Shortliffe, Edward H.; Bates, David W.; Bloomrosen, Meryl; Greenwood, Karen; Safran, Charles; Steen, Elaine B.; Tang, Paul C.; Williamson, Jeffrey J.
Don E. Detmer has served as President and Chief Executive Officer of the American Medical Informatics Association (AMIA) for the past five years, helping to set a course for the organization and demonstrating remarkable leadership as AMIA has evolved into a vibrant and influential professional association. On the occasion of Dr. Detmer's retirement, we fondly reflect on his professional life and his many contributions to biomedical informatics and, more generally, to health care in the U.S. and globally. PMID:19574463
Detmer, D E
Substantial global and national commitment will be required for current healthcare systems and health professional practices to become learning care systems utilizing information and communications technology (ICT) empowered by informatics. To engage this multifaceted challenge, a vision is required that shifts the emphasis from silos of activities toward integrated systems. Successful systems will include a set of essential elements, e.g., a sufficient ICT infrastructure, evolving health care processes based on evidence and harmonized to local cultures, a fresh view toward educational preparation, sound and sustained policy support, and ongoing applied research and development. Increasingly, leaders are aware that ICT empowered by informatics must be an integral part of their national and regional visions. This paper sketches out the elements of what is needed in terms of objectives and some steps toward achieving them. It summarizes some of the progress that has been made to date by the American and International Medical Informatics Associations working separately as well as collaborating to conceptualize informatics capacity building in order to bring this vision to reality in low resource nations in particular.
Hasman, Arie; Haux, Reinhold
Education in medical informatics is needed not only for those who want to become specialist in this area but also for health professionals. Since students, depending on the program they are enlisted in, require different types of knowledge and skills in medical informatics, curricula should be
Bouhaddou, O; Bennani Othmani, M; Diouny, S
Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector. Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco. These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability. For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.
This Brief highlights Informatics and related techniques to Computer Science Professionals, Engineers, Medical Doctors, Bioinformatics researchers and other interdisciplinary researchers. Chapters include the Bioinformatics of Diabetes and several computational algorithms and statistical analysis approach to effectively study the disorders and possible causes along with medical applications.
Swiss Society for Medical Informatics (SSMI) started to build a postgraduate curriculum in medical informatics a year ago. The aim is to build a curriculum with different modules allowing the healthcare professionals to follow individual path in order to fulfill their objectives. The professionals who could benefit from the curriculum are physicians, nurses, medical assistants, computer specialists in the healthcare domain. Different levels of certificates or diplomas will be given depending on the number of modules taken and the professional background. Modules can be taken in different ways: universities, hospitals, distance learning.... The kickoff meeting for the leading group of this curriculum chaired by Dr Denz from Zurich was held on June 5 and 6 1998 was Swiss Nursing informatics group is active in this field. Working Group 5 (WG5) "Nursing Informatics in Europe" is supporting countries efforts in building nursing informatics curriculum. Promoting links between specialists in this domain in different countries. Selecting relevant Websites to be used. Disseminating information to country members of WG5.
Buckeridge, David L; Goel, Vivek
Background There is strong support for educating physicians in medical informatics, and the benefits of such education have been clearly identified. Despite this, North American medical schools do not routinely provide education in medical informatics. Methods We conducted a qualitative study to identify issues facing the introduction of medical informatics into an undergraduate medical curriculum. Nine key informants at the University of Toronto medical school were interviewed, and their responses were transcribed and analyzed to identify consistent themes. Results The field of medical informatics was not clearly understood by participants. There was, however, strong support for medical informatics education, and the benefits of such education were consistently identified. In the curriculum we examined, medical informatics education was delivered informally and inconsistently through mainly optional activities. Issues facing the introduction of medical informatics education included: an unclear understanding of the discipline; faculty and administrative detractors and, the dense nature of the existing undergraduate medical curriculum. Conclusions The identified issues may present serious obstacles to the introduction of medical informatics education into an undergraduate medicine curriculum, and we present some possible strategies for addressing these issues. PMID:12207827
Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron
-Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. -To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. -The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. -Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). -PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.
Arokiasamy, J.; Ball, M.; Barnett, D.; Bearman, M.; Bemmel van, J.; Douglas, J.; Fisher, P.; Garrie, R.; Gatewood, L.; Goossen, W.; Grant, A.; Hales, J.; Hasman, A.; Haux, R.; Hovenga, E.; Johns, M.; Knaup, P.; Leven, F. J.; Lorenzi, N.; Murray, P.; Neame, R.; Protti, D.; Power, M.; Richard, J.; Schuster, E.; Swinkels, W.; Yang, J.; Zelmer, L.; Zvárová, Jana
Roč. 40, č. 5 (2001), s. 267-277 ISSN 0026-1270 Institutional research plan: AV0Z1030915 Keywords : health informatics * medical informatics * education * recommendations * International Medical Informatics Association * IMIA Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.254, year: 2001
Medical Imaging Informatics has become a fast evolving discipline at the crossing of Informatics, Computational Sciences, and Medicine that is profoundly changing medical practices, for the patients' benefit.
Arocha José F
Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences
Liang, Jun; Wei, Kunyan; Meng, Qun; Chen, Zhenying; Zhang, Jiajie
Background As the world’s second-largest economy, China has launched health reforms for the second time and invested significant funding in medical informatics (MI) since 2010; however, few studies have been conducted on the outcomes of this ambitious cause. Objective This study analyzed the features of major MI meetings held in China and compared them with similar MI conferences in the United States, aiming at informing researchers on the outcomes of MI in China and the US from the professional conference perspective and encouraging greater international cooperation for the advancement of the field of medical informatics in China and, ultimately, the promotion of China’s health reform. Methods Qualitative and quantitative analyses of four MI meetings in China (i.e., CMIAAS, CHINC, CHITEC, and CPMI) and two in the US (i.e., AMIA and HIMSS) were conducted. Furthermore, the size, constituent parts and regional allocation of participants, topics, and fields of research for each meeting were determined and compared. Results From 1985 to 2016, approximately 45,000 individuals attended the CMIAAS and CPMI (academic), CHINC and CHITEC (industry), resulting in 5,085 documented articles. In contrast, in 2015, 38,000 and 3,700 individuals, respectively, attended the American HIMSS (industry) and AMIA (academic) conferences and published 1,926 papers in the latter. Compared to those of HIMSS in 2015, the meeting duration of Chinese industry CHITEC was 3 vs. 5 days, the number of vendors was 100 vs. 1,500+, the number of sub-forums was 10 vs. 250; while compared to those of AMIA, the meeting duration of Chinese CMIAAS was 2 vs. 8 days, the number of vendors was 5 vs. 65+, the number of sub-forums was 4 vs. 26. HIMSS and AMIA were more open, international, and comprehensive in comparison to the aforementioned Chinese conferences. Conclusions The current MI in China can be characterized as “hot in industry application, and cold in academic research.” Taking into
Full Text Available The article describes the state and some trends in the development of medical informatics especially regarding the fields of scientific information, knowledge discovery in databases, and the role of standards in data exchange.The ways of publication of scientific documents experienced dramatic changes with the development of the www, hence causing major changes in daily information practice. Contemporary textual databases contain full documents of hypertextual and multimedia nature and links to full documents are increasingly common within the records of bibliographic databases. The last decade brought the advent of the web information tools, from web portals to global search engines, which are powerful aids but demand strong precaution regarding the quality of retrieved documents from the users. On the other hand, we are witnessing the development of digital libraries of scientific documents as a result of the self-organization of academic institutions, research groups and individuals, often in the opposition to the interests of publishing companies.The information support as an important element of medical procedures made possible the exchange of data between all segments of the health-care system and it has become clear that lack of standards governing structure, understanding and safety is among the biggest obstacles to successful data exchange.In addition, the article comprises a report on the methods of knowledge discovery in databases, which help us discover hidden structures and potential knowledge, invisible to the normal data-processing software, in the enormous amount of data.
Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron
Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics have been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: The objective of the study is to develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:27563486
Clemmer, Terry P.
The goal of medical informatics is to improve care. This requires the commitment and harmonious collaboration between the computer scientists and clinicians and an integrated database. The vision described is how medical information systems are going to impact the way medical care is delivered in the future.
Chouvarda, I; Maglaveras, N
This paper aims to present an overview of the medical informatics landscape in Greece, to describe the Greek ehealth background and to highlight the main education and research axes in medical informatics, along with activities, achievements and pitfalls. With respect to research and education, formal and informal sources were investigated and information was collected and presented in a qualitative manner, including also quantitative indicators when possible. Greece has adopted and applied medical informatics education in various ways, including undergraduate courses in health sciences schools as well as multidisciplinary postgraduate courses. There is a continuous research effort, and large participation in EU-wide initiatives, in all the spectrum of medical informatics research, with notable scientific contributions, although technology maturation is not without barriers. Wide-scale deployment of eHealth is anticipated in the healthcare system in the near future. While ePrescription deployment has been an important step, ICT for integrated care and telehealth have a lot of room for further deployment. Greece is a valuable contributor in the European medical informatics arena, and has the potential to offer more as long as the barriers of research and innovation fragmentation are addressed and alleviated.
Mantas, John; Ammenwerth, Elske; Demiris, George; Hasman, Arie; Haux, Reinhold; Hersh, William; Hovenga, Evelyn; Lun, K. C.; Marin, Heimar; Martin-Sanchez, Fernando; Wright, Graham
Objective: The International Medical Informatics Association (IMIA) agreed on revising the existing international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop
Suárez-Obando, Fernando; Camacho Sánchez, Jhon
The use of computers in medical practice has enabled novel forms of communication to be developed in health care. The optimization of communication processes is achieved through the use of standards to harmonize the exchange of information and provide a common language for all those involved. This article describes the concept of a standard applied to medical informatics and its importance in the development of various applications, such as computational representation of medical knowledge, disease classification and coding systems, medical literature searches and integration of biological and clinical sciences. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
van Bemmel, J H; McCray, A T
The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field.
In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.
This project built a medical informatics data warehouse (MedInfo DDW) in an Oracle database to analyze medical information which has been collected through Baylor Family Medicine Clinic (FCM) Logician application. The MedInfo DDW used Star Schema with dimensional model, FCM database as operational data store (ODS); the data from on-line transaction processing (OLTP) were extracted and transferred to a knowledge based data warehouse through SQLLoad, and the patient information was analyzed by using on-line analytic processing (OLAP) in Crystal Report.
Banerjee, Rahul; George, Paul; Priebe, Cedric; Alper, Eric
We aimed to investigate medical students' attitudes about Clinical Informatics (CI) training and careers. We distributed a web-based survey to students at four US allopathic medical schools. Five hundred and fifty-seven medical students responded. Interest in CI training opportunities (medical school electives, residency electives, or academic fellowships) surpassed respondents' prior awareness of these opportunities. Thirty percent of student respondents expressed at least some interest in a CI-related career, but they were no more aware of training opportunities than their peers who did not express such an interest. Almost one third of medical students who responded to our survey expressed an interest in a CI-related career, but they were generally unaware of CI training and mentoring opportunities available to them. Early outreach to such medical students, through elective classes, professional society incentives, or expert partnerships, may positively influence the size and skill set of the future CI workforce. We should work as a field to increase the quantity, quality, and publicity of CI learning opportunities for interested medical students. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Hucíková, Anežka; Babic, Ankica
YouTube as an online video-sharing service in the context of Web 2.0 goes beyond the bounds of pure fun, for which the platform was primarily established. Nowadays, commonly to other social media, it serves also educational, informational and last but not least, marketing purposes. The importance of video sharing is supported by several predictions about video reaching over 90% of global internet traffic by 2020. Using qualitative content analysis over selected YouTube videos, paper examines the current situation of the platform's marketing potential usage by medical informatics organizations, researches and other healthcare professionals. Results of the analysis demonstrate several ways in which YouTube is already used to inform, educate or promote above-mentioned medical institutions. However, their engagement in self-promo or spreading awareness of their research projects via YouTube is considered to be low.
Full Text Available The article reviews features of teaching Medical Informatics and Statistics. The course is referred to the disciplines of Mathematical and Natural sciences. The course is provided in all the faculties of I. M. Sechenov First Moscow State Medical University. For students of Preventive Medicine Department the time frame allotted for studying the course is significantly larger than for similar course provided at other faculties. To improve the teaching methodology of the discipline an analysis of the curriculum has been carried out, attendance and students’ performance statistics have been summarized. As a result, the main goals and objectives have been identified. Besides, general educational functions and the contribution to the solution of problems of education, students’ upbringing and development have been revealed; two stages of teaching have been presented. Recommendations referred to the newest methodological development aimed at improving the quality of teaching the discipline are provided. The ways of improving the methods and organizational forms of education are outlined.
Huang, H K
Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd
Roč. 50, - (1998), s. 219-223 ISSN 1386-5056 Keywords : information technologies * education * training * medical informatics * medical statistics * epidemiology Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.357, year: 1998
Academic Medicine, 1999
The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health…
e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work.
Huang, H K; Deshpande, Ruchi; Documet, Jorge; Le, Anh H; Lee, Jasper; Ma, Kevin; Liu, Brent J
A medical imaging informatics infrastructure (MIII) platform is an organized method of selecting tools and synthesizing data from HIS/RIS/PACS/ePR systems with the aim of developing an imaging-based diagnosis or treatment system. Evaluation and analysis of these systems can be made more efficient by designing and implementing imaging informatics simulators. This tutorial introduces the MIII platform and provides the definition of treatment/diagnosis systems, while primarily focusing on the development of the related simulators. A medical imaging informatics (MII) simulator in this context is defined as a system integration of many selected imaging and data components from the MIII platform and clinical treatment protocols, which can be used to simulate patient workflow and data flow starting from diagnostic procedures to the completion of treatment. In these processes, DICOM and HL-7 standards, IHE workflow profiles, and Web-based tools are emphasized. From the information collected in the database of a specific simulator, evidence-based medicine can be hypothesized to choose and integrate optimal clinical decision support components. Other relevant, selected clinical resources in addition to data and tools from the HIS/RIS/PACS and ePRs platform may also be tailored to develop the simulator. These resources can include image content indexing, 3D rendering with visualization, data grid and cloud computing, computer-aided diagnosis (CAD) methods, specialized image-assisted surgical, and radiation therapy technologies. Five simulators will be discussed in this tutorial. The PACS-ePR simulator with image distribution is the cradle of the other simulators. It supplies the necessary PACS-based ingredients and data security for the development of four other simulators: the data grid simulator for molecular imaging, CAD-PACS, radiation therapy simulator, and image-assisted surgery simulator. The purpose and benefits of each simulator with respect to its clinical relevance
Hu, Dehua; Sun, Zhenling; Li, Houqing
To outline the history of medical informatics education in the People's Republic of China, systematically analyze the current status of medical informatics education at different academic levels (bachelor's, master's, and doctoral), and suggest reasonable strategies for the further development of the field in China. The development of medical informatics education was divided into three stages, defined by changes in the specialty's name. Systematic searches of websites for material related to the specialty of medical informatics were then conducted. For undergraduate education, the websites surveyed included the website of the Ministry of Education of the People's Republic of China (MOE) and those of universities or colleges identified using the baidu.com search engine. For postgraduate education, the websites included China's Graduate Admissions Information Network (CGAIN) and the websites of the universities or their schools or faculties. Specialties were selected on the basis of three criteria: (1) for undergraduate education, the name of specialty or program was medical informatics or medical information or information management and information system; for postgraduate education, medical informatics or medical information; (2) the specialty was approved and listed by the MOE; (3) the specialty was set up by a medical college or medical university, or a school of medicine of a comprehensive university. The information abstracted from the websites included the year of program approval and listing, the university/college, discipline catalog, discipline, specialty, specialty code, objectives, and main courses. A total of 55 program offerings for undergraduate education, 27 for master's-level education, and 5 for PhD-level education in medical informatics were identified and assessed in China. The results indicate that medical informatics education, a specialty rooted in medical library and information science education in China, has grown significantly in that
Ma, Xiaoyan; Han, Zhongdong; Ma, Hua
This article aims at clarifying the strategic significance of developing medical informatics, conducting SWOT analysis on this discipline and hence establishing the strategic objectives and focal points for its development.
Morris, Theodore A.; McCain, Katherine W.
Abstract Objective: Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field. Design: To better understand the field's disciplinary nature, the authors examine the intercitation relationships of its journal literature. To determine its internal structure, they examined its journal cocitation patterns. Measurements: The authors used data from the Science Citation Index (SCI) and Social Science Citation Index (SSCI) to perform intercitation studies among productive journal titles, and software routines from SPSS to perform multivariate data analyses on cocitation data for proposed core journals. Results: Intercitation network analysis suggests that a core literature exists, one mark of a separate discipline. Multivariate analyses of cocitation data suggest that major focus areas within the field include biomedical engineering, biomedical computing, decision support, and education. The interpretable dimensions of multidimensional scaling maps differed for the SCI and SSCI data sets. Strong links to information science literature were not found. Conclusion: The authors saw indications of a core literature and of several major research fronts. The field appears to be viewed differently by authors writing in journals indexed by SCI from those writing in journals indexed by SSCI, with more emphasis placed on computers and engineering versus decision making by the former and more emphasis on theory versus application (clinical practice) by the latter. PMID:9760393
The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra
Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.
Full Text Available Newer healthcare technologies and treatment procedures are being developed rapidly, and clinicians are incorporating them into their daily practice. They are integrating the past and the present knowledge for better patient healthcare. Previously, it had been difficult to organize, store and retrieve medical and patient information. But, today, with the advent of computers and, moreover, information technology has led to the development of medical informatics that is helping physicians to overcome these challenges. Medical informatics deals with all aspects of understanding and promoting the effective organization analysis, management and use of information in healthcare, which are being highlighted in this review paper.
Morris, Theodore Allan
Previous bibliometric analyses of Medical Informatics’ internal structure used MEDLINE records as the unit of study. EMBASE, a product of Excerpta Medica, carries a wider international scope and offers complementary retrieval results to MEDLINE. Since much medical informatics critical thinking originated abroad and migrated to North America, this difference in coverage may also indicate a different perspective of “what constitutes medical informatics.” Using traditional bibliometric and multivariate data analysis techniques, the present work examines EMBASE indexing records for the same 1995–1999 time frame as earlier MEDLINE studies to identify and compare structural features of the field.. PMID:14728448
Phillips, M; Kalet, I; McNutt, T; Smith, W
Biomedical informatics encompasses a very large domain of knowledge and applications. This broad and loosely defined field can make it difficult to navigate. Physicists often are called upon to provide informatics services and/or to take part in projects involving principles of the field. The purpose of the presentations in this symposium is to help medical physicists gain some knowledge about the breadth of the field and how, in the current clinical and research environment, they can participate and contribute. Three talks have been designed to give an overview from the perspective of physicists and to provide a more in-depth discussion in two areas. One of the primary purposes, and the main subject of the first talk, is to help physicists achieve a perspective about the range of the topics and concepts that fall under the heading of 'informatics'. The approach is to de-mystify topics and jargon and to help physicists find resources in the field should they need them. The other talks explore two areas of biomedical informatics in more depth. The goal is to highlight two domains of intense current interest--databases and models--in enough depth into current approaches so that an adequate background for independent inquiry is achieved. These two areas will serve as good examples of how physicists, using informatics principles, can contribute to oncology practice and research. Learning Objectives: To understand how the principles of biomedical informatics are used by medical physicists. To put the relevant informatics concepts in perspective with regard to biomedicine in general. To use clinical database design as an example of biomedical informatics. To provide a solid background into the problems and issues of the design and use of data and databases in radiation oncology. To use modeling in the service of decision support systems as an example of modeling methods and data use. To provide a background into how uncertainty in our data and knowledge can be
Jaspers, M. W. M.; Gardner, R. M.; Gatewood, L. C.; Haux, R.; Evans, R. S.
PURPOSE: Today, the need for health informatics training for health care professionals is acknowledged and educational opportunities for these professionals are increasing. To contribute to these efforts, a new initiative was undertaken by the Medical Informatics Program of the University of
Medical informatics involves the use of computer system-analytic tools to support patients of public health care and this forms the basis of hospital information systems. ... Yet, health information systems hold tremendous benefits for improving the quality of care including effective utilization of scare human resources.
Roč. 9, - (2005), s. 269-274 ISSN 1335-2393. [YBERC 2005. Young Biomedical Engineers and Researchers Conference. Stará Lesná, 13.07.2005-15.07.2005] Institutional research plan: CEZ:AV0Z10300504 Keywords : medical informatics * information society * telemedicine * education * research and development Subject RIV: BD - Theory of Information
Hasman, Arie; Mantas, John; Zarubina, Tatyana
This contribution presents the development of medical informatics education in Europe. It does not discuss all developments that took place. Rather it discerns several themes that indicate the progress in the field, starting from the initiation phase to the final quality control phase. PMID:24648617
The open access paradigm has become an important approach in today's information and communication society. Funders and governments in different countries stipulate open access publications of funded research results. Medical informatics as part of the science, technology and medicine disciplines benefits from many research funds, such as National Institutes of Health in the US, Wellcome Trust in UK, German Research Foundation in Germany and many more. In this study an overview of the current open access programs and conditions of major journals in the field of medical informatics is presented. It was investigated whether there are suitable options and how they are shaped. Therefore all journals in Thomson Reuters Web of Science that were listed in the subject category "Medical Informatics" in 2014 were examined. An Internet research was conducted by investigating the journals' websites. It was reviewed whether journals offer an open access option with a subsequent check of conditions as for example the type of open access, the fees and the licensing. As a result all journals in the field of medical informatics that had an impact factor in 2014 offer an open access option. A predominantly consistent pricing range was determined with an average fee of 2.248 € and a median fee of 2.207 €. The height of a journals' open access fee did not correlate with the height of its Impact Factor. Hence, medical informatics journals have recognized the trend of open access publishing, though the vast majority of them are working with the hybrid method. Hybrid open access may however lead to problems in questions of double dipping and the often stipulated gold open access.
Röhrig, R; Stausberg, J; Dugas, M
The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.
respect to Medical Physics, and conversely see how Informatics may assist the medical physicist in filling some of the current gaps in their activities. 3. Understand general informatics concepts and areas of investigation including imaging and workflow standards, systems integration, computing architectures, ontologies, data mining and business analytics, data visualization and human-computer interface tools, and the importance of quantitative imaging for the future of Medical Physics and Imaging Informatics. 4. Become familiar with on-going efforts to address current challenges facing future research into and clinical implementation of quantitative imaging applications. © 2012 American Association of Physicists in Medicine.
Perry, Gerald J; Roderer, Nancy K; Assar, Soraya
The article offers a current perspective on medical informatics and health sciences librarianship. The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as "boundary spanners," incorporating human factors that unite technology with health care delivery.
The paper describes the history of medical informatics in Czechoslovakia and the Czech Republic. It focuses on the topics of medical informatics education and decision support methods and systems. Several conferences held in Czechoslovakia and in the Czech Republic organized in cooperation with IMIA or EFMI are described. Support of European Union and Czech agencies in several European and national projects focused on medical informatics topics highly contributed to medical informatics development in Czechoslovakia and the Czech Republic and to the establishment of the European Center for Medical Informatics, Statistics and Epidemiology as the joint workplace of Charles University in Prague and Academy of Sciences of the Czech Republic in 1994.
