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Consumer health informatics: a consensus description and commentary from American Medical Informatics Association members.

BACKGROUND: Although interest in Consumer Health Informatics (CHI) has increased, a consensus definition of CHI does not yet exist. PURPOSE: To conduct a hypothesis-generating survey of AMIA members regarding definition and research agenda for CHI. METHODS: We solicited participation among AMIA members in an Internet-based survey focusing on issues related to a definition of CHI. RESULTS: One hundred thirty-five AMIA members responded. Participants indicated a broad spectrum of topics important to CHI including "self-help for disease management" and "patient access to their own medical records." CHI research was felt to rely heavily on public health methods such as epidemiology and outcomes research, a paradigm shift from traditional medical informatics. Responses indicated a perceived lack of funding and need for further research in CHI. CONCLUSIONS: A working definition should emphasize the multidisciplinary nature of CHI, include consumer input into CHI design, and focus on public health approaches to evaluation.

Community Participation↗

Comparing structural perspectives on Medical Informatics: EMBASE vs. MEDLINE.

Previous bibliometric analyses of Medical Informatics' internal structure used MEDLINE records as the unit of study. EMBASE, a product of Excerpta Medica, carries a wider international scope and offers complementary retrieval results to MEDLINE. Since much medical informatics critical thinking originated abroad and migrated to North America, this difference in coverage may also indicate a different perspective of "what constitutes medical informatics." Using traditional bibliometric and multivariate data analysis techniques, the present work examines EMBASE indexing records for the same 1995-1999 time frame as earlier MEDLINE studies to identify and compare structural features of the field.

Abstracting and Indexing↗

An international course on strategic information management for medical informatics students: aim, content, structure, and experiences.

We report on a course for medical informatics students on hospital information systems, especially on its strategic information management. Starting as course at the Medical Informatics Program of the University of Heidelberg/University of Applied Sciences Heilbronn, it is now organized as international course in the framework of the International Partnership for Health Informatics Education (http:// www.iphie.org) jointly for medical information science students from the University of Amsterdam, medical informatics students, as well as health information management students from the Universities of Heidelberg/Heilbronn. In 2002, medical informatics students from the Master of Science program of the newly founded University for Health Informatics and Technology Tyrol (UMIT) at Innsbruck, Austria, joined. We report about the aim of this course, its audience, and the educational programs involved, about its content and structure, as well as about our experiences gained so far.

Curriculum↗

Teaching medical informatics to biomedical engineering students: experiences over 15 years.

The Departments of Biomedical Engineering and Medical Informatics at Linköping University in Sweden were established in 1972-1973. The main purpose was to develop and offer courses in medicine, biomedical engineering and medical informatics to students in electrical engineering and computer science, for a specialization in biomedical engineering and medical informatics. The courses total about 400 hours of scheduled study in the subjects of basic cell biology, basic medicine (terminology, anatomy, physiology), biomedical engineering and medical informatics. Laboratory applications of medical computing are mainly taught in biomedical engineering courses, whereas clinical information systems, knowledge based decision support and computer science aspects are included within the medical informatics courses.

Biomedical Engineering↗

The handbook of medical informatics and its web site.

Since the new Handbook of Medical Informatics was published in 1997, a beta-version of a web site ("MI WEB") has been opened that supports the teaching of the Handbook. MI Web refers to the text of the full Handbook, using an extensive Glossary that is shared by both the paper Handbook and the web site. New material for teaching will continuously be added to the MI Web, realizing that the field of health informatics is progressing exponentially, that the teaching of medical informatics is of great importance for students in medicine and health care, and that these students will be the health professionals of the future. Training in medical informatics is also of value for practicing clinicians who are overwhelmed by the avalanche of systems that are available on the market.

Humans↗

Structural relationships within medical informatics.

This study seeks to increase our understanding of the structure of Medical Informatics. In particular, it focuses on the relationships between information science and information technology on the one hand, and biomedical research, clinical practice, and medical education on the other, that have defined "medical informatics." Using indexing terms and MeSH tree structures assigned to medical informatics literature covered by MEDLINE, co-occurrence analysis provides a "map" of the field. Major research and application focuses arrayed within the map elucidate a finer structure than reported previously. Dimensions "Techniques vs. Systems" and "Signs & Symptoms vs. Processes" form the two axes of the map and relate to the relationships underlying the indexing assignments given to the literature studied. Related studies underway using the INSPEC database will provide a complementary perspective on the structure of medical informatics as a field.

Bibliometrics↗

Medical informatics between technology, philosophy and science.

Medical (health) informatics occupies the central place in all the segments of modern medicine in the past thirty years--in practical work, education and scientific research. In all that, computers have taken over the most important role and are used intensively for the development of the health information systems. Following activities develop within the area of health informatics: health-documentation, health-statistics, health-informatics and biomedical scientific and professional information. The medical informatics as the separate medical discipline very quickly gets developed, both in Bosnia and Herzegovina. In our country, the medical informatics is a separate subject for the last ten years, regarding to the Medical curriculum at the biomedical faculties in Bosnia and Herzegovina is in accordance with the project of the education related to Bologna declaration and the project EURO MEDICINA.

Bosnia and Herzegovina↗

On medical informatics.

This paper summarizes the author's point of view of defining medical informatics, to stimulate further discussions on how this "newly emerging discipline" should further proceed. We realize that the term "informatics" is related rather to the term "information science" than to "computer science". Accordingly, medical informatics deals with the systematic processing of information in medicine. Many information systems in medicine are interrelated and can hardly be regarded as independent systems. As a result, medicine becomes gradually more an "empirical science of extreme complexity". Because of its complexity and wide range of applications, medical informatics should be considered as a separate discipline, its aim being to contribute to the systematic processing of information in medicine. The contribution of medical informatics should be a better understanding of the human being and means for the provision of high quality patient care.

