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At least 1,333 records · Page 74Linked to original sources
PubMed2004

[Relevance of research networks in internal medicine].

Coming from a short international review reasons for networking of scientific research in Germany are given. Success and challenges of medical competence networks are listed, and it is argued how important it is to bridge networks in health care and medical research networks. Some examples from internal medicine are given. The prominent central role of patients is emphasized. Finally it is stated that Germany so far has not established the prerequisites to implement sustainable collaborative infrastructures. Specifically financial, legal, and political support is missing. In addition, it becomes clear that -- in contrast to the USA -- Germany lacks sufficient medical informatics specialists as well as health managers trained to manage IT or networked research. The planned introduction of a telematics infrastructure for health in Germany is perceived as a big chance for improvement.

Computer Communication Networks↗
PubMed2006

Informatics and public health at CDC.

Since CDC acquired its first mainframe computer in 1964, the use of information technology in public health practice has grown steadily and, during the past 2 decades, dramatically. Public health informatics (PHI) arrived on the scene during the 1990s after medical informatics (intersecting information technology, medicine, and health care) and bioinformatics (intersecting mathematics, statistics, computer science, and molecular biology). Similarly, PHI merged the disciplines of information science and computer science to public health practice, research, and learning. Using strategies and standards, practitioners employ PHI tools and training to maximize health impacts at local, state, and national levels. They develop and deploy information technology solutions that provide accurate, timely, and secure information to guide public health action.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

The strategic approach of managing healthcare data exchange in Austria.

OBJECTIVES: The exchange of electronic medical data between healthcare providers constitutes an integral part of modern medicine, and its importance is growing. Efficient application on a national level requires a uniform approach to the management of healthcare data exchange, avoiding isolated solutions that are expensive and also incompatible. METHODS: In this communication we explain the basic concepts of establishing a nationwide framework to guide healthcare data exchange in Austria. To achieve this goal, a three-step approach was adopted: (i) creating general guidelines to direct electronic medical data exchange; (ii) defining detailed standards for electronic messages; (iii) organizing pilot projects to implement these standards, and further improving the general guidelines based on the results of the pilot projects. RESULTS: We present the MAGDA-LENA framework which guides healthcare data exchange in Austria, and compare it with the US framework HIPAA. We describe several communication scenarios for which concrete message standards were developed in recent years, based on the MAGDA-LENA framework. We further discuss the implementation of these standards in four pilot projects. CONCLUSIONS: The strategic approach of managing healthcare data exchange presented in this paper is expected to have a substantial impact on medical informatics in Austria over the next few years.

Austria↗
PubMed2004

Computers in the ICU: where we started and where we are now.

The first use of computers in critical care units were described in the mid 1960s. They reported the use of very large mainframe computers that filled entire rooms yet had very limited memory and processing capacities by today's standards. These were limited to only a few institutions until microprocessors were developed increasing computation speed and expanding memory capacity by many magnitudes. This allowed smaller more affordable stand alone systems to be developed and the inclusion of microprocessors into bedside devices. As the capacity expanded uses broadened. Simple results review developed into a more complete electronic medical record. Databases were created allowing population analysis for research and systems quality improvement activities. Decision support started as simple alerting of potential errors and dangers and expanded into more sophisticated clinical decision-making support. With this came problems that needed solutions. As the amount of information became overwhelming to the bedside clinician, methods to filter and display data made it more useful. Security and confidentiality became major concerns. Data input solutions had to be found including interfaces between computers, bedside devices and instruments designed to automate data input like scanners, bar coders, and other devices. The biggest issue of all however, was developing acceptance among clinicians and creating the cultural change required for successful implementation of electronic medical records. This paper will explore these issues.

Computer Systems↗
PubMed2006

MobileMed: a PDA-based mobile clinical information system.

Patient clinical data are distributed and often fragmented in heterogeneous systems, and therefore the need for information integration is a key to reliable patient care. Once the patient data are orderly integrated and readily available, the problems in accessing the distributed patient clinical data, the well-known difficulties of adopting a mobile health information system, are resolved. This paper proposes a mobile clinical information system (MobileMed), which integrates the distributed and fragmented patient data across heterogeneous sources and makes them accessible through mobile devices. The system consists of four main components: a smart interface, an HL7 message server (HMS), a central clinical database (CCDB), and a web server. The smart interface and the HMS work in concert to generate HL7 messages from the existing legacy systems, which essentially send the patient data in HL7 messages to the CCDB to be stored and maintained. The CCDB and the web server enable the physicians to access the integrated up-to-date patient data. By proposing the smart interface approach, we provide a means for effortless implementation and deployment of such systems. Through a performance study, we show that the HMS is reliable yet fast enough to be able to support efficient clinical data communication.

Computer Communication Networks↗
PubMed2005

GEMSS: grid-infrastructure for medical service provision.

