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PubMed1994

Simulation of micropopulations in epidemiology: tutorial 1. Simulation: an introduction. A series of tutorials illustrated by coronary heart disease models.

This is the first in a series of tutorials concerning the simulation of micropopulation models for use in epidemiological research. The series emphasizes the techniques that are in use at the National Micropopulation Simulation Resource at the University of Minnesota. This initial series of tutorials uses chronic disease models, specifically coronary heart disease models, to illustrate the principles and methodologies employed. The series is intended for persons having some familiarity with electronic, digital computation and desiring to know more about a specific class of simulations, namely those that apply Monte Carlo techniques in the simulation of micropopulation models as a part of biomedical research. It is the author's hope that these tutorials will be particularly useful for students in medical informatics; they could also be of interest to professionals in both the computational and the biomedical sciences.

Chronic Disease↗
PubMed2004

Structuring European biomedical informatics to support individualized healthcare: current issues and future trends.

Bioinformatics and Medical Informatics are disciplines that up to now have followed separate development with few contacts and synergies between them in Europe. The elucidation of the human genome has however evidenced the need and the possibilities for a strong synergy between the two. Classical epidemiological and clinical research on the one hand, and genomic research on the other, separately considered, are no longer enough for advancing in the so-called genomic medicine, and a new integrative approach is required. Biomedical Informatics is the emerging discipline that aims to put these two worlds together so that the discovery and creation of novel diagnostic and therapeutic methods is fostered. On the basis of the results of the European Commission-funded BIOINFOMED Study, an INFOBIOMED Network of Excellence has been recently constituted with the main objective of setting a durable structure for the described collaborative approach at a European level. Initially formed by fifteen renowned European organisations, the main objective of the INFOBIOMED network is therefore to enable the reinforcement of European BMI as an integrative discipline.

Biomedical Research↗
PubMed2004

A web-based federated neuroinformatics model for surgical planning and clinical research applications in epilepsy.

There is an increasing need to efficiently share diverse clinical and image data among different clinics, labs, and departments of a medical center enterprise to facilitate better quality care and more effective clinical research. In this paper, we describe a web-based, federated information model as a viable technical solution with applications in medical refractory epilepsy and other neurological disorders. We describe four such online applications developed in a federated system prototype: surgical planning, image analysis, statistical data analysis, and dynamic extraction, transforming, and loading (ETL) of data from a heterogeneous collection of data sources into an epilepsy multimedia data warehouse (EMDW). The federated information system adopts a three-tiered architecture, consisting of a user-interface layer, an application logic layer, and a data service layer. We implemented two complementary federated information technologies, i.e., XML (eXtensible Markup Language) and CORBA (Common Object Request Broker Architecture), in the prototype to enable multimedia data exchange and brain images transmission. The preliminary results show that the federated prototype system provides a uniform interface, heterogeneous information integration and efficient data sharing for users in our institution who are concerned with the care of patients with epilepsy and who pursue research in this area.

Animals↗
PubMed2002

Implementing clinical information systems: a multiple-case study within a US hospital.

The rapid movement of information technologies into health care organizations has raised managerial concern regarding the capability of today's institutions to satisfactorily manage their introduction. Indeed, several health care institutions have consumed huge amounts of money and frustrated countless people in wasted information systems implementation efforts. Unfortunately, there are no easy answers as to why so many health informatics projects are not more successful. The aim of this study is to provide a deeper understanding of clinical information systems implementation. The research reported in this paper focuses on building a theory of the dynamic nature of the implementation process, that is, the how and why of what happened. The general approach taken was inspired by the work of Eisenhardt (1989) on building theories from case study research. We examined the implementation process, use and consequences of three distinct clinical information systems at a large tertiary care teaching hospital. A series of four research propositions reflecting the dynamic nature of the implementation process are offered as each of the three cases are analyzed. Findings add a number of new perspectives and empirical insights to the existing body of knowledge in the fields of IT implementation and medical informatics.