Chilton, L; Berger, J E; Melinkovich, P; Nelson, R; Rappo, P D; Stoddard, J; Swanson, J; Vanchiere, C; Lustig, J; Gotlieb, E M; Deutsch, L; Gerstle, R; Lieberthal, A; Shiffman, R; Spooner, S A; Stern, M
Pediatricians and pediatric medical and surgical subspecialists should know their legal responsibilities to protect the privacy of identifiable patient health information. Although paper and electronic medical records have the same privacy standards, health data that are stored or transmitted electronically are vulnerable to unique security breaches. This statement describes the privacy and confidentiality needs and rights of pediatric patients and suggests appropriate security strategies to deter unauthorized access and inappropriate use of patient data. Limitations to physician liability are discussed for transferred data. Any new standards for patient privacy and confidentiality must balance the health needs of the community and the rights of the patient without compromising the ability of pediatricians to provide quality care.
Dezelic, Gjuro; Kern, Josipa; Petrovecki, Mladen; Ilakovac, Vesna; Hercigonja-Szekeres, Mira
A historical survey of medical informatics (MI) in Croatia is presented from the beginnings in the late sixties of the 20th century to the present time. Described are MI projects, applications in clinical medicine and public health, start and development of MI research and education, beginnings of international cooperation, establishment of the Croatian Society for MI and its membership to EFMI and IMIA. The current status of computerization of the Croatian healthcare system is sketched as well as the present graduate and postgraduate study MI curricula. The information contained in the paper shows that MI in Croatia developed and still develops along with its advancement elsewhere. PMID:24648620
Knaup, P; Haag, M; Leven, F J; Dickhaus, H
Health and medical informatics (HMI) is an evolving discipline. Therefore, evolving educational programs in HMI have to take a variety of requirements into account. The aim of this paper is to analyze these requirements and to compare them with the medical informatics program Heidelberg/Heilbronn, Germany. Systematic analysis of the IMIA recommendations on educating HMI, the Bologna declaration, current technological and health care developments and the results of graduates surveys. The latest revision of the Heidelberg/Heilbronn medical informatics program not only takes current developments into account but also realizes the IMIA recommendations, the Bologna declaration and graduates' data and feedback obtained in structured surveys. The topics bioinformatics, IT security and telemedicine were strengthened, taking major research and application trends into account. The program has been transformed into a consecutive bachelor/master program. It qualifies its graduates to work in the field of medical informatics as well as in informatics. Medical informatics is a very broad field. Programs have to make concessions to scope: It is not possible to provide profound knowledge and skills in computer science and also teach a variety of application areas like bioinformatics, public health informatics and clinical informatics in depth within one medical informatics program. Many graduate programs in various nations concentrate on providing HMI skills to health care professionals.
Walpole, Sarah; Taylor, Paul; Banerjee, Amitava
Health informatics has growing importance in clinical practice with successive General Medical Council recommendations. However, prior data suggest that undergraduate medical education largely neglects this area. An up-to-date, UK-wide view of health informatics training in medical schools is required. An online survey was developed using current guidance and recommendations of UK professional bodies. Senior academic staff and health informatics educators at all 34 UK medical schools were invited to complete the survey. Quantitative and qualitative data regarding health informatics in the undergraduate medical curriculum. A total of 26/34 (76%) of UK medical schools responded and 23 provided full information. Aspects most frequently mentioned were literature searching and research governance. Seventeen per cent of respondents felt there was little or no HI training, although clinical record keeping was addressed by all medical schools. Pedagogies used to teach health informatics were self-directed learning (78%) to lecture based (70%), seminars (70%), informal teaching in clinical settings (57%) and problem-based learning (22%). Health informatics was usually integrated vertically and horizontally across the curriculum (76%). Assessment and updates of the health informatics curriculum are limited (57 and 41%, respectively). Thirty-two per cent of respondents reported a low level of confidence among students to use health informatics as doctors. In the most up-to-date survey of health informatics teaching in UK medical schools, there are three major findings. First, the proportion of health informatics in the medical undergraduate curriculum is low. Second, there was variation in content, pedagogy and timing across medical schools. Third, health informatics is rarely assessed and course content is not regularly updated. There is a role for national guidelines and further research in this area of the curriculum which is rapidly gaining in prominence.
Safdari, Reza; Shahmoradi, Leila; Hosseini-Beheshti, Molouk-Sadat; Nejad, Ahmadreza Farzaneh; Hosseiniravandi, Mohammad
Encyclopedias and their compilation have become so prevalent as a valid cultural medium in the world. The daily development of computer industry and the expansion of various sciences have made indispensable the compilation of electronic, specialized encyclopedias, especially the web-based ones. This is an applied-developmental study conducted in 2014. First, the main terms in the field of medical informatics were gathered using MeSH Online 2014 and the supplementary terms of each were determined, and then the tree diagram of the terms was drawn based on their relationship in MeSH. Based on the studies done by the researchers, the tree diagram of the encyclopedia was drawn with respect to the existing areas in this field, and the terms gathered were put in related domains. In MeSH, 75 preferred terms together with 249 supplementary ones were indexed. One of the informatics' sub-branches is biomedical informatics and health which itself consists of three sub-divisions of bioinformatics, clinical informatics, and health informatics. Medical informatics which is a subdivision of clinical informatics has developed from the three fields of medical sciences, management and social sciences, and computational sciences and mathematics. Medical Informatics is created of confluence and fusion and applications of the three major scientific branches include health and biological sciences, social sciences and management sciences, computing and mathematical sciences, and according to that the structure of MeSH is weak for future development of Encyclopedia of Medical Informatics.
Haux, R.; Ammenwerth, E.; ter Burg, W. J.; Pilz, J.; Jaspers, M. W. M.
We report on a course for medical informatics students on hospital information systems, especially on its strategic information management. Starting as course at the Medical Informatics Program of the University of Heidelberg/University of Applied Sciences Heilbronn, it is now organized as
Lei, Jianbo; Meng, Qun; Li, Yuefeng; Liang, Minghui; Zheng, Kai
In contrast to China's giant health information technology (HIT) market and tremendous investments in hospital information systems the contributions of Chinese scholars in medical informatics to the global community are very limited. China would like to have a more important position in the global medical informatics community. A better understanding of the differences between medical informatics research and education in China and the discipline that emerged abroad will better inform Chinese scholars to develop right strategies to advance the field in China and help identify an appropriate means to collaborate more closely with medical informatics scholars globally. For the first time, this paper divides the evolution of medical informatics in China into four stages based on changes in the core content of research, the educational orientation and other developmental characteristics. The four stages are infancy, incubation, primary establishment and formal establishment. This paper summarizes and reviews major supporting journals and publications, as well as major organizations. Finally, we analyze the main problems that exist in the current disciplinary development in China related to medical informatics research and education and offer suggestions for future improvement. The evolution of medical informatics shows a strong and traditional concentration on medical library/bibliographic information rather than medical (hospital information or patient information) information. Misdirected-concentration, a lack of formal medical informatics trained teaching staff and mistakenly positioning medical informatics as an undergraduate discipline are some of the problems inhibiting the development of medical informatics in China. These lessons should be shared and learned for the global community. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Nadri, Hamed; Rahimi, Bahlol; Timpka, Toomas; Sedghi, Shahram
The number of citations that a research paper receives can be used as a measure of its scientific impact. The objective of this study was to identify and to examine the characteristics of top 100 cited articles in the field of Medical Informatics based on data acquired from the Thomson Reuters' Web of Science (WOS) in October, 2016. The data was collected using two procedures: first we included articles published in the 24 journals listed in the "Medical Informatics" category; second, we retrieved articles using the key words: "informatics", "medical informatics", "biomedical informatics", "clinical informatics" and "health informatics". After removing duplicate records, articles were ranked by the number of citations they received. When the 100 top cited articles had been identified, we collected the following information for each record: all WOS database citations, year of publication, journal, author names, authors' affiliation, country of origin and topics indexed for each record. Citations for the top 100 articles ranged from 346 to 7875, and citations per year ranged from 11.12 to 525. The majority of articles were published in the 2000s (n=43) and 1990s (n=38). Articles were published across 10 journals, most commonly Statistics in medicine (n=71) and Medical decision making (n=28). The articles had an average of 2.47 authors. Statistics and biostatistics modeling was the most common topic (n=71), followed by artificial intelligence (n=12), and medical errors (n=3), other topics included data mining, diagnosis, bioinformatics, information retrieval, and medical imaging. Our bibliometric analysis illustrated a historical perspective on the progress of scientific research on Medical Informatics. Moreover, the findings of the current study provide an insight on the frequency of citations for top cited articles published in Medical Informatics as well as quality of the works, journals, and the trends steering Medical Informatics.
Cimino, J J; Allen, B A; Clayton, P D
The Department of Medical Informatics at Columbia University College of Physicians and Surgeons consists of a faculty of 17 full- and part-time faculty. The Department faculty collaborate with the Department of Computer Science and several clinical departments of the medical center. We offer courses in medical informatics, formal degrees (M.A., M.Phil. and Ph.D.) and a postdoctoral training program. In addition to academic offerings, the close affiliation with the Columbia-Presbyterian Medical Center and the primary responsibilities for clinical information systems offers trainees unique opportunities to work with and develop real-world applications. Faculty research programs include work on the Integrated Advanced Information Management System (IAIMS), Unified Medical Language System (UMLS), High-Performance Computing and Communications (HPCC), Electronic Medical Records, automated decision support and technology transfer through the Center for Advanced Technology.
NONE DECLARED LAST TWO YEARS, THE HEALTH INFORMATICS PROFESSION CELEBRATED FIVE JUBILEES IN BOSNIA AND HERZEGOVINA: thirty years from the introduction of the first automatic manipulation of data, twenty years from the establishment of Society for Medical Informatics BiH, fifteen years from the establishment of the Scientific and Professional Journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica", fifteen years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina and five years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article are eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Gadd, Cynthia S; Williamson, Jeffrey J; Steen, Elaine B; Fridsma, Douglas B
In 2005, AMIA leaders and members concluded that certification of advanced health informatics professionals would offer value to individual practitioners, organizations that hire them, and society at large. AMIA's work to create advanced informatics certification began by leading a successful effort to create the clinical informatics subspecialty for American Board of Medical Specialties board-certified physicians. Since 2012, AMIA has been working to establish advanced health informatics certification (AHIC) for all health informatics practitioners regardless of their primary discipline. In November 2015, AMIA completed the first of 3 key tasks required to establish AHIC, with the AMIA Board of Directors' endorsement of proposed eligibility requirements. This AMIA Board white paper describes efforts to establish AHIC, reports on the current status of AHIC components, and provides a context for the proposed AHIC eligibility requirements. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Lyu, Peng-Hui; Yao, Qiang; Mao, Jin; Zhang, Shi-Jing
The aim of this study is to analyze the research trends of medical informatics over the last 12 years. A new method based on MeSH terms was proposed to identify emerging topics and trends of medical informatics research. Informetric methods and visualization technologies were applied to investigate research trends of medical informatics. The metric of perspective factor (PF) embedding MeSH terms was appropriately employed to assess the perspective quality for journals. The emerging MeSH terms have changed dramatically over the last 12 years, identifying two stages of medical informatics: the "medical imaging stage" and the "medical informatics stage". The focus of medical informatics has shifted from acquisition and storage of healthcare data by integrating computational, informational, cognitive and organizational sciences to semantic analysis for problem solving and clinical decision-making. About 30 core journals were determined by Bradford's Law in the last 3 years in this area. These journals, with high PF values, have relative high perspective quality and lead the trend of medical informatics.
Martin-Sanchez, F.; Iakovidis, I.; Norager, S.; Maojo, V.; de Groen, P.; Van der Lei, J.; Jones, T.; Abraham-Fuchs, K.; Apweiler, R.; Babic, A.; Baud, R.; Breton, V.; Cinquin, P.; Doupi, P.; Dugas, M.; Eils, R.; Engelbrecht, R.; Ghazal, P.; Jehenson, P.; Kulikowski, C.; Lampe, K.; De Moor, G.; Orphanoudakis, S.; Rossing, N.; Sarachan, B.; Sousa, A.; Spekowius, G.; Thireos, G.; Zahlmann, G.; Zvárová, Jana; Hermosilla, I.; Vicente, F. J.
Roč. 37, - (2004), s. 30-42 ISSN 1532-0464 Institutional research plan: CEZ:AV0Z1030915 Keywords : bioinformatics * medical informatics * genomics * genomic medicine * biomedical informatics Subject RIV: BD - Theory of Information Impact factor: 1.013, year: 2004
Prokosch, H U; Ganslandt, T
Even though today most university hospitals have already implemented commercial hospital information systems and started to build up comprehensive electronic medical records, reuse of such data for data warehousing and research purposes is still very rare. Given this situation, the focus of this paper is to present an overview on exemplary projects, which have already tackled this challenge, reflect on current initiatives within the United States of America and the European Union to establish IT infrastructures for clinical and translational research, and draw attention to new challenges in this area. This paper does not intend to provide a fully comprehensive review on all the issues of clinical routine data reuse. It is based, however, on a presentation of a large variety of historical, but also most recent activities in data warehousing, data retrieval and linking medical informatics with translational research. The article presents an overview of the various international approaches to this issue and illustrates concepts and solutions which have been published, thus giving an impression of activities pursued in this field of medical informatics. Further, problems and open questions, which have also been named in the literature, are presented and three challenges (to establish comprehensive clinical data warehouses, to establish professional IT infrastructure applications supporting clinical trial data capture and to integrate medical record systems and clinical trial databases) related to this area of medical informatics are identified and presented. Translational biomedical research with the aim "to integrate bedside and biology" and to bridge the gap between clinical care and medical research today and in the years to come, provides a large and interesting field for medical informatics researchers. Especially the need for integrating clinical research projects with data repositories built up during documentation of routine clinical care, today still leaves
Williams, D. R.; Bashshur, R. L.; Pool, S. L.; Doarn, C. R.; Merrell, R. C.; Logan, J. S.
This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.
Rebholz-Schuhman, Dietrich; Cameron, Graham; Clark, Dominic; van Mulligen, Erik; Coatrieux, Jean-Louis; Del Hoyo Barbolla, Eva; Martin-Sanchez, Fernando; Milanesi, Luciano; Porro, Ivan; Beltrame, Francesco; Tollis, Ioannis; Van der Lei, Johan
Background The SYMBIOmatics Specific Support Action (SSA) is "an information gathering and dissemination activity" that seeks "to identify synergies between the bioinformatics and the medical informatics" domain to improve collaborative progress between both domains (ref. to ). As part of the project experts in both research fields will be identified and approached through a survey. To provide input to the survey, the scientific literature was analysed to extract topics relevant to both medical informatics and bioinformatics. Results This paper presents results of a systematic analysis of the scientific literature from medical informatics research and bioinformatics research. In the analysis pairs of words (bigrams) from the leading bioinformatics and medical informatics journals have been used as indication of existing and emerging technologies and topics over the period 2000–2005 ("recent") and 1990–1990 ("past"). We identified emerging topics that were equally important to bioinformatics and medical informatics in recent years such as microarray experiments, ontologies, open source, text mining and support vector machines. Emerging topics that evolved only in bioinformatics were system biology, protein interaction networks and statistical methods for microarray analyses, whereas emerging topics in medical informatics were grid technology and tissue microarrays. Conclusion We conclude that although both fields have their own specific domains of interest, they share common technological developments that tend to be initiated by new developments in biotechnology and computer science. PMID:17430562
Full Text Available This paper investigates the ability of a group of Primary Care professionals to acquire appropriate document retrieval skills, so that they can apply evidence based health care techniques to their various Primary Care roles. The participants, most of whom had little prior experience of the Internet, were enrolled on a two-year part-time Postgraduate Diploma / MSc in Primary Care. As part of the course, they took a compulsory 12-week module in Medical Informatics. A specific task was set: to find appropriate information on Meningococcal Meningitis and Public Health, by using National Library of Medicine's PUBMED bibliographic retrieval system and other unspecified Internet sources. A supplementary piece of coursework required the group to become information providers by providing tutorials on the world wide web. Analysis of the reports showed that the participants were able to learn and use the information tools successfully and that appropriate skills can be transferred in a short time. Overall nine were positive as to the benefits of the evidence-based approach contributing to local health care, with nine expressing mixed views and two having more negative opinions.
Sônia Aparecida Dias Serafim
Full Text Available INTRODUCTION: Informatics and automation are important tools for the reduction of work, errors and costs in a hospital pharmacy. OBJECTIVES: To describe the structuring and function of an informatized system for the dispensing of medications and to assess its effect on nursing and pharmacy services during the period from 1997 to 2003. MATERIALS AND METHODS: In this descriptive and retrospective study, we performed an analysis of documents addressing the structuring and implementation of the informatized medication dispensing system. In addition, we analyzed the perceptions of nurses, pharmacists and pharmacy assistants who participated in the structuring phase of the system when interviewed about the effect of informatization on administrative aspects (e.g., requisition of medications, presentation of the dispensed medication and system operationalization. RESULTS: The major advantages provided by the new system were 1 the elimination of manual transcripts for prescribed medications, 2 increased speed, 3 better identification of the doses prescribed by physicians, 4 medication labels containing all necessary identification and 5 practicality and safety of optical bar code-based verification of the requested and dispensed medications. CONCLUSIONS: The great majority of the interviewees considered the informatized medication supply system to be of good quality. Analysis of the data provided information that could contribute to the expansion and refinement of the system, provide support for studies regarding the utilization of medications and offer new perspectives for work and productivity.
In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.
Gonzalez Bernaldo de Quiros, F; Luna, D; Otero, P; Baum, A; Borbolla, D
Medical Informatics (MI) is an emerging discipline with a high need of trained and skillful professionals. To describe the educational experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires. A descriptive study of the development of the Medical Informatics Residency Program (MIRP) and the e-learning courses related to medical informatics. A four-year MIRP with 15 rotations was started in 2000, and was awarded national educational accreditation. Eight residents have been fully trained and their main academic contributions are shown in this study. The e-learning courses related to medical informatics (Healthcare Management, Epidemiology & Biostatistics, Information Retrieval, Computer Literacy started, 10x10 Spanish version and HL7 introductory course) started in 2006 and were followed by more than 2266 students from all over the world, with an increase trend in foreign students. These educational activities have produced skilled human resources for the development and maintenance of the health informatics projects at our Hospital. In parallel, the number of students trained by e-learning continues to increase, demonstrating the worldwide need of knowledge in this field.
Karcher, Donald S.; Harrison, James H.; Sinard, John H.; Riben, Michael W.; Boyer, Philip J.; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron
Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:28725772
Walter H. Henricks MD
Full Text Available Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016. Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.
Janamanchi, Balaji; Katsamakas, Evangelos; Raghupathi, Wullianallur; Gao, Wei
Little has been published about the application profiles and development patterns of open source software (OSS) in health and medical informatics. This study explores these issues with an analysis of health and medical informatics related OSS projects on SourceForge, a large repository of open source projects. A search was conducted on the SourceForge website during the period from May 1 to 15, 2007, to identify health and medical informatics OSS projects. This search resulted in a sample of 174 projects. A Java-based parser was written to extract data for several of the key variables of each project. Several visually descriptive statistics were generated to analyze the profiles of the OSS projects. Many of the projects have sponsors, implying a growing interest in OSS among organizations. Sponsorship, we discovered, has a significant impact on project success metrics. Nearly two-thirds of the projects have a restrictive license type. Restrictive licensing may indicate tighter control over the development process. Our sample includes a wide range of projects that are at various stages of development (status). Projects targeted towards the advanced end user are primarily focused on bio-informatics, data formats, database and medical science applications. We conclude that there exists an active and thriving OSS development community that is focusing on health and medical informatics. A wide range of OSS applications are in development, from bio-informatics to hospital information systems. A profile of OSS in health and medical informatics emerges that is distinct and unique to the health care field. Future research can focus on OSS acceptance and diffusion and impact on cost, efficiency and quality of health care.
Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga
The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.
Maojo, Victor; Kulikowski, Casimir A.
In this report, the authors compare and contrast medical informatics (MI) and bioinformatics (BI) and provide a viewpoint on their complementarities and potential for collaboration in various subfields. The authors compare MI and BI along several dimensions, including: (1) historical development of the disciplines, (2) their scientific foundations, (3) data quality and analysis, (4) integration of knowledge and databases, (5) informatics tools to support practice, (6) informatics methods to support research (signal processing, imaging and vision, and computational modeling, (7) professional and patient continuing education, and (8) education and training. It is pointed out that, while the two disciplines differ in their histories, scientific foundations, and methodologic approaches to research in various areas, they nevertheless share methods and tools, which provides a basis for exchange of experience in their different applications. MI expertise in developing health care applications and the strength of BI in biological “discovery science” complement each other well. The new field of biomedical informatics (BMI) holds great promise for developing informatics methods that will be crucial in the development of genomic medicine. The future of BMI will be influenced strongly by whether significant advances in clinical practice and biomedical research come about from separate efforts in MI and BI, or from emerging, hybrid informatics subdisciplines at their interface. PMID:12925552
Byrd, Gary D; Winkelstein, Peter
Based on the authors' shared interest in the interprofessional challenges surrounding health information management, this study explores the degree to which librarians, informatics professionals, and core health professionals in medicine, nursing, and public health share common ethical behavior norms grounded in moral principles. Using the "Principlism" framework from a widely cited textbook of biomedical ethics, the authors analyze the statements in the ethical codes for associations of librarians (Medical Library Association [MLA], American Library Association, and Special Libraries Association), informatics professionals (American Medical Informatics Association [AMIA] and American Health Information Management Association), and core health professionals (American Medical Association, American Nurses Association, and American Public Health Association). This analysis focuses on whether and how the statements in these eight codes specify core moral norms (Autonomy, Beneficence, Non-Maleficence, and Justice), core behavioral norms (Veracity, Privacy, Confidentiality, and Fidelity), and other norms that are empirically derived from the code statements. These eight ethical codes share a large number of common behavioral norms based most frequently on the principle of Beneficence, then on Autonomy and Justice, but rarely on Non-Maleficence. The MLA and AMIA codes share the largest number of common behavioral norms, and these two associations also share many norms with the other six associations. The shared core of behavioral norms among these professions, all grounded in core moral principles, point to many opportunities for building effective interprofessional communication and collaboration regarding the development, management, and use of health information resources and technologies.
Rose, Eric; Zeiger, Roni; Corley, Sarah; Gorman, Paul; Yackel, Thomas; Hersh, William
We describe a new methodology for development of a medical informatics curriculum for practicing clinicians. The curriculum is based on a biaxial framework in which information is categorized by type of application and role of the learner in relation to the application. The curriculum development process incorporates feedback from practicing clinicians on an ongoing basis.
... Organizations: Delisting for Cause for Medical Informatics AGENCY: Agency for Healthcare Research and Quality... Safety Organization (PSO) due to its failure to correct a deficiency. The Patient Safety and Quality... organizations whose mission and primary activity is to conduct activities to improve patient safety and the...
