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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↗
PubMed2005

Improving end of life care: an information systems approach to reducing medical errors.

Chronic and terminally ill patients are disproportionately affected by medical errors. In addition, the elderly suffer more preventable adverse events than younger patients. Targeting system wide "error-reducing" reforms to vulnerable populations can significantly reduce the incidence and prevalence of human error in medical practice. Recent developments in health informatics, particularly the application of artificial intelligence (AI) techniques such as data mining, neural networks, and case-based reasoning (CBR), presents tremendous opportunities for mitigating error in disease diagnosis and patient management. Additionally, the ubiquity of the Internet creates the possibility of an almost ideal network for the dissemination of medical information. We explore the capacity and limitations of web-based palliative information systems (IS) to transform the delivery of care, streamline processes and improve the efficiency and appropriateness of medical treatment. As a result, medical error(s) that occur with patients dealing with severe, chronic illness and the frail elderly can be reduced.The palliative model grew out of the need for pain relief and comfort measures for patients diagnosed with cancer. Applied definitions of palliative care extend this convention, but there is no widely accepted definition. This research will discuss the development life cycle of two palliative information systems: the CONFER QOLP management information system (MIS), currently used by a community-based palliative care program in Brooklyn, New York, and the CAREN case-based reasoning prototype. CONFER is a web platform based on the idea of "eCare". CONFER uses XML (extensible mark-up language), a W3C-endorced standard mark up to define systems data. The second system, CAREN, is a CBR prototype designed for palliative care patients in the cancer trajectory. CBR is a technique, which tries to exploit the similarities of two situations and match decision-making to the best-known precedent cases. The prototype uses the opensource CASPIAN shell developed by the University of Aberystwyth, Wales and is available by anonymous FTP. We will discuss and analyze the preliminary results we have obtained using this CBR tool. Our research suggests that automated information systems can be used to improve the quality of care at the end of life and disseminate expert level 'know how' to palliative care clinicians. We will present how our CBR prototype can be successfully deployed, capable of securely transferring information using a Secure File Transfer Protocol (SFTP) and using a JAVA CBR engine.

Artificial Intelligence↗
PubMedDate not supplied

The World Wide Web: a review of an emerging internet-based technology for the distribution of biomedical information.

The Internet is rapidly evolving from a resource used primarily by the research community to a true global information network offering a wide range of databases and services. This evolution presents many opportunities for improved access to biomedical information, but Internet-based resources have often been difficult for the non-expert to develop and use. The World Wide Web (WWW) supports an inexpensive, easy-to-use, cross-platform, graphic interface to the Internet that may radically alter the way we retrieve and disseminate medical data. This paper summarizes the Internet and hypertext origins of the WWW, reviews WWW-specific technologies, and describes current and future applications of this technology in medicine and medical informatics. The paper also includes an appendix of useful biomedical WWW servers.

Computer Communication Networks↗
PubMed2004

[Imaging procedures in gastroenterology].

Recent achievements in fields of physics, microelectronical devices and informatical sciences opened huge possibilities of applications in medical specialities. Spread imaging over routine high-resolution instruments continue to be in focus of scientific researches varying from simple staining techniques to most sophisticated photodynamical techniques. Magnetic resonance imaging and computed tomography are radiological specialties, however; we mentioned them for promising achievements in computed data analysis and further improvements of virtual colonoscopy. During the last few years techniques of magnifying endoscopy have been improved including trials with narrow band endoscopy, autoflourescence endoscopy, elastic scattering spectroscopy and laser confocal microscopy. In many indications capsula endoscopy have been applied successfully.

Diagnostic Imaging↗
PubMedDate not supplied

Health Level Seven (HL7): standard for healthcare electronic data transmissions.

The nursing profession needs computer-formatted data that can be exchanged within and between agencies. The exchange of electronic data, both in the United States and in the international community, requires agreement on the format of the data elements to be exchanged. The Health Level Seven (HL7) standard is a proposed voluntary standard for healthcare applications that addresses the way information is exchanged electronically. This brief article will provide background information regarding the development and status of HL7 and its implications for nursing. From the clinical perspective, nurses follow standards of care developed by professional organizations. These standards facilitate clear communication among nurses, consumers, and members of other disciplines. Similarly, the electronic transmission and exchange of clinical information must have a standard to ensure that messages arrive and are decoded correctly. Many standards for electronic data already exist; financial transactions such as banking are familiar examples. The theme of the 1990 Symposium on Computer Applications in Medical Care (SCAMC), was Standards in Medical Informatics. Many pertinent papers and workshops were presented. However, references to electronic data standards are found primarily in conference proceedings and technical manuals. Thus, although activity is widespread, and events are rapidly moving in the healthcare industry, most of the information is not yet widely available. It seems timely, therefore, to provide background material to nurses in order for them to participate in the process.

