[Clinical practice and informatics: medical informatics understood by the clinician].
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Artificial Intelligence↗
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Results for “Medical Informatics”
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Preparing for change: concepts and education in medical informatics.
Medical informatics as a medical discipline has developed over the last decades in parallel with an even more amazing proliferative development in medicine. The question is raised whether this new science, based on formalized and methodological approaches, may contribute to the development of a general theory in medicine as a consequence of the recognition of the influence of control mechanisms and structured information in molecular biology. It is suggested that medical informatics dedicates research to problems 'inside medicine' and that curricula are developed which bring a basic understanding for medical informatics to the medical student. The following teaching is suggested: basic mandatory courses, electives and inclusions of aspect of medical informatics in the various parts of clinical teaching. The possibility is discussed that the resulting teaching approaches may also be used to convey knowledge in medicine: teaching concepts versus teaching details. Finally, a description of the functional topology of expert systems as they develop is attempted and brought into relation to the architecture of hospital information systems. The increasing importance of expert systems also raises the question of 'decisional trials' as verification procedures when these new tools enter medical practice.
Artificial Intelligence↗
Origins of medical informatics.
Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in the 1960s and medical informatics was identified as a new specialty in the 1970s.
History, 20th Century↗
The National Library of Medicine and medical informatics.
Medical informatics attempts to provide the theoretic and scientific basis for the use of automated information systems in biomedicine. Even though a new field, its roots are in the 19th century. The National Library of Medicine (NLM) began classifying the medical literature and publishing the Index Medicus in 1897; in the early 1960s, the growth of the index gave rise to MEDLARS, the first successful, large-scale, computerized bibliographic system. In 1971, about the time MEDLARS evolved into a nationwide on-line retrieval system known as MEDLINE, a committee of the Association of American Medical Colleges published a report calling for the NLM to exert strong leadership in developing computer applications for information transfer in medicine. The NLM has sponsored several training and research programs in this area and is now developing the concept of "centers of excellence" in medical informatics. In addition, there are a number of current research and development activities within the NLM internal and extramural programs that may influence the progress of medical informatics.
History, 19th Century↗
[Medical informatics].
Medical informatics is the discipline concerned with information and information streams in health care. The development of information technology has been intensified in recent years and is now influencing the international development within the health care sectors. During the coming decade, integrated hospital networks will supple communication within and between hospitals. New productivity measures useful in administrative planning are being developed. Patient data are being digitalized and stored electronically, and interactive media are implemented in education. Primarily, however, chip-based technologies find application in the evaluation of the increasing quantity of paraclinical data. Internationally product development and research are actively underway. The EEC has established development programmes specifically stimulating these activities. Is Denmark going to take an active part in this development, formalized frames are required.
Denmark↗
Report of a Joint Working Conference on Medical Informatics. Assessment of medical informatics technology.
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Medical Informatics↗
Teaching medical informatics to medical students in the Federal Republic of Germany.
The medical curriculum in the Federal Republic of Germany (FRG) is regulated by federal legislation. Medical informatics is part of this curriculum and is therefore taught by all 27 medical faculties in the FRG, 24 of which have related departments. The teaching situation in general and the specific approach at the author's department are described.
Attitude to Computers↗
Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics.
In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.
Germany↗
The status of medical informatics in Canadian medical schools.
Many have suggested that information technology in its various forms will continue to have an effect on all aspects of medicine, including medical education. If so, the introduction of information technology into medicine brings with it critical educational policy questions. This paper reports on the findings of an inquiry into the impact of information technology on medical education. It reviews the extent to which Canadian and American medical colleges have adopted the 1985 recommendations of the American Association of Medical Colleges. In particular, it looks at the recommendations that "medical informatics should become an integral part of the medical curriculum" and that "the teaching of medical informatics should include opportunities for specific instruction in its fundamentals as well as adequate examples of its application throughout the medical curriculum".