The article studies the development process of medical informatics specialty terminology as the ground for further research into foreign countries' experience, including the Canadian one, of specialists' professional training in the field of MI. The study determines the origin and chief stages of the formation and development of the medical…
Otto, Anthony; Kushniruk, Andre
It is generally accepted that Information Technology (IT) is a highly desirable and a very necessary ingredient of modern health care. Review of available literature reveals a paucity of medical informatics and information technology courses in undergraduate medical curricula and a lack of research to assess the effectiveness of medical informatics in undergraduate medical education. The need for such initiatives is discussed and a pilot project is described that evaluated the effectiveness of education in the use of Electronic Medical Record (EMR) applications. Educational activities, for example, could be medical students conducting virtual medical encounters or interacting with EMR applications. An EMR application, which was used in several related projects, has been adapted to the educational environment: standardized patient records can be created and cloned so that individual students can interact with a "standard" patient and alter the patient's data.
Gillette, William; Patrick, Timothy B
This poster reports a preliminary review of medical identity theft. Financial identity theft has received a great deal of media attention. Medical identity theft is a particular kind of identity theft that has received little attention. There are two main subtypes of medical identity theft. In the first type the stolen medical identity is used to receive medical services, and in the second type the stolen medical identity is used to commit healthcare fraud.
Li, Man; Pickering, Brian W.; Smith, Vernon D.; Hadzikadic, Mirsad; Gajic, Ognjen; Herasevich, Vitaly
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and adminis...
Man Li; Brian W. Pickering; Vernon D. Smith; Mirsad Hadzikadic; Ognjen Gajic; Vitaly Herasevich
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and adminis...
Clinical Informatics Consult Service Positively Affects Some Clinical Decisions in the ICU. A Review of: Mulvaney, Shelagh A., Leonard Bickman, Nunzia B. Giuse, Warren E. Lambert, Nila A. Sathe, and Rebecca N. Jerome." A Randomized Effectiveness Trial of a Clinical Informatics Consult Service: Impact on Evidence-based Decision-making and Knowledge Implementation." Journal of the American Medical Informatics Association 15.2 (2008: 203-11.
Full Text Available Objective – To determine whether the provision of synthesized research evidence provided by the Clinical Informatics Consult Service (CICS affects the clinical decision-making of clinicians working in intensive care units (ICUs.Design – Non-blinded randomized control effectiveness trial.Setting – ICUs in United States-based 658 bed university hospital providing tertiary care for adults and children.Subjects – Clinical staff working within one of four ICUs who submitted a request for clinical information during the study period.Methods – Valid requests submitted by clinical staff from the four clinical ICUs (medical, paediatric, trauma, or neonatal were randomly allocated to receive information from the CICS (CICS provided or no information (no CICS provided. Pre-consult forms, completed at the time of the request, examined reasons for the request and the clinical actions clinicians thought might be influenced by the search results. Requestors could opt out of the no CICS provided group either before or after the randomization of their request. Responses to requests, supplied within 0.5 to 7 days as agreed with the requestor, included a search strategy and bibliographic references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research. Clinicians within both groups were free to conduct their own searches and reviews. An online evaluation form, emailed to recipients, was used to assess the impact of the information supplied. The evaluation form asked clinicians to record the time spent on their own searches, sources of information consulted including colleagues, the immediate and future impact of the information provided (either from the CICS or their own searches, what influence the information had on their clinical actions, whether there were any barriers to using the information, and quality and overall satisfaction with the results provided by the CICS. Data was analyzed according to the
Musso, Carlos; Aguilera, Jerónimo; Otero, Carlos; Vilas, Manuel; Luna, Daniel; de Quirós, Fernán González Bernaldo
Biomedical informatics in Health (BIH) is the discipline in charge of capturing, handling and using information in health and biomedicine in order to improve the processes involved with assistance and management. Informatic nephrology has appeared as a product of the combination between conventional nephrology with BIH and its development has been considerable in the assistance as well as in the academic field. Regarding the former, there is increasing evidence that informatics technology can make nephrological assistance be better in quality (effective, accessible, safe and satisfying), improve patient's adherence, optimize patient's and practitioner's time, improve physical space and achieve health cost reduction. Among its main elements, we find electronic medical and personal health records, clinical decision support system, tele-nephrology, and recording and monitoring devices. Additionally, regarding the academic field, informatics and Internet contribute to education and research in the nephrological field. In conclusion, informatics nephrology represents a new field which will influence the future of nephrology.
Hovenga, Evelyn J S
We are witnessing a paradigm shift in higher education as a result of technological advances, adoption of on-line learning and a greater participation in e-commerce by higher education providers. Given the dearth of academics with high-level expertise in health informatics in many countries, we need to explore how best to use our scarce resources to have the greatest possible impact regarding the preparation of health professionals such that they can make the best possible use of available informatics technologies to support health service delivery. The International Medical Informatics Association's (IMIA) education working group together with its institutional (academic members) is exploring how best to provide global and collaborative health informatics education and research. Central Queensland University (CQU), one of these members, is also working with the Health Level Seven (HL7) organisation to provide specific standards education internationally using flexible delivery methods. A number of issues requiring further exploration and resolutions have been identified. An overview of these is provided.
Medical school professors and lecturers are often called to be practicing clinicians, researchers in their own field, in addition to executing their education and curricular responsibilities. Some further accumulate healthcare management responsibilities. These areas pose conflicting demands on time and intellectual activity, but despite their apparent differences, knowledge and skills from management, leadership and informatics may prove useful in helping to smooth these conflicts and hence increase personal effectiveness in these areas. This article tries to clarify some concepts and advance why training in management, leadership and health informatics would seem particularly useful for the medical academic. As opposed to the idea of educational dispersion/specialization, the concept of an integrative tetrahedronal education framework is advanced as a way to plan workshops and other faculty development activities which could be implemented transnationally as well as locally.
Lovis, Christian; Blaser, Jürg
Biomedical informatics (BMI) is an umbrella scientific field that covers many domains, as defined several years ago by the International Medical Informatics Association and the American Medical Informatics Association, two leading players in the field. For example, one of the domains of BMI is clinical informatics, which has been formally recognised as a medical subspecialty by the American Board of Medical Specialty since 2011. Most OECD (Organisation for Economic Co-operation and Development) countries offer very strong curricula in the field of BMI, strong research and development funding with clear tracks and, for most of them, inclusion of BMI in the curricula of health professionals, but BMI remains only marginally recognised in Switzerland. Recent major changes, however, such as the future federal law on electronic patient records, the personalised health initiative or the growing empowerment of citizens towards their health data, are adding much weight to the need for BMI capacity-building in Switzerland.
Full Text Available William R Hersh,1 Paul N Gorman,1 Frances E Biagioli,2 Vishnu Mohan,1 Jeffrey A Gold,3 George C Mejicano4 1Department of Medical Informatics and Clinical Epidemiology, 2Department of Family Medicine, 3Department of Medicine, 4School of Medicine, Oregon Health & Science University, Portland, OR, USA Abstract: Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area. Keywords: curriculum transformation, clinical decision support, patient safety, health care quality, patient engagement
Liang, Jun; Wei, Kunyan; Meng, Qun; Chen, Zhenying; Zhang, Jiajie; Lei, Jianbo
China launched its second health reform in 2010 with considerable investments in medical informatics (MI). However, to the best of our knowledge, research on the outcomes of this ambitious undertaking has been limited. Our aim was to understand the development of MI and the state of continuing education in China and the United States from the perspective of conferences. We conducted a quantitative and qualitative analysis of four MI conferences in China and two in the United States: China Medical Information Association Annual Symposium (CMIAAS), China Hospital Information Network Annual Conference (CHINC), China Health Information Technology Exchange Annual Conference (CHITEC), China Annual Proceeding of Medical Informatics (CPMI) versus the American Medical Informatics Association (AMIA) and Healthcare Information and Management Systems Society (HIMSS). The scale, composition, and regional distribution of attendees, topics, and research fields for each conference were summarized and compared. CMIAAS and CPMI are mainstream academic conferences, while CHINC and CHITEC are industry conferences in China. Compared to HIMSS 2016, the meeting duration of CHITEC was 3 versus 5 days, the number of conference sessions was 132 versus 950+, the number of attendees was 5000 versus 40,000+, the number of vendors was 152 versus 1400+, the number of subforums was 12 versus 230, the number of preconference education symposiums and workshops was 0 versus 12, and the duration of preconference educational symposiums and workshops was 0 versus 1 day. Compared to AMIA, the meeting duration of Chinese CMIAAS was 2 versus 5 days, the number of conference sessions was 42 versus 110, the number of attendees was 200 versus 2500+, the number of vendors was 5 versus 75+, and the number of subforums was 4 versus 10. The number of preconference tutorials and working groups was 0 versus 29, and the duration of tutorials and working group was 0 versus 1.5 days. Given the size of the Chinese
Full Text Available Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR in complex environments such as intensive care units (ICU. We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and administrative data from heterogeneous sources within the EMR to support research and practice improvement in the ICUs. Examples of intelligent alarms – “sniffers”, administrative reports, decision support and clinical research applications are presented.
Li, Man; Pickering, Brian W; Smith, Vernon D; Hadzikadic, Mirsad; Gajic, Ognjen; Herasevich, Vitaly
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and administrative data from heterogeneous sources within the EMR to support research and practice improvement in the ICUs. Examples of intelligent alarms -- "sniffers", administrative reports, decision support and clinical research applications are presented.
Haux, Reinhold; Kulikowski, Casimir A; Bakken, Suzanne; de Lusignan, Simon; Kimura, Michio; Koch, Sabine; Mantas, John; Maojo, Victor; Marschollek, Michael; Martin-Sanchez, Fernando; Moen, Anne; Park, Hyeoun-Ae; Sarkar, Indra N; Leong, Tze Yun; McCray, Alexa T
Medical informatics, or biomedical and health informatics (BMHI), has become an established scientific discipline. In all such disciplines there is a certain inertia to persist in focusing on well-established research areas and to hold on to well-known research methodologies rather than adopting new ones, which may be more appropriate. To search for answers to the following questions: What are research fields in informatics, which are not being currently adequately addressed, and which methodological approaches might be insufficiently used? Do we know about reasons? What could be consequences of change for research and for education? Outstanding informatics scientists were invited to three panel sessions on this topic in leading international conferences (MIE 2015, Medinfo 2015, HEC 2016) in order to get their answers to these questions. A variety of themes emerged in the set of answers provided by the panellists. Some panellists took the theoretical foundations of the field for granted, while several questioned whether the field was actually grounded in a strong theoretical foundation. Panellists proposed a range of suggestions for new or improved approaches, methodologies, and techniques to enhance the BMHI research agenda. The field of BMHI is on the one hand maturing as an academic community and intellectual endeavour. On the other hand vendor-supplied solutions may be too readily and uncritically accepted in health care practice. There is a high chance that BMHI will continue to flourish as an important discipline; its innovative interventions might then reach the original objectives of advancing science and improving health care outcomes.
Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil
A continuous effort to improve healthcare education today is currently driven from the need to create competent health professionals able to meet healthcare demands. Limited research reporting how educational data manipulation can help in healthcare education improvement. The emerging research field of visual analytics has the advantage to combine big data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognise visual patterns. The aim of this study was therefore to explore novel ways of representing curriculum and educational data using visual analytics. Three approaches of visualization and representation of educational data were presented. Five competencies at undergraduate medical program level addressed in courses were identified to inaccurately correspond to higher education board competencies. Different visual representations seem to have a potential in impacting on the ability to perceive entities and connections in the curriculum data.
Luneski, A; Konstantinidis, E; Bamidis, P D
Affective computing (AC) is concerned with emotional interactions performed with and through computers. It is defined as "computing that relates to, arises from, or deliberately influences emotions". AC enables investigation and understanding of the relation between human emotions and health as well as application of assistive and useful technologies in the medical domain. 1) To review the general state of the art in AC and its applications in medicine, and 2) to establish synergies between the research communities of AC and medical informatics. Aspects related to the human affective state as a determinant of the human health are discussed, coupled with an illustration of significant AC research and related literature output. Moreover, affective communication channels are described and their range of application fields is explored through illustrative examples. The presented conferences, European research projects and research publications illustrate the recent increase of interest in the AC area by the medical community. Tele-home healthcare, AmI, ubiquitous monitoring, e-learning and virtual communities with emotionally expressive characters for elderly or impaired people are few areas where the potential of AC has been realized and applications have emerged. A number of gaps can potentially be overcome through the synergy of AC and medical informatics. The application of AC technologies parallels the advancement of the existing state of the art and the introduction of new methods. The amount of work and projects reviewed in this paper witness an ambitious and optimistic synergetic future of the affective medicine field.
Carroll, Cathryn A.; Rychlewski, Walt; Teat, Marty; Clawson, Darrin
This report describes an innovative training program designed to foster entrepreneurship and professionalism in students interested in the field of medical informatics. The course was developed through a private–public interinstitutional collaboration involving four academic institutions, one private firm specializing in health care information management systems, and a philanthropic organization. The program challenged students to serve in multiple roles on multidisciplinary teams and develop an innovative hand-held solution for drug information retrieval. Although the course was technically and behaviorally rigorous and required extensive hands-on experience in a nontraditional learning environment, both students and faculty responded positively. PMID:15064292
Witte, H; Ungureanu, M; Ligges, C; Hemmelmann, D; Wüstenberg, T; Reichenbach, J; Astolfi, L; Babiloni, F; Leistritz, L
The main objective is to show current topics and future trends in the field of medical signal processing which are derived from current research concepts. Signal processing as an integrative concept within the scope of medical informatics is demonstrated. For all examples time-variant multivariate autoregressive models were used. Based on this modeling, the concept of Granger causality in terms of the time-variant Granger causality index and the time-variant partial directed coherence was realized to investigate directed information transfer between different brain regions. Signal informatics encompasses several diverse domains including: processing steps, methodologies, levels and subject fields, and applications. Five trends can be recognized and in order to illustrate these trends, three analysis strategies derived from current neuroscientific studies are presented. These examples comprise high-dimensional fMRI and EEG data. In the first example, the quantification of time-variant-directed information transfer between activated brain regions on the basis of fast-fMRI data is introduced and discussed. The second example deals with the investigation of differences in word processing between dyslexic and normal reading children. Different dynamic neural networks of the directed information transfer are identified on the basis of event-related potentials. The third example shows time-variant cortical connectivity networks derived from a source model. These examples strongly emphasize the integrative nature of signal informatics, encompassing processing steps, methodologies, levels and subject fields, and applications.
Sengstack, Patricia; Thyvalikakath, Thankam Paul; Poikonen, John; Middleton, Blackford; Payne, Thomas; Lehmann, Christoph U
Summary Introduction The emerging operational role of the “Chief Clinical Informatics Officer” (CCIO) remains heterogeneous with individuals deriving from a variety of clinical settings and backgrounds. The CCIO is defined in title, responsibility, and scope of practice by local organizations. The term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). Background The American Medical Informatics Association (AMIA) identified a need to better delineate the knowledge, education, skillsets, and operational scope of the CCIO in an attempt to address the challenges surrounding the professional development and the hiring processes of CCIOs. Discussion An AMIA task force developed knowledge, education, and operational skillset recommendations for CCIOs focusing on the common core aspect and describing individual differences based on Clinical Informatics focus. The task force concluded that while the role of the CCIO currently is diverse, a growing body of Clinical Informatics and increasing certification efforts are resulting in increased homogeneity. The task force advised that 1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges. Conclusion A better defined and specified education and skillset for all CCIO positions will motivate the CCIO workforce and empower them to perform the job of a 21st century CCIO. Formally educated and trained CCIOs will provide a competitive advantage to their respective enterprise by fully utilizing the power of Informatics science. PMID:27081413
Starting with the quotation by Paul Ricoeur: Man needs love indeed; he needs justice still more; but most of all he needs meaning, this paper states that in this present situation medical education does not prepare students to deal with human needs, neither their own nor those of their patients. This is due to the almost exclusive devotion to hard sciences, contaminated by unscientific ideological drift, which tends to negate subjectivity and to suppress any significance of human destiny. Although medical informatics, by definition, eliminates meaning and knowledge, it can - if properly used as a complement and not as a competitor of human intelligence - help to renovate medical education, introduce true humanistic dimensions, and restore the element of human subjectivity.
Hilty, Donald M; Hales, Deborah J; Briscoe, Greg; Benjamin, Sheldon; Boland, Robert J; Luo, John S; Chan, Carlyle H; Kennedy, Robert S; Karlinsky, Harry; Gordon, Daniel B; Yager, Joel; Yellowlees, Peter M
This article provides a brief overview of important issues for educators regarding medical education and technology. The literature describes key concepts, prototypical technology tools, and model programs. A work group of psychiatric educators was convened three times by phone conference to discuss the literature. Findings were presented to and input was received from the 2005 Summit on Medical Student Education by APA and the American Directors of Medical Student Education in Psychiatry. Knowledge of, skills in, and attitudes toward medical informatics are important to life-long learning and modern medical practice. A needs assessment is a starting place, since student, faculty, institution, and societal factors bear consideration. Technology needs to "fit" into a curriculum in order to facilitate learning and teaching. Learning about computers and applying computer technology to education and clinical care are key steps in computer literacy for physicians.
Fernando, Juanita; Lindley, Jennifer
This case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers. The students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon. Assessment by mHealth informatics champions supported the students' independent learning. Promotion of mHealth curriculum must be transparent and clear. Our elective delivery was hampered by a lack of suitable mobile device ownership and limited availability of useful, free apps. Technological jargon required clarification. Educators require particular mHealth informatics and educational expertise to support mHealth pedagogies. This learning helps to prepare medical curriculum designers for addressing evolving mHealth practice horizons.
Petrovecki, Mladen; Rahelić, Dario; Bilić-Zulle, Lidija; Jelec, Vjekoslav
To investigate whether and to what extent various parameters, such as individual characteristics, computer habits, situational factors, and pseudoscientific variables, influence Medical Informatics examination grade, and how inadequate statistical analysis can lead to wrong conclusions. The study included a total of 382 second-year undergraduate students at the Rijeka University School of Medicine in the period from 1996/97 to 2000/01 academic year. After passing the Medical Informatics exam, students filled out an anonymous questionnaire about their attitude toward learning medical informatics. They were asked to grade the course organization and curriculum content, and provide their date of birth; sex; study year; high school grades; Medical Informatics examination grade, type, and term; and describe their computer habits. From these data, we determined their zodiac signs and biorhythm. Data were compared by the use of t-test, one-way ANOVA with Tukey's honest significance difference test, and randomized complete block design ANOVA. Out of 21 variables analyzed, only 10 correlated with the average grade. Students taking Medical Informatics examination in the 1998/99 academic year earned lower average grade than any other generation. Significantly higher Medical Informatics exam grade was earned by students who finished a grammar high school; owned and regularly used a computer, Internet, and e-mail (p< or =0.002 for all items); passed an oral exam without taking a written test (p=0.004), or did not repeat the exam (p<0.001). Better high-school students and students with better grades from high-school informatics course also scored significantly better (p=0.032 and p<0.001, respectively). Grade in high-school mathematics, student's sex, and time of year when the examination was taken were not related to the grade, and neither were pseudoscientific parameters, such as student zodiac sign, zodiac sign quality, or biorhythm cycles, except when intentionally
Pickens, D; Flynn, M; Peck, D
Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidence-based medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. MRI 2.0: This presentation will look into the future of clinical MR imaging and what the clinical medical physicist will need to be doing as the technology of MR imaging evolves. Many of the measurement techniques used today will need to be expanded to address the advent of higher field imaging systems and dedicated imagers for specialty applications. Included will be the need to address quality assurance and testing metrics for multi-channel MR imagers and hybrid devices such as MR/PET systems. New pulse sequences and acquisition methods, increasing use of MR spectroscopy, and real-time guidance procedures will place the burden on the medical physicist to define and use new tools to properly evaluate these systems, but the clinical applications must be understood so that these tools are use correctly. Finally, new rules, clinical requirements, and regulations will mean that the medical physicist must actively work to keep her/his sites compliant and must work closely with physicians to ensure best performance of these systems. Informatics Display 1.0 to 2.0: Medical displays are an integral part of medical imaging operation. The DICOM and AAPM (TG18) efforts have led to clear definitions of performance requirements of monochrome medical displays that can be followed by medical physicists to ensure proper performance. However
Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education. How informatics can optimize communication for residents, promote information technology use, refine documentation techniques, reduce medical errors, and improve clinical decision making will be reviewed. It is hoped that this article will increase faculty and trainees' knowledge of the field of informatics, awareness of available technology, and will assist practitioners to maximize their ability to provide quality care to their patients. This article will also introduce the idea of incorporating informatics specialists into residency programs to help practitioners deliver more evidenced-based care and to further improve their efficiency. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
RESTful web services nowadays are state-of-the-art in business transactions over the internet. They are however not very much used in medical informatics and in clinical research, especially not in Europe. To make an inventory of RESTful web services that can be used in medical informatics and clinical research, including those that can help in patient empowerment in the DACH region and in Europe, and to develop some new RESTful web services for use in clinical research and regulatory review. A literature search on available RESTful web services has been performed and new RESTful web services have been developed on an application server using the Java language. Most of the web services found originate from institutes and organizations in the USA, whereas no similar web services could be found that are made available by European organizations. New RESTful web services have been developed for LOINC codes lookup, for UCUM conversions and for use with CDISC Standards. A comparison is made between "top down" and "bottom up" web services, the latter meant to answer concrete questions immediately. The lack of RESTful web services made available by European organizations in healthcare and medical informatics is striking. RESTful web services may in short future play a major role in medical informatics, and when localized for the German language and other European languages, can help to considerably facilitate patient empowerment. This however requires an EU equivalent of the US National Library of Medicine.
Geissbühler, A; Lovis, C; Spahni, S; Appel, R D; Ratib, O; Boyer, C; Hochstrasser, D F; Baud, R
To report about the work of Prof. Jean-Raoul Scherrer, and show how his humanist vision, his medical skills and his scientific background have enabled and shaped the development of medical informatics over the last 30 years. Starting with the mainframe-based patient-centered hospital information system DIOGENE in the 70s, Prof. Scherrer developed, implemented and evolved innovative concepts of man-machine interfaces, distributed and federated environments, leading the way with information systems that obstinately focused on the support of care providers and patients. Through a rigorous design of terminologies and ontologies, the DIOGENE data would then serve as a basis for the development of clinical research, data mining, and lead to innovative natural language processing techniques. In parallel, Prof. Scherrer supported the development of medical image management, ranging from a distributed picture archiving and communication systems (PACS) to molecular imaging of protein electrophoreses. Recognizing the need for improving the quality and trustworthiness of medical information on the Web, Prof. Scherrer created the Health-On-the-Net (HON) foundation. These achievements, made possible thanks to his visionary mind, deep humanism, creativity, generosity and determination, have made of Prof. Scherrer a true pioneer and leader of the human-centered, patient-oriented application of information technology for improving healthcare.
