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PubMed1997

Integrating medical informatics into the medical undergraduate curriculum.

The advent of healthcare reform and the rapid application of new technologies have resulted in a paradigm shift in medical practice. Integrating medical Informatics into the full spectrum of medical education is a viral step toward implementing this new instructional model, a step required for the understanding and practice of modern medicine. We have developed an informatics curriculum, a new educational paradigm, and an intranet-based teaching module which are designed to enhance adult-learning principles, life-long self education, and evidence-based critical thinking. Thirty two, fourth year medical students have participated in a one month, full time, independent study focused on but not limited to four topics: mastering the windows-based environment, understanding hospital based information management systems, developing competence in using the internet/intranet and world wide web/HTML, and experiencing distance communication and TeleVideo networks. Each student has completed a clinically relevant independent study project utilizing technology mastered during the course. This initial curriculum offering was developed in conjunction with faculty from the College of Medicine, College of Engineering, College of Education, College of Business, College of Public Health. Florida Center of Instructional Technology, James A. Haley Veterans Hospital, Moffitt Cancer Center, Tampa General Hospital, GTE, Westshore Walk-in Clinic (paperless office), and the Florida Engineering Education Delivery System. Our second step toward the distributive integration process was the introduction of Medical Informatics to first, second and third year medical students. To date, these efforts have focused on undergraduate medical education. Our next step is to offer workshops in Informatics to college of medicine faculty, to residents in post graduate training programs (GME), and ultimately as a method of distance learning in continuing medical education (CME).

Computer Communication Networks↗
PubMed1994

The development of a client application for the collaborative social and medical services system.

This paper describes the design and implementation of a client application for the Baylor College of Medicine Teen Health Clinics. The application is the front end to the Collaborative Social and Medical Services System (CSMSS) under development by Baylor's Medical Informatics and Computing Research Program [8]. The application provides distributed access to an underlying object oriented database system. A process driven and patient centered design will provide staff members with a complete set of services, including forms for data entry and viewing, query, and access management to facilitate efficient and effective delivery of services. Role-specific interfaces will be supplied for clerks, nurses, nurse practitioners, physicians, and social workers. The client application is being designed using object oriented methodologies and technologies with the C++ programming language, and will operate within a Microsoft Windows operating environment utilizing Object Linking and Embedding for application interoperability.

Adolescent↗
PubMed2006

Factors influencing success and failure of health informatics systems--a pilot Delphi study.

OBJECTIVES: The aim is to gain information on factors influencing success and failure for Health Informatics applications from a group of medical informaticians. METHODS: Based on the presentations at a special topic conference on success and failure in Health ICT and analysis of the proceedings, we conducted a Delphi study on success and failure aspects. RESULTS: A total of 110 success factors and 27 failure criteria were identified, distributed on categories like functional, organizational, behavioral, technical, managerial, political, cultural, legal, strategy, economy, education and user acceptance. These factors and criteria were rated for six different system types. Unanimously it was agreed that "collaboration and co-operation" and "setting goals and courses" are "essential for the success" of clinical systems, and "user acceptance" for educational systems. Similarly, the score "essential in order to avoid a failure" were given unanimously on clinical systems for "response rate and other performance measures" and on administrative systems for "not understanding the organizational context" with "not understanding or foreseeing the extent to which the new IT-system affects the organization, its structure and/or work procedures" as the highest scoring sub-item. CONCLUSIONS: All success factors and failure criteria were considered relevant by the Delphi expert panel. There is no small set of relevant factors or indicators, but success or failure of a Health ICT depends on a large set of issues. Further, clinical systems and decision support systems depend on more factors than other systems.

Delphi Technique↗
PubMed1999

[Outline of Health Level Seven (HL7) standard].

Health Level Seven (HL7) is a standard for medical informatics exchange between healthcare providers. Its applicable area includes order entry of many kinds, test result reporting, prescriptions, Admit/Discharge/Transfer of patient, etc. It is one of the most successful medical standards. Merits of HL7 are 1) its richness of elements of details for laboratory test orders and results, 2) its protocol definitions for HIS-LIS data exchange, 3) its standard body's healthy management, and 4) its popularity makes related softwares more available and less expensive. Limitations of HL7 are 1) its difficulty of expression of clinical findings, signs, and symptoms, which comprise electronic medical records, all because of lack of adequate code of these items, and 2) its being a description of fixed timing of examination results, not being a sequence of episode of the patient. HL7 Japan have been founded in 1998, as the 7th international affiliate of HL7. Its secretariat facility is provided by JAHIS (Japan Association of Healthcare Information System vendors). Its activities comprise; 1) HL7 seminars held more than 3 times each year, 2) Japanese language publication of HL7 standards and related documents, and 3) submission of requirements from Japanese users to HL7 USA for coming versions.

Clinical Laboratory Information Systems↗
PubMed1997

Acceptance of a speech interface for biomedical data collection.

Speech interfaces have the potential to address the data entry bottleneck of many applications is the field of medical informatics. An experimental study evaluated the effect of perceptual structure on a multimodal speech interface for the collection of histopathology data. A perceptually structured multimodal interface, using speech and direct manipulation, was shown to increase speed and accuracy. Factors influencing user acceptance are also discussed.

Attitude to Computers↗
PubMed1993

Modelling for natural language understanding.

Natural Language Understanding (NLU) is a rapidly growing field in medical informatics. Its potential for tomorrow's applications is important. However, it is limited by its ability to ground its components on a solid model of the domain. This opens the way for the emergence of the discipline of medical domain modelling, as part of the vast field of Knowledge Base (KB) engineering. This article aims at describing the current development of a multilingual natural language system, strongly oriented towards the semantics of the domain. Special emphasis is presently given to the task of building a domain model, and to establish direct links with the language platform. The result is a model-driven NLU system. Numerous benefits are expected in the long term.