Attitude to Computers↗
Medical informatics: an emerging medical discipline. Council on Scientific Affairs and Council on Long Range Planning and Development of the American Medical Association.
The use of computer technology in medicine is no longer the domain of only a few "gadget" happy high-tech aficionados. The rapid pace of medical progress and the increasing demands on physicians' time mandate that mechanisms be developed to deliver the tools of contemporary information management directly into the hands of all practicing physicians. It is with this intent that the Council on Long-range Planning and Development and the Council on Scientific Affairs of the American Medical Association have developed an informational report on Medical Informatics. The technology for producing information about medicine and patients is well into the information age. However, the technology for managing this information has not kept up, at least to the extent of being available in medical facilities where it is needed. Most users of medical information, physicians included, have not crossed the threshold into the electronic/computer era of information acquisition, distribution, and assimilation. The continuing development of the physician as computer user will create a more efficient work environment for the physician while at the same time improving patient care.
Databases, Bibliographic↗
A vocabulary for medical informatics.
The terminology in medical informatics is evolving rapidly. The organizers of MEDINFO and SCAMC have used different sets of keywords to index their documents. Recognizing the limitations of this approach, members of those organizations joined with the National Library of Medicine in the creation of a better terminology for medical informatics. A hierarchical structure was placed on the terms to produce a thesaurus typical of the sort often used in the indexing and retrieving of documents. The building of this thesaurus began with an automatic merging of the thesaurus used by the Association of Computing Machinery and the Information Sciences component of the "Medical Subject Headings." This product was pruned by eliminating terms not related to those in the MEDINFO keyword list or not in the medical informatics literature. Further refinement of the thesaurus resulted from extensive discussions among the authors of this paper. The first major application of this terminology has been to the indexing of the articles in "MEDINFO-86 Proceedings." Major components of this medical informatics thesaurus also have been incorporated into the "Medical Subject Headings." This paper describes the process of preparing the thesaurus and presents an evaluation of its coverage of the "MEDINFO-86 Proceedings."
Abstracting and Indexing↗
"Medical informatics in a medical research facility. An interactive multimedia presentation". Diabetes as a model.
This interactive demonstration provides a model for integrating information in a medical facility. By the use of networking computers, diagnostic data and scientific data are shared between geographically-separated clinical and research units. Data collected in a patient database in the outpatient clinic is sorted on specified qualifying criteria and the resulting subset further analyzed for research studies. To show the process of patient selection from a general database to a diabetes database, and further selection to a subset of diabetes, i.e., Diabetic Neuropathy, the authors used HyperCard. Firstly, HyperCard provided us with a flexible design allowing for both vertical and horizontal progressions. Because we wanted to include an educational component on diabetes and its complications, this flexibility was important. At any point in the demonstration, the viewer is able to access more information nested in several levels. Secondly, we wanted to be able to import a variety of programs that are used to translate diagnostic data into scientific data that is analyzed and prepared for publication in a medical textbook or journal. According to Douglas Adams, author of "Pathways and Relationships", HyperCard occupies the same niche in the evolution of software as human beings do in the evolution of life. "It's the fact that we are unspecialized but infinitely adaptable that has been our success as a species. In the same way, HyperCard is unspecialized but can turn its hand to any kind of task. And if the task is beyond it, HyperCard can use the phone, go for a ride on Excel, or go out and find a powerful graphics tool or sophisticated wordprocessing program!"
Academies and Institutes↗
[Medical informatics].
The fundamentals of medical informatics education are described on the basis of the current understanding of its aims and tasks. The use of a system in medical decision making is pointed out together with its basic characteristics. The significance of the introduction of information systems into the health system is presented as well as the perspectives of their further development in the future. The principles of medical informatics education are presented as well as the present situation in medical informatics education in the world and in this country with a view of the future.
Humans↗
Evolution of medical informatics societies in the United States.