Gadd, Cynthia S; Williamson, Jeffrey J; Steen, Elaine B; Andriole, Katherine P; Delaney, Connie; Gumpper, Karl; LaVenture, Martin; Rosendale, Doug; Sittig, Dean F; Thyvalikakath, Thankam; Turner, Peggy; Fridsma, Douglas B
AMIA is leading the effort to strengthen the health informatics profession by creating an advanced health informatics certification (AHIC) for individuals whose informatics work directly impacts the practice of health care, public health, or personal health. The AMIA Board of Directors has endorsed a set of proposed AHIC eligibility requirements that will be presented to the future AHIC certifying entity for adoption. These requirements specifically establish who will be eligible to sit for the AHIC examination and more generally signal the depth and breadth of knowledge and experience expected from certified individuals. They also inform the development of the accreditation process and provide guidance to graduate health informatics programs as well as individuals interested in pursuing AHIC. AHIC eligibility will be determined by practice focus, education in primary field and health informatics, and significant health informatics experience. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Drozda, Joseph P; Roach, James; Forsyth, Thomas; Helmering, Paul; Dummitt, Benjamin; Tcheng, James E
The US Food and Drug Administration (FDA) has recognized the need to improve the tracking of medical device safety and performance, with implementation of Unique Device Identifiers (UDIs) in electronic health information as a key strategy. The FDA funded a demonstration by Mercy Health wherein prototype UDIs were incorporated into its electronic information systems. This report describes the demonstration's informatics architecture. Prototype UDIs for coronary stents were created and implemented across a series of information systems, resulting in UDI-associated data flow from manufacture through point of use to long-term follow-up, with barcode scanning linking clinical data with UDI-associated device attributes. A reference database containing device attributes and the UDI Research and Surveillance Database (UDIR) containing the linked clinical and device information were created, enabling longitudinal assessment of device performance. The demonstration included many stakeholders: multiple Mercy departments, manufacturers, health system partners, the FDA, professional societies, the National Cardiovascular Data Registry, and information system vendors. The resulting system of systems is described in detail, including entities, functions, linkage between the UDIR and proprietary systems using UDIs as the index key, data flow, roles and responsibilities of actors, and the UDIR data model. The demonstration provided proof of concept that UDIs can be incorporated into provider and enterprise electronic information systems and used as the index key to combine device and clinical data in a database useful for device evaluation. Keys to success and challenges to achieving this goal were identified. Fundamental informatics principles were central to accomplishing the system of systems model. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org
Cummins, M. R.; Gundlapalli, A. V.; Murray, P.; Park, H.-A.; Lehmann, C. U.
Summary Introduction Official recognition and certification for informatics professionals are essential aspects of workforce development. Objective: To describe the history, pathways, and nuances of certification in nursing informatics across the globe; compare and contrast those with board certification in clinical informatics for physicians. Methods (1) A review of the representative literature on informatics certification and related competencies for nurses and physicians, and relevant websites for nursing informatics associations and societies worldwide; (2) similarities and differences between certification processes for nurses and physicians, and (3) perspectives on roles for nursing informatics professionals in healthcare Results The literature search for ‘nursing informatics certification’ yielded few results in PubMed; Google Scholar yielded a large number of citations that extended to magazines and other non-peer reviewed sources. Worldwide, there are several nursing informatics associations, societies, and workgroups dedicated to nursing informatics associated with medical/health informatics societies. A formal certification program for nursing informatics appears to be available only in the United States. This certification was established in 1992, in concert with the formation and definition of nursing informatics as a specialty practice of nursing by the American Nurses Association. Although informatics is inherently interprofessional, certification pathways for nurses and physicians have developed separately, following long-standing professional structures, training, and pathways aligned with clinical licensure and direct patient care. There is substantial similarity with regard to the skills and competencies required for nurses and physicians to obtain informatics certification in their respective fields. Nurses may apply for and complete a certification examination if they have experience in the field, regardless of formal training. Increasing
Cummins, M R; Gundlapalli, A V; Murray, P; Park, H-A; Lehmann, C U
Official recognition and certification for informatics professionals are essential aspects of workforce development. To describe the history, pathways, and nuances of certification in nursing informatics across the globe; compare and contrast those with board certification in clinical informatics for physicians. (1) A review of the representative literature on informatics certification and related competencies for nurses and physicians, and relevant websites for nursing informatics associations and societies worldwide; (2) similarities and differences between certification processes for nurses and physicians, and (3) perspectives on roles for nursing informatics professionals in healthcare Results: The literature search for 'nursing informatics certification' yielded few results in PubMed; Google Scholar yielded a large number of citations that extended to magazines and other non-peer reviewed sources. Worldwide, there are several nursing informatics associations, societies, and workgroups dedicated to nursing informatics associated with medical/health informatics societies. A formal certification program for nursing informatics appears to be available only in the United States. This certification was established in 1992, in concert with the formation and definition of nursing informatics as a specialty practice of nursing by the American Nurses Association. Although informatics is inherently interprofessional, certification pathways for nurses and physicians have developed separately, following long-standing professional structures, training, and pathways aligned with clinical licensure and direct patient care. There is substantial similarity with regard to the skills and competencies required for nurses and physicians to obtain informatics certification in their respective fields. Nurses may apply for and complete a certification examination if they have experience in the field, regardless of formal training. Increasing numbers of informatics nurses are pursuing
King, Samuel B; Lapidus, Mariana
The authors' goal was to assess changes in the role of librarians in informatics education from 2004 to 2013. This is a follow-up to "Metropolis Redux: The Unique Importance of Library Skills in Informatics," a 2004 survey of informatics programs. An electronic survey was conducted in January 2013 and sent to librarians via the MEDLIB-L email discussion list, the library section of the American Association of Colleges of Pharmacy, the Medical Informatics Section of the Medical Library Association, the Information Technology Interest Group of the Association of College and Research Libraries/New England Region, and various library directors across the country. Librarians from fifty-five institutions responded to the survey. Of these respondents, thirty-four included librarians in nonlibrary aspects of informatics training. Fifteen institutions have librarians participating in leadership positions in their informatics programs. Compared to the earlier survey, the role of librarians has evolved. Librarians possess skills that enable them to participate in informatics programs beyond a narrow library focus. Librarians currently perform significant leadership roles in informatics education. There are opportunities for librarian interdisciplinary collaboration in informatics programs. Informatics is much more than the study of technology. The information skills that librarians bring to the table enrich and broaden the study of informatics in addition to adding value to the library profession itself.
Coggins, Clemency Chase
Formal medical publication began in the United States with The Medical Repository in 1797. Between 1741, the date of the first American magazine, and 1797 medical articles were included in general magazines. This study deals with ten representative magazines and reviews their general content. The varying content of the medical articles is analyzed into broad categories, and several important physicians, contributors to the magazines, are discussed. The Medical Repository is treated as a culmination of eighteenth century medical publication. PMID:14306031
Sorana D. BOLBOACĂ
Full Text Available Aim: A survey was conducted in undergraduate medical students enrolled in 3 or 4-year degree programs in Nursing, Midwifery, Radiology and Medical Imaging (technician, Physiotherapy and Kinetotherapy (technician and Clinical laboratory (technician in order to identify their perception of the medical informatics and statistics curriculum. Material and Method: A qualitative study was carried out in 1st year undergraduate students at the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania during the 2008-2009 academic year. A questionnaire containing 10 categories of items for assessing lectures and 19 for assessing practical activities was developed as an online tool with a database connection using Google Docs. Results: Students’ attendance to lectures proved not to be statistically related with their final mark. The mean final mark obtained by students (6.02±1.57 proved to be statistically lower compared to the expected mean (6.58±1.23; t = -2.76, DF = 54, p = 0.0078. The teacher, the problems solved during lectures, the lecture summaries as well as the course web page proved to statistically influence the learning process. The results revealed that all students were satisfied with the materials used within lectures and practical activities as well as with the objectiveness of the final evaluation. Most students classified the difficulty of the practical activities as reasonable (p < 0.05 and their pace as just about right (p< 0.05. The overall quality of the practical activities was classified as easy by 13% of respondents, pretty easy by 30%, reasonable by 29%, and difficult by 25%. Conclusions: Overall, undergraduate students were satisfied with the materials used within lectures and practical activities as well as with the teacher’s attitude and support in the learning process.
Full Text Available The 13 th World Congress on Medical and Health Informatics (Medinfo was held in 2010 between 12 and 15 September in Cape Town, South Africa. This triennial international gathering is the official conference of the International Medical Informatics Association (IMIA and brings together leading health informatics leaders, scientists, clinicians, researchers, vendors, developers and government and health care planners from around the globe. The conference attracted 905 submissions and resulted in a program that included 260 oral presentations, 349 posters presentations and 21 scientific demonstrations representing contributions from 58 countries. The Medinfo program covered all aspects of health informatics from traditional areas, such as hospital information systems, patient registries, nursing informatics, data integration, standards, interoperability issues and decision support, to innovative topics, such as translational bioinformatics, text mining, intelligent data analysis, emerging technologies, quality, social networking, workflow and organizational issues. The outgoing President of the IMIA, Professor Reinhold Haux, presented on health informatics challenges into the future, reinforcing that today and in the future, health care has to be considered as part of a continuous and coordinated life-time journey and not just as episodes of disease. Medical informatics has a key role to play in this paradigm shift. The new IMIA President, Professor Antoine Geissbuhler, was announced at the closing ceremony. The next Medinfo congress will take place in Copenhagen, Denmark, in September 2013.
Karp, Julie K; Weston, Christine M; King, Karen E
Blood transfusion is the most common procedure performed in American hospitals, and transfusions are commonly ordered by physicians without formal training in transfusion medicine. Several transfusion medicine curricula have been proposed, including those developed through the Transfusion Medicine Academic Awards (TMAA). To our knowledge, no comprehensive study has assessed how transfusion medicine is incorporated into undergraduate medical education. We conducted an online survey to determine the manner in which transfusion medicine is incorporated into American undergraduate medical education. The survey was e-mailed to administrators of medical education at all of the 129 American medical schools accredited by the Association of American Medical Colleges. Eighty-six (67%) of the 129 identified medical school administrators responded. Seventy-one (83%) of the 86 administrators reported that their undergraduate medical education curriculum provides didactic lectures in transfusion medicine, with 48% of medical schools providing 1 or 2 hours of lecture-based instruction. A minority reported small group sessions devoted to transfusion medicine topics. While a slim majority reported the availability of transfusion medicine electives, only one of 84 administrators reported that such a rotation is required. Seventy-six of 83 (92%) administrators were unfamiliar with either the 1989 or the 1995 TMAA transfusion medicine curricula. Transfusion medicine content in American undergraduate medical education is variable and the influence of the TMAA program on contemporary medical school curricula is questionable. Future efforts in this area should focus on standardizing and improving undergraduate medical education in transfusion medicine. © 2011 American Association of Blood Banks.
Vinik, E; Sirman, D; Georges, L P; Phillips, J
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!"
Lillehaug, S I; Lajoie, S P
The potential benefits of artificial intelligence in medicine (AIM) were never realized as anticipated. This paper addresses ways in which such potential can be achieved. Recent discussions of this topic have proposed a stronger integration between AIM applications and health information systems, and emphasize computer guidelines to support the new health care paradigms of evidence-based medicine and cost-effectiveness. These proposals, however, promote the initial definition of AIM applications as being AI systems that can perform or aid in diagnoses. We challenge this traditional philosophy of AIM and propose a new approach aiming at empowering health care workers to become independent self-sufficient problem solvers and decision makers. Our philosophy is based on findings from a review of empirical research that examines the relationship between the health care personnel's level of knowledge and skills, their job satisfaction, and the quality of the health care they provide. This review supports addressing the quality of health care by empowering health care workers to reach their full potential. As an aid in this empowerment process we argue for reviving a long forgotten AIM research area, namely, AI based applications for medical education and training. There is a growing body of research in artificial intelligence in education that demonstrates that the use of artificial intelligence can enhance learning in numerous domains. By examining the strengths of these educational applications and the results from previous AIM research we derive a framework for empowering medical personnel and consequently raising the quality of health care through the use of advanced AI based technology.
... Toxicology Course Registration/Survey/Conditions Committee Members Technology Media Forum Case Notes Links Toxicology Treatment Centers Choosing ... ASM) - Agenda Satellite Session I: Epidemic of Addiction Satellite Session II: Zika Toxicology for Medical Students & Residents FIT Research ... Module 6-7: Psychological Consequences of Mass Exposure and Risk Communication Module 8: Neurotoxins Module 9: Water, Food, and ...
Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P
To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and
Mezei, Lina; Murinson, Beth B
Knowledgeable and compassionate care regarding pain is a core responsibility of health professionals associated with better medical outcomes, improved quality of life, and lower healthcare costs. Education is an essential part of training healthcare providers to deliver conscientious pain care but little is known about whether medical school curricula meet educational needs. Using a novel systematic approach to assess educational content, we examined the curricula of Liaison Committee on Medical Education-accredited medical schools between August 2009 and February 2010. Our intent was to establish important benchmark values regarding pain education of future physicians during primary professional training. External validation was performed. Inclusion criteria required evidence of substantive participation in the curriculum management database of the Association of American Medical Colleges. A total of 117 U.S. and Canadian medical schools were included in the study. Approximately 80% of U.S. medical schools require 1 or more pain sessions. Among Canadian medical schools, 92% require pain sessions. Pain sessions are typically presented as part of general required courses. Median hours of instruction on pain topics for Canadian schools was twice the U.S. median. Many topics included in the International Association for the Study of Pain core curriculum received little or no coverage. There were no correlations between the types of pain education offered and school characteristics (eg, private versus public). We conclude that pain education for North American medical students is limited, variable, and often fragmentary. There is a need for innovative approaches and better integration of pain topics into medical school curricula. This study assessed the scope and scale of pain education programs in U.S. and Canadian medical schools. Significant gaps between recommended pain curricula and documented educational content were identified. In short, pain education was
Rice, D P; Wilson, D
Federal initiatives during the last decade have resulted in considerable changes in the American medical economy. Large sums of money have been infused into the system under Medicare and Medicaid, substantially improving access to care for the aged and the poor. At the same time, the improvements in knowledge and medical technology that have occurred have been largely underwritten by the tremendous increases in third-party payment mechanisms. These costly new technologies have contributed significantly to the high cost of hospital care and to the increased specialization of physician's services. The chronic inflation in medical expenditures and the explosive increases in Federal subsidization of medical care have led to questions concerning the efficacy of medical care for improving health status. There is a considerable lack of evidence for a causal relationship between what is done to the patient and the outcome of the medical care process as measured by mortality, disability, and capacity to carry on activities. Various attempts have been made to control the chronic inflation of medical expenditures, but success is uneven and elusive. Alternatives in financing medical care services currently under debate include various provisions to control costs and utilization, but attention should be directed to organizing American medical care services in general, toward the more rational use of our resources.
Ganesh Chandra Sahoo
Full Text Available Acute organophosphorous pesticide (OP poisoning kills a lot of people each year. Treatment of acute OP poisoning is of very difficult task and is a time taking event. Present day informatics methods (telemedicine, bioinformatics methods (data mining, molecular modeling, docking, cheminformatics, and nanotechnology (nanomedicine should be applied in combination or separately to combat the rise of death rate due to OP poisoning. Use of informatics method such as Java enabled camera mobiles will enable us early detection of insecticidal poisoning. Even the patients who are severely intoxicated (suicidal attempts can be diagnosed early. Telemedicine can take care for early diagnosis and early treatment. Simultaneously efforts must be taken with regard to nanotechnology to find lesser toxic compounds (use less dose of nanoparticle mediated compounds: nano-malathion as insecticides and find better efficacy of lesser dose of compounds for treatment (nano-atropine of OP poisoning. Nano-apitropine (atropine oxide may be a better choice for OP poisoning treatment as the anticholinergic agent; apitropine and hyoscyamine have exhibited higher binding affinity than atropine sulfate. Synthesis of insecticides (malathion with an antidote (atropine, apitropine in nanoscale range will prevent the lethal effect of insecticides.
Capurro, Daniel; Soto, Mauricio; Vivent, Macarena; Lopetegui, Marcelo; Herskovic, Jorge R
Biomedical Informatics is a new discipline that arose from the need to incorporate information technologies to the generation, storage, distribution and analysis of information in the domain of biomedical sciences. This discipline comprises basic biomedical informatics, and public health informatics. The development of the discipline in Chile has been modest and most projects have originated from the interest of individual people or institutions, without a systematic and coordinated national development. Considering the unique features of health care system of our country, research in the area of biomedical informatics is becoming an imperative.
Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron
The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
Otero, P; Hersh, W; Jai Ganesh, A U
The growing volume and diversity of health and biomedical data indicate that the era of Big Data has arrived for healthcare. This has many implications for informatics, not only in terms of implementing and evaluating information systems, but also for the work and training of informatics researchers and professionals. This article addresses the question: What do biomedical and health informaticians working in analytics and Big Data need to know? We hypothesize a set of skills that we hope will be discussed among academic and other informaticians. The set of skills includes: Programming - especially with data-oriented tools, such as SQL and statistical programming languages; Statistics - working knowledge to apply tools and techniques; Domain knowledge - depending on one's area of work, bioscience or health care; and Communication - being able to understand needs of people and organizations, and articulate results back to them. Biomedical and health informatics educational programs must introduce concepts of analytics, Big Data, and the underlying skills to use and apply them into their curricula. The development of new coursework should focus on those who will become experts, with training aiming to provide skills in "deep analytical talent" as well as those who need knowledge to support such individuals.
Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae
The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.
Should Degree Programs in Biomedical and Health Informatics be Dedicated or Integrated? : Reflections and Recommendations after more than 40 Years of Medical Informatics Education at TU Braunschweig, including 10 Years of B.Sc. and 15 Years of M.Sc. Integrated Degree Curricula.
Haux, Reinhold; Marschollek, Michael; Wolf, Klaus-Hendrik; Zeisberg, Ute
Education in biomedical and health informatics (BMHI) has been established in many countries throughout the world. For degree programs in BMHI we can distinguish between those that are completely stand-alone or dedicated to the discipline vs. those that are integrated within another program. After running integrated degree medical informatics programs at TU Braunschweig for 10 years at the B.Sc. and for 15 years at the M.Sc level, we (1) report about this educational approach, (2) analyze recommendations on, implementations of, and experiences with degree educational programs in BMHI worldwide, (3) summarize our lessons learned with the integrated approach at TU Braunschweig, and (4) suggest an answer to the question, whether degree programs in biomedical and health informatics should be dedicated or integrated. According to our experience at TU Braunschweig and based on our analysis of publications, there is a clear dominance of dedicated degree programs in BMHI. The specialization in medical informatics within a computer science program, as offered at TU Braunschweig, may be a good way of implementing an integrated, informatics-based approach to medical informatics, in particular if a dual degree option can be chosen. The option of curricula leading to double degrees, i.e. in this case to two separate degrees in computer science and in medical informatics might, however, be a better solution.
Roberts, Kirk; Boland, Mary Regina; Pruinelli, Lisiane; Dcruz, Jina; Berry, Andrew; Georgsson, Mattias; Hazen, Rebecca; Sarmiento, Raymond F; Backonja, Uba; Yu, Kun-Hsing; Jiang, Yun; Brennan, Patricia Flatley
The field of biomedical informatics experienced a productive 2015 in terms of research. In order to highlight the accomplishments of that research, elicit trends, and identify shortcomings at a macro level, a 19-person team conducted an extensive review of the literature in clinical and consumer informatics. The result of this process included a year-in-review presentation at the American Medical Informatics Association Annual Symposium and a written report (see supplemental data). Key findings are detailed in the report and summarized here. This article organizes the clinical and consumer health informatics research from 2015 under 3 themes: the electronic health record (EHR), the learning health system (LHS), and consumer engagement. Key findings include the following: (1) There are significant advances in establishing policies for EHR feature implementation, but increased interoperability is necessary for these to gain traction. (2) Decision support systems improve practice behaviors, but evidence of their impact on clinical outcomes is still lacking. (3) Progress in natural language processing (NLP) suggests that we are approaching but have not yet achieved truly interactive NLP systems. (4) Prediction models are becoming more robust but remain hampered by the lack of interoperable clinical data records. (5) Consumers can and will use mobile applications for improved engagement, yet EHR integration remains elusive. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S
Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.
Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike…
Richesson, Rachel L
This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are
Full Text Available Hereditary diseases and disorders constitute a public health problem. Many people in rural communities of developing countries of the world are particularly ignorant about the cause, modes of transmissions and the treatment plans for such diseases. In some cases, some people lack essential knowledge between common and rare hereditary diseases.It is therefore appropriate and essential to develop a mobile application that will act as an educative resource and a good knowledge base for common and rare hereditary diseases.The aim of this research is to develop AMAHD (Android Mobile Informatics Application for some Hereditary Diseases and Disorders.The objectives of this research are to create an android mobile application that will act as a reference point and provide useful information about various hereditary diseases to medical personnel and professionals; provide additional educational resource to biological and bioinformatics researchers in different higher institutions; and provide a pedagogical, diagnostic and complementary foundational learning tool for African research students in biosciences, bioinformatics, and all other categories of students that currently engage in multidisciplinary research in the aspect of hereditary diseases.Essential data was sourced from relevant literature. We developed AMAHD through an integration of programming languages in Java and XML (Extended Markup Language. SQLite was used to implement the database. We developed a Logical Disjunction Rule-based Algorithm (LDRA for the AMAHDâs diagnosis module.A comparative analysis between existing commercial hereditary mobile applications and AMAHD was conducted and the results presented. A world-wide online survey (spanning Africa, Asia, Europe, America and Australia was conducted to sample the opinion of individuals across the globe on the classification of hereditary diseases as either rare or common, within their respective regions. In addition, an evaluation of
entire 2011 Air Force Medical Research Symposium and includes abstracts of all the oral presentations and posters. First presented is the symposium’s...ems •Anger Issues •Takes Tranquilizers o r Anti-Depressants •Sleep Problems -Dependent with Medical Issues .. f inancial Difficulties ·P~ems
Pulley, Jill M; Harris, Paul A; Yarbrough, Tonya; Swafford, Jonathan; Edwards, Terri; Bernard, Gordon R
The regulatory review and approval process is a significant part of the workflow associated with initiating clinical and translational research projects. Ambiguity concerning submission requirements and expected times associated with the review process can create additional work for research teams and ultimately delay important scientific projects. In an effort to provide assistance to investigators, we have developed an online interactive interface which elicits basic study characteristics for a single project and subsequently produces a list of required administrative applications needed for approval along with clear instructions concerning expectations from the research team. This system, the Vanderbilt Customized Action Plan (V-CAP), was launched in October 2006 and has been well received by researchers. In this article, the authors present (1) the V-CAP project design, (2) a reference workflow associated with Vanderbilt policies and regulations, (3) the V-CAP metrics of use by Vanderbilt research teams, and (4) a list of recommendations for other academic centers considering a similar systems-based approach for helping researchers efficiently navigate processes related to regulatory approval. The informatics-systems-based approach of the V-CAP is scalable to other academic medical centers and may serve as a useful model to help researchers navigate the complexity of the regulatory approvals process.
eLearning in der Medizinischen Informatik – ein Ansatz, Medizinstudenten das Fach Medizininformatik näherzubringen? Ergebnisse einer Onlineevaluation / eLearning in Medical Informatics – an approach to introduce Medical Informatics to medical students? Results of an online survey
Full Text Available Aim: This paper’s aim is to evaluate an e-learning-platform, which is meant to introduce medical students to medical informatics’ contents. Methods: The e-learning-platform MindMailer regularly sends e-mails, containing links to the lecture-related exercise forms to the students. It has been established as part of medical informatics training and was evaluated by means of an online survey. Results: The questionnaire has been accessed by 91 (60% of 151 students and finished by 81 (54%. The leading motivations to use the MindMailer were the granted four extra points at the exam, and the training effect therefor. The students declared that they have been sensitized to medical informatics’ issues and that it has been an effective training-tool for the exam. Conclusion: The students gave a good rating to the MindMailer. We succeeded in introducing the medical students to medical informatics. However, the tool should not be established at all subjects in medical education in order not to jeopardize the beneficial effect of continuous learning by accepting an ‘alert-overflow’ with a consecutive alert-fatigue.