Attitude of Health Personnel↗
PubMed1990

[Informatics in the School of Medicine of the University of Chile. II. The school network and access to data bases].

Projects on informatics at the School of Medicine of the University of Chile are being brought about in accordance with both its institutional goals and present trends in technology. Prominent among the latter are the widespread distribution of autonomous processing power represented by low-cost computers and the ease of communication at local and worldwide levels. Our main project has been the design and start of a computer network that integrates the School's Departments and the geographically dispersed teaching hospitals. The principal services provided by the network are local and international electronic mail, access to data bases, and emulation of mainframe terminals (eg, to run remotely a mainframe's statistics software). Automated bibliographic search has been made available both through remote access to Medline data base and through local usage of compact disc (CD-ROM) versions. Since our network is open, it should become a forceful mean of assisting and integrating the biomedical community throughout the country.

CD-ROM↗
PubMed2005

Granularity, scale and collectivity: when size does and does not matter.

Bridging levels of "granularity" and "scale" are frequently cited as key problems for biomedical informatics. However, detailed accounts of what is meant by these terms are sparse in the literature. We argue for distinguishing two notions: "size range," which deals with physical size, and "collectivity," which deals with aggregations of individuals into collections, which have emergent properties and effects. We further distinguish these notions from "specialisation," "degree of detail," "density," and "connectivity." We argue that the notion of "collectivity"--molecules in water, cells in tissues, people in crowds, stars in galaxies--has been neglected but is a key to representing biological notions, that it is a pervasive notion across size ranges--micro, macro, cosmological, etc.--and that it provides an account of a number of troublesome issues including the most important cases of when the biomedical notion of parthood is, or is not, best represented by a transitive relation. Although examples are taken from biomedicine, we believe these notions to have wider application.

Animals↗
PubMed1998

[Medical informatics on the eve of the 21st century and the tasks of the dental service in Russia].

The problems and tasks of information provision of dental service in Russia for all levels, from federal to regional health center are discussed as well as the concept of development and program of information provision in dentistry, software for automated working places of dentists, local network for dental centers and dentistry departments, software for differential diagnosis and treatment of the main dental diseases, such as caries, pulpitis, periodontitis, diseases of the periodontium and buccal mucosa, benign tumors, etc., for rapid screening of dental patients for AIDS and other diseases, design and software for computers intended for computer training of students and dentists, stomatology search and reference information system, etc.

Computer-Assisted Instruction↗
PubMed1997

Health system informatics.

The application of informatics in a health system in general and to pharmacy in particular is discussed. Informatics is the use of information technology to enhance the quality of care, facilitate accountability, and assist in cost containment. Tying the pieces of health care into a seamless system using informatics principles yields a more rational approach to caregiving. A four-layer hierarchy of information systems can be found in any health system: layer 1, the foundational layer formed by a transaction-processing system; 2, the management information system; 3, decision support; and 4, advanced informatics applications such as expert systems. Other industries appear to be ahead of health care in investing in informatics applications. Pharmacy is one of the key health care professions that must adopt informatics. A stepwise structure for pharmacy informatics has been proposed; it consists of establishing a relationship with the patient, establishing a database, listing and ranking problems, choosing among alternatives, and planning and monitoring. Informatics should be approached by determining where the department is going strategically. Informatics standards will be needed. Pharmacists will need to use informatics to enhance their worth on the health care team and to improve patient care.

Case Management↗
PubMed2006

New trends in the virtualization of hospitals--tools for global e-Health.

The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre-operative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. As data and computing resources in a virtual hospital are distributed over many sites the concept of the Grid should be integrated with other communication networks and platforms. A promising approach is the implementation of service-oriented architectures for an invisible grid, hiding complexity for both application developers and end-users. Examples of promising medical applications of Grid technology are the real-time 3D-visualization and manipulation of patient data for individualized treatment planning and the creation of distributed intelligent databases of medical images.

Artificial Intelligence↗
PubMed2005

Molecular MR imaging in oncology.