Medical informatics, the application of computers to medicine, was supported by engineering groups in the 1950s, by biomedical engineering societies in the 1960s, and by medical informatics organizations in the 1970s and 1980s. Because of the highly specialized and technical nature of medical informatics, the dissemination of early articles on the subject was largely dependent on publication of the proceedings and transactions of meetings of professional organizations. The American Medical Informatics Association (AMIA) was recently formed from the merger of three professional organizations, each dedicated to medical informatics: the American Association for Medical systems and Informatics (AAMSI), the American College for Medical Informatics (ACMI), and the Symposium on Computer Applications in Medical Care (SCAMC). An increase in professional interest and activity in medical informatics is anticipated in the 1990s.
Directories as Topic↗
[Medical informatics as a complementary method in medical education].
The practice of the decision making at the bed side especially highlights the place to be devoted to medical informatics both at the pre- and post-graduate levels. Still in a relatively recent past, say the 50s-60s, most of the medical educational efforts were delivered when watching and then imitating the medical behaviour of an older physician. The medical educators were aware that besides the formal lessons related to selected chapters of medical textbooks, there were an obvious need for better training in the ability to make sound clinical judgements. If this ability has been considered only as an artful and intuitive process neither subjected to theoretical analysis nor to be captured in a formal quantitative model, now things have changed to such an extent that it becomes broadly shared that a science of medical decision making can be reasonably founded and this threefold: 1) Upon a formulated logic, 2) The probability theory, and 3) A value theory. The first gives the hand to artificial intelligence (AI) technics, the third to medical information data bases dealing either with patients (like in hospital information systems) or with literature like MEDLINE or electronic "cookbooks". Basically the probabilistic theory is based here upon a priori probabilities related to patients informations and data and opens the way to bayesian decision making. After this little summary it is stressed that educational informatics in medicine would appear either very central or very marginal, if not optional.
Computer-Assisted Instruction↗
A review of medical education and medical informatics.
Physicians have considerable difficulty collecting and interpreting information from patients, dealing with the uncertainties associated with diagnosing and treating their patients, communicating precisely with one another, keeping up to date, and applying recommended procedures when indicated. Some of the advances in information technology may help physicians to manage information more effectively through more accessible, validated clinical indexes, data bases of diagnostic test characteristics, computerized audits of clinical activities with feedback, expert systems, on-line access to the medical literature, and other tools of medical informatics. Medical educators can catalyze this process by facilitating the introduction of information technology into academic clinical settings so that students can learn its use first-hand and by promoting the evolution of this and other aspects of medical informatics, a new discipline dedicated to the solution of information problems in health care. The potential roles for computer-aided instruction and centralized computer laboratories in medical schools are much less clear.
Canada↗
Continuous quality improvement and medical informatics: the convergent synergy.
Continuous quality improvement (CQI) and medical informatics specialists need to converge their efforts to create synergy for improving health care. Health care CQI needs medical informatics' expertise and technology to build the information systems needed to manage health care organizations according to quality improvement principles. Medical informatics needs CQI's philosophy and methods to build health care information systems that can evolve to meet the changing needs of clinicians and other stakeholders. This paper explores the philosophical basis for convergence of CQI and medical informatics efforts, and then examines a clinical computer workstation development project that is applying a combined approach.
Computer Security↗
Ten years of medical informatics. Introduction.
The discussions of the Tenth Anniversary of the Symposium on Computer Applications in Medical Care (SCAMC) are summarized. Eight different subject areas are addressed: Medical informatics and medical education; Decision making, medical artificial intelligence, modelling and simulations; Image processing, 3-D graphics, and computer networks; Reimbursement policy, legal and regulatory issues; Encoding and representation of medical meaning; Ambulatory medical records systems; Hospital information systems; and Software environments for developing medical information systems. The activities of the 10th SCAMC consisted of Tutorials, Panel Discussions, a Plenary Session, Scientific Demonstrations, and an International Student Paper Competition in Medical Informatics.
Computer Communication Networks↗