McGinnis, Patrick J.
Health Informatics (HI) is a dynamic discipline based on the medical sciences, information sciences, and cognitive sciences. Its domain can broadly be defined as medical information management. The purpose of this paper is to provide an overview of this domain, discuss the current "state of the art," and indicate the likely growth areas for health informatics. The sources of information used in this paper are selected publications from the literature of Health Informatics, HI 5300: Introduction to Health Informatics, which is a course from the Department of Health Informatics at the University of Texas Houston Health Sciences Center, and the author's personal experience in practicing telemedicine and implementing an electronic medical record at the NASA-Johnson Space Center. The conclusion is that the direction of Health Informatics is in the direction of data management, transfer, and representation via electronic medical records and the Internet.
Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.
Kannry, Joseph; Sengstack, Patricia; Thyvalikakath, Thankam Paul; Poikonen, John; Middleton, Blackford; Payne, Thomas; Lehmann, Christoph U
The emerging operational role of the "Chief Clinical Informatics Officer" (CCIO) remains heterogeneous with individuals deriving from a variety of clinical settings and backgrounds. The CCIO is defined in title, responsibility, and scope of practice by local organizations. The term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). The American Medical Informatics Association (AMIA) identified a need to better delineate the knowledge, education, skillsets, and operational scope of the CCIO in an attempt to address the challenges surrounding the professional development and the hiring processes of CCIOs. An AMIA task force developed knowledge, education, and operational skillset recommendations for CCIOs focusing on the common core aspect and describing individual differences based on Clinical Informatics focus. The task force concluded that while the role of the CCIO currently is diverse, a growing body of Clinical Informatics and increasing certification efforts are resulting in increased homogeneity. The task force advised that 1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges. A better defined and specified education and skillset for all CCIO positions will motivate the CCIO workforce and empower them to perform the job of a 21st century CCIO. Formally educated and trained CCIOs will provide a competitive advantage to their respective enterprise by fully utilizing the power of Informatics science.
Massoudi, B L; Chester, K G
Objectives: To survey advances in public and population health and epidemiology informatics over the past 18 months. Methods: We conducted a review of English-language research works conducted in the domain of public and population health informatics and published in MEDLINE or Web of Science between January 2015 and June 2016 where information technology or informatics was a primary subject or main component of the study methodology. Selected articles were presented using a thematic analysis based on the 2011 American Medical Informatics Association (AMIA) Public Health Informatics Agenda tracks as a typology. Results: Results are given within the context developed by Dixon et al., (2015) and key themes from the 2011 AMIA Public Health Informatics Agenda. Advances are presented within a socio-technical infrastructure undergirded by a trained, competent public health workforce, systems development to meet the business needs of the practice field, and research that evaluates whether those needs are adequately met. The ability to support and grow the infrastructure depends on financial sustainability. Conclusions: The fields of public health and population health informatics continue to grow, with the most notable developments focused on surveillance, workforce development, and linking to or providing clinical services, which encompassed population health informatics advances. Very few advances addressed the need to improve communication, coordination, and consistency with the field of informatics itself, as identified in the AMIA agenda. This will likely result in the persistence of the silos of public health information systems that currently exist. Future research activities need to aim toward a holistic approach of informatics across the enterprise. Georg Thieme Verlag KG Stuttgart.
Singer, Jennifer S; Cheng, Eric M; Baldwin, Kevin; Pfeffer, Michael A
Few opportunities exist for physician trainees to gain exposure to, and training in, the field of clinical informatics, an Accreditation Council for Graduate Medical Education-accredited, recently board-certified specialty. Currently, 21 approved programs exist nationwide for the formal training of fellows interested in pursuing careers in this discipline. Residents and fellows training in medical and surgical fields, however, have few avenues available to gain experience in clinical informatics. An early introduction to clinical informatics brings an opportunity to generate interest for future career trajectories. At University of California Los Angeles (UCLA) Health, we have developed a novel, successful, and sustainable program, the Resident Informaticist Program, with the goals of exposing physician trainees to the field of clinical informatics and its academic nature and providing opportunities to expand the clinical informatics workforce. Herein, we provide an overview of the development, implementation, and current state of the UCLA Health Resident Informaticist Program, with a blueprint for development of similar programs. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Welche Kompetenzen in Medizinischer Informatik benötigen Ärztinnen und Ärzte? Vorstellung des Lernzielkatalogs Medizinische Informatik für Studierende der Humanmedizin [What competencies in Medical Informatics are required for physicians? Presentation of a catalog regarding learning objectives for medical students
Full Text Available [english] Competencies in Medical Informatics are important for all physicians, for instance regarding electronic health records or digital imaging systems. Physicians spend more than 25% of their working time with information management. The International Medical Informatics Association (IMIA recommends 40 hours of curricular training dedicated to Medical Informatics for physicians. In this context, a national project group of the German Association for Medical Informatics, Biometry and Epidemiology developed a catalog of learning objectives for medical students regarding Medical Informatics. Seven areas of competencies were identified: Medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing. Overall, 42 learning objectives were identified and consented. For each objective a rationale why a physician needs this competence was provided. In addition, each objective was categorized according to competence context (A=covered by Medical Informatics, B=core subject of Medical Informatics, C=optional subject of Medical Informatics, competence level (1=referenced knowledge, 2=applied knowledge, 3=routine knowledge and CanMEDS competence role (1=Medical Expert, 2=Communicator, 3=Collaborator, 4=Manager, 5=Health Advocate, 6=Professional, 7=Scholar. [german] Von der GMDS-Projektgruppe „MI-Lehre in der Medizin“ wurde unter Beteiligung aller Standorte, an denen derzeit Lehrveranstaltungen in diesem Fach durchgeführt werden, in einem mehrstufigen Verfahren ein national konsentierter Lernzielkatalog Medizinische Informatik (MI für Studierende der Humanmedizin erarbeitet, der sich am Konzept des Nationalen Kompetenzbasierten Lernzielkatalogs Medizin (NKLM orientiert.
Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.
Martha Ingrid Preddie
one correct answer was due to the answers from 5 (10.9% questions changing from correct to incorrect, while the answers to 6 questions (13.0% changed from incorrect to correct. The ability to provide correct answers differed among the various resources. Google and Cochrane provided the correct answers about 50% of the time while PubMed, Ovid MEDLINE, UpToDate, Ovid Evidence Based Medicine Reviews and InfoPOEMs were more likely to be associated with incorrect answers. Physicians also seemed unable to determine when they needed to search for informationi n order to make an accurate decision.Conclusion – Clinician‐selected electronic information resources did not guarantee accuracy in the answers provided to simulated clinical questions. At times the use of these resources caused physicians to change self‐determined correct answers to incorrect ones. The authors state that this was possibly due to factors such as poor choice of resources, ineffective search strategies, time constraints and automation bias. Library and information practitioners have an important role to play in identifying and advocating for appropriate information resources to be integrated into the electronic medical record systems provided by healthcare institutions to ensure evidence based health care delivery.
Monteleoni, Claire; Schmidt, Gavin A.; Alexander, Francis J.; Niculescu-Mizil, Alexandru; Steinhaeuser, Karsten; Tippett, Michael; Banerjee, Arindam; Blumenthal, M. Benno; Ganguly, Auroop R.; Smerdon, Jason E.;
The impacts of present and potential future climate change will be one of the most important scientific and societal challenges in the 21st century. Given observed changes in temperature, sea ice, and sea level, improving our understanding of the climate system is an international priority. This system is characterized by complex phenomena that are imperfectly observed and even more imperfectly simulated. But with an ever-growing supply of climate data from satellites and environmental sensors, the magnitude of data and climate model output is beginning to overwhelm the relatively simple tools currently used to analyze them. A computational approach will therefore be indispensable for these analysis challenges. This chapter introduces the fledgling research discipline climate informatics: collaborations between climate scientists and machine learning researchers in order to bridge this gap between data and understanding. We hope that the study of climate informatics will accelerate discovery in answering pressing questions in climate science.
Hinton, Elizabeth G; Oelschlegel, Sandra; Vaughn, Cynthia J; Lindsay, J Michael; Hurst, Sachiko M; Earl, Martha
This study utilizes an informatics tool to analyze a robust literature search service in an academic medical center library. Structured interviews with librarians were conducted focusing on the benefits of such a tool, expectations for performance, and visual layout preferences. The resulting application utilizes Microsoft SQL Server and .Net Framework 3.5 technologies, allowing for the use of a web interface. Customer tables and MeSH terms are included. The National Library of Medicine MeSH database and entry terms for each heading are incorporated, resulting in functionality similar to searching the MeSH database through PubMed. Data reports will facilitate analysis of the search service.
James A. Rodger
Full Text Available Entering medical encounter data by hand is time-consuming. In addition, data are often not entered into the database in a timely enough fashion to enable their use for subsequent mission planning. The Patient Informatics Processing Software semi-automates the data collection process onboard ships. Then data within these images are captured and used to populate a database, after which multiple ship databases are used for reporting and analysis. In this paper, we used the Patient Informatics Processing Software Hybrid Hadoop Hive to orchestrate database processing via various ships, by marshaling the distributed servers, running the various tasks in parallel, managing all of the communications and data transfers between the various parts of the system, and providing for redundancy and fault tolerance. Then we employed the Apache Hive as a data warehouse infrastructure built on top of Hadoop for data summarization, query, and analysis to identify traumatic brain injury (TBI as well as other injury cases. Finally, a proposed Misdiagnosis Minimization Approach method was used for data analysis. We collected data on three ship variables (Byrd, Boxer, Kearsage and injuries to four body regions (head, torso, extremities, and abrasions to determine how the set of collected variables relates to the body injuries. Two dimensions or canonical variables (survival vs. mortality were necessary to understand the association between the two sets of variables. Our method improved data classification and showed that survival, mortality, and morbidity rates can be derived from the superset of Medical Operations data and used for future decision-making and planning. We suggest that an awareness of procedural errors as well as methods to reduce misclassification should be incorporated into all TBI clinical trials. Keywords: Decision support, Traumatic brain injuries, Apache hive, Symbolic data analysis, Informatics, Data mining
Hsu, William; El-Saden, Suzie; Taira, Ricky K
Imaging is one of the most important sources of clinically observable evidence that provides broad coverage, can provide insight on low-level scale properties, is noninvasive, has few side effects, and can be performed frequently. Thus, imaging data provides a viable observable that can facilitate the instantiation of a theoretical understanding of a disease for a particular patient context by connecting imaging findings to other biologic parameters in the model (e.g., genetic, molecular, symptoms, and patient survival). These connections can help inform their possible states and/or provide further coherent evidence. The field of radiomics is particularly dedicated to this task and seeks to extract quantifiable measures wherever possible. Example properties of investigation include genotype characterization, histopathology parameters, metabolite concentrations, vascular proliferation, necrosis, cellularity, and oxygenation. Important issues within the field include: signal calibration, spatial calibration, preprocessing methods (e.g., noise suppression, motion correction, and field bias correction), segmentation of target anatomic/pathologic entities, extraction of computed features, and inferencing methods connecting imaging features to biological states.
Martin-Sanchez, Fernando; Rowlands, David; Schaper, Louise; Hansen, David
The Certified Health Informatician Australasia (CHIA) program consists of an online exam, which aims to test whether a candidate has the knowledge and skills that are identified in the competencies framework to perform as a health informatics professional. The CHIA Health Informatics Competencies Framework provides the context in which the questions for the exam have been developed. The core competencies for health informatics that are tested in the exam have been developed with reference to similar programs by the American Medical Informatics Association, the International Medical Informatics Association and COACH, Canada's Health Informatics Association, and builds on the previous work done by the Australian Health Informatics Education Council. This paper shows how the development of this competency framework is helping to raise the profile of health informaticians in Australasia, contributing to a wider recognition of the profession, and defining more clearly the body of knowledge underpinning this discipline. This framework can also be used as a set of guidelines for recruiting purposes, definitions of career pathways, or the design of educational and training activities. We discuss here the current status of the program, its resultsandprospectsfor the future.
Smith, Ronald D.; Williams, Mitsuko
This study used the peer-reviewed biomedical literature to define the veterinary informatics knowledgebase and associated subspecialties, and assesses the level of activity in the field over the thirty-year period from 1966 through 1995. Grateful Med was used to search the MEDLINE bibliographic database for articles that shared one or more Medical Subject Headings (MeSH) keywords from the veterinary and medical informatics subject headings. Each of ninety-five MeSH medical informatics terms was assigned to one of twelve veterinary informatics subspecialties. The number of articles retrieved by each MeSH keyword and subspecialty was calculated. A total of 611 articles were retrieved, representing the contributions of 1,338 authors published in 153 journals. The field experienced slow growth over the twenty-year period from 1966 through 1985. In the following decade, the cumulative number of veterinary informatics articles almost tripled and the percentage of veterinary-related articles that included an informatics component increased almost two-and-one-half fold. Despite this recent growth, the number of veterinary-related articles with an informatics component has never exceeded 1% of either the veterinary or medical informatics literature over the past thirty years, and representation of veterinary subspecialties in the literature varied widely. PMID:10658963
Bronzino, Joseph D
Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering.Biomedical Signals, Imaging, and Informatics, the third volume of the handbook, presents material from respected scientists with diverse backgrounds in biosignal processing, medical imaging, infrared imaging, and medical informatics.More than three dozen specific topics are examined, including biomedical s
Scott, Philip J.; Cornet, Ronald; McCowan, Colin; Peek, Niels; Fraccaro, Paolo; Geifman, Nophar; Gude, Wouter T.; Hulme, William; Martin, Glen P.; Williams, Richard
The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE) conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and
The rate commitment to ISO 214 standard among the persian abstracts of approved research projects at school of health management and medical informatics, Isfahan University of Medical Sciences, Isfahan, Iran.
Papi, Ahmad; Khalaji, Davoud; Rizi, Hasan Ashrafi; Shabani, Ahmad; Hassanzadeh, Akbar
Commitment to abstracting standards has a very significant role in information retrieval. The present research aimed to evaluate the rate of Commitment to ISO 214 Standard among the Persian abstracts of approved research projects at School of Health Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran. This descriptive study used a researcher-made checklist to collect data, which was then analyzed through content analysis. The studied population consisted of 227 approved research projects in the School of Health Management and Medical Informatics, Isfahan University of Medical Sciences during 2001-2010. The validity of the checklist was measured by face and content validity. Data was collected through direct observations. Statistical analyzes including descriptive (frequency distribution and percent) and inferential statistics (Chi-square test) were performed in SPSS-16. The highest and lowest commitment rates to ISO 214 standard were in using third person pronouns (100%) and using active verbs (34/4%), respectively. In addition, the highest commitment rates to ISO 214 standard (100%) related to mentioning third person pronouns, starting the abstract with a sentence to explain the subject of the research, abstract placement, and including keyword in 2009. On the other hand, during 2001-2003, the lowest commitment rate was observed in reporting research findings (16/7%). Moreover, various educational groups differed significantly only in commitment to study goals, providing research findings, and abstaining from using abbreviations, signs, and acronyms. Furthermore, educational level of the corresponding author was significantly related with extracting the keywords from the text. Other factors of ISO 214 standard did not have significant relations with the educational level of the corresponding author. In general, a desirable rate of commitment to ISO 214 standard was observed among the Persian abstracts of approved research
... a wheelchair. Franklin Delano Roosevelt (1882-1945) , thirty-second President of the United States, was born before the advent of modern medical science. Elected president in 1932, he led the country through the Great Depression and World War II. His most famous saying was, "The only ...
Fetterolf, Donald; Brodie, Bridget
The American College of Medical Quality is a national organization of health care professionals who are interested in the advancement of medical quality as a field. Composed primarily of doctorate-level individuals in medicine, dentistry, and podiatry, it also includes affiliate members in preprofessional training as well as nursing. Origins of the organization date to 1973, when it was first called the American College of Utilization Review Physicians. It is formally recognized by the American Medical Association and holds a seat in its House of Delegates. The College views the advancement of medical quality as a field of study within itself and offers multiple venues for self-education, testing, and professional networking for its members. Recently, rising national awareness of quality in health care as a field of endeavor has elevated enrollment levels and increased interest in the organization.
Dale, Sannisha K; Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J
African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.g. viral suppression) than do their White counterparts. In a 6-month longitudinal study, we investigated whether medical mistrust among African-American males with HIV (214 enrolled, 140 with longitudinal data) predicted lower electronically monitored antiretroviral medication adherence. General medical mistrust (e.g. suspicion towards providers), but not racism-related mistrust (e.g. belief that providers treat African-Americans poorly due to race), predicted lower continuous medication adherence over time (b=−.08, se=.04, p=.03). Medical mistrust may contribute to poor health outcomes. Intervention efforts that address mistrust may improve adherence among African-Americans with HIV. PMID:25293970
Guenther, Johanna T
This study was part of the Medical Library Association's Nursing and Allied Health Resources Section's project to map the nursing literature. It identified core journals in nursing informatics and the journals referenced in them and analyzed coverage of those journals in selected indexes. Five core journals were chosen and analyzed for 1996, 1997, and 1998. The references in the core journal articles were examined for type and number of formats cited during the selected time period. Bradford's Law of Scattering divided the journals into frequency zones. The time interval, 1990 to 1998, produced 71% of the references. Internet references could not be tracked by date before 1990. Twelve journals were the most productive, 119 journals were somewhat productive, and 897 journals were the least productive. Journal of the American Medical Informatics Association was the most prolific core journal. The 1998 journal references were compared in CINAHL, PubMed/MEDLINE, Science Citation Index, and OCLC Article First. PubMed/MEDLINE had the highest indexing score.
Samuel, Hamman W; Zaïane, Osmar R
We present a searchable repository of codes of ethics and standards in health informatics. It is built using state-of-the-art search algorithms and technologies. The repository will be potentially beneficial for public health practitioners, researchers, and software developers in finding and comparing ethics topics of interest. Public health clinics, clinicians, and researchers can use the repository platform as a one-stop reference for various ethics codes and standards. In addition, the repository interface is built for easy navigation, fast search, and side-by-side comparative reading of documents. Our selection criteria for codes and standards are two-fold; firstly, to maintain intellectual property rights, we index only codes and standards freely available on the internet. Secondly, major international, regional, and national health informatics bodies across the globe are surveyed with the aim of understanding the landscape in this domain. We also look at prevalent technical standards in health informatics from major bodies such as the International Standards Organization (ISO) and the U. S. Food and Drug Administration (FDA). Our repository contains codes of ethics from the International Medical Informatics Association (IMIA), the iHealth Coalition (iHC), the American Health Information Management Association (AHIMA), the Australasian College of Health Informatics (ACHI), the British Computer Society (BCS), and the UK Council for Health Informatics Professions (UKCHIP), with room for adding more in the future. Our major contribution is enhancing the findability of codes and standards related to health informatics ethics by compilation and unified access through the health informatics ethics repository.
Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian
The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.
The American Society of Health- System Pharmacists (ASHP) believes that specially trained pharmacy technicians can assume important supportive roles in pharmacy informatics. These roles include automation and technology systems management, management of projects, training and education, policy and governance, customer service, charge integrity, and reporting. Such roles require pharmacy technicians to gain expertise in information technology (IT) systems, including knowledge of interfaces, computer management techniques, problem resolution, and database maintenance. This knowledge could be acquired through specialized training or experience in a health science or allied scientific field (e.g., health informatics). With appropriate safeguards and supervision, pharmacy technician informaticists (PTIs) will manage IT processes in health-system pharmacy services, ensuring a safe and efficient medication-use process.
Alamantariotou, Kleopatra; Zisi, Dimitra
Consumer health informatics is a part of medical informatics that has as first priority to analyse the interaction between Information Technology (IT) and health consumers. Consumer health informatics applications are designed to interact directly with the customer with or without the essential presence of healthcare. This field of virtual informatics tended to be developed by people other than clinical professions. The purpose of this paper is to provide a brief overview of best practices and methods for customers' health information and to describe the best interactive visual learning tools for health education. Consumer health informatics is an interdisciplinary field much as other informatics fields. Some disciplines that may find consumer health informatics valuable include public health, nursing, health education and communication sciences. It is important that organisations such as medical universities and governmental agencies to provide trustworthy high-quality health information on internet and work harder and create practical health education tools.
Kamin, Carol; Souza, Kevin H; Heestand, Diane; Moses, Anna; O'Sullivan, Patricia
To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.
Klann, Jeffrey G; McCoy, Allison B; Wright, Adam; Wattanasin, Nich; Sittig, Dean F; Murphy, Shawn N
The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service "cells" that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a "carousel" of SMART apps. We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of medications and presents a line-graph display of
McCoy, Allison B; Wright, Adam; Wattanasin, Nich; Sittig, Dean F; Murphy, Shawn N
Background The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Objective Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. Methods First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service “cells” that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a “carousel” of SMART apps. Results We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of
Chen, E S; Sarkar, I N
To identify the breadth of informatics sub-discipline terms used in the literature for enabling subsequent organization and searching by sub-discipline. Titles in five literature sources were analyzed to extract terms for informatics sub-disciplines: 1) United States (U.S.) Library of Congress Online Catalog, 2) English Wikipedia, 3) U.S. National Library of Medicine (NLM) Catalog, 4) PubMed, and 5) PubMed Central. The extracted terms were combined and standardized with those in four vocabulary sources to create an integrated list: 1) Library of Congress Subject Headings (LCSH), 2) Medical Subject Headings (MeSH), 3) U.S. National Cancer Institute Thesaurus (NCIt), and 4) EMBRACE Data and Methods (EDAM). Searches for terms in titles from each literature source were conducted to obtain frequency counts and start years for characterizing established and potentially emerging sub-disciplines. Analysis of 6,949 titles from literature sources and 67 terms from vocabulary sources resulted in an integrated list of 382 terms for informatics sub-disciplines mapped to 292 preferred terms. In the last five decades, "bioinformatics", "medical informatics", "health informatics", "nursing informatics", and "biomedical informatics" were associated with the most literature. In the current decade, potentially emerging sub-disciplines include "disability informatics", "neonatal informatics", and "nanoinformatics" based on literature from the last five years. As the field of informatics continues to expand and advance, keeping up-to-date with historical and current trends will become increasingly challenging. The ability to track the accomplishments and evolution of a particular sub-discipline in the literature could be valuable for supporting informatics research, education, and training.
Dixon, Brian E; Newlon, Christine M
Informatics is a popular topic in literature, in media, and in education. However, nursing professionals and even nursing faculty may not have a clear understanding of informatics. The authors conducted a small simulation study to examine how nursing students enrolled in a doctor of philosophy program-future nursing educators-perceived informatics and its core elements. Using an online collaboration tool, the students were asked to create a plan for integrating informatics into a simulated undergraduate nursing program. The results of the study provide lessons for nursing professionals and educators. Students identified only a handful of competencies believed important by informatics initiatives led by the American Nurses Association and the Technology Informatics Guiding Education Reform. Although most students believed an undergraduate curriculum should teach computer skills, only a few participants identified information literacy skills, such as privacy and security of health information, as important for beginning nurses. Although limited, findings articulate the need for a universally accepted definition of informatics and a shared understanding of an informatics core curriculum.
