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PubMed1998

Distributed cognition and knowledge-based controlled medical terminologies.

Controlled medical terminologies (CMTs) are playing central roles in clinical information systems and medical knowledge resource applications. As these terminologies grow, they are able to support more complex tasks but require more intensive efforts to create and maintain them. Several terminologies are evolving into knowledge bases of medical concepts. The knowledge they include is being used to support distributed cognition in two forms: complex medical decisions involving multiple people and applications, and coordination of maintenance of the terminologies themselves.

Artificial Intelligence↗

PubMed2005

Ontologies and semantic data integration.

The increased generation of data in the pharmaceutical R&D process has failed to generate the expected returns in terms of enhanced productivity and pipelines. The inability of existing integration strategies to organize and apply the available knowledge to the range of real scientific and business issues is impacting on not only productivity but also transparency of information in crucial safety and regulatory applications. The new range of semantic technologies based on ontologies enables the proper integration of knowledge in a way that is reusable by several applications across businesses, from discovery to corporate affairs.

Databases as Topic↗

PubMed1999

What does IT have in store for nursing?

Globalization, our culture of change, and the information age shape 21st-century information technology. Find out the applications and implications for nursing.

Diffusion of Innovation↗

PubMed2001

[Principles and advanced techniques for better internetpresentations in obstetrics and gynecology].

Internet presentations are common tools for better medical communication and better scientific work. Meanwhile a great number of gynecological and obstetrical institutions present data via the world wide web within a wide range of quality and performance. Specific HTML editors offer quick and easy presentations, but only advanced internet techniques enable interesting multimedia presentations. N-tier applications are the future standard and we must integrate them in general informatical systems. New Concepts, actual tools and general problems will be discussed and new principles similar to actual E commerce techniques are able to solve our special medical demands.

Computer Security↗

PubMedDate not supplied

A patient's perspective of medical informatics.

From my viewpoint as a patient, 1. Medical knowledge has expanded to the point that individuals cannot adequately improve quality without the assistance of computer programs. 2. The medical profession must concentrate on why and how computer program projects must be used, not on why they cannot be used. 3. The successful application of computer programs to clinical medicine is dependent mainly on the efforts of individual institutions and people at the local level.

Diagnosis, Computer-Assisted↗

PubMed2005

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↗

PubMed1991

A new microcomputer software system evaluation paradigm: the medical perspective.

The new fourth-generation software has enormously eased the burden of computing for users, but they have also created a confusing, difficult problem in software evaluation and selection. Therefore it is argued that a sound and complete evaluation paradigm is a key element in an efficient and effective software system design and use process. While much has been written about software evaluation in general, in the medical field, the guidances and recommendations previously provided are too general to be of practical use. Considering also the other weaknesses of conventional evaluation paradigms we have decided to develop a more adequate one which will have a solid theoretical framework, specific guidances, strict and well-defined taxonomic space, and a fair ranking approach. In the present paper we will therefore introduce our new evaluation paradigm and show its applicability in evaluation and selection of medical software systems according to their usability.

Classification↗

PubMed2005

A prognostic model for temporal courses that combines temporal abstraction and case-based reasoning.

Since clinical management of patients and clinical research are essentially time-oriented endeavours, reasoning about time has become a hot topic in medical informatics. Here we present a method for prognosis of temporal courses, which combines temporal abstractions with case-based reasoning. It is useful for application domains where neither well-known standards, nor known periodicity, nor a complete domain theory exist. We have used our method in two prognostic applications. The first one deals with prognosis of the kidney function for intensive care patients. The idea is to elicit impairments on time, especially to warn against threatening kidney failures. Our second application deals with a completely different domain, namely geographical medicine. Its intention is to compute early warnings against approaching infectious diseases, which are characterised by irregular cyclic occurrences. So far, we have applied our program on influenza and bronchitis. In this paper, we focus on influenza forecast and show first experimental results.

Computer Simulation↗

PubMed2002

Imaging and the Human Brain Project: a review.

