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Building nursing informatics courses on the Web.

The Information Technology is rapidly being integrated into Educational Institutions and Health Care Environments. Although the use of computer for education and training is not new to the academic society, further prospects are available through the use of emerging technologies as the Multimedia and the World Wide Web. In today's rapidly changing healthcare environment, the need for high quality, cost effective education for employees, consumers, and students is gaining increased attention. The development of customised computer-based training programs has long been beyond the capabilities or financial resources of most healthcare organisations; however, with recent advancements in technology, this situation is rapidly changing. The Nurses represent the greater part of the Health Care Professionals thus the education of this group is of outmost importance for the health-care environments. The World Wide Web can be used as an educational tool in order to have better-educated Nurses not only by supporting the Academic institutions but also by providing Distance Learning Education covering new aspects of the Nursing Science. The purpose of this paper is to increase the understanding of the ways in which the emerging technologies of Multimedia and the World Wide Web can enhance the learning process, and also provide education at a distance.

Computer Communication Networks↗

Translating traditional principles of system development into a process for designing clinical information systems.

Traditional software development methodologies enhanced by a clinical component result in information systems that support the practice of nursing. This paper describes the clinical informatics model used to develop and evaluate a mobile computer assessment tool. Data entry of atomic-level elements, with storage in a relational database, allows the synthesis and analysis by multiple disciplines to aid in real-time decision making. The system is designed to improve the recording and accessibility of patient data and nursing observations on a geriatric unit at the Salt Lake VA Medical Center.

Clinical Medicine↗

Patient learning centre Soppi: A way to promote human-computer interaction in health care.

The Patient Learning Centre was founded in Hyvinkää Hospital in 2000 to support patients and their families' informational needs. In order to evaluate the Learning Centre's effectiveness we started a development project. One of the purposes was to analyze patients' Internet and computer use. The data for the describing survey-research was collected by questionnaires at two occasions. At the end of the project a number of patients who used internet had increased, one third did not use a computer at all. Getting information in discussions with the nurse was however the most important way. To develop user friendly methods in getting information is a challenge.

Data Collection↗

Informatics in dental education: a horizon of opportunity.

Computers have presented society with the largest array of opportunities since the printing press. More specifically in dental education they represent the path to freedom from the memory-based curriculum. Computers allow us to be constantly in touch with the entire scope of knowledge necessary for decision making in every aspect of the process of preparing young men and women to practice dentistry. No longer is it necessary to spend the energy or time previously used to memorize facts, test for retention of facts or be concerned with remembering facts when dealing with our patients. Modern information management systems can assume that task allowing dentists to concentrate on understanding, skill, judgement and wisdom while helping patients deal with their problems within a health care system that is simultaneously baffling in its complexity and overflowing with options. This paper presents a summary of the choices facing dental educators as computers continue to afford us the freedom to look differently at teaching, research and practice. The discussion will elaborate some of the ways dental educators must think differently about the educational process in order to utilize fully the power of computers in curriculum development and tracking, integration of basic and clinical teaching, problem solving, patient management, record keeping and research. Some alternative strategies will be discussed that may facilitate the transition from the memory-based to the computer-based curriculum and practice.

Attitude to Computers↗

The four year's experience with HEPAR-computer assisted diagnostic program.

The computer system HEPAR has been outlined and prepared by the research team of medical and informatics specialists at the Medical Center of Postgraduate Education and Warsaw research institutes (Inst. Biocyb. and Biotech. PAS, Inst. of Food and Aliment), and for the last four years has been applied practically at the Clinic of Gastroenterology and Methabolic Diseases of Bródnowski Hospital in Warsaw.

Diagnosis, Computer-Assisted↗

[Political aspects and aims of telematics].

Germany has a health care system that uses sophisticated technologies. On the other hand, with respect to the most important human asset--good health--duplication of work, media discontinuity, and incompatible documentations persist. The sector-oriented service structures and pillars of our health-care system are also reflect ed in the area of informatics and communication technologies. In the German health care system every institution in itself is an isolated solution, partially in line with the latest scientific research, but singular. As a rule, the limits of information technology are reached where the economic and business capacities of one's own institution are exhausted. So the essential advantage of telematics, which is in particular the use of synergistic benefits, is given away. Therefore, both the infrastructural conditions for the use of telematics have to be improved and also important key applications such as the electronic prescription have to be encouraged. By introducing the new electronic health card, the nation wide use of health telematics in Germany can be promoted. The activities of the Federal Government and the legislation initiated within the scope of the Act on the Modernization of the Statutory Health Insurance serve to expedite these improvements. The extension of the current health insurance card to an electronic health card is the task of the central associations of self-administration. They are also obligated to fulfill the agreement on the infrastructure necessary for the electronic health card.