The implementation and integration of systems biology approaches with the emerging nanosciences and microchip technology will revolutionize profoundly molecular imaging and fuel the drive toward a more predictive and individualized health care. In combination with informatics platforms, key gene and protein targets will be identified, and serve as more effective targets for diagnostic and therapeutic interventions. Drug development also will be expedited by the judicious selection of more appropriate molecular biomarkers that will serve as objective end points of treatment efficacy, in addition to facilitating the development of new target-specific therapeutics. Finally, with the more widespread proliferation of high-field magnets and advancements in imaging hardware; acquisition methods; and novel,"smart" MR agents, the ability to achieve higher resolution analyses of tumor biology, cell track-ing, and gene expression will be realized more fully. Although radiologists will continue to serve as diagnostic consultants and assist in management decisions, the contributions from new developments in the biologic and molecular sciences will significantly alter the scope of our profession. Radiologists will be required to participate more actively in the individualized care of the patient and cultivate a deeper understanding of the underlying molecular basis of disease and molecular pharmacology for facilitating selection of the most appropriate combination of imaging studies that address biologically relevant questions. These radical changes in our profession will necessitate the re-education and emergence of a small cadre of professionals that is educated broadly in multiple scientific disciplines, and demonstrate expertise in clinical care and the basic sciences. The optimistic view is that this already is happening.

Biomarkers↗
PubMed2004

HICOPS: human interface computer program in space.

BACKGROUND: During long experimental set ups, a protocol book usually guides cosmonauts. This is not very easy to work with in microgravity conditions and is not very efficient. For the cardiovascular physiology experiment CARDIOCOG during the Belgian Soyuz Mission (Odissea, November 2002) we developed a software program that guided the cosmonauts through the experiment. The software was developed in LabVIEW, thoroughly tested by CNES and the Russian space authorities and transported to the ISS as a stand-alone application. An adapted version was used during the Spanish Cervantes Mission in October 2003. RESULTS: This program provided several advantages: (1) error procedures could be easily dealt with in using the program's incorporated error structure; (2) the experimental sequences were easy to follow for the cosmonauts; (3) the experimental duration was exactly the same for all repetitions of the experiment, since the program imposed the timing; (4) after the flight, we were able to reconstruct all sequences of the experiment using a log-file that was automatically created during the different steps of the experiment; and (5) we were able to impose exact breathing frequencies to the cosmonauts using a visual aid. CONCLUSION: Less training was necessary for the cosmonauts to learn the experiment. Reconstruction of the experiment timing was easy. Exact breathing frequencies were obtained at each repetition. The program HICOPS worked to the overall satisfaction of the cosmonauts and they preferred working with HICOPS instead of with paper flow sheets. Data for the cardiovascular experiment during both missions were obtained in a standardised way.

Aerospace Medicine↗
PubMed1995

Computers and networks in medical and healthcare systems.

Information technology has an important and expanding role in the delivery of high quality healthcare services. Until recently health informatics systems have generally been developed as independent centralized databases. With computing communications technologies now being introduced into major hospitals, many new information services can now be provided to enhance the patient-care provider interaction. This paper firstly reviews (existing and currently evolving) information technologies related to text and image-based patient related data. A case study of the introduction of network services at the Austin Hospital, Melbourne, then describes the advantages of computing communication technologies in the healthcare environment, and outlines the strategy adopted to implement these services in a clinically advantageous cost-effective manner.

Computer Communication Networks↗
PubMed1998

HL7 version 3--an object-oriented methodology for collaborative standards development.

In January of 1997, Health Level Seven (HL7) began developing Version 3.0 of its standard. The Version 3 effort represents a transformation of the way that HL7 and its Technical Committees will develop future HL7 information interchange standards. This transformation involves applying object-oriented modelling to the development and specification of information interchange standards. This paper discusses the rationale that led HL7 to undertake this change and provides an overview of the Version 3 Message Development Framework which is HL7's new methodology. It also considers the features of the Version 3 methodology that can facilitate the development of international collaboration and consensus in health informatics standards.

Computer Simulation↗