OBJECTIVES: Survey current work primarily funded by the US Human Brain Project (HBP) that involves substantial use of images. Organize this work around a framework based on the physical organization of the body. METHODS: Pointers to individual research efforts were obtained through the HBP home page as well as personal contracts from HBP annual meetings. References from these sources were followed to find closely related work. The individual research efforts were then studied and characterized. RESULTS: The subject of the review is the intersection of neuroinformatics (information about the brain), imaging informatics (information about images), and structural informatics (information about the physical structure of the body). Of the 30 funded projects currently listed on the HBP web site, at least 22 make heavy use of images. These projects are described in terms of broad categories of structural imaging, functional imaging, and image-based brain information systems. CONCLUSIONS: Understanding the most complex entity known (the brain) gives rise to many interesting and difficult problems in informatics and computer science. Although much progress has been made by HBP and other neuroinformatics researchers, a great many problems remain that will require substantial informatics research efforts. Thus, the HPB can and should be seen as an excellent driving application area for biomedical informatics research.

Brain↗

PubMedDate not supplied

Q-methodology: definition and application in health care informatics.

OBJECTIVE: To introduce the Q-methodology research technique to the field of health informatics. Q-methodology--the systematic study of subjectivity--was used to identify and categorize the opinions of primary care physicians and medical students that contributed to our understanding of their reasons for acceptance of and/or resistance to adapting information technologies in the health care workplace. DESIGN: Thirty-four physicians and 25 medical students from the Chicago area were surveyed and asked to rank-order 30 opinion statements about information technologies within the health care workplace. The Q-methodology research technique was employed to structure an opinion typology from their rank-ordered statements. (The rank-ordered sorts were subjected to correlation and by-person factor analysis to obtain groupings of participants who sorted the opinion statements into similar arrangements.) RESULTS: The typology for this study revealed groupings of similar opinion-types associated with the likelihood of physicians and medical students to adapt information technology into their health care workplace. A typology of six opinions was identified in the following groups: (1) Full-Range Adopters; (2) Skills-Concerned Adopters; (3) Technology-Critical Adopters; (4) Independently-Minded and Concerned; (5) Inexperienced and Worried; and (6) Business-Minded and Adaptive. It is imperative to understand that in the application of Q-methodology, the domain is subjectivity and research is performed on small samples. The methodology is a combination of qualitative and quantitative research techniques that reveals dimensions of subjective phenomena from a perspective intrinsic to the individual to determine what is statistically different about the dimensions and to identify characteristics of individuals who share common viewpoints. Low response rates do not bias Q-methodology because the primary purpose is to identify a typology, not to test the typology's proportional distribution within the larger population. CONCLUSION: Q-methodology can allow for the simultaneous study of objective and subjective issues to determine an individual's opinion and forecast their likeliness to adapt information technologies in the health care workplace. This study suggests that an organization's system implementers could employ Q-methodology to individualize and customize their approach to understanding the personality complexities of physicians in their organization and their willingness to adapt and utilize information technologies within the workplace.

Attitude of Health Personnel↗

PubMed2006

Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper.

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.

Access to Information↗

PubMed2005

Generating models of surgical procedures using UMLS concepts and multiple sequence alignment.

Surgical procedures can be viewed as a process composed of a sequence of steps performed on, by, or with the patient's anatomy. This sequence is typically the pattern followed by surgeons when generating surgical report narratives for documenting surgical procedures. This paper describes a methodology for semi-automatically deriving a model of conducted surgeries, utilizing a sequence of derived Unified Medical Language System (UMLS) concepts for representing surgical procedures. A multiple sequence alignment was computed from a collection of such sequences and was used for generating the model. These models have the potential of being useful in a variety of informatics applications such as information retrieval and automatic document generation.

Abstracting and Indexing↗

PubMed1991

Nurses' perspectives on problems of hospitalized PCP patients: implications for the development of a nursing taxonomy.

The phenomena of interest in nursing informatics research are the data, information and knowledge related to nursing. This study presents nurses' perspectives on the problems of patients hospitalized for Pneumocystis carinii pneumonia from four data sources: nurse interview, intershift report, care plan, and nurses' notes. Even within this narrowly specified sample, patient problems showed variation across sources of data. The results of this study demonstrate the difficulties inherent in developing a nursing taxonomy when there is not consensus about the relevant data for nursing within a specific patient sample. Although existing information technology is capable of processing large volumes of nursing data, the lack of a common taxonomy limits the usefulness of the technology for documentation of care and decision support applications.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Reviews in radiology informatics: establishing a core informatics curriculum.