Computer Communication Networks↗

A study of collaboration among medical informatics research laboratories.

The InterMed Collaboratory involves five medical institutions (Stanford University, Columbia University, Brigham and Women's Hospital, Massachusetts General Hospital, and McGill University) whose mandate has been to join in the development of shared infrastructural software, tools, and system components that will facilitate and support the development of diverse, institution-specific applications. Collaboration among geographically distributed organizations with different goals and cultures provides significant challenges. One experimental question, underlying all that InterMed has set out to achieve, is whether modern communication technologies can effectively bridge such cultural and geographical gaps, allowing the development of shared visions and cooperative activities so that the end results are greater than any one group could have accomplished on its own. In this paper we summarize the InterMed philosophy and mission, describe our progress over 3 years of collaborative activities, and present study results regarding the nature of the evolving collaborative processes, the perceptions of the participants regarding those processes, and the role that telephone conference calls have played in furthering project goals. Both informal introspection and more formal evaluative work, in which project participants became subjects of study by our evaluation experts from McGill, helped to shift our activities from relatively unfocused to more focused efforts while allowing us to understand the facilitating roles that communications technologies could play in our activities. Our experience and study results suggest that occasional face-to-face meetings are crucial precursors to the effective use of distance communications technologies; that conference calls play an important role in both task-related activities and executive (project management) activities, especially when clarifications are required; and that collaborative productivity is highly dependent upon the gradual development of a shared commitment to a well-defined task that leverages the varying expertise of both local and distant colleagues in the creation of tools of broad utility across the participating sites.

Computer Communication Networks↗

Integrating medical informatics into the medical undergraduate curriculum.

The advent of healthcare reform and the rapid application of new technologies have resulted in a paradigm shift in medical practice. Integrating medical Informatics into the full spectrum of medical education is a viral step toward implementing this new instructional model, a step required for the understanding and practice of modern medicine. We have developed an informatics curriculum, a new educational paradigm, and an intranet-based teaching module which are designed to enhance adult-learning principles, life-long self education, and evidence-based critical thinking. Thirty two, fourth year medical students have participated in a one month, full time, independent study focused on but not limited to four topics: mastering the windows-based environment, understanding hospital based information management systems, developing competence in using the internet/intranet and world wide web/HTML, and experiencing distance communication and TeleVideo networks. Each student has completed a clinically relevant independent study project utilizing technology mastered during the course. This initial curriculum offering was developed in conjunction with faculty from the College of Medicine, College of Engineering, College of Education, College of Business, College of Public Health. Florida Center of Instructional Technology, James A. Haley Veterans Hospital, Moffitt Cancer Center, Tampa General Hospital, GTE, Westshore Walk-in Clinic (paperless office), and the Florida Engineering Education Delivery System. Our second step toward the distributive integration process was the introduction of Medical Informatics to first, second and third year medical students. To date, these efforts have focused on undergraduate medical education. Our next step is to offer workshops in Informatics to college of medicine faculty, to residents in post graduate training programs (GME), and ultimately as a method of distance learning in continuing medical education (CME).

Computer Communication Networks↗

Medical informatics, artefacts or science?

Successful and productive medical informatics research is evidently a combination of luck, creative art, and science, but some researchers focus too much on building computer artefacts and writing anecdotal reports of their experience. They need to adopt a less technology-fixated approach, be willing to evaluate their systems and publish failures as well as successes, and attempt to generalise their results as hypotheses for others to test. It does appear that medical informatics is a distinct discipline, and one based on scientific principles, but it is less clear whether these principles originate within the discipline or elsewhere. If elsewhere, it is usually unclear whether their validity has been tested with the atypical information, decisions and context that medicine represents. This article has presented some criteria for judging such scientific principles, and described a process which would lead to such principles, if they exist, being uncovered more rapidly. If our discipline is to thrive and take root in firm ground, such activities need to be taken seriously by all, otherwise we could end up building edifices on sand.

Delivery of Health Care↗

Exchanging clinical knowledge via Internet.

The need for effective and efficient exchange of clinical knowledge is increasing. Paper based methods for managing clinical knowledge are not meeting the demand for knowledge and this has undoubtedly contributed to the widely reported failures of clinical guidelines. Internet affords both opportunities and dangers for clinical knowledge. Systems such as Wax have demonstrated the importance of intuitive structure in the management of knowledge. We report on a new initiative for the global management of clinical knowledge.

Artificial Intelligence↗

Healthcare telematic applications in Cyprus.

