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Computer Communication Networks↗

[Virtual reality in medical education].

Virtual reality technology has found new applications in industry over the last few years. Medical literature has for several years predicted a break-through in this technology for medical education. Although there is a great potential for this technology in medical education, there seems to be a wide gap between expectations and actual possibilities at present. State of the technology was explored by participation at the conference "Medicine meets virtual reality V" (San Diego Jan. 22-25 1997) and a visit to one of the leading laboratories on virtual reality in medical education. In this paper we introduce some of the basic terminology and technology, review some of the topics covered by the conference, and describe projects running in one of the leading laboratories on virtual reality technology for medical education. With this information in mind, we discuss potential applications of the current technology in medical education. Current virtual reality systems are judged to be too costly and their usefulness in education too limited for routine use in medical education.

Anatomy, Cross-Sectional↗

The technologic imperative: a new agenda for nursing education and practice, Part 1.

Here's an explanation of what the National Advisory Council on Nurse Education and Practice is and a description of the environment and issues that compelled its recent effort, a report on the state of nursing informatics. The report set forth specific goals for expanding the use of informatics in nursing education and practice.

Computer User Training↗

The technologic imperative: a new agenda for nursing education and practice, Part 2.

The National Advisory Council on Nurse Education and Practice (NACNEP), which advises the Secretary of the Department of Health and Human Services, recently published a report on the state of nursing informatics. Part 2 of this two-part series offers a definition of nursing informatics and nursing's role in furthering it, details the current state of nursing informatics education/training, and delineates key goals.

Computer User Training↗

The medical information needs of internists and pediatricians at an academic medical center.

Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems.

Academic Medical Centers↗

Practical Approaches to the Development of Biomedical Informatics: the INFOBIOMED Network of Excellence.

Biomedical Informatics (BMI) is the emerging discipline that aims to facilitate integration of Bioinformatics and Medical Informatics for the purpose of accelerating discovery and the generation of novel diagnostic and therapeutic modalities. Building on the success of the European Commission-funded BIOINFOMED Study, an INFOBIOMED Network of Excellence has been constituted with the main objective of setting a structure for a collaborative approach at a European level. Initially formed by fifteen European organizations, the main objective of the INFOBIOMED network is therefore to enable the reinforcement of European BMI at the forefront of these emergent interdisciplinary fields. The paper describes the structure of the network, the integration approaches regarding databases and four pilot applications.

Biomedical Research↗

Bioinformatics: towards new directions for public health.

OBJECTIVES: Epidemiologists are reformulating their classical approaches to diseases by considering various issues associated to "omics" areas and technologies. Traditional differences between epidemiology and genetics include background, training, terminologies, study designs and others. Public health and epidemiology are increasingly looking forward to using methodologies and informatics tools, facilitated by the Bioinformatics community, for managing genomic information. Our aim is to describe which are the most important implications related with the increasing use of genomic information for public health practice, research and education. To review the contribution of bioinformatics to these issues, in terms of providing the methods and tools needed for processing genetic information from pathogens and patients. To analyze the research challenges in biomedical informatics related with the need of integration of clinical, environmental and genetic data and the new scenarios arisen in public health. METHODS: Review of the literature, Internet resources and material and reports generated by internal and external research projects. RESULTS: New developments are needed to advance in the study of the interactions between environmental agents and genetic factors involved in the development of diseases. The use of biomarkers, biobanks, and integrated genomic/clinical databases poses serious challenges for informaticians in order to extract useful information and knowledge for public health, biomedical research and healthcare. CONCLUSIONS: From an informatics perspective, integrated medical/biological ontologies and new semantic-based models for managing information provide new challenges for research in areas such as genetic epidemiology and the "omics" disciplines, among others. In this regard, there are various ethical, privacy, informed consent and social implications, that should be carefully addressed by researchers, practitioners and policy makers.

Computational Biology↗

Implementing instructional technology. Strategies for success.

This article describes strategies for the integration of computer technology in a university-based school of nursing. Faculty concerns related to use of computer technology were assessed in a previous study. A series of computer technology and literacy workshops were developed based on this assessment. Computer use increased and faculty concerns about technology decreased after workshop participation. Other strategies to integrate computer technology include developing an informatics committee and planning and initiating a technology infrastructure consisting of hardware and software resources, and a local area network. Strategic planning was initiated placing increasing emphasis on curriculum integration of computer technology and nursing informatics.

Attitude to Computers↗

Cognitive match interface design, a base concept for guiding the development of user friendly computer application packages.

The authors present a base concept which unites the various prescriptions for creating and implementing a user friendly computer system. Making the system operate and interact with the user in a manner which parallels the flow of the user's own thought processes is the key issue. The authors illustrate this concept with examples from a system they recently developed to create and store patient records for the health care industry. Additionally they outline a procedure for creating patient/client data storage systems.

Cognition↗

NIGHTINGALE MM system--the work in progress.

A multimedia computer based system for the self-learning of Nursing Informatics has been designed as a part of NIGHTINGALE project. A video thread has been designed as a central structure and "a real life anchor" for the abstract concepts related to the Electronic Patient Record. The hypermedia structure of the application has been maintained through the mapping of illustrated IT entries to specific points in the video sequences.

Computer-Assisted Instruction↗

A new form of application service provider (ASP) in the development of data systems and data flow and management of data in (multiple campus) health care institutions.

There is a distinct lag in the way the informatics management is applied, implemented and used in health care institutions in comparison to other industries. Part of this is caused by strict regulations, but there also seems to be a defined trust and attitude problem from the medical corps towards dependency from automatisation. The only way to guarantee overall advance however is to apply technology implementations which enhance the performance capabilities of the medical corps, the way they already have in other fields. We propose a new model for implementing software applications and their communication on the scale of a multi campus health care institution.

Computer Communication Networks↗

Health services, coordination and the Internet.

The on-going specialization of medical services requires socioeconomic coordination of different health services. The GP is the key to improve this primary coordination. To qualify referral decisions by the GP an Internet-like information system (VisInfo) has been implemented in Denmark. This VisInfo contains information on (1) alternative periods of waiting, (2) medical guidelines for specific treatments (3) clinical home pages, and (4) links to non-medical providers of health services (NGOs). VisInfo was originally implemented in the Counties of Funen, Northern Jutland and Vejle in 1993-1995. A number of other counties are implementing similar information systems whereof the County of Frederiksborg, recently has implemented the first real Internet-system. Provisional experiences with the VisInfo strategy is presented on (1) the general user interest, (2) elaborations of the strategy, and (3) organization. Based on the BlackSeaDiab Action Plan and the BlackSea TeleDiab project, the potential for dissemination of medical informatics in the Black Sea Region through an adaption of the VisInfo strategy is discussed.

Caregivers↗

Health professionals' views of informatics education: findings from the AMIA 1999 spring conference.

Health care leaders emphasize the need to include information technology and informatics concepts in formal education programs, yet integration of informatics into health educational programs has progressed slowly. The AMIA 1999 Spring Congress was held to address informatics educational issues across health professions, including the educational needs in the various health professions, goals for health informatics education, and implementation strategies to achieve these goals. This paper presents the results from AMIA work groups focused on informatics education for non-informatics health professionals. In the categories of informatics needs, goals, and strategies, conference attendees suggested elements in these areas: educational responsibilities for faculty and students, organizational responsibilities, core computer skills and informatics knowledge, how to learn informatics skills, and resources required to implement educational strategies.

Computer User Training↗