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PubMed1995

[Validation of a computer-assisted procedure for producing blood and blood component transfusions].

BACKGROUND: The validation of computer-aided methods in the production of stored blood and blood components represents for a pharmaceutical institution a basic condition for the carrying out of the decrees of pharmaceutical companies. When validating computer-aided methods in medicine or pharmacy, the fields of informatics and technology have to be linked to applications in medicine and pharmacy. METHOD: In many cases the methods for the documented proof that a system achieves the expected capacity are too complex, so that a validation is only practicable in module groups. This is shown with an example of the blood typing on microtiter plates. RESULTS: After the selection of the hard- and software according to the safety criteria of information technology taking into consideration functional classes and degrees of quality, a complete documentation of the validation of blood typing on the microtiter plate was carried out.

Blood Banks↗
PubMed2002

Informatics competencies for nurse managers and their staffs.

Nurses have always dealt with data, information, and knowledge. Therefore, as automated information systems become increasingly important in health care, all nurses should have core competencies in computer skills and data and information management. These competencies differ according to the skill level of the nurse, from a beginning nurse to nursing manager, and on to those who specialize in nursing informatics.

Computer User Training↗
PubMed2003

Proteomic informatics: in silico methods lead to data management challenges.

Proteomics, which identifies proteins and analyzes their function in cells, is foreseen as the next challenge in biomedicine as diseases in the body are most easily recognized through the function of their proteins. Achieving this recognition is more difficult than pure gene analysis: it is estimated that 35,000 genes are present in human DNA, encoding more than 1 million proteins. A myriad of in vitro and in silico technologies now exist for studying proteins and their biological function. This review focuses on the vast array of in silico proteomic analysis methods, highlights public and commercial repositories for this data, and discusses the challenges associated with resolving and integrating the knowledge originating from this data.

Amino Acid Sequence↗
PubMed2005

Health information systems - past, present, future.

In 1984, Peter Reichertz gave a lecture on the past, present and future of hospital information systems. In the meantime, there has been a tremendous progress in medicine as well as in informatics. One important benefit of this progress is that our life expectancy is nowadays significantly higher than it would have been even some few decades ago. This progress, leading to aging societies, is of influence to the organization of health care and to the future development of its information systems. Twenty years later, referring to Peter Reichertz' lecture, but now considering health information systems (HIS), two questions are discussed: which were lines of development in health information systems from the past until today? What are consequences for health information systems in the future? The following lines of development for HIS were considered as important: (1) the shift from paper-based to computer-based processing and storage, as well as the increase of data in health care settings; (2) the shift from institution-centered departmental and, later, hospital information systems towards regional and global HIS; (3) the inclusion of patients and health consumers as HIS users, besides health care professionals and administrators; (4) the use of HIS data not only for patient care and administrative purposes, but also for health care planning as well as clinical and epidemiological research; (5) the shift from focusing mainly on technical HIS problems to those of change management as well as of strategic information management; (6) the shift from mainly alpha-numeric data in HIS to images and now also to data on the molecular level; (7) the steady increase of new technologies to be included, now starting to include ubiquitous computing environments and sensor-based technologies for health monitoring. As consequences for HIS in the future, first the need for institutional and (inter-) national HIS-strategies is seen, second the need to explore new (transinstitutional) HIS architectural styles, third the need for education in health informatics and/or biomedical informatics, including appropriate knowledge and skills on HIS. As these new HIS are urgently needed for reorganizing health care in an aging society, as last consequence the need for research around HIS is seen. Research should include the development and investigation of appropriate transinstitutional information system architectures, of adequate methods for strategic information management, of methods for modeling and evaluating HIS, the development and investigation of comprehensive electronic patient records, providing appropriate access for health care professionals as well as for patients, in the broad sense as described here, e.g. including home care and health monitoring facilities. Comparing the world in 1984 and in 2004, we have to recognize that we imperceptibly, stepwise arrived at a new world. HIS have become one of the most challenging and promising fields of research, education and practice for medical informatics, with significant benefits to medicine and health care in general.

Computer Systems↗
PubMedDate not supplied

Nursing informatics needs assessment. Are distance programs needed?

Nursing informatics is a small but growing specialty area in nursing. The authors describe the results of a needs assessment designed to determine interest in a distance-based master's degree and certificate program in nursing informatics. Information was also collected on computer and Internet proficiency for a large sample of BSN graduates. Results suggest that there is an interest in informatics, although somewhat less than was found previously. Respondents indicated that a knowledge of nursing informatics could provide additional career opportunities and that there was a general lack of programs available.

Adult↗
PubMedDate not supplied

Medical informatics and health care organizations.

A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole.

Costs and Cost Analysis↗
PubMed2005

Bioinformatics meets clinical informatics.

