads I, II, and V2; derive the missing leads of the standard 12-lead ECG (thanks to either a generic or a patient-specific transform), compare each ECG with a reference ECG by means of advanced neural network-based decision-making methods taking into account the serial ECG measurements and the patient risk factors and clinical data; and generate different levels of alarms and forward the alarm messages with the recorded ECGs and the patient's Personal electronic Health Record (PHR) to the relevant health care providers by means of a standard Bluetooth-enabled, GSM/GPRS-compatible mobile phone. The ECG records are SCP-ECG encoded and stored with the PHR on a secure personal SD Card embedded in the PEM device. The alarm messages and the PHR are XML encoded. Major alarm messages are automatically transmitted to the nearest emergency call center. Medium or minor alarms are sent on demand to a central PEM Alarm Web Server. Health professionals are informed by a Short Message Service. The PEM embeds itself a Web server to facilitate the reviewing and/or update of the PHR during a routine visit at the office of the general physician or cardiologist. Eighty PEM prototypes have been finalized and tested for several weeks on 697 citizens/patients in different clinical and self-care situations involving end users (188 patients), general physicians (10), and cardiologists (9). The clinical evaluation indicates that the EPI-MEDICS concept may save lives and is very valuable for prehospitalization triage.

Allied Health Personnel↗
PubMed2003

Making messaging standards work: from definition to interoperability at runtime.

The synchronisation of data between healthcare IT applications is done by exchanging (in the broader sense) messages which are formatted according to one of many standards that are used in healthcare. The most successful standard enabling such communication and co-operation for health is HL7 established in the mid-eighties starting as a communication standard within hospitals. HL7 included soon other domains such as home care, clinical studies, and prescription communication. So, HL7 supports shared care between primary, secondary and territory healthcare establishments. Another very successful standard is DICOM for communicating image information among modalities and (radiology) information systems. This review paper discusses integration issues for specification and development of messaging standards and their impact on applications.

Computer Communication Networks↗
PubMed2004

IRMA--content-based image retrieval in medical applications.

The impact of content-based access to medical images is frequently reported but existing systems are designed for only a particular modality or context of diagnosis. Contrarily, our concept of image retrieval in medical applications (IRMA) aims at a general structure for semantic content analysis that is suitable for numerous applications in case-based reasoning or evidence-based medicine. Within IRMA, stepwise processing results in six layers of information modeling (raw data layer, registered data layer, feature layer, scheme layer, object layer, knowledge layer) incorporating medical expert knowledge. At the scheme layer, medical images are represented by a hierarchical structure of ellipses (blobs) describing image regions. Hence, image retrieval transforms to graph matching. The multilayer processing is implemented using a distributed system designed with only three core elements. The central database holds program sources, process-ing schemes, images, features, and blob trees; the scheduler balances distributed computing by addressing daemons running on all connected workstations; and the web server provides graphical user interfaces for data entry and retrieval..

Computer Graphics↗
PubMed2005

Health. Care. Anywhere. Today.

What if clinical quality medical equipment were available to every consumer in a form factor that was inexpensive, accurate, and easy to use? What if this equipment provided information that previously was un-measurable or very difficult to measure? What if the physiological state of individuals, at resolutions measured in thousandths of a second instead of in visits per year, could be measured easily, making it possible to ascertain caloric intake and expenditure, patterns of sleep, contextual activities such as working-out and driving, even parameters of mental state and health. What aspect of healthcare would not change? We present a system that is available today that enables this vision. This award-winning multi-channel wearable physiological monitor has enabled the collection of more than 90 million minutes of data in natural settings from thousands of subjects engaged in diverse activities. Data modeling efforts are resulting in applications that present meaningful and actionable information in real-time to users and their designated collaborators (physicians, family members, counselors, coaches, etc.) We describe the SenseWear system, its design, and a summary of validation studies, current commercial applications, and ongoing research. This discussion will show how the convergence of design for wearability, advances in machine learning, and improvements in wireless technology will manifest the future of health care as personal, ubiquitous, and collaborative.

Clothing↗
PubMed1990

Applications of computer technology in dentistry.

Technological advances in industrial manufacturing have contributed to improvement in productivity and quality of dental care. However, computer technology has also been exploited but not to the same extent as other forms of technology. This paper examines computer applications that have been utilised by various groups of dental professionals in the provision of dental care and in dental education. The benefits derived from existing applications and future possibilities are seen in the following fields. In practice management, besides the usual collecting, sorting and searching of data, productivity and efficiency are greatly increased through computer appointments, recall and practice analysis programmes. In patient education, the use of computer graphics has enabled simulation of cosmetic changes to be presented to the patient with before and after possibilities. Dental education and communications have moved forward with the introduction of Computer Assisted Instruction programmes, and bibliographic databases including electronic transmission of Continuing Dental Education which are now easily available. In the field of Diagnostics and Treatment planning, the advent of CAD-CAM has made possible the use of cutting devices which mills a 3-dimensional model of the designed restoration from solid blocks of gold. Computer applications has also been used in forensic dentistry where identification systems describe tooth conditions and other oral characteristics besides automated screening and matching of antemortem databases.

Computer-Assisted Instruction↗