The advent of digital imaging and information management within the radiology department has prompted the growth of a new radiology subspecialty: Radiology Informatics. With appropriate training, radiologists can become leaders in Medical Informatics and guide the growth of this technology throughout the medical enterprise. Radiology Informatics fellowships, as well as radiology residency programs, provide inconsistent exposure to all the elements of this subspecialty, in part because of the lack of a common curriculum. The Society for Computer Applications in Radiology (SCAR) has developed a curriculum intended to guide training in Radiology Informatics. This article is the first in a series presented by SCAR and the Journal of Digital Imaging, titled "Reviews in Radiology Informatics." The series is designed to sample from each of the major components in the Radiology Informatics Curriculum, to spark further interest in the field and provide content for informatics education.

Curriculum↗

PubMedDate not supplied

Integrating medical informatics and health services research: the need for dual training at the clinical health systems and policy levels.

Reams of data pertaining directly to the core health services research mission are accumulating in large-scale organizational and clinical information systems. Health services researchers who grasp the structure of information systems and databases and the function of software applications can use existing data more effectively, assist in establishing new databases, and develop new tools to survey populations and collect data. At the same time, informaticians are needed who can structure databases that serve the needs of health service research and who can design and evaluate applications that effectively improve health care delivery. As long as health services researchers and informaticians work in separate spheres, however, opportunities to use data from health care encounters to improve care, expand knowledge, and develop more effective policies will be missed. This paper provides a brief exploration of 1) existing successful collaborations between health services researchers and informaticians and 2) needs and opportunities for additional joint work in several core research areas.

Curriculum↗

PubMed2004

VISION2003: virtual learning units for medical training and education.

The project VISION2003 consists of several partners with different professions ranging from medicine to medical informatics, from computer science to didactics. Its aim is the development, testing, introduction and a long-time maintenance of an open, web-based, intelligent and adaptive teaching and learning system for medical education. The system is expected to enhance the acceptance and efficiency of conventional ways of learning by supplementing and supporting them and creating new methods for imparting knowledge ["VISION2003, Lehr-und Lernsysteme in der Medizin: Intelligente und Multimediale, Internetbasierte adaptive und intelligente Autorensysteme für kooperatives Training in der Medizin", (last valid on 17 January 2003) and Ein offenes sprachkonzept für verteilte wissensverarbeitung in der medizin, Tagungsabstract XVI International Congress of the European Federation for Medical Informatics MIE, September 2000]. This is done exemplarily in the specific fields of oncology, accident-surgery and cardiology in consideration of actual standards and didactical measures. The range of possible applications is wide, from electronically accessible scripts through example cases to complex simulations. The main focus of the project is the creation of an open and flexible internet platform for delivering multimedia-based learning units and the development of adaptive and intelligent authoring systems.

Computer-Assisted Instruction↗

PubMed2006

Bridging the gap between biological and clinical informatics in a graduate training program.

Several training programs in biomedical informatics in the United States are attempting to integrate biological and clinical informatics. However, significant differences in the cultures underlying these two disciplines pose barriers to a uniform educational solution. This paper recounts the experience at Columbia University in adapting a graduate program with an initial focus on clinical informatics to train bioinformaticians. The analysis begins by considering the development of the medical and biological informatics cultures over a 17-year period. Then we review how two separate curricula evolved to serve the needs of each group. Interviews with bioinformatics students and faculty indicated some dissatisfaction with the curriculum that developed within clinical informatics. Their comments are considered in the light of an analysis of the relationship between the application domains of biomedical informatics as a discipline. In response, a new curriculum was developed in which bioinformatics and clinical informatics are regarded as subdivisions of the same subject. A key feature of this curriculum is a new course, Theory and Methods in Biomedical Informatics, which presents informatics principles in their general form, and illustrates their application with examples drawn from across the biomedical spectrum. The paper concludes with suggestions for integrating informatics training programs at other institutions.

Computational Biology↗

PubMed2003

How could primary care meet the informatics needs of UK Biobank? A Scottish proposal.

UK Biobank is an ambitious post-genomic project involving the recruitment and follow-up of 500 000 volunteers aged 45 to 69 years. Many primary care teams will be involved in the study directly or indirectly. The programme of research will use at least five data sources: paper-based questionnaires, blood samples, genotype information derived from the bloods, clinical/prescribing data from the medical records, and data on deaths. We describe three of the key challenges to primary care informatics posed by this project: patient recruitment, confidentiality, and data management. We then describe solutions proposed in Scotland, based on existing technologies. Some of these may be applicable elsewhere in the other Regional Collaborating Centres and other large-scale collaborative projects which rely on primary care informatics.

Aged↗