The field of bioinformatics has exploded over the past decade. Hopes have run high for the impact on preventive, diagnostic, and therapeutic capabilities of genomics and proteomics. As time has progressed, so has our understanding of this field. Although the mapping of the human genome will certainly have an impact on health care, it is a complex web to unweave. Addressing simpler "Single Nucleotide Polymorphisms" (SNPs) is not new, however, the complexity and importance of polygenic disorders and the greater role of the far more complex field of proteomics has become more clear. Proteomics operates much closer to the actual cellular level of human structure and proteins are very sensitive markers of health. Because the proteome, however, is so much more complex than the genome, and changes with time and environmental factors, mapping it and using the data in direct care delivery is even harder than for the genome. For these reasons of complexity, the expected utopia of a single gene chip or protein chip capable of analyzing an individual's genetic make-up and producing a cornucopia of useful diagnostic information appears still a distant hope. When, and if, this happens, perhaps a genetic profile of each individual will be stored with their medical record; however, in the mean time, this type of information is unlikely to prove highly useful on a broad scale. To address the more complex "polygenic" diseases and those related to protein variations, other tools will be developed in the shorter term. "Top-down" analysis of populations and diseases is likely to produce earlier wins in this area. Detailed computer-generated models will map a wide array of human and environmental factors that indicate the presence of a disease or the relative impact of a particular treatment. These models may point to an underlying genomic or proteomic cause, for which genomic or proteomic testing or therapies could then be applied for confirmation and/or treatment. These types of diagnostic and therapeutic requirements are most likely to be introduced into clinical practice through traditional forms of clinical practice guidelines and clinical decision support tools. The opportunities created by bioinformatics are enormous, however, many challenges and a great deal of additional research lay ahead before this research bears fruit widely at the care delivery level.

Computational Biology↗
PubMed1992

Iliad's role in the generalization of learning across a medical domain.

Medical informatics could facilitate more effective analysis and use of clinical knowledge by means of expert systems. To be most effective, such systems should be constructed in a manner which is consistent with physicians' cognitive processes. Our past five years' work with a system called Iliad indicates that it provides effective medical training and education. The current research extends our previous work by using a wider array of training and test cases. We also evaluated whether training on specific cases could generalize to improved testing performance on related cases, which featured similar complaints and pathophysiologic mechanisms, but different final diagnoses. In their junior internal medicine clerkship, students (n = 100) completed 1300 Iliad training cases covering 48 diagnoses. The findings indicated improved problem solving on the specifically trained cases as well as the generalization cases. We discuss a possible training model for expert systems such as Iliad.

Computer-Assisted Instruction↗
PubMed1998

Interface design for health care environments: the role of cognitive science.

An important challenge in the development of computer-based health care environments is the design of effective user interfaces. In this paper we consider a number of aspects of interface design related to the study of human-computer interaction from a cognitive perspective. It is argued that user interfaces must be designed with consideration of the information requirements, cognitive capabilities and limitations of the end users. Greater concern for fundamental research in design of user interfaces is also needed to complement short-term goals and approaches to improving user interfaces. Towards these objectives, several emerging trends are beginning to have an important impact in the design of health care interfaces. This includes the recognition of the need for iterative design and evaluation of user interfaces, applying theoretical frameworks and methods from cognitive science. An understanding of distributed as well as individual cognition will also become critical in the development of effective user interfaces as access to health care systems becomes increasingly widespread.

Cognition↗
PubMed1994

Data compression for medical report archiving.

In a hospital environment, where large numbers of reports are compiled, data compression offers a method for substantially reducing the required disk space whilst protecting the confidentiality of patient data. An analysis is given of the most important parameters that influence compression of free-text data, to realize an efficient implementation of an archiving system for medical reports. An overall reduction of the required disk space by more than 50% can be attained, as well as supplementary level of protection. A slight increase in access time is thereby inevitable, but almost insignificant. Such an archiving system constitutes a necessary component for an intelligent information retrieval system. The access to information contained in medical documents (by means of natural language processing and artificial intelligence techniques) is considered to be one of the key issues in the field of medical informatics for the coming decades.

Archives↗
PubMed1998

Clinical informatics in medical education: yesterday, today, tomorrow. Experiences at the first Faculty of Medicine, Charles University.

The subject known as clinical informatics started to develop in the 60's in medical education of clinical disciplines and was mainly concerned with structuring information for instruction and examinations. This application contributed substantially to the development of the discipline of medical education that started to be considered as a legitimate new field that could become a clinical sub-specialty in its own right. Due to uneven access to computer hardware the area developed differently in the West and East. We elaborated our projects for application of didactic games in internal medicine for the paper and pencil system. On turn of the 90's the use of PCs brought new possibilities for the application of computer programme support in the analysis of the effectiveness of the system of instruction in internal medicine we were concerned with. We carried out two longitudinal studies in clinical memory of the 4th and 6th year students of the same study cycle. In a non-anonymous questionnaire, more than 1000 respondents described their experience in observation/examination of 70 recommended disorders important for internal practice. We offer some unpublished results showing how the clinical memory of the students is formed during the four-year study and how few possibilities there are for some students to see some manifestations of various clinical disorders. Thinking about the future we are preparing a series of integrated medical and language programmes for the use of the multi-medial approach.

