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PubMed2004

Bioinformatics: perspectives for the future.

I give here a very personal perspective of Bioinformatics and its future, starting by discussing the origin of the term (and area) of bioinformatics and proceeding by trying to foresee the development of related issues, including pattern recognition/data mining, the need to reintegrate biology, the potential of complex networks as a powerful and flexible framework for bioinformatics and the interplay between bio- and neuroinformatics. Human resource formation and market perspective are also addressed. Given the complexity and vastness of these issues and concepts, as well as the limited size of a scientific article and finite patience of the reader, these perspectives are surely incomplete and biased. However, it is expected that some of the questions and trends that are identified will motivate discussions during the IcoBiCoBi round table (with the same name as this article) and perhaps provide a more ample perspective among the participants of that conference and the readers of this text.

Bioethics↗
PubMed2004

Healthcare compunetics.

Changes in life expectancy, healthy life expectancy and health seeking behaviour are having an impact on the demand for care. Such changes could occur across the whole population, or for specific groups. Changes for specific groups will be particularly affected by policy initiatives, while both these and wider changes will be affected by people's levels of engagement with their health and the health service itself. Levels of education, income and media coverage of health issues are also important. These factors could also encourage an increase in people caring for themselves and their families or community. People are now expecting a patient-centred service with safe high quality treatment, comfortable accommodation services, fast access and an integrated joined-up system. The uptake of integrated Information and Communication technologies (ICT) will be crucial. Healthcare Compunetics, the combination of computing and networking customised for medical and care, will provide the common policy and framework for combined multi-disciplinary research, development, implementation and usage.

Artificial Intelligence↗
PubMed2005

Clinician style and examination room computers: a video ethnography.

BACKGROUND AND OBJECTIVES: The use of computers in medical examination rooms is growing. Advocates of this technology suggest that all family physicians should have and use examination room computers (ERCs) within the near future. This study explored how family physicians incorporate the use of ERCs in their interactions with patients. METHODS: This qualitative study involved five family physicians, one family nurse practitioner, and a convenience sample of 29 patients. Data included videotaped visits, clinician interviews, and videotape reviews. The setting was an urban family practice with a 7-year history of viewing electronic medical records. The main outcome measures were themes emergent from videotaped data. RESULTS: We identified three distinct practice styles that shaped the use of the ERC: informational, interpersonal, and managerial styles. Clinicians with an informational style are guided by their attention to gathering data as prompted by the computer screen. Clinicians with an interpersonal style focus their attention and body language on patients. Clinicians with a managerial style bridge informational and interpersonal styles by alternating their attention in defined intervals between patients and the computer. CONCLUSIONS: Family physicians have varying practice styles that affect the way they use examination room computers during visits with patients.

Adolescent↗
PubMed2005

Situated, strategic, and AI-Enhanced technology introduction to healthcare.

We work hard on creating AI-wings for physicians to let them fly higher and faster in diagnosing patients--a task that physicians do not want to automate. What we do not work hard on is determining the ENVIRONMENT in which physicians' AI wings are supposed to function. It seems to be a job for social/business analysts that have their own separate kingdom. For the sake of all of us (potential patients!) social/business consultants and their methodologies should not be treated as a separate kingdom. The most urgent task is to achieve synergy between (1) AI/Fuzzy/Neural research, (2) Applied medical AI, (3) Social/Business research on medical institutions. We need this synergy in order to assure humanistic medical technology; technology flexible and sensitive enough to facilitate healthcare work while leaving space for human pride and creativity. In order to achieve humanistic technology, designers should consider the impact of technological breakthroughs on the organizations in which this technology will function and the nature of work of humans destined to use this technology. Situated (different for each organization), Strategic (based on an in-depth knowledge of Healthcare business), and AI-Enhanced (ended with a dynamic model) method for introducing technology to Healthcare allows identifying areas where technology can make medical work easier. Using this method before automating human work will get us closer to the ideal where there is no discontinuity between design and use of programs; where the technology matches users' needs perfectly--the world with humanistic technology and healthcare workers with AI-wings.

Artificial Intelligence↗
PubMedDate not supplied

Neologisms in medical practice: their potential to be 'useful', 'useless' or 'misleading'.

BACKGROUND: The advances in human endeavours have led to changes in technology. New words, neologisms, have been creeping up and are coined with astounding speed. While these terms are fascinating etymologically, their impact needs to be appreciated from a realistic perspective to keep one aware of the collateral changes we are importing into common language, particularly in medical practice. The aim of this paper is to identify some of such neologisms, outline their current use and then discuss their potential to be 'useful' 'useless' or 'misleading'. METHODS: Terminologies in medical practice and information technology have been selected by the authors and their meanings have been analysed. RESULTS: The terminologies of our present interest include: Computer literacy; Surfing the web; Networking; Information technology; Medical informatics; Telemedicine; Capacity building; Problem-based learning; Mentoring; Learning curve; Evidence-based medicine; Impression; Comorbid conditions; Family medicine; Andropause; Surgical site infection; Confidence interval. CONCLUSION: Neologisms are inescapable in the face of rapid advances in knowledge, equipment and information dissemination to and through diverse cultures and languages. In their assimilation, we should be considerate in discarding familiar terms that have served time.

Humans↗
PubMed2005

Promoting safe nursing care by bringing visibility to the disciplinary aspects of interdisciplinary care.

The provision of safe and effective interdisciplinary care requires making the unique and interdependent aspects of disciplinary care visible and understandable. Ideally, the electronic health record (EHR) should capture both disciplinary and interdisciplinary care. This paper reports on a "real time" pilot of a technology supported method of documenting, communicating, and tracking the nursing component of the patient's plan of care for eventual integration into EHR. An intensive care unit tested the intervention that included the adoption and use of the NANDA, NOC, and NIC terminologies. Multiple methods were used to evaluate the impact of the care planning method for a 12 month period. We found that the increased visibility of nursing care promoted greater awareness and understanding (collective mind) of care and in turn enhanced continuity. The results of the pilot were used to further refine our theoretical framework and method for the multi-site study currently underway.

Attitude to Computers↗
PubMed1990

Computer applications in dermatology.

Advances in computer technology both in hardwares and softwares has stimulated the proliferation of the use of computers in dermatology. The computers enable the voluminous medical literature and records to be compiled and accessed readily. Information technology enables dermatologists to conduct literature searches efficiently and helps in the management of patients. The information compiled in the computers as databases together with its capability to handle complex statistical analysis also enables dermatologists and computer scientists to develop expert systems to assist the dermatologist in the diagnosis and prognostication of diseases and to predict disease trends. Computers have also allowed dermatologists to assess visual images objectively, making it possible to study treatment response more accurately.

Artificial Intelligence↗
PubMed1995

The computerization of ambulatory pediatric practice.

With the shift in pediatrics toward emphasis on preventive care and anticipatory guidance, especially in this era of care- and cost-management, quality care is becoming increasingly synonymous with good information processing. To achieve our maximum effectiveness as clinicians as well as business persons, because pediatrics is a business, we must learn to use the tool that the rest of the business world has long ago discovered and implemented: computerization. Most important, we must apply this technology not only to the business of medicine, but to the practice of medicine itself, for that is where our future and the future of our children lie. From the perspective of someone who has been there, I will discuss what computerized information access and information processing has allowed us to accomplish in practice, and I will give a glimpse of what medicine will be like when we all can manipulate medical information so rapidly that it enables us to practice true preventive care aggressively, to give anticipatory guidance and parent education in a timely manner, and to assess and monitor the progress of our children effectively.

Ambulatory Care↗