Computer Communication Networks↗
PubMed2006

Developing a medical image content repository for e-learning.

The integration of medical informatics and e-learning systems could provide many advanced applications including training, knowledge management, telemedicine, etc. Currently, both the domains of e-learning and medical image have sophisticated specifications and standards. It is a great challenge to bring about integration. In this paper, we describe the development of a Web interface for searching and viewing medical images that are stored in standard medical image servers. With the creation of a Web solution, we have reduced the overheads of integration. We have packaged Digital Imaging and Communications in Medicine (DICOM) network services as a component that can be used via a Web server. The Web server constitutes a content repository for searching, editing, and storing Web-based medical image content. This is a simple method by which the use of Picture Archiving and Communication System (PACS) can be extended. We show that the content repository can easily interact and integrate with a learning system. With the integration, the user can easily generate and assign medical image content for e-learning. A Web solution might be the simplest way for system integration. The demonstration in this paper should be useful as a method of expanding the usage of medical information. The construction of a Web-based repository and integrated with a learning system may be also applicable to other domains.

Computer Security↗
PubMed2006

Current issues in health care informatics.

Health care informatics has emerged as a diverse and important new field of study. The field can be very broadly defined as the science that addresses how best to use information to improve health care. The field includes the four areas of bioinformatics, medical informatics, public health informatics, and consumer health informatics. Health care informatics applications can be used to improve the quality of patient care, to increase productivity, and to provide access to knowledge. After providing an overview of the field, the 10 articles contained in this special issue are briefly discussed. The first six articles address a diverse set of topics such as the use of health care informatics to conduct research, clinical information systems used by the U.S. Air Force, electronic medical records and physician satisfaction in Oman, and a point of care documentation system used by hospice care providers. The last four articles discuss the complex issues raised by the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Delivery of Health Care↗
PubMedDate not supplied

Expanding the guidelines for electronic communication with patients: application to a specific tool.

In 1998, the American Medical Informatics Association (AMIA) published a white paper entitled "Guidelines for the Clinical Use of Electronic Mail with Patients," which outlined a practical framework for this interaction. Interest in the use of other Internet-based tools, such as the World Wide Web, to enhance clinical communication is increasing. In such systems, static information can be made centrally available to patients and interactive tools such as messaging systems, schedules, and individualized care regimens can be integrated within the site. Site-specific guidelines are needed to address potential problems inherent in the particular services being offered. This article presents advice on developing site-specific guidelines, with examples, based on experience gained in developing and refining guidelines for the use of PatientWeb at the Massachusetts General Hospital Department of Neurology.

Computer Communication Networks↗
PubMed2004

Milestones in Romanian medical informatics.

The paper concerns the major activities in the field of medical informatics in Romania: education, computer technology, implementation in healthcare, role of industry, IT use in medical applications and research.

Hospital Information Systems↗
PubMed1997

Informatics in the care of patients: ten notable challenges.

What is medical informatics, and why should practicing physicians care about it? Medical informatics is the study of the concepts and conceptual relationships within biomedical information and how they can be harnessed for practical applications. In the past decade, the field has exploded as health professionals recognize the importance of strategic information management and the inadequacies of traditional tools for information storage, retrieval, and analysis. At the same time that medical informatics has established a presence within many academic and industrial research facilities, its goals and methods have become less clear to practicing physicians. In this article, I outline 10 challenges in medical informatics that provide a framework for understanding developments in the field. These challenges have been divided into those relating to infrastructure, specific performance, and evaluation. The primary goals of medical informatics, as for any other branch of biomedical research, are to improve the overall health of patients by combining basic scientific and engineering insights with the useful application of these insights to important problems.

California↗
PubMed2003

Biomedical informatics: precious scientific resource and public policy dilemma.

Biomedical informatics includes the application of computers, information networks and systems, and a growing body of scientific understanding to a range of problems. As skill in this field increases and as progress in virtually all modern biomedical science becomes more data intensive, informatics becomes a precious resource. Applications areas include access to knowledge, discovery in genomics, medical records, mathematical modeling, and bioengineering. At the same time, progress in informatics is deeply dependent on resolution of four major public policy issues: digital intellectual property rights, genetic testing protection, medical data privacy, and the role of biomedical data in the context of information warfare and homeland security.

Anatomy, Cross-Sectional↗
PubMed1987

A vocabulary for medical informatics.