Cantor, Michael N
Translational informatics (TI) is extremely important for the pharmaceutical industry, especially as the bar for regulatory approval of new medications is set higher and higher. This paper will explore three specific areas in the drug development lifecycle, from tools developed by precompetitive consortia to standardized clinical data collection to the effective delivery of medications using clinical decision support, in which TI has a major role to play. Advancing TI will require investment in new tools and algorithms, as well as ensuring that translational issues are addressed early in the design process of informatics projects, and also given higher weight in funding or publication decisions. Ultimately, the source of translational tools and differences between academia and industry are secondary, as long as they move towards the shared goal of improving health.
Jaspers, M. W.; Mantas, J.; Borycki, E.; Hasman, A.
Objectives: The educational activities initiated by the International Medical Informatics Association (IMIA) have had global impacts and influenced national societies and local academic programs in the field of Biomedical and Health Informatics (BMHI). After the successful publication and
In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self-congratulation.
McNutt, L A; van Ryn, M; Clark, C; Fraiser, I
To examine the relationship between intimate partner violence (IPV) victimization and patient satisfaction with medical encounters among an African-American population. Cross-sectional, self-administered, anonymous survey. Community-based, primary care center. Consecutive African-American women recruited from an urban health center. A total of 102 women provided sufficient information to reveal whether they were currently experiencing IPV and to allow us to assess their experiences in their most recent primary care encounter. Patients' perceptions of their most recent encounter using questions adopted from the Medical Interview Satisfaction Scale and Consultation Satisfaction Questionnaire. We used the Conflicts Tactics Scale, supplemented with questions measuring sexual violence and emotional abuse, to assess IPV "in the past year." Women who reported current IPV rated several aspects of the encounter more negatively than did women who did not report current abuse. The IPV victims were less likely to report that they felt respected and accepted during the encounter, and they provided lower ratings of the quality of communication with their providers. It is unclear why victims of partner violence experience medical encounters as less satisfactory. Researchers need to expand studies of medical encounters as experienced by abused women to determine whether IPV status adversely affects general medical care.
Shkirkova, Kristina; Akam, Eftitan Y; Huang, Josephine; Sheth, Sunil A; Nour, May; Liang, Conrad W; McManus, Michael; Trinh, Van; Duckwiler, Gary; Tarpley, Jason; Vinuela, Fernando; Saver, Jeffrey L
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center. Results From May 2014 to October 2014, the Synapse ERm application was used by 33 stroke team members in 84 Code Stroke alerts. Patient age was 69.6 (±17.1), with 41.5% female. Final diagnosis was: ischemic stroke 64.6%, transient ischemic attack 7.3%, intracerebral hemorrhage 6.1%, and cerebrovascular-mimic 22.0%. Each patient Synapse ERm record was viewed by a median of 10 (interquartile range 6-18) times by a median of 3 (interquartile range 2-4) team members. The most used feature was computerized tomography, magnetic resonance, and catheter angiography image display. In-app tweet team, communications were sent by median 1 (interquartile range 0-1, range 0-13) users per case and viewed by median 1 (interquartile range 0-3, range 0-44) team members. Use of the system was associated with rapid treatment times, faster than national guidelines, including median door-to-needle 51.0 min (interquartile range 40.5-69.5) and median door-to-groin 94.5 min (interquartile range 85.5-121.3). In user surveys, the mobile information platform was judged easy to employ in 91% (95% confidence interval 65%-99%) of uses and of added help in stroke management in 50% (95% confidence interval 22%-78%). Conclusion The Synapse ERm mobile platform for stroke team distribution and integration of clinical and imaging data was feasible to implement, showed high ease of use, and moderate perceived added utility in therapeutic management.
Anholt, R Michele; Berezowski, John; Ribble, Carl S; Russell, Margaret L; Stephen, Craig
Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.
R Michele Anholt
Full Text Available Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6% of the target cases underwent diagnostic testing of which 36/88 (40.9% had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4% and specificity (85%, 95% confidence interval, 80.2%-89.1%. Overall, 7400/15,928 (46.5% of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.
Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C
We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical
Pulley, Jill M.; Harris, Paul A.; Yarbrough, Tonya; Swafford, Jonathan; Edwards, Terri; Bernard, Gordon R.
The regulatory review and approval process is a significant part of the workflow associated with initiating clinical and translational research projects. Ambiguity concerning submission requirements and expected times associated with the review process can create additional work for research teams and ultimately delay important scientific projects. In an effort to provide assistance to investigators, we have developed an online interactive interface which elicits basic study characteristics for a single project and subsequently produces a list of required administrative applications needed for approval along with clear instructions concerning expectations from the research team. This system, the Vanderbilt Customized Action Plan (V-CAP), was launched in October, 2006 and been used extensively. The informatics systems-based approach is scalable to other academic medical centers and the authors report details concerning: (1) V-CAP project design; (2) a reference workflow associated with Vanderbilt policies and regulations; (3) V-CAP metrics of use by Vanderbilt research teams; and (4) a list of recommendations for other academic centers considering a similar systems-based approach for helping researchers efficiently navigate processes related to regulatory approval. PMID:20042844
Philip J. Scott; Ronald Cornet; Colin McCowan; Niels Peek; Paolo Fraccaro; Nophar Geifman; Wouter T. Gude; William Hulme; Glen P. Martin; Richard Williams
Introduction: The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE) conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and 149 poster abstracts from the congress. Discussion: The twin programmes of “Big Data” and “Digital Health” are not always joined up by coherent policy and investment priorities. Sub...
Burke, R V; Ryutov, T; Neches, R; Upperman, J S
1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. A literature search was conducted using MEDLINE, CINHL and the Cochrane Library using the key words "children" AND "disaster preparedness and disaster" AND "informatics". A total of 314 papers were initially produced by the search and eight that met the selection criteria were included in the review. Four themes emerged: tools for disaster preparedness, education, reunification and planning and response. The literature pertaining to informatics and pediatric disaster preparedness is sparse and many gaps still persist. Current disaster preparedness tools focus on the general population and do not specifically address children. The most progress has been achieved in family reunification; however, the recommendations delineated are yet to be completed.
Augestad, K M; Berntsen, G; Lassen, K; Bellika, J G; Wootton, R; Lindsetmo, R O
The Consolidated Standards for Reporting Trials (CONSORT) were published to standardize reporting and improve the quality of clinical trials. The objective of this study is to assess CONSORT adherence in randomized clinical trials (RCT) of disease specific clinical decision support (CDS). A systematic search was conducted of the Medline, EMBASE, and Cochrane databases. RCTs on CDS were assessed against CONSORT guidelines and the Jadad score. 32 of 3784 papers identified in the primary search were included in the final review. 181 702 patients and 7315 physicians participated in the selected trials. Most trials were performed in primary care (22), including 897 general practitioner offices. RCTs assessing CDS for asthma (4), diabetes (4), and hyperlipidemia (3) were the most common. Thirteen CDS systems (40%) were implemented in electronic medical records, and 14 (43%) provided automatic alerts. CONSORT and Jadad scores were generally low; the mean CONSORT score was 30.75 (95% CI 27.0 to 34.5), median score 32, range 21-38. Fourteen trials (43%) did not clearly define the study objective, and 11 studies (34%) did not include a sample size calculation. Outcome measures were adequately identified and defined in 23 (71%) trials; adverse events or side effects were not reported in 20 trials (62%). Thirteen trials (40%) were of superior quality according to the Jadad score (≥3 points). Six trials (18%) reported on long-term implementation of CDS. The overall quality of reporting RCTs was low. There is a need to develop standards for reporting RCTs in medical informatics.
Jun, Jungmi; Oh, Kyeung Mi
This study examines Korean American community newspapers' representation of risks and benefits involved with medical tourism offered in Korea. Using framing theory, this research attempts to explain Korean Americans' highly positive perceptions and high willingness to use health and medical services in Korea through medical tourism rather than using such services in the United States. The result of content analyses indicated that Korean American community newspapers are rarely engaged in risk communication and lack sufficient information about potential risks of medical tourism while emphasizing diverse benefits. Korean ethnic media, as the primary source of health communication for Korean Americans, should provide more reliable health and medical information for the population's appropriate health management.
Hasman, A; Haux, R
Modeling is a significant part of research, education and practice in biomedical and health informatics. Our objective was to explore which types of models of processes are used in current biomedical/health informatics research, as reflected in publications of scientific journals in this field. Also, the implications for medical informatics curricula were investigated. Retrospective, prolective observational study on recent publications of the two official journals of the International Medical Informatics Association (IMIA), the International Journal of Medical Informatics (IJMI) and Methods of Information in Medicine (MIM). All publications of the years 2004 and 2005 from these journals were indexed according to a given list of model types. Random samples out of these publications were analysed in more depth. Three hundred and eighty-four publications have been analysed, 190 of IJMI and 194 of MIM. For publications in special issues (121 in IJMI) and special topics (132 in MIM) we found differences between theme-centered and conference-centered special issues/special topics (SIT) publications. In particular, we could observe a high variation between modeling in publications of theme-centered SITs. It became obvious that often sound formal knowledge as well as a strong engineering background is needed for carrying out this type of research. Usually, this knowledge and the related skills can be best provided in consecutive B.Sc. and M.Sc. programs in medical informatics (respectively, health informatics, biomedical informatics). If the focus should be primarily on health information systems and evaluation this can be offered in a M.Sc. program in medical informatics. In analysing the 384 publications it became obvious that modeling continues to be a major task in research, education and practice in biomedical and health informatics. Knowledge and skills on a broad range of model types are needed in biomedical/health informatics.
To summarize current excellent research in the field of education and consumer health informatics. Synopsis of the articles on education and consumer health informatics selected for the IMIA Yearbook of Medical Informatics 2007. The consumer health informatics papers selected reflect the growing importance of communication and information retrieval systems in health care both for patients and professionals. Sound exemplary studies point out both the benefit for patients as well as the economic advantages of such systems. On the education sector, an intelligent tutoring system for medical students based on natural language dialogue serves as an example for the advancement and refinement of methods. The selected articles demonstrate the potential of advanced communication and information systems in health care. The physician-patient relationship though must not be affected by the introduction of these systems in order to ensure acceptance by both patients and physicians. Therefore these tools should be used in addition to current processes, and not as a replacement.
Otero, P; Hersh, W
Web 3.0 is transforming the World Wide Web by allowing knowledge and reasoning to be gleaned from its content. Describe a new scenario in education and training known as "Education 3.0" that can help in the promotion of learning in health informatics in a collaborative way. Review of the current standards available for curricula and learning activities in in Biomedical and Health Informatics (BMHI) for a Web 3.0 scenario. A new scenario known as "Education 3.0" can provide open educational resources created and reused throughout different institutions and improved by means of an international collaborative knowledge powered by the use of E-learning. Currently there are standards that could be used in identifying and deliver content in education in BMHI in the semantic web era such as Resource Description Format (RDF), Web Ontology Language (OWL) and Sharable Content Object Reference Model (SCORM). In addition, there are other standards to support healthcare education and training. There are few experiences in the use of standards in e-learning in BMHI published in the literature. Web 3.0 can propose new approaches to building the BMHI workforce so there is a need to build tools as knowledge infrastructure to leverage it. The usefulness of standards in the content and competencies of training programs in BMHI needs more experience and research so as to promote the interoperability and sharing of resources in this growing discipline.
Fahy, Brenda G.; Balke, C. William; Umberger, Gloria H.; Talbert, Jeffery; Canales, Denise Niles; Steltenkamp, Carol L.; Conigliaro, Joseph
Accelerating the translation of new scientific discoveries to improve human health and disease management is the overall goal of a series of initiatives integrated in the National Institutes of Health (NIH) “Roadmap for Medical Research.” The Clinical and Translational Research Award (CTSA) program is, arguably, the most visible component of the NIH Roadmap providing resources to institutions to transform their clinical and translational research enterprises along the goals of the Roadmap. The CTSA program emphasizes biomedical informatics as a critical component for the accomplishment of the NIH’s translational objectives. To be optimally effective, emerging biomedical informatics programs must link with the information technology (IT) platforms of the enterprise clinical operations within academic health centers. This report details one academic health center’s transdisciplinary initiative to create an integrated academic discipline of biomedical informatics through the development of its infrastructure for clinical and translational science infrastructure and response to the CTSA mechanism. This approach required a detailed informatics strategy to accomplish these goals. This transdisciplinary initiative was the impetus for creation of a specialized biomedical informatics core, the Center for Biomedical Informatics (CBI). Development of the CBI codified the need to incorporate medical informatics including quality and safety informatics and enterprise clinical information systems within the CBI. This paper describes the steps taken to develop the biomedical informatics infrastructure, its integration with clinical systems at one academic health center, successes achieved, and barriers encountered during these efforts. PMID:21383632
Bayne, C G
On September 12, 1996, the American Medical Association, with an educational grant from Hoffmann-La Roche, sponsored a National Press Conference in New York City at the Millenium Broadway Hotel on Times Square. Attended by more than 40 of the nation's top health care correspondents from the leading magazine and newspapers in the country, this conference was designed to promote "The Revolution in Home and Outpatient Care." With an emphasis on new sites and new technologies, speakers from the Academy of Homecare Physicians presented a number of related subjects.
Hedgecock, Joan; Steyer, Terrence E
The American Medical Student Association (AMSA) Foundation is the programming arm of AMSA. The AMSA Foundation has administered several Title VII contracts designed to enhance the primary care education, leadership development, and cultural competence of the next generation of physicians, dentists, and other graduate-level health professionals. The authors discuss several AMSA programs developed with Title VII funding: Generalist Physicians in Training; Promoting, Reinforcing, and Improving Medical Education; National Primary Care Week; Leadership Seminar Series; and Achieving Diversity in Dentistry and Medicine. This article summarizes the work of these programs and discusses the impact that decreased funding has had on the training of our nation's future health professionals.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
А А Меджидова
Full Text Available The article draws attention to the fact that the Informatization of primary education is a uniform process, in which I the first turn mathematics and computer science are associated. Learning these disciplines is in natural interrelation and this comes from the nature of these disciplines. But in other subjects both mathematics and computer science play an applied role. It is proved that at the modern stage of Informatization in education contributes to improving the quality of assimilated knowledge acquired and skills.The article touches upon issues that reveal the relevance of the subject of Informatics in education. In connection with the information development there is a need of Informatization of education and society as a whole. The basic concepts of Informatics as a scientific and academic discipline are shown. Set out the subject, object and objectives of teaching science. Methodical program of the subject, aimed to develop school education is also considered.
Sánchez-Mendiola, Melchor; Martínez-Franco, Adrián I; Lobato-Valverde, Marlette; Fernández-Saldívar, Fabián; Vives-Varela, Tania; Martínez-González, Adrián
Biomedical Informatics (BMI) education in medical schools is developing a sound curricular base, but there are few published reports of their educational usefulness. The goal of this paper is to assess knowledge change and satisfaction in medical students after a BMI curriculum. The National Autonomous University of México Faculty of Medicine (UNAM) recently implemented a curricular reform that includes two BMI sequential courses (BMI-1 and BMI-2). The research design was one-group pretest-posttest. An objective test with evidence of validity was used for knowledge measurement. A satisfaction questionnaire was applied at the end of the courses. Two-tailed paired Student's t-tests were applied, comparing knowledge scores in the pre and post-test for each course. The study included student cohorts during two consecutive academic years. The 2013 BMI-1 course (n = 986 students) knowledge pretest score was 43.0 ± 8.6 (mean percent correct ± SD), and the post-test score was 57.7 ± 10.3 (p < 0.001); the 2014 BMI-1 (n = 907) pretest score was 43.7 ± 8.5, and the post-test was 58.1 ± 10.5 (p < 0.001). The 2012 BMI-2 course (n = 683) pretest score was 26.3 ± 7.9, the post-test score was 44.3 ± 13.3 (p < 0.001); the 2013 BMI-2 (n = 926) pretest score was 27.5 ± 7.5, and the post-test was 42.0 ± 11.0 (p < 0.001). The overall opinion of the students regarding the course was from good to excellent, with a response rate higher than 90%. The satisfaction questionnaires had high reliability (Cronbach's alpha of 0.93). The study shows a significant increase in BMI knowledge after an educational intervention in four medical student cohorts, and an overall positive evaluation by the students. Long-term follow-up is needed, as well as controlled studies of BMI educational interventions using performance endpoints.
Elkin, P L; Brown, S H; Wright, G
This article is part of a For-Discussion-Section of Methods of Information in Medicine on "Biomedical Informatics: We are what we publish". It is introduced by an editorial and followed by a commentary paper with invited comments. In subsequent issues the discussion may continue through letters to the editor. Informatics experts have attempted to define the field via consensus projects which has led to consensus statements by both AMIA. and by IMIA. We add to the output of this process the results of a study of the Pubmed publications with abstracts from the field of Biomedical Informatics. We took the terms from the AMIA consensus document and the terms from the IMIA definitions of the field of Biomedical Informatics and combined them through human review to create the Health Informatics Ontology. We built a terminology server using the Intelligent Natural Language Processor (iNLP). Then we downloaded the entire set of articles in Medline identified by searching the literature by "Medical Informatics" OR "Bioinformatics". The articles were parsed by the joint AMIA / IMIA terminology and then again using SNOMED CT and for the Bioinformatics they were also parsed using HGNC Ontology. We identified 153,580 articles using "Medical Informatics" and 20,573 articles using "Bioinformatics". This resulted in 168,298 unique articles and an overlap of 5,855 articles. Of these 62,244 articles (37%) had titles and abstracts that contained at least one concept from the Health Informatics Ontology. SNOMED CT indexing showed that the field interacts with most all clinical fields of medicine. Further defining the field by what we publish can add value to the consensus driven processes that have been the mainstay of the efforts to date. Next steps should be to extract terms from the literature that are uncovered and create class hierarchies and relationships for this content. We should also examine the high occurring of MeSH terms as markers to define Biomedical Informatics
The Utilization of Wireless Handheld Computers with MEDLINE is an Effective Mechanism for Answering Clinical Questions at the Point of Care. A Review of: Hauser, Susan E., Dina Demner-Fushman, Joshua L. Jacobs, Susanne M. Humphrey, Glenn Ford, and George R. Thoma. “Using Wireless Handheld Computers to Seek Information at the Point of Care: An Evaluation by Clinicians.” Journal of the American Medical Informatics Association 14.6 (Nov./Dec. 2007: 807-15.
Martha Ingrid Preddie
Full Text Available Objective – To assess the effectiveness of wireless handheld computers (HHCs for information retrieval in clinical environments and the role of MEDLINE in answering clinical questions at the point of care. Design – A prospective single-cohort study.Setting – Teaching rounds in the intensive care units and general medicine wards in two hospitals associated with a university’s school of medicine in the United States. Subjects – Five internal medicine residents with training in evidence-based practice.Methods – While accompanying medical teams on teaching rounds for approximately four consecutive weeks, each resident used MD on Tap (an application for handheld computers on a TreoTM 650 PDA/cell phone to find answers in real time, to questions that were raised by members of the medical teams. Using a special version of MD on Tap, each resident initialized a UserID. Serving as evaluators, the residents described and categorized clinical scenarios and recognized questions. They also formulated search terms, searched MEDLINE and identified citations determined to be useful for answering the questions. An intermediate server collected details of all MEDLINE search query transactions, including system response time, the user (based on UserIDs, citations selected for viewing, the saving of citations to HHC memory, as well as use of the Linkout and Notes features. In addition evaluators submitted daily summaries. These summaries included information on the scenarios, clinical questions, evidence-based methodology (EBM category, the team member who was the source of the question, the PubMed Identifiers (PMIDs of relevant citations, and comments. At the end of the data collection period, each evaluator submitted a summary report consisting of a qualitative and quantitative evaluation of his experience using MEDLINE via the handheld device to find relevant evidence based information at the point of care. The report also focused on the usefulness
Feng, Rung-Chuang; Lee, Ying-Li; Lee, Tso-Ying
The development of information technology has changed the world and allowed the innovation of nursing-care services. In recent years, the development of nursing informatics in Taiwan has been catching up with international trends and has been regarded positively by the international medical informatics community. The integration of information technology into medical care system has created the new nursing role of "informatics nurse." Although the certification system and job descriptions for these nurses have become increasingly comprehensive in many nations, Taiwan remains in the early development stage in these regards. Taiwan informatics nurses continue to face unclear and inadequately stated role responsibilities and job titles, undefined training requirements, and a lack of a clear qualification / certification system. This paper introduces the role functions and professional growth of informatics nurses and introduces the framework for a certification system in order to give to various medical and paramedical staffs a better understanding of informatics nursing and to recognize the important role played by informatics nurses in the process of healthcare informatics development.
E-mailed Evidence Based Summaries Impact Physician Learning More than Practice. A Review of: Grad, Roland M., Pierre Pluye, Jay Mercer, Bernard Marlow, Marie Eve Beauchamp, Michael Shulha, Janique Johnson-Lafleur and Sharon Wood-Dauphinee. “Impact of Research-based Synopses Delivered as Daily E-mail: A Prospective Observational Study.” Journal of the American Medical Informatics Association (200815.2: 240-5.
Gale G. Hannigan
Full Text Available Objective – To determine the use and construct validity of a method to assess the cognitive impact of information derived from daily e-mail evidence based summaries (InfoPOEMs, and to describe the self-reported impact of these InfoPOEMs.Design – Prospective, observational study over a period of 150 days employing a questionnaire and rating scale.Setting – This study was conducted via the Internet between September 8, 2006 and February 4, 2007.Subjects – Canadian Medical Association (CMA members who received InfoPOEMs via e-mail as of September 2006 were invited to participate. For inclusion in the analyses, a participant was defined as a practising family physician or general practitioner who submitted at least five ratings of InfoPOEMS during the study period (n=1,007.Methods – Volunteers completed a demographic questionnaire and provided informed consent online. Each subsequent InfoPOEM delivered included a link to a “ten-item impact assessment scale” (241. Participants checked “all that apply” of descriptive statements such as: My practice was (will be improved; I learned something new; I think this information is potentially harmful. Each combination of selections made was considered a pattern of cognitive impact. College of Family Physicians of Canada received continuing medical education (CME credit for each InfoPOEM rated. Data were collected by the CMA and forwarded weekly to the investigators who used descriptive statistics, principal component analysis, and multilevel factor analysis to analyze the data.Main Results – 1,007 participants rated an average of 61 InfoPOEMs (ranging from five to 111. A total of 61,493 patterns of cognitive impact were submitted. Eighty-five different patterns were observed, i.e., there were 85 different combinations of the scale’s statements used. Ten patterns accounted for 89.4% of the reports. The top five patterns were: I learned something new (35.2%; No impact (17.1%; This
Klugman, Craig M
Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools' websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 (as of June 2016) member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools (145 AAMC; 31 AACOM). 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean (MD 45.4; DO 37.1) and 30 (MD 29; DO 37.5) median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students.