OBJECTIVES: a) To present a review of ongoing health telematic applications in Cyprus. b) To promote the use of these health telematic applications in the Cyprus region. c) To help in the spin off of other health telematic applications thus enabling the offering of a better health service to the citizens. METHODS AND RESULTS: The health telematics applications include a medical system for emergency telemedicine (AMBULANCE and EMERGENCY-112 projects), a system for the evaluation of the risk of stroke by telemedicine (EROS), a diagnostic telepathology network in gynaecological cancer (TELEGYN), a collaborative virtual medical team for home healthcare of cancer patients (DITIS), and a health telematics training network (HEALTHNET). The paper refers to the set-up and characteristics of these applications and tries to relate them with the health policies that should be applied in Cyprus. CONCLUSIONS: It is anticipated that this paper will promote the importance of health telematics applications for Cyprus and increase the awareness on the possibilities that these applications offer for health policies in all levels of health related human resources.

Ambulances↗

Setting a national informatics agenda for nursing education and practice to prepare nurses to develop and use information technology.

Efforts to build a telecommunications infrastructure that will link people nationally and internationally includes a focus on health care. A telecommunications infrastructure will add value to providers and consumers of health care only if they are able to use it to access and share information. Nurses often have information technology available to them, but are inadequately prepared to use it. Under the direction of the National Advisory Council for Nursing Education and Practice (NACNEP), the Division of Nursing convened a panel of experts in nursing informatics to recommend an informatics agenda. Using a nominal group technique the informatics experts identified informatics needs and recommended initiatives that would better prepare nurses to use and develop information technology. Their recommendations were reviewed by NACNEP resulting in a national informatics agenda for nursing education and practice.

Computer User Training↗

Implementation and evaluation of the MSc course in health informatics in Greece.

OBJECTIVES: Health informatics is a well established and important multi-disciplinary and inter-disciplinary field that not only involves informatics but also medicine, nursing, engineering, biology and other-related subjects. The program has been organized on the basis of an inter-university approach with the participation of five Greek universities. The paper aims at providing a current description of the academic program and a preliminary evaluation of the implementation phase. METHODS: The paper presents a case study of a curriculum implementation from the phase of curriculum development to the phase of implementation and evaluation. Due to the interdisciplinary character of the course appropriate procedures were undertaken to ensure that mixed backgrounds can assimilate the broad spectrum of the teaching material taught. In the first stages of the implementation international students mainly from Europe attended the course. In addition, local graduates provided an extra dimension to the multi-layered difficulties and challenges of such a course implementation. RESULTS: The students registered in the course were from different backgrounds and disciplines. They were mainly from health sciences and engineering schools. The interdisciplinary arrangement of the course facilitated the proper exchange of thoughts, skills, and knowledge among and between students and teachers. CONCLUSIONS: The postgraduate course in health informatics at the University of Athens has now been running for more than fifteen consecutive years and is one of the first and longest standing courses in Europe. Continuous evaluation and adaptation is required to fit within the changing and evolving amazing field of biomedical and health informatics.

Computational Biology↗

Use of a neural network to assign serologic specificities to HLA-A, -B and -DRB1 allelic products.

A computational method was used to predict the serologic specificities of HLA molecules encoded by the HLA-A, -B, and -DRB1 loci. The polypeptide sequences of a subset of alleles (numbering 149) with well-defined serologic assignments were used to train a neural network to predict broad and split serologic assignments for each HLA allelic product. The resultant neural network assignments were compared with those of a validation set containing the sequences of 74 HLA-A, 175 HLA-B, and 117 HLA-DRB1 alleles that had previous serologic test assignments but were not part of the training set. The network was able to correctly predict at least one of the serologic assignments of the majority of the validation alleles (99% of the HLA-A set, 86% HLA-B, 94% HLA-DRB1). The remainder received either no assignment (1% HLA-A, 13% HLA-B, 5% HLA-DRB1) or a different but closely related assignment (1% HLA-B and -DRB1). Overall, the variation in serologic assignment by the network appeared comparable to the assignments seen among different laboratories using serologic techniques. When used to predict the serologic assignments of 393 HLA alleles without known serologic types, the network was able to predict assignments for most alleles (95% HLA-A, 85% HLA-B, 96% HLA-DRB1). The majority of these assignments were consistent with assignments predicted by sequence homologies with known alleles. The remainder did not receive an assignment and likely represent new combinations of epitopes.

Alleles↗

A health informatics educational framework.

There is a need to be able to define a Health Informatician by their graduate attributes. Futhermore global health informatics education that facilitates student mobility requires a common understanding of educational outcomes. An internationally agreed health informatics education framework will facilitate us to meet these needs. This chapter provides an overview of a considerable amount of work undertaken in a number of countries and by IMIA's health and medical informatics education working group. We need to make good use of these foundations as they clarify the various health informatics roles and functions together with their associated health informatics competency requirements. We are now in a good position to progress this work by developing a health informatics qualifications and educational framework. This is expected to assist educational providers with curriculum development.

Computer User Training↗