Computer-Assisted Instruction↗
PubMed1986

Computers in dentistry.

Traditionally, each professional school has developed its own course or department of health care informatics. We may find it more efficient and productive to establish a department of Medical Informatics to serve all health science colleges. Therefore the initial costs would be reduced and the common knowledge bank would be greatly increased. In a position paper written for the Association of Academic Health Centers lies the detailed plans for the establishment of an integrated health sciences center computer resource. The inclusion of computer courses in the curriculum can be summarized in the following action step. The chief administrative officer of the academic health center should facilitate the work of the deans of the schools of the health professions in convening faculty task forces that will address the introduction of computer literacy and computer applications in health care to the curricula. Although dental informatics is still in its infancy, we must lay a solid foundation for the controlled growth and development of this field of dental science. The problems encountered in developing a course in dental informatics are not unique to this one area. All specialties of health care are grappling with the questions posed by medical informaticians. Although each specialty has its own needs and requirements, the basic underlying principles of medical informatics remains the same. The knowledge we can gain by the exchange of experiences between all fields can greatly increase the speed and accuracy of development. The primary goal of computer literacy in dental education should be to prepare our students for the changing practice environment of the future.

Computer Literacy↗
PubMed1989

Addressing challenges in nursing informatics instruction.

Objectives for the interactive experiences include exposure to a wide variety of computer applications; in-depth experience with at least one application; overcoming computer fear; appreciating the rigid, logical flow of computerized problem-solving; and appreciating the benefits and limitations of computer applications for a variety of purposes. Ultimately, a major purpose of transferring informatics content is related to stimulating students' imagination with respect to the computer's ability to aid their professional endeavors. Robinson (1984) describes the imagination factor: "I think the total potential of computers is only limited by our imagination. It's like giving an artist a palette that has an infinite number of colors, some of them invisible to the naked eye. . . It is a tool for the realization of ideas." Students who have been exposed to the benefits of major categories of computer applications can appreciate computer capabilities with respect to exploring scientific and nursing phenomena, and building databases to store and access information (Newbern, 1985). These students should have enough theoretical and experimental knowledge of computers to become actively involved in making creative, informed decisions about how computers will be applied to nursing in their professional setting. Hardin and Skiba (1982) noted a gap between the powerful information processing capabilities of the computer and its relatively limited use by nursing--a gap which still exists today. Students who have participated in an idea generation course on computer applications can help to bridge this gap, helping nursing to take full advantage of the computer-saturated environments of the future.

Computer User Training↗
PubMed1994

The evolution of undergraduate medical informatics programmes.

This article summarizes developments in the teaching of medical informatics to undergraduate health care professionals. Whilst clinical schools are adopting quite different approaches to informatics education and training, there seem to be a number of common factors shaping educational policies and the resultant programmes. Different professional schools face similar problems in relation to resources and staff development. At the same time, examination of different syllabuses suggests the existence of divergent models as to what medical informatics should encompass, as well as different views as to what elements of the domain should be included in preliminary or undergraduate courses. The relevance of these trends to health libraries is briefly considered.

Attitude to Computers↗
PubMed2001

Training in medical informatics: combining onsite and online instruction.

The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of on-site and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.

Brazil↗
PubMed1996

The role of standards in a dynamic area.

It proves difficult to achieve a good measure of security in medical informatics applications. A number of reasons for this are analyzed. It is argued, that standardisation will help in solving this problem to a certain extent, but a more complete solution is possible when this is used in close conjunction with legal instruments (e.g. EU directives) and advice of a less strict nature, like guidelines. On the whole, a pragmatic step-by-step approach is needed, although there are signs that the general environment for these developments is improving.

Computer Literacy↗
PubMed2004

Metropolis redux: the unique importance of library skills in informatics.

OBJECTIVES: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies. METHODS: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service. RESULTS: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included. CONCLUSIONS: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.

Education, Continuing↗
PubMed2002

Anatomical informatics: Millennial perspectives on a newer frontier.

One of the most ancient of sciences, anatomy has evolved over many centuries. Its methods have progressively encompassed dissection instruments, manual illustration, stains, microscopes, cameras and photography, and digital imaging systems. Like many other more modern scientific disciplines in the late 20th century, anatomy has also benefited from the revolutionary development of digital computers and their automated information management and analytical capabilities. By using newer methods of computer and information sciences, anatomists have made outstanding contributions to science, medicine, and education. In that regard, there is a strong rationale for recognizing anatomical informatics as a proper subdiscipline of anatomy. A high-level survey of the field reveals important anatomical applications of computer sciences methods in imaging, image processing and visualization, virtual reality, modeling and simulation, structural database processing, networking, and artificial intelligence. Within this framework, computational anatomy is a developing field focusing on data-driven mathematical models of bodily structures. Mastering such computer sciences and informatics methods is crucial for new anatomists, who will shape the future in research, clinical knowledge, and teaching.

Anatomy↗