Marshall, Nina L
A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.
Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T; Becich, Michael J
This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM) training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical) informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC)), Richard Hersheberger, PhD (Currently, Dean at Roswell Park), and Megan Seippel, MS (the administrator) launched the University of Pittsburgh Cancer Institute (UPCI) Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI) was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical informatics
Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T.; Becich, Michael J.
This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM) training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical) informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC)), Richard Hersheberger, PhD (Currently, Dean at Roswell Park), and Megan Seippel, MS (the administrator) launched the University of Pittsburgh Cancer Institute (UPCI) Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI) was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical informatics
Until the 1950's, moral aspects of clinical practice were handled in the USA within the medical profession. Over the last 30 years, these issues have become subjects for public debate, and have changed the public perception of medicine, in four steps. In the 1950's, moral theologians questioned the implications of medical technology at the edges of life. In the late '60s and '70s, these theologians were joined by political activists, whose zeal provoked a counter-reaction from physicians. In the late '70s and early '80s, the debate became largely theoretical; but in the late '80s it is once again "clinical", though respecting the rights of patients, their families, and other nonphysicians to participate in the relevant moral decisions. In part, these four steps reflect the special feature of American social history in the last 30 years; but in part they also had counterparts in Britain and elsewhere. Either way, the monopoly control over the ethics of medical practice exercised by doctors before the 1950s is unlikely to return.
The Internet has the potential to provide patients and physicians with rapid access to high quality, timely evidence regarding health and medical diagnosis and treatment. However, many barriers must be surmounted before this potential is achieved. Quality of content must be able to be verified, including the accuracy and timeliness of the information, the source of the information, and the objectivity of the source. Advertising and sponsorship must not influence content and should not be juxtaposed with related content. Individuals must be able to access information without loss of personal privacy. To address these issues, the American Medical Association has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed specifically for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web.
Chauvin, Sheila W; Anderson, William; Mylona, Elza; Greenberg, Ruth; Yang, Tong
Little is known about common elements or "best practices" of new faculty orientation (NFO) programs in medical schools. The objective was to examine school-wide NFO programs in North American medical schools. We reviewed the literature and conducted a web-based survey. Analyses included descriptive statistics and content analysis. We found little evidence of "best practices." Of the 106 responding schools (106/148=71.62%), 72 (67.9%) reported some type of school-wide NFO program. The typical program was organized by an Office of Faculty Affairs or Faculty Development, targeted broad goals, 4 to 8 hour long, offered early in the academic year, and used 2 or more presentation formats (e.g., oral, print). Based on the literature, this study appears to be the first comprehensive description of NFO programs in medical schools. Multiple types of NFO are needed to accommodate the diversity of faculty and faculty responsibilities. School-wide programs may serve best to develop institutional affiliation and collegiality.
Raymond, Mark; Nagy, Paul G.
The American Board of Imaging Informatics (ABII) was founded in 2005 by the Society of Imaging Informatics in Medicine (SIIM) and the American Registry of Radiologic Technologists (ARRT). ABII?s mission is to enhance patient care, professionalism, and competence in imaging informatics. This is accomplished primarily through the development and administration of a certification examination. The creation of the exam has been an exercise in open community involvement with SIIM providing access t...
Margolis, Alvaro; Gonzalez-Martinez, Francisco; Noboa, Oscar; Abbud-Filho, Mario; Lorier, Leticia; Nin, Marcelo; Silvariño, Ricardo; García, Sofía; Pefaur, Jacqueline; Greloni, Gustavo C; Noronha, Irene L; Lopez, Antonio; Ribeiro-Alves, María A; Tanús, Roberto; Fernández-Cean, Juan
A continuing medical education (CME) course was implemented for Latin American nephrologists in 2013. The topic was Immunopathology in native and transplanted kidneys. The course was given in Spanish and Portuguese. The activities included a distance education seven-week asynchronous online modality with multiple educational strategies. Thirty hours of study workload were estimated to complete the course. Four hundred and ninety-eight physicians coming from 18 countries registered for the course; 442 of them participated in it. Of those who participated, 51% received a certificate of completion and 29% a certificate of participation. Sixty-five percent of registrants participated in the case discussions. Eighty-six percent were very satisfied and 13% were satisfied. Lack of time to devote to the course was the main limitation expressed (62%), while Internet access or difficulties in the use of technology were considered by only 12 and 6% of participants, respectively. There was a significant increase in knowledge between before and after the course; the average grade increased from 64 to 83%. In conclusion, technology-enabled education demonstrated potential to become an instrument for Latin American nephrologists.
In the last twenty years the rapid change in the informatics sector has had economic and social impact on private and government activities. The Supreme Council for Science and Technology of Turkey assigned highest priority to the informatics in its meeting in February 1993. With this advice TUBITAK (The Scientific and Technical Research Council of Turkey) intends to give a strong impulse to development of a research policy in this field.
Guenther, Johanna T.
Objective: This study was part of the Medical Library Association's Nursing and Allied Health Resources Section's project to map the nursing literature. It identified core journals in nursing informatics and the journals referenced in them and analyzed coverage of those journals in selected indexes.
Kulikowski, Casimir A; Geissbuhler, Antoine
To provide an editorial introduction to the 2011 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors. A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2011 IMIA Yearbook. This 2011 issue of the IMIA Yearbook highlights important developments in the development of Web 3.0 capabilities that are increasing in Health Informatics, impacting the activities in research, education and practice in this interdisciplinary field. There has been steady progress towards introducing semantics into informatics systems through more sophisticated representations of knowledge in their underlying information. Health Informatics 3.0 capabilities are identified from the recent literature, illustrated by selected papers published during the past 12 months, and articles reported by IMIA Working Groups. Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on Web 3.0 challenges and opportunities.
Burke, R.V.; Ryutov, T.; Neches, R.; Upperman, J.S.
Objective 1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. Methods A literature search was conducted using MEDLINE, CINHL and the Cochrane Library using the key words “children” AND “disaster preparedness and disaster” AND “informatics”. Results A total of 314 papers were initially produced by the search and eight that met the selection criteria were included in the review. Four themes emerged: tools for disaster preparedness, education, reunification and planning and response. Conclusion The literature pertaining to informatics and pediatric disaster preparedness is sparse and many gaps still persist. Current disaster preparedness tools focus on the general population and do not specifically address children. The most progress has been achieved in family reunification; however, the recommendations delineated are yet to be completed. PMID:23616840
Johnson-Throop, Kathy A.
To improve on-orbit clinical capabilities by developing and providing operational support for intelligent, robust, reliable, and secure, enterprise-wide and comprehensive health care and biomedical informatics systems with increasing levels of autonomy, for use on Earth, low Earth orbit & exploration class missions. Biomedical Informatics is an emerging discipline that has been defined as the study, invention, and implementation of structures and algorithms to improve communication, understanding and management of medical information. The end objective of biomedical informatics is the coalescing of data, knowledge, and the tools necessary to apply that data and knowledge in the decision-making process, at the time and place that a decision needs to be made.
Athavale, A V; Zodpey, Sanjay P
Public health informatics is emerging as a new and distinct specialty area in the global scenario within the broader discipline of health informatics. The potential role of informatics in reducing health disparities in underserved populations has been identified by a number of reports from all over the world. The article discusses the scope, the limitations, and future perspective of this novice discipline in context to India. It also highlights information and technology related tools namely Geographical Information Systems, Telemedicine and Electronic Medical Record/Electronic Health Record. India needs to leverage its "technology" oriented growth until now (e.g., few satellite-based telemedicine projects, etc.) simultaneously toward development of "information"-based public health informatics systems in future. Under the rapidly evolving scenario of global public health, the future of the public health governance and population health in India would depend upon building and integrating the comprehensive and responsive domain of public health informatics.
Scott, Philip J; Cornet, Ronald; McCowan, Colin; Peek, Niels; Fraccaro, Paolo; Geifman, Nophar; Gude, Wouter T; Hulme, William; Martin, Glen P; Williams, Richard
The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE) conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and 149 poster abstracts from the congress. The twin programmes of "Big Data" and "Digital Health" are not always joined up by coherent policy and investment priorities. Substantial global investment in health IT and data science has led to sound progress but highly variable outcomes. Society needs an approach that brings together the science and the practice of health informatics. The goal is multi-level Learning Health Systems that consume and intelligently act upon both patient data and organizational intervention outcomes. Informatics for Health demonstrated the art of the possible, seen in the breadth and depth of our contributions. We call upon policy makers, research funders and programme leaders to learn from this joined-up approach.
Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon
The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Ramapriyan, H. K.
Over the last 10-15 years, significant advances have been made in information management, there are an increasing number of individuals entering the field of information management as it applies to Geoscience and Remote Sensing data, and the field of informatics has come to its own. Informatics is the science and technology of applying computers and computational methods to the systematic analysis, management, interchange, and representation of science data, information, and knowledge. Informatics also includes the use of computers and computational methods to support decision making and applications. Earth Science Informatics (ESI, a.k.a. geoinformatics) is the application of informatics in the Earth science domain. ESI is a rapidly developing discipline integrating computer science, information science, and Earth science. Major national and international research and infrastructure projects in ESI have been carried out or are on-going. Notable among these are: the Global Earth Observation System of Systems (GEOSS), the European Commissions INSPIRE, the U.S. NSDI and Geospatial One-Stop, the NASA EOSDIS, and the NSF DataONE, EarthCube and Cyberinfrastructure for Geoinformatics. More than 18 departments and agencies in the U.S. federal government have been active in Earth science informatics. All major space agencies in the world, have been involved in ESI research and application activities. In the United States, the Federation of Earth Science Information Partners (ESIP), whose membership includes over 180 organizations (government, academic and commercial) dedicated to managing, delivering and applying Earth science data, has been working on many ESI topics since 1998. The Committee on Earth Observation Satellites (CEOS)s Working Group on Information Systems and Services (WGISS) has been actively coordinating the ESI activities among the space agencies.The talk will present an overview of current efforts in ESI, the role members of IEEE GRSS play, and discuss
This project examines the oral accounts of former slaves, as recorded in the WPA narratives in the 1930s, to study the development of African American medical culture in the Antebellum South. Through an examination of these transcribed memories, my research investigates how African American praxes with medicinal flora, healing techniques, and spiritual harmony, reflected their ethnomedical and cosmological ideologies. The duality of these ideologies represents an African American medical iden...
Jones, Richard G; Johnson, Owen A; Batstone, Gifford
The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a
This paper presents the development of medical informatics education during the years from the establishment of the International Medical Informatics Association (IMIA) until today. A search in the literature was performed using search engines and appropriate keywords as well as a manual selection of papers. The search covered English language papers and was limited to search on papers title and abstract only. The aggregated papers were analyzed on the basis of the subject area, origin, time span, and curriculum development, and conclusions were drawn. From the results, it is evident that IMIA has played a major role in comparing and integrating the Biomedical and Health Informatics educational efforts across the different levels of education and the regional distribution of educators and institutions. A large selection of references is presented facilitating future work on the field of education in biomedical and health informatics.
Summary Objective This paper presents the development of medical informatics education during the years from the establishment of the International Medical Informatics Association (IMIA) until today. Method A search in the literature was performed using search engines and appropriate keywords as well as a manual selection of papers. The search covered English language papers and was limited to search on papers title and abstract only. Results The aggregated papers were analyzed on the basis of the subject area, origin, time span, and curriculum development, and conclusions were drawn. Conclusions From the results, it is evident that IMIA has played a major role in comparing and integrating the Biomedical and Health Informatics educational efforts across the different levels of education and the regional distribution of educators and institutions. A large selection of references is presented facilitating future work on the field of education in biomedical and health informatics. PMID:27488405
Lehmann, C U; Gundlapalli, A V
In 1962, Methods of Information in Medicine ( MIM ) began to publish papers on the methodology and scientific fundamentals of organizing, representing, and analyzing data, information, and knowledge in biomedicine and health care. Considered a companion journal, Applied Clinical Informatics ( ACI ) was launched in 2009 with a mission to establish a platform that allows sharing of knowledge between clinical medicine and health IT specialists as well as to bridge gaps between visionary design and successful and pragmatic deployment of clinical information systems. Both journals are official journals of the International Medical Informatics Association. As a follow-up to prior work, we set out to explore congruencies and interdependencies in publications of ACI and MIM. The objectives were to describe the major topics discussed in articles published in ACI in 2014 and to determine if there was evidence that theory in 2014 MIM publications was informed by practice described in ACI publications in any year. We also set out to describe lessons learned in the context of bridging informatics practice and theory and offer opinions on how ACI editorial policies could evolve to foster and improve such bridging. We conducted a retrospective observational study and reviewed all articles published in ACI during the calendar year 2014 (Volume 5) for their main theme, conclusions, and key words. We then reviewed the citations of all MIM papers from 2014 to determine if there were references to ACI articles from any year. Lessons learned in the context of bridging informatics practice and theory and opinions on ACI editorial policies were developed by consensus among the two authors. A total of 70 articles were published in ACI in 2014. Clinical decision support, clinical documentation, usability, Meaningful Use, health information exchange, patient portals, and clinical research informatics emerged as major themes. Only one MIM article from 2014 cited an ACI article. There
"MedTRIS" (Medical Triage and Registration Informatics System): A Web-based Client Server System for the Registration of Patients Being Treated in First Aid Posts at Public Events and Mass Gatherings.
Gogaert, Stefan; Vande Veegaete, Axel; Scholliers, Annelies; Vandekerckhove, Philippe
First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.
The RAS Informatics lab group develops tools to track and analyze “big data” from the RAS Initiative, as well as analyzes data from external projects. By integrating internal and external data, this group helps improve understanding of RAS-driven cancers.
Blerot, J.F.; Kschwendt, H.
Open systems and standards in a multi product environment are the EURATOM guidelines. Consequently, the OSI model, UNIX (POSIX) and X/OPEN specifications determine the EURATOM informatic strategy. The major objectives are the development of secured telecommunications, the migration to open systems and the integration of data processing from measurements in the plants to accountancy the headquarters
Kohli, Marc; Dreyer, Keith J; Geis, J Raymond
Informatics innovations of the past 30 years have improved radiology quality and efficiency immensely. Radiologists are groundbreaking leaders in clinical information technology (IT), and often radiologists and imaging informaticists created, specified, and implemented these technologies, while also carrying the ongoing burdens of training, maintenance, support, and operation of these IT solutions. Being pioneers of clinical IT had advantages of local radiology control and radiology-centric products and services. As health care businesses become more clinically IT savvy, however, they are standardizing IT products and procedures across the enterprise, resulting in the loss of radiologists' local control and flexibility. Although this inevitable consequence may provide new opportunities in the long run, several questions arise. What will happen to the informatics expertise within the radiology domain? Will radiology's current and future concerns be heard and their needs addressed? What should radiologists do to understand, obtain, and use informatics products to maximize efficiency and provide the most value and quality for patients and the greater health care community? This article will propose some insights and considerations as we rethink radiology informatics.
Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 1. International Olympiad in Informatics. Information and Announcements Volume 7 Issue 1 January 2002 pp 102-107. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/007/01/0102-0107. Resonance ...
Full Text Available Abstract Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians" can be essential members of translational medicine teams.
Sarkar, Indra Neil
Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams.
American Medical Association, Chicago, IL.
This is a collection of twenty speeches presented at the American Medical Association's Air Pollution Medical Conference, October 5-7, 1970. Speeches included: Air Pollution Control: The Physician's Role; Air Pollution Problems in Nuclear Power Development; Airway Resistance and Collateral Ventilation; Asbestos Air Pollution in Urban Areas;…
Baker, Robert B; Washington, Harriet A; Olakanmi, Ololade; Savitt, Todd L; Jacobs, Elizabeth A; Hoover, Eddie; Wynia, Matthew K; Blanchard, Janice; Boulware, L Ebony; Braddock, Clarence; Corbie-Smith, Giselle; Crawley, LaVera; LaVeist, Thomas A; Maxey, Randall; Mills, Charles; Moseley, Kathryn L; Williams, David R
An independent panel of experts, convened by the American Medical Association (AMA) Institute for Ethics, analyzed the roots of the racial divide within American medical organizations. In this, the first of a 2-part report, we describe 2 watershed moments that helped institutionalize the racial divide. The first occurred in the 1870s, when 2 medical societies from Washington, DC, sent rival delegations to the AMA's national meetings: an all-white delegation from a medical society that the US courts and Congress had formally censured for discriminating against black physicians; and an integrated delegation from a medical society led by physicians from Howard University. Through parliamentary maneuvers and variable enforcement of credentialing standards, the integrated delegation was twice excluded from the AMA's meetings, while the all-white society's delegations were admitted. AMA leaders then voted to devolve the power to select delegates to state societies, thereby accepting segregation in constituent societies and forcing African American physicians to create their own, separate organizations. A second watershed involved AMA-promoted educational reforms, including the 1910 Flexner report. Straightforwardly applied, the report's population-based criterion for determining the need for phySicians would have recommended increased training of African American physicians to serve the approximately 9 million African Americans in the segregated south. Instead, the report recommended closing all but 2 African American medical schools, helping to cement in place an African American educational system that was separate, unequal, and destined to be insufficient to the needs of African Americans nationwide.
Valenta, Annette L; Meagher, Emma A; Tachinardi, Umberto; Starren, Justin
Since the inception of the Clinical and Translational Science Award (CTSA) program in 2006, leaders in education across CTSA sites have been developing and updating core competencies for Clinical and Translational Science (CTS) trainees. By 2009, 14 competency domains, including biomedical informatics, had been identified and published. Since that time, the evolution of the CTSA program, changes in the practice of CTS, the rapid adoption of electronic health records (EHRs), the growth of biomedical informatics, the explosion of big data, and the realization that some of the competencies had proven to be difficult to apply in practice have made it clear that the competencies should be updated. This paper describes the process undertaken and puts forth a new set of competencies that has been recently endorsed by the Clinical Research Informatics Workgroup of AMIA. In addition to providing context and background for the current version of the competencies, we hope this will serve as a model for revision of competencies over time. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
This book provides a broad overview of the topic Bioinformatics (medical informatics + biological information) with a focus on data, information and knowledge. From data acquisition and storage to visualization, privacy, regulatory, and other practical and theoretical topics, the author touches on several fundamental aspects of the innovative interface between the medical and computational domains that form biomedical informatics. Each chapter starts by providing a useful inventory of definitions and commonly used acronyms for each topic, and throughout the text, the reader finds several real-world examples, methodologies, and ideas that complement the technical and theoretical background. Also at the beginning of each chapter a new section called "key problems", has been added, where the author discusses possible traps and unsolvable or major problems. This new edition includes new sections at the end of each chapter, called "future outlook and research avenues," providing pointers to future challenges.
This volume presents the proceedings of the International Conference on Health Informatics (ICHI). The conference was a new special topic conference initiative by the International Federation of Medical and Biological Engineering (IFMBE), held in Vilamoura, Portugal on 7-9 November, 2013. The main theme of the ICHI2013 was “Integrating Information and Communication Technologies with Biomedicine for Global Health”. The proceedings offer a unique forum to examine enabling technologies of sensors, devices and systems that optimize the acquisition, transmission, processing, storage, retrieval of biomedical and health information as well as to report novel clinical applications of health information systems and the deployment of m-Health, e-Health, u-Health, p-Health and Telemedicine.
Healthcare information technologies are now routinely deployed in a variety of healthcare contexts. These contexts differ widely, but the smooth integration of IT systems is crucial, so the design, implementation, and evaluation of safe, effective, efficient and easy to adopt health informatics...... involves careful consideration of both human and organizational factors. This book presents the proceedings of the Context Sensitive Health Informatics (CSHI) conference, held in Copenhagen, Denmark, in August 2013. The theme of this year’s conference is human and sociotechnical approaches. The Human......: patients and IT; usability test and evaluation; work tasks and related contexts; human factors and simulation; and context and systems design, and outline theories and models for studying contextual issues and insights related to how health information technologies can be better designed to accommodate...
Kohli, Marc; Dreyer, Keith J; Geis, J Raymond
Imaging 3.0 is a radiology community initiative to empower radiologists to create and demonstrate value for their patients, referring physicians, and health systems. In image-guided health care, radiologists contribute to the entire health care process, well before and after the actual examination, and out to the point at which they guide clinical decisions and affect patient outcome. Because imaging is so pervasive, radiologists who adopt Imaging 3.0 concepts in their practice can help their health care systems provide consistently high-quality care at reduced cost. By doing this, radiologists become more valuable in the new health care setting. The authors describe how informatics is critical to embracing Imaging 3.0 and present a scorecard that can be used to gauge a radiology group's informatics resources and capabilities. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Monique S. Roy
Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria as well as psychological (high hostility risk factors.
Kuziemsky, Craig; Nøhr, Christian; Aarts, Jos
Context is a key consideration when designing and evaluating health information technology (HIT) and cannot be overstated. Unintended consequences are common post HIT implementation and even well designed technology may not achieve desired outcomes because of contextual issues. While context shou...... informatics. The papers and presentations outlines theories and models for studying contextual issues and insights on how we can better design HIT to accommodate different healthcare contexts....
Despite recommendations by medical reformers that medical sociology be included in the curriculum, there is currently little evidence of a far-reaching integration of sociological perspectives in American medical education. Yet, support for the relevance of sociological knowledge has since the late 1960s helped to diffuse external pressures for change in health care and medical education. As a symbol of the communitarian commitment of the medical profession, claims in favor of the incorporation of sociological perspectives have thus occasionally, and largely unintentionally, served the public relations interests of biomedicine. However, the more recent interest in medical ethics has to some degree transformed medicine's educational agenda and the definition of medical 'human values'. Whereas the rhetorical expropriation of medical sociology primarily has concerned medicine's responsibility vis-à-vis society as a whole, the new medical ethics education signifies a return to a more individualistically oriented medical morality.
Topaz, Maxim; Ronquillo, Charlene; Peltonen, Laura-Maria; Pruinelli, Lisiane; Sarmiento, Raymond Francis; Badger, Martha K; Ali, Samira; Lewis, Adrienne; Georgsson, Mattias; Jeon, Eunjoo; Tayaben, Jude L; Kuo, Chiu-Hsiang; Islam, Tasneem; Sommer, Janine; Jung, Hyunggu; Eler, Gabrielle Jacklin; Alhuwail, Dari
In the summer of 2015, the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA NISIG) Student Working Group developed and distributed an international survey of current and future trends in nursing informatics. The survey was developed based on current literature on nursing informatics trends and translated into six languages. Respondents were from 31 different countries in Asia, Africa, North and Central America, South America, Europe, and Australia. This paper presents the results of responses to the survey question: "What should be done (at a country or organizational level) to advance nursing informatics in the next 5-10 years?" (n responders = 272). Using thematic qualitative analysis, responses were grouped into five key themes: 1) Education and training; 2) Research; 3) Practice; 4) Visibility; and 5) Collaboration and integration. We also provide actionable recommendations for advancing nursing informatics in the next decade.
Vilarinho, Yuri C
This paper examines the characteristics and the conditions for the emergence of the nosological category known as irritable heart syndrome to be found in Anglo-American medical literature in the second half of the nineteenth century. In the context of the American Civil War, it looks at some of the socio-historical elements, which comprised the medical care given to certain cardiac symptoms shown by soldiers. It emphasizes the moral values influencing the medical attitudes of military physicians towards symptoms of fear experienced by combatants, as well as the British and American etiological theories, which contributed to the nosological characterization of the suffering of soldiers afflicted with palpitations. Finally, it offers a brief analysis of the specific nature of the medical category known as irritable heart syndrome in the light of the categories of fear described by current psychiatric nosology.