Artificial Intelligence↗
PubMed1997

The internal challenges of medical informatics.

Haux's [7] basic assumption that the object of medical informatics is: "... to assure and to improve the quality of healthcare as well as the quality of research and education in medicine and in the health sciences ..." is taken as a starting point to discuss the three main topics: What is the meaning of medical informatics (i.e. what should be the main activities of medical informatics to bring maximum benefit to medicine)? What are the achievements and failures of medical informatics today (again considering the impact on the quality of healthcare)? What are the main challenges? Concerning the definition of medical informatics it is argued that one should not hide the link to basic informatics and, for that matter to computers, completely behind abstract definitions. After an analysis of the purposes of the definition of a discipline, a differentiated definition of the scope of medical informatics, rather general when concerning the field of scientific interest, more focused when concerning the practical (constructive) applications, is proposed. Contrasting Haux's chapter on achievements of medical informatics we concentrate on and analyse non fulfilled promises of medical informatics to derive lessons for the future and to propose 'generic' (or core) tasks of medical informatics to meet the challenges of the future. A set of 'internal challenges' of medical informatics to change priorities and attitudes within the discipline is put forward to enable medical informatics to meet the 'external challenges' listed by Haux.

Artificial Intelligence↗
PubMed1998

A study on home health care support information system for health evaluation.

The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying multifunctional telephone set and an IC memory card, by which complaints, symptoms, and conditions by them can be collected, recorded, and transmitted to medical facilities. We also conducted an experiment for trial use of the system with the cooperation of elderly female volunteers. It was recognized that the elderly volunteers could operate the system with the help of public health nurses and their health information could be collected by the system. Although the developed system has some problems, it was suggested that the system would be useful for the support of health evaluation of elderly at home.

Aged↗
PubMed1989

The status of medical informatics in Canadian medical schools.

Many have suggested that information technology in its various forms will continue to have an effect on all aspects of medicine, including medical education. If so, the introduction of information technology into medicine brings with it critical educational policy questions. This paper reports on the findings of an inquiry into the impact of information technology on medical education. It reviews the extent to which Canadian and American medical colleges have adopted the 1985 recommendations of the American Association of Medical Colleges. In particular, it looks at the recommendations that "medical informatics should become an integral part of the medical curriculum" and that "the teaching of medical informatics should include opportunities for specific instruction in its fundamentals as well as adequate examples of its application throughout the medical curriculum".

Attitude to Computers↗
PubMed2004

Translation research: from accurate diagnosis to appropriate treatment.

This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB) and Health Insurance Portability and Accountability Act (HIPAA) compliance, data standardization, sample procurement, quality control (QC), quality assurance (QA), data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease.

Journal Article↗
PubMedDate not supplied

Are medical informatics and nursing informatics distinct disciplines? The 1999 ACMI debate.

The 1999 debate of the American College of Medical Informatics focused on the proposition that medical informatics and nursing informatics are distinctive disciplines that require their own core curricula, training programs, and professional identities. Proponents of this position emphasized that informatics training, technology applications, and professional identities are closely tied to the activities of the health professionals they serve and that, as nursing and medicine differ, so do the corresponding efforts in information science and technology. Opponents of the proposition asserted that informatics is built on a re-usable and widely applicable set of methods that are common to all health science disciplines, and that "medical informatics" continues to be a useful name for a composite core discipline that should be studied by all students, regardless of their health profession orientation.

Medical Informatics↗
PubMed1995

The use of artificial intelligence in the analysis of sports performance: a review of applications in human gait analysis and future directions for sports biomechanics.

Computers have played an important supporting role in the development of experimental and theoretical sports biomechanics. The role of the computer now extends from data capture and data processing through to mathematical and statistical modelling and simulation and optimization. This paper seeks to demonstrate that elevation of the role of the computer to involvement in the decision-making process, through the use of artificial intelligence techniques, would be a potentially rewarding future direction for the discipline. In the absence of significant previous work in this area, this paper reviews experiences in a parallel field of medical informatics, namely gait analysis. Research into the application of expert systems and neural networks to gait analysis is reviewed, observations made and comparisons drawn with the biomechanical analysis of sports performance. Brief explanations of the artificial intelligence techniques discussed in the paper are provided. The paper concludes that the creation of an expert system for a specific well-defined sports technique would represent a significant advance in the development of sports biomechanics.

Artificial Intelligence↗
PubMed1991

[Medical informatics and health care in Subotica yesterday, today and tomorrow].

The application of information systems in health care throughout the world has begun ten years after the first generation of computers. Computers are a tool for doing business in all segments of health care. After a presentation of the development of informatics in the world and in our surroundings, a survey of events related to the health-care informatics in Subotica is given, as well as the perspective which is expected.

Health Services↗
PubMed1995

Patients, patient records, and ethical principles.

This paper argues that the "fair information principles" are an insufficient guide to the ethical treatment of patient records, because they lack a proper theoretical basis, are procedurally as well as substantively incomplete, and are ethically dangerous. The paper shows how more appropriate guidelines can be developed by treating patient records as patient analogs in decision-space and applying ethical principles to them. It extends this to a sketch of how a Code of Ethics for Medical Informatics Professionals can be derived in a similar way. The application of ethical principles to patient records is also explained and defended.

Computer Security↗
PubMed1992

Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics.

In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.

Germany↗