The terminology in medical informatics is evolving rapidly. The organizers of MEDINFO and SCAMC have used different sets of keywords to index their documents. Recognizing the limitations of this approach, members of those organizations joined with the National Library of Medicine in the creation of a better terminology for medical informatics. A hierarchical structure was placed on the terms to produce a thesaurus typical of the sort often used in the indexing and retrieving of documents. The building of this thesaurus began with an automatic merging of the thesaurus used by the Association of Computing Machinery and the Information Sciences component of the "Medical Subject Headings." This product was pruned by eliminating terms not related to those in the MEDINFO keyword list or not in the medical informatics literature. Further refinement of the thesaurus resulted from extensive discussions among the authors of this paper. The first major application of this terminology has been to the indexing of the articles in "MEDINFO-86 Proceedings." Major components of this medical informatics thesaurus also have been incorporated into the "Medical Subject Headings." This paper describes the process of preparing the thesaurus and presents an evaluation of its coverage of the "MEDINFO-86 Proceedings."

Abstracting and Indexing↗
PubMed1992

Dimensions of knowledge sharing and reuse.

Many workers in medical informatics are seeking to reuse knowledge in new applications and to share encoded knowledge across software environments. Knowledge reuse involves many dimensions, including the reapplication of lexicons, ontologies, inference syntax, tasks, and problem-solving methods. Principal obstacles to all current work in knowledge sharing involve the difficulties of achieving consensus regarding what knowledge representations mean, of enumerating the context features and background knowledge required to ascribe meaning to a particular knowledge representation, and of describing knowledge independent of specific interpreters or inference engines. Progress in the area of knowledge sharing will necessitate more practical experience with attempts to interchange knowledge as well as better tools for viewing and editing knowledge representations at appropriate levels of abstraction. The PROTEGE-II project is one attempt to provide a knowledge-base authoring environment in which developers can experiment with the reuse of knowledge-level problem-solving methods, task models, and domain ontologies.

Artificial Intelligence↗
PubMed2006

CI for a DSS to predict nursing coverage in a geriatric care facility.

The vast and growing area of informatics presents the single biggest change in how societies grow, work, and live. Strong emphasis is placed on environment, work safety, disease minimization, illness detection, and care interventions. The informatics in these areas is not adequately used to realize the full benefits to society, but using computational intelligence or soft computing techniques, we obtain a closer acceptance of confidence in the application of informatics to improve quality of life. There is a vast array of applications of informatics in society like bioinformatics, genetic detection, medical diagnosis, manufacturing, environmental responsibility, transportation design, etc. By using neural networks and genetic algorithms, reasoning on the data sources can result in emerging nursing informatics patterns where prediction can become more and more accurate in an acuity system that ultimately gives effective therapeutic care and decreased rates of mortality. In this paper, I propose the use of CI techniques to determine crisp data that can be incorporated into decision-making for nursing care.

Aged↗
PubMed1998

ATRAS: a decision support application layered on the W3-EMRS architecture.

The creation of portable decision support systems (DSSs) remains an important goal in medical informatics. The Adrenal Test Retrieval and Analysis System (ATRAS) has been developed as an example of a simple yet highly effective decision support application which runs in a system-independent way. It is the first implementation of a decision support application layered on the World Wide Web Electronic Medical Record System (W3-EMRS) architecture, which allows for unified access to remote heterogeneous electronic medical record system (EMRS) databases.

Adrenal Cortex Hormones↗
PubMed1998

Modern architectures for intelligent systems: reusable ontologies and problem-solving methods.

When interest in intelligent systems for clinical medicine soared in the 1970s, workers in medical informatics became particularly attracted to rule-based systems. Although many successful rule-based applications were constructed, development and maintenance of large rule bases remained quite problematic. In the 1980s, an entire industry dedicated to the marketing of tools for creating rule-based systems rose and fell, as workers in medical informatics began to appreciate deeply why knowledge acquisition and maintenance for such systems are difficult problems. During this time period, investigators began to explore alternative programming abstractions that could be used to develop intelligent systems. The notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) domain-independent problem-solving methods-standard algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper will highlight how intelligent systems for diverse tasks can be efficiently automated using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.

Algorithms↗
PubMedDate not supplied

The important role of international exchange in the development of medical informatics in developing countries: a report from China.

China is a developing country, and so is inferior to the developed countries in many aspects of science and technology. It is similarly a new member in the world ranking of the application of computers in biomedicine. However, since implementing the policy of reform and opening to the outside world in 1976, China has achieved greater success in biomedical signal and image processing, biomedical data processing, computer-aided diagnosis, computerized hospital management, etc. China's development shows that international exchange and cooperation are very important for the development of medical informatics in developing countries, and the application of computers in biomedicine has progressively spread all over the world and is increasingly taking root in the hearts of the people.

China↗