OBJECTIVES: The European GEMSS Project is concerned with the creation of medical Grid service prototypes and their evaluation in a secure service-oriented infrastructure for distributed on demand/supercomputing. Key aspects of the GEMSS Grid middleware include negotiable QoS support for time-critical service provision, flexible support for business models, and security at all levels in order to ensure privacy of patient data as well as compliance to EU law. METHODS: The GEMSS Grid infrastructure is based on a service-oriented architecture and is being built on top of existing standard Grid and Web technologies. The GEMSS infrastructure offers a generic Grid service provision framework that hides the complexity of transforming existing applications into Grid services. For the development of client-side applications or portals, a pluggable component framework has been developed, providing developers with full control over business processes, service discovery, QoS negotiation, and workflow, while keeping their underlying implementation hidden from view. RESULTS: A first version of the GEMSS Grid infrastructure is operational and has been used for the set-up of a Grid test-bed deploying six medical Grid service prototypes including maxillo-facial surgery simulation, neuro-surgery support, radio-surgery planning, inhaled drug-delivery simulation, cardiovascular simulation and advanced image reconstruction. CONCLUSIONS: The GEMSS Grid infrastructure is based on standard Web Services technology with an anticipated future transition path towards the OGSA standard proposed by the Global Grid Forum. GEMSS demonstrates that the Grid can be used to provide medical practitioners and researchers with access to advanced simulation and image processing services for improved preoperative planning and near real-time surgical support.

Access to Information↗
PubMed2006

Medical informatics and bioinformatics: integration or evolution through scientific crises?

OBJECTIVES: To contribute a new perspective on recent investigations into the scientific foundations of medical informatics (MI) and bioinformatics (BI). To support efforts that could generate synergies and new research directions. METHODS: MI and BI are compared and contrasted from a philosophy of science perspective. Historical examples from MI and BI are analyzed based on contrasting viewpoints about the evolution of scientific disciplines. RESULTS: Our analysis suggests that the scientific approaches of MI and BI involve different assumptions and foundations, which, together with largely non-overlapping communities of researchers for the two disciplines, have led to different courses of development. We indicate how their respective application domains, medicine, and biology may have contributed to these differences in development. CONCLUSIONS: An analysis from the point of view of the philosophy of science is characteristic of established scientific disciplines. From a Kuhnian perspective, both disciplines may be entering a period of scientific crisis, where their foundations are questioned and where new ideas (or paradigm shifts) and a progressive research programme are needed to advance them scientifically. We discuss research directions and trends both supporting and challenging integration of the subdisciplines of MI and BI into a unified field of biomedical informatics (BMI), centered around the evolution of information cybernetics.

Computational Biology↗
PubMed2006

Success and failure factors in the regional health information system design process--results from a constructive evaluation study.

OBJECTIVES: To identify success and failure factors in the design process of a regional health information system. METHODS: A constructive evaluation study including interviews, observations, usability study and document analysis. RESULTS: Modelling was found to be a key element for the successful implementation of a health information system. The developed service chain model helped to define use cases and to implement seamless service chains. User participation in the design process was a success factor resulting in good user acceptance and signs of positive impacts on work practices. Evaluation study also helped system developers to guide the system's further development. An important failure factor identified was the lack of semantic interoperability of the system components. CONCLUSIONS: The results emphasize the socio-technical nature of health information systems. The starting point for development should be thorough insight into the health care work practices where the information systems are to be used. Successful system design should start from modelling of work processes, data and information flows and definition of concepts and their relations. Health informatics as a scientific discipline provides theories and models for the design and development process.

Attitude to Computers↗
PubMed1994

[Informatics education in undergraduate study at the 1st Medical School of Charles University].

History of medical informatics at the 1st Medical Faculty goes to 25 years back. Currently curriculum is divided in two parts. In the first year of studies and obligatory course of computer technique is organized including: computer functions, communications with computers, database systems and text editors. In the 4th year of studies a course in clinical informatics is realized including: principles of computer science, statistical software, artificial intelligence, computer in pedagogy, scientific information, classification in medicine, biological signal and picture analysis, hospital information systems, computer in outpatient ward, clinical decision support, computer simulation in clinical medicine, computers in pharmacology, computer in metabolic care, computers in medical devices. In this way medical students are prepared to be able to use technical means in scientific information management.

Czech Republic↗
PubMedDate not supplied

A national education strategy to develop nursing informatics competencies.

Advances in the sophistication of information and communication technologies offer nursing practitioners opportunities for better information management, more complete documentation of their work, and knowledge development to support evidence-based nursing practice. However, a nursing culture that recognizes and adopts the contributions of technology to practice is required to take advantage of these opportunities. The nature of this change suggests a shift in emphasis from specialists in Nursing Informatics (NI) to NI being integrated into all four domains of nursing practice. The magnitude of change required on individual, organizational and professional levels points to the need for Nursing Informatics education strategies on a national level. Recognizing the role and history of NI specialists, defining NI and the required NI competencies are necessary first steps in developing such a plan. Expanding and adapting the educational infrastructure required to support this initiative follows. A working committee at the national level with representatives from a number of stakeholder groups is currently working on a National Nursing Informatics Project to address these issues. This article summarizes key points of an initial discussion paper.