This article describes the Australian Informatics Competition (AIC), a non-programming competition aimed at identifying students with potential in programming and algorithmic design. It is the first step in identifying students to represent Australia at the International Olympiad in Informatics. The main aim of the AIC is to increase awareness of…
Full Text Available Based on international standardization and power utility practices, this paper presents a preliminary and systematic study on the field of energy informatics and analyzes boundary expansion of information and energy system, and the convergence of energy system and ICT. A comprehensive introduction of the fundamentals and standardization of energy informatics is provided, and several key open issues are identified.
Biyao Huang; Xiaomin Bai; Zhenyu Zhou; Quansheng Cui; Daohua Zhu; Ruwei Hu
Based on international standardization and power utility practices, this paper presents a preliminary and systematic study on the field of energy informatics and analyzes boundary expansion of information and energy system, and the convergence of energy system and ICT. A comprehensive introduction of the fundamentals and standardization of energy informatics is provided, and several key open issues are identified.
Koch, Sabine; Hägglund, Maria
In the light of an aging society, effective delivery of healthcare will be more dependent on different technological solutions supporting the decentralization of healthcare, higher patient involvement and increased societal demands. The aim of this article is therefore, to describe the role of health informatics in the care of elderly people and to give an overview of the state of the art in this field. Based on a review of the existing scientific literature, 29 review articles from the last 15 years and 119 original articles from the last 5 years were selected and further analysed. Results show that review articles cover the fields of information technology in the home environment, integrated health information systems, public health systems, consumer health informatics and non-technology oriented topics such as nutrition, physical behaviour, medication and the aging process in general. Articles presenting original data can be divided into 5 major clusters: information systems and decision support, consumer health informatics, emerging technologies, home telehealth, and informatics methods. Results show that health informatics in elderly care is an expanding field of interest but we still do lack knowledge about the elderly person's needs of technology and how it should best be designed. Surprisingly, few studies cover gender differences related to technology use. Further cross-disciplinary research is needed that relates informatics and technology to different stages of the aging process and that evaluates the effects of technical solutions.
Many health care providers believe that the autopsy is no longer relevant in high-technology medicine era. This has fueled a decline in the hospital autopsy rate. Although it seems that advanced diagnostic tests answer all clinical questions, studies repeatedly demonstrate that an autopsy uncovers as many undiagnosed conditions today as in the past. The forensic autopsy rate has also declined, although not as precipitously. Pathologists are still performing a nineteenth century autopsy procedure that remains essentially unchanged. Informatics offers several potential answers that will evolve the low-tech autopsy into the high-tech autopsy. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Automation and emerging information technologies are being adopted by cytology laboratories to augment Pap test screening and improve diagnostic accuracy. As a result, informatics, the application of computers and information systems to information management, has become essential for the successful operation of the cytopathology laboratory. This review describes how laboratory information management systems can be used to achieve an automated and seamless workflow process. The utilization of software, electronic databases and spreadsheets to perform necessary quality control measures are discussed, as well as a Lean production system and Six Sigma approach, to reduce errors in the cytopathology laboratory.
Longenecker, Herbert E., Jr.; Campbell, S. Matt; Landry, Jeffrey P.; Pardue, Harold; Daigle, Roy J.
In addition to being a relevant program for health information technology workers, a recently proposed Health Informatics program was designed with additional objectives in mind: that the program is compatible with the IS 2010 Model Curriculum and that it satisfies the International Medical Informatics Association recommendation for undergraduate…
Molina, Yamile; Hempstead, Bridgette H; Thompson-Dodd, Jacci; Weatherby, Shauna Rae; Dunbar, Claire; Hohl, Sarah D; Malen, Rachel C; Ceballos, Rachel M
African-American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African-American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30-74-year-old women who self-identified as African-American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African-Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized that staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram.
Beninger, Paul; Ibara, Michael A
The discipline of pharmacovigilance is rooted in the aftermath of the thalidomide tragedy of 1961. It has evolved as a result of collaborative efforts by many individuals and organizations, including physicians, patients, Health Authorities, universities, industry, the World Health Organization, the Council for International Organizations of Medical Sciences, and the International Conference on Harmonisation. Biomedical informatics is rooted in technologically based methodologies and has evolved at the speed of computer technology. The purpose of this review is to bring a novel lens to pharmacovigilance, looking at the evolution and development of the field of pharmacovigilance from the perspective of biomedical informatics, with the explicit goal of providing a foundation for discussion of the future direction of pharmacovigilance as a discipline. For this review, we searched [publication trend for the log 10 value of the numbers of publications identified in PubMed] using the key words [informatics (INF), pharmacovigilance (PV), phar-macovigilance þ informatics (PV þ INF)], for [study types] articles published between [1994-2015]. We manually searched the reference lists of identified articles for additional information. Biomedical informatics has made significant contributions to the infrastructural development of pharmacovigilance. However, there has not otherwise been a systematic assessment of the role of biomedical informatics in enhancing the field of pharmacovigilance, and there has been little cross-discipline scholarship. Rapidly developing innovations in biomedical informatics pose a challenge to pharmacovigilance in finding ways to include new sources of safety information, including social media, massively linked databases, and mobile and wearable wellness applications and sensors. With biomedical informatics as a lens, it is evident that certain aspects of pharmacovigilance are evolving more slowly. However, the high levels of mutual interest in
Puschel, Klaus; Repetto, Paula; Bernales, Margarita; Barros, Jorge; Perez, Ivan; Snell, Linda
Latin America has experienced a tremendous growth in a number of medical schools, and there are concerns about their quality of training in critical areas such as professionalism. Medical professionalism is a cultural construct. The aim of the study was to compare published definitions of medical professionalism from Latin American and non-Latin American regions and to design an original and culturally sound definition. A mixed methods approach was used with three phases. First, a systematic search and thematic analysis of the literature were conducted. Second, a Delphi methodology was used to design a local definition of medical professionalism. Third, we used a qualitative approach that combined focus groups and personal interviews with students and deans from four medical schools in Chile to understand various aspects of professionalism education. The data were analyzed using NVivo software. A total of 115 nonrepeated articles were identified in the three databases searched. No original definitions of medical professionalism from Latin America were found. Twenty-six articles met at least one of the three decisional criteria defined and were fully reviewed. Three theoretical perspectives were identified: contractualism, personalism, and deontology. Attributes of medical professionalism were classified in five dimensions: personal, interpersonal, societal, formative, and practical. Participants of the Delphi panel, focus groups, and personal interviews included 36 medical students, 12 faculties, and four deans. They took a personalistic approach to design an original definition of medical professionalism and highlighted the relevance of respecting life, human dignity, and the virtue of prudence in medical practice. Students and scholars differed on the value given to empathy and compassion. This study provides an original and culturally sound definition of medical professionalism that could be useful in Latin American medical schools. The methodology used in the
The start of Latin America's love story with fungi may be placed in pre-Hispanic times when the use of fungi in both ritual ceremonies and daily life were common to the native civilizations. But the medical mycology discipline in Latin America started at the end of the 19th Century. At that time, scholars such as A. Posadas, R. Seeber, A. Lutz and P. Almeida, discovered agents of fungal diseases, the study of which has influenced the regional research ever since. Heirs to them are the researchers that today thrive in regional Universities and Research Institutes. Two current initiatives improve cooperation among Latin American medical mycologists. First, the periodical organization of International Paracoccidioidomycosis Meetings (seven so far, from 1979 to 1999); second, the creation of the Latin American Association for Mycology in 1991 (three Congresses, from 1993 to 1999). Latin American publications have increased in international specialized journals such as that from our Society (ISHAM) (from 8% in 1967 to 19% in 1999), and the Iberoamerican Journal of Mycology (Revista Iberoamericana de Micologia; > 40% from 1997 to 1999). In addition, Latin American participation at ISHAM International Congresses has risen from 6.9% in 1975 to 21.3% in 1997, and 43.2% at the 14th ISHAM Congress, held for the first time in a Latin American country, Argentina. A significant contribution of women to the scientific establishment of Latin American medical mycology (e.g., 45% of Latin American papers vs. 18% of other regions published in Journal of Medical and Veterinary Mycology in 1987, had women as authors or coauthors) suggests a better academic consideration of Latin American women against their counterparts in the developed world. Taken together, all these figures reflect the enthusiasm of our Latin American colleagues in the field, despite the difficulties that afflict our region, and affect our work.
Blash, Anthony; Saltsman, Connie L; Steil, Condit
Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.
The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members is based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.
Full Text Available The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs, and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.
Hassanien, Aboul; El-Bendary, Nashwa; Dey, Nilanjan
The conference topics address different theoretical and practical aspects, and implementing solutions for intelligent systems and informatics disciplines including bioinformatics, computer science, medical informatics, biology, social studies, as well as robotics research. The conference also discuss and present solutions to the cloud computing and big data mining which are considered hot research topics. The conference papers discussed different topics – techniques, models, methods, architectures, as well as multi aspect, domain-specific, and new solutions for the above disciplines. The accepted papers have been grouped into five parts: Part I—Intelligent Systems and Informatics, addressing topics including, but not limited to, medical application, predicting student performance, action classification, and detection of dead stained microscopic cells, optical character recognition, plant identification, rehabilitation of disabled people. Part II—Hybrid Intelligent Systems, addressing topics including, b...
Kulikowski, Casimir A.; Bakken, Suzanne; de Lusignan, Simon; Kimura, Michio; Koch, Sabine; Mantas, John; Maojo, Victor; Marschollek, Michael; Martin-Sanchez, Fernando; Moen, Anne; Park, Hyeoun-Ae; Sarkar, Indra Neil; Leong, Tze Yun; McCray, Alexa T.
Summary Background Medical informatics, or biomedical and health informatics (BMHI), has become an established scientific discipline. In all such disciplines there is a certain inertia to persist in focusing on well-established research areas and to hold on to well-known research methodologies rather than adopting new ones, which may be more appropriate. Objectives To search for answers to the following questions: What are research fields in informatics, which are not being currently adequately addressed, and which methodological approaches might be insufficiently used? Do we know about reasons? What could be consequences of change for research and for education? Methods Outstanding informatics scientists were invited to three panel sessions on this topic in leading international conferences (MIE 2015, Medinfo 2015, HEC 2016) in order to get their answers to these questions. Results A variety of themes emerged in the set of answers provided by the panellists. Some panellists took the theoretical foundations of the field for granted, while several questioned whether the field was actually grounded in a strong theoretical foundation. Panellists proposed a range of suggestions for new or improved approaches, methodologies, and techniques to enhance the BMHI research agenda. Conclusions The field of BMHI is on the one hand maturing as an academic community and intellectual endeavour. On the other hand vendor-supplied solutions may be too readily and uncritically accepted in health care practice. There is a high chance that BMHI will continue to flourish as an important discipline; its innovative interventions might then reach the original objectives of advancing science and improving health care outcomes. PMID:28119991
Mills, Michael D.
The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed
Kim, Hyeoneui; Ohno-Machado, Lucila; Oh, Janet; Jiang, Xiaoqian
We analyzed 741 journal articles on nursing informatics published in 7 biomedical/nursing informatics journals and 6 nursing journals from 2005 to 2013 to begin to understand publication trends in nursing informatics research and identify gaps. We assigned a research theme to each article using AMIA 2014 theme categories and normalized the citation counts using time from publication. Overall, nursing informatics research covered a broad spectrum of research topics in biomedical informatics and publication topics seem to be well aligned with the high priority research agenda identified by the nursing informatics community. The research themes with highest volume of publication were Clinical Workflow and Human Factors, Consumer Informatics and Personal Health Records, and Clinical Informatics, for which an increasing trend in publication was noted. Articles on Informatics Education and Workforce Development; Data Mining, NLP, Information Extraction; and Clinical Informatics showed steady and high volume of citations.
van Mulligen, Erik M; Cases, Montserrat; Hettne, Kristina; Molero, Eva; Weeber, Marc; Robertson, Kevin A; Oliva, Baldomero; de la Calle, Guillermo; Maojo, Victor
The European INFOBIOMED Network of Excellence recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. A carefully developed 3-year training program for biomedical informatics students addressed these educational aspects through the following four activities: (1) an internet course database containing an overview of all Medical Informatics and BioInformatics courses, (2) a BioMedical Informatics Summer School, (3) a mobility program based on a 'brokerage service' which published demands and offers, including funding for research exchange projects, and (4) training challenges aimed at the development of multi-disciplinary skills. This paper focuses on experiences gained in the development of novel educational activities addressing work in multidisciplinary teams. The training challenges described here were evaluated by asking participants to fill out forms with Likert scale based questions. For the mobility program a needs assessment was carried out. The mobility program supported 20 exchanges which fostered new BMI research, resulted in a number of peer-reviewed publications and demonstrated the feasibility of this multidisciplinary BMI approach within the European Union. Students unanimously indicated that the training challenge experience had contributed to their understanding and appreciation of multidisciplinary teamwork. The training activities undertaken in INFOBIOMED have contributed to a multi-disciplinary BMI approach. It is our hope that this work might provide an impetus for training efforts in Europe, and yield a new generation of biomedical informaticians.
Steckler, Taylor J; Brownlee, Michael J; Urick, Benjamin Y; Farley, Matthew J
Pharmacy informatics involves the customization and application of information technology to improve medication-related processes. It is a critical function given the recent expansion of technology and prevalence of medication use throughout healthcare. Despite the necessity for pharmacy involvement, many pharmacists and student pharmacists are unaware of how to get started in informatics. Ideally, training should start early with student pharmacists being enrolled in introductory courses taught by leaders in the field. Students especially interested in informatics can build upon their classroom experience with postgraduate year two (PGY2) residencies in several informatics-related areas. Additionally, current pharmacists can gather information from national pharmacy organizations and local information technology pharmacists to prepare for projects in the field. These approaches provide opportunities for all pharmacists to expand their knowledge and establish the basis for highly-motivated pharmacists to become experts in informatics. Copyright © 2017 Elsevier Inc. All rights reserved.
Almeida, M J
The invigoration of Latin American medical education during the past decade has been remarkable. The new initiatives which have taken place and the innovative programmes which have been enacted are analysed with reference to the seminal participation in international ventures. The analysis demonstrates that, while South American regional development was undeniably and profoundly influenced by the world movement in medical education, there has also been a reciprocal influence. South America has contributed notably to global action. The extent of the contribution by South America to the world movement, and the benefits gained in turn, make it self-evident that continuation of such bilateral exchange is crucial, and is to be energetically promoted.
Ingram, D; Murphy, J
Previous case reports in this series on Education and Training have looked at specialist courses for postgraduate students seeking an in-depth knowledge of informatics and a career in the field. By contrast, this review describes a project designed to pilot a series of learning opportunities for undergraduate medical students. Although some UK medical colleges have opted to introduce informatics into the curriculum as a discipline in its own right, the Informatics Department at St Bartholomew's Hospital Medical College chose a different approach. When a new curriculum was introduced at St Bartholomew's and at The London Hospital Medical College, the Head of the Informatics Department saw this as an ideal opportunity to explore ways of integrating informatics into the curriculum. The initiatives described in this paper were made possible as a result of an award from the UK government Department of Employment. Money from an Enterprise in Higher Education grant funded a range of programmes, one of which was designed to introduce students to selected aspects of informatics and to demonstrate what is feasible in the undergraduate curriculum. The work carried out over a period of three and a half years was intended to provide the basis for the next phase of curriculum development. However, in the wake of the restructuring which has taken place in London medical colleges, the Informatics Department at what was St Bartholomew's has relocated to University College London Medical School, and is now called The Centre for Health Informatics and Multiprofessional Education (CHIME). University College is designing a new medical curriculum and CHIME is drawing on the experience gained through the Enterprise Project to find the best way to integrate informatics into this curriculum.
Sipes, Carolyn; Hunter, Kathleen; McGonigle, Dee; West, Karen; Hill, Taryn; Hebda, Toni
, given that Health Information Technology Competencies includes all healthcare workers, while the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools and the American Nurses Association Nursing Informatics: Scope and Standards of Practice are nurse specific. No clear cross mapping across these tools and the standards of nursing informatics practice exists. Further examination and review are needed to translate Health Information Technology Competencies as a viable tool for nursing informatics use in the US.
Haux, R; Koch, S
In 1962, Methods of Information in Medicine (MIM) began to publish papers on the methodology and scientific fundamentals of managing data, information, and knowledge in biomedicine and health care. Meeting an increasing demand for research about practical implementation of health information systems, the journal Applied Clinical Informatics (ACI) was launched in 2009. Both journals are official journals of the International Medical Informatics Association (IMIA). Based on prior analyses, we aimed to describe major topics published in MIM during 2014 and to explore whether theory of MIM influenced practice of ACI. Our objectives were further to describe lessons learned and to discuss possible editorial policies to improve bridging from theory to practice. We conducted a retrospective, observational study reviewing MIM articles published during 2014 (N=61) and analyzing reference lists of ACI articles from 2014 (N=70). Lessons learned and opinions about MIM editorial policies were developed in consensus by the two authors. These have been influenced by discussions with the journal's associate editors and editorial board members. The publication topics of MIM in 2014 were broad, covering biomedical and health informatics, medical biometry and epidemiology. Important topics discussed were biosignal interpretation, boosting methodologies, citation analysis, health-enabling and ambient assistive technologies, health record banking, safety, and standards. Nine ACI practice articles from 2014 cited eighteen MIM theory papers from any year. These nine ACI articles covered mainly the areas of clinical documentation and medication-related decision support. The methodological basis they cited from was almost exclusively related to evaluation. We could show some direct links where theory impacted practice. These links are however few in relation to the total amount of papers published. Editorial policies such as publishing systematic methodological reviews and clarification of
Rutkow, 96. 30 .1 8 Adams, 5. 19 Ballet , 10 . . 20 Adams, 7-8. 21 Francis Trevelyan Miller and Robert Sampson Lanier: The Photographic History of...1989 Dammann, Gordon and Alfred Jay Ballet . The Images of Civil War Medicine, a photographic history . New York:Demos Medical Publishing, 2008 Denny...Winfree Professor of American History at Penn State University and CDR : . " Timothy Atmajian, MC, USN who provided me guidance and insight to the
Rubin, Zachary; Blackham, Kristine
This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Spencer, Julie A
Informatics education must prepare today's nurses to manage a deluge of information and use technology effectively. In addition, U.S. health care is being redesigned with technology that improves patient safety and quality of care. The Institute of Medicine's recommendations for health care safety and professional education prompted initiatives by the National League for Nursing, the American Association of Colleges of Nursing, and others to make informatics a fundamental part of nursing education. The Quality and Safety Education for Nurses (QSEN) project outlines specific competency goals for informatics knowledge, skills, and attitudes. However, progress toward integration of informatics in nursing curricula has been slow, and additional strategies need further exploration and discussion in the nursing literature. This article uses the QSEN framework to present strategies for teaching multiple facets of informatics in the classroom, simulation laboratory, and clinical settings in a baccalaureate nursing curriculum. Copyright 2012, SLACK Incorporated.
To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.
Robert A Dugger
Full Text Available Relatively little is known about American medical student's attitudes toward caring for the uninsured, limiting physician reimbursement and the role of cost-effectiveness data in medical decision-making. We assessed American medical student's attitudes regarding these topics as well as demographic predictors of those attitudes, and compared them to practicing physicians.A survey instrument was explicitly designed to compare medical student attitudes with those previously reported by physicians. Between December 1st 2010 and March 27th 2011 survey responses were collected from more than 2% of the total estimated 2010-2011 US medical student population enrolled at 111 of 159 accredited US medical schools within the 50 United States (n = 2414 of possible 98197. Medical students were more likely to object to reimbursement cuts, and more likely to object to the use of cost effectiveness data in medical decision making than current physicians according to the literature. Specialty preference, political persuasion, and medical student debt were significant predictors of health policy attitudes. Medical students with anticipated debt in excess of $200,000 were significantly less willing to favor limiting reimbursement to improve patient access (OR: 0.73 [95% confidence interval (CI: 0.59-0.89], and significantly more likely to object to using cost effectiveness data to limit treatments (OR 1.30, 95% CI 1.05-1.60 when compared to respondents with anticipated debt less than $200,000.When compared to physicians in the literature, future physicians may be less willing to favor cuts to physician reimbursements and may be more likely to object to the use of cost effectiveness data. Political orientation, specialty preference and anticipated debt may be important predictors of health policy attitudes among medical students. Early career medical providers with primary care ambitions and those who anticipate less debt may be more likely to support healthcare
The text of a Federal Trade Commission cease-and-desist order against the American Medical Association (AMA) is reprinted. The order prohibits the AMA from restricting or declaring unethical the advertising of physician services or the participation of physicians in health maintenance organizations.
Summary Background In 2009, Applied Clinical Informatics (ACI) – focused on applications in clinical informatics – was launched as a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of the International Medical Informatics Association. Objectives To explore which congruencies and interdependencies exist in publications from theory to practice and from practice to theory and to determine existing gaps. Major topics discussed in ACI and MIM were analyzed. We explored if the intention of publishing companion journals to provide an information bridge from informatics theory to informatics practice and vice versa could be supported by this model. In this manuscript we will report on congruencies and interdependences from practice to theory and on major topics in MIM. Methods Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 were indexed and analyzed. Results Hundred and ninety-six publications were analyzed (ACI 87, MIM 109). In MIM publications, modelling aspects as well as methodological and evaluation approaches for the analysis of data, information, and knowledge in biomedicine and health care were frequently raised – and often discussed from an interdisciplinary point of view. Important themes were ambient-assisted living, anatomic spatial relations, biomedical informatics as scientific discipline, boosting, coding, computerized physician order entry, data analysis, grid and cloud computing, health care systems and services, health-enabling technologies, health information search, health information systems, imaging, knowledge-based decision support, patient records, signal analysis, and web science. Congruencies between journals could be found in themes, but with a different focus on content. Interdependencies from practice to theory, found in these publications, were only limited. Conclusions Bridging from informatics theory to
Acharya, U; Dua, Prerna
The book is a unique effort to represent a variety of techniques designed to represent, enhance, and empower multi-disciplinary and multi-institutional machine learning research in healthcare informatics. The book provides a unique compendium of current and emerging machine learning paradigms for healthcare informatics and reflects the diversity, complexity and the depth and breath of this multi-disciplinary area. The integrated, panoramic view of data and machine learning techniques can provide an opportunity for novel clinical insights and discoveries.
... Updated American Veterinary Medical Association Guidelines for the Euthanasia of Animals: 2013 Edition... for the Euthanasia of Animals: 2013 Edition (Guidelines). The NIH is seeking input from the public on... updated AVMA Guidelines for the Euthanasia of Animals: 2013 Edition must be submitted electronically at...
These are the abstracts of the 2017 American College of Medical Toxicology (ACMT) Annual Scientific Meeting. Included here are 120 abstracts that will be presented in March 2017, including research studies from around the globe and the ToxIC collaboration, clinically significant case reports describing new toxicologic phenomena, and encore presentations from