Electronic Data Processing↗

Description of a blockcourse in medical informatics.

This paper describes a blockcourse in medical informatics. The course is presented to fourth, fifth and sixth year medical students and lasts one week. During the course all aspects of medical informatics are considered. Programming, databases, information systems, signal analysis, pattern recognition, expert systems, etc. are explained. Lectures alternate with hands-on experience. The subjects discussed in the lectures are rehearsed during the practical sessions, so that gaps in the student's knowledge are immediately detected. The blockcourse has been positively rated by the students.

Computer-Assisted Instruction↗

Medical informatics: between science and engineering, between academia and industry.

OBJECTIVE: To analyze the nature and appropriate role of the Medical Informatics research and practice area in the 21st Century, and to determine its links to academic environments versus industrial companies and health-care organizations. METHODS: A qualitative analysis of the state of the art of Medical Informatics, based on observation of current medical informatics programs and research in academic and industrial sites. RESULTS AND CONCLUSIONS: Medical Informatics is definitely a scientific and technological area of endeavor, although somewhat ill-defined in scope. It is situated between science and engineering, but much closer to the engineering world, and its multidisciplinary nature fits well the engineering paradigm. It is better viewed as a specialization of the informatics field rather than as a basic medical science. However, there are good arguments as to why Medicine should be the first among equals to have its own informatics domain. Medical Informatics must have extensions to both academia and industry to survive. Medical informaticians, whether implicitly or explicitly, exist in three different environments: academic, clinical (user), and industrial (informatics developer); all three environments must be considered when trying to predict the future of this new multidisciplinary area.

Engineering↗

Standards of medical informatics in Japan.

Standardization activities related to medical informatics in Japan are briefly introduced in this paper. Because two kinds of portable media that are MODs (Magneto Optical Disk) and IC cards are supposed to be practically used in medicine, standardization works are currently supported by Japanese government. With an introduction of the organizations their standards and policy are explained.

Computer Systems↗

Medical informatics education: basic assumption for successful implementation of information technology in the health care sector.

In the paper we mention the trends in medical informatics education and we present the development of medical informatics education in the Czech Republic. The actual situation at Czech faculties giving pregraduate courses covering medical informatics topics is described. The enhanced development of medical informatics education via European cooperation is shown. Finally, new approaches to medical informatics education using Internet and special educational software are mentioned.

Czech Republic↗

Implementation and evaluation of a distance learning introductory course in medical informatics.

CONTEXT: There is a growing interest in and need for continuing education in medical informatics delivered by distance learning. OBJECTIVES: Implement and evaluate a distance learning introductory course in medical informatics. METHODS: A Web-based version of our on-campus "Introduction to Medical Informatics" course was implemented using streaming audio lectures, threaded discussion boards, and several other teaching modalities. Evaluation was performed using an adaptation of our on-campus course evaluation instrument. RESULTS: The course was implemented with no major technological or pedagogical problems. Student satisfaction with teaching modalities and other course modalities was high. CONCLUSIONS: The learning technologies used in this course were implemented successfully and a Graduate Certificate Program is planned to further meet educational needs in medical informatics.

Education, Distance↗

Curriculum for medical informatics at the University of Heidelberg/School of Technology Heilbronn.

The specialized university curriculum for medical informatics at the University of Heidelberg/School of Technology Heilbronn described in this paper is one of the oldest educational approaches in the field of medical informatics, and has been successful for more than 20 years with more than 600 graduates (Diplom-Informatiker der Medizin). It is based on the concept of medical informatics as an independent medical discipline, and covers the total spectrum ranging from health care economics, biosignal and medical image processing, model building in medicine, to information and knowledge processing in medicine. It is a program of 4.5 years duration with a strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. Thirty-five students are admitted each semester, and in total about 390 students enrolled. The faculty consists of 17 full-time members and about 25 part-time lecturers.

Curriculum↗

The challenge of ubiquitous computing in health care: technology, concepts and solutions. Findings from the IMIA Yearbook of Medical Informatics 2005.

OBJECTIVES: To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics. METHODS: Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA). RESULTS: The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare. CONCLUSIONS: Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality.

Biomedical Technology↗

Training synergies between medical informatics and health services research: successes and challenges.

Stanford's two decades of success in linking medical informatics and health services research in both training and investigational activities reflects advantageous geography and history as well as natural synergies in the two areas. Health services research and medical informatics at Stanford have long shared a quantitative, analytic orientation, along with linked administration, curriculum, and clinical activities. Both the medical informatics and the health services research curricula draw on diverse course offerings throughout the university, and both the training and research overlap in such areas as outcomes research, large database analysis, and decision analysis/decision support. The Stanford experience suggests that successful integration of programs in medical informatics and health services research requires areas of overlapping or synergistic interest and activity among the involved faculty and, hence, in time, among the students. This is enhanced by a mixture of casual and structured contact among students from both disciplines, including social interactions. The challenges to integration are how to overcome any geographic separation that may exist in a given institution; the proper management of relationships with those sub-areas of medical informatics that have less overlap with health services research; and the need to determine how best to exploit opportunities for collaboration that naturally occur.

California↗

(Bio) medical informatics in the next decade.

Even though medical informatics is most often viewed from the perspective of its host disciplines in clinical and biologic medicine, it has an identity and agenda of its own. This paper is an attempt to promote discussion about the long-term role and agenda for medical informatics as a discipline into the next decade. The discussion has two main lines of argument, one about the "engineering" goals of informatics and the other about the "basic research" goals. These are, of course, influenced by ongoing of developments in computing, communications, and software infrastructures, but informatics is now mature enough that many of its goals transcend these changes.

Forecasting↗