Canada↗
PubMed1997

Medical informatics in perinatology project AGUSTINA in Argentina.

This paper reviews the development of the field of medical informatics in Latin America. It also describes the preliminary results of a computer-based data management system, named AGUSTINA, which is comprised of maternal and infant data on 6195 deliveries that occurred between June 1990 and December 1995 in a hospital in the surroundings of Buenos Aires, Argentina. These data were fundamental for the instrumentation of preventive community-oriented activities in the area. Finally, this paper describes recommendations for future actions in the area of medical informatics in Latin America.

Adolescent↗
PubMed1996

Collaborative medical informatics research using the Internet and the World Wide Web.

The InterMed Collaboratory is an interdisciplinary project involving six participating medical institutions. There are two broad mandates for the effort. The first is to further the development, sharing, and demonstration of numerous software and system components, data sets, procedures and tools that will facilitate the collaborations and support the application goals of these projects. The second is to provide a distributed suite of clinical applications, guidelines, and knowledge-bases for clinical, educational, and administrative purposes. To define the interactions among the components, datasets, procedures, and tools that we are producing and sharing, we have identified a model composed of seven tiers, each of which supports the levels above it. In this paper we briefly describe those tiers and the nature of the collaborative process with which we have experimented.

Computer Communication Networks↗
PubMed1997

"Just-in-time" clinical information.

The just-in-time (JIT) model originated in the manufacturing industry as a way to manage parts inventories process so that specific components could be made available at the appropriate times (that is, "just in time"). This JIT model can be applied to the management of clinical information inventories, so that clinicians can have more immediate access to the most current and relevant information at the time they most need it--when making clinical care decisions. The authors discuss traditional modes of managing clinical information, and then describe how a new, JIT model may be developed and implemented. They describe three modes of clinician-information interactions that a JIT model might employ, the scope of information that may be made available in a JIT model (global information or local, case-specific information), and the challenges posed by the implementation of such an information-access model. Finally, they discuss how JIT information access may change how physicians practice medicine, various ways JIT information may be delivered, and concerns about the trustworthiness of electronically published and accessed information resources.

Clinical Competence↗
PubMedDate not supplied

The virtues of the virtual world. Enhancing the technology/knowledge professional interface for life-long learning.

Nurses are quintessential learners. Nested between the fields of science and technology, the professional mandate for life-long learning has never been greater. The expanding demands for performance and quality coupled with the reality of diminishing time and resources increasingly frustrate and challenge providers in the field. By blending the best of current training and education with the emerging potential of virtual learning, new models for enhancing clinical reasoning and performance will simplify the challenges of complexity, moving it to higher order. In this transition lies the key to restoring the joy and commitment of professional practice while enhancing the capacity to care with competence.

Computer-Assisted Instruction↗
PubMed1999

Critical care and the World Wide Web.

The Internet was created in 1969, when the Advanced Research Projects Agency of the United States Department of Defense fired up an experimental network consisting of only four computers. Over the past five years there has been an exponential explosion in the number of computers added to this network. It is estimated that Internet traffic doubles every 100 days with more than 100 million people worldwide now on-line. The Internet is so vast that practically every aspect of human interest is represented is some form or fashion. From recreation to applied science and technology, and from Critical Care Medicine case scenarios to digitized radiology images and pathology specimens, the Internet has become increasingly useful for critical care practitioners. To date, no resource is better equipped to assist critical care providers in many of their daily tasks. This article presents some of the historical developments of the Internet as well as common applications that are useful for critical care practitioners.

Critical Care↗
PubMed1996

The CyberDoc project: using portable computing to enhance a community-based primary care clerkship.

In July 1995, MCP-Hahnemann School of Medicine of the Allegheny University of the Health Sciences introduced its first-ever required clerkship in family medicine. It was decided that computer skills and applications would be an integral part of this rotation, and a special program, CyberDoc, was developed for the clerkship by some of the university's informatics professionals and family medicine faculty. CyberDoc is a suite of laptop-computer applications, based almost exclusively on "off-the-shelf" database and connectivity programs and designed expressly for students at community-based training sites. CyberDoc allows faculty members to track students' progress at off-site clerkships, and allows the students to access pharmaceutical and drug-interaction databases, the university's online academic information system (including MEDLINE), all basic Internet functions, e-mail, and an array of other applications. The authors briefly describe the background, goals, and structure of the CyberDoc project, as well as the preliminary outcomes of CyberDoc's pilot year.

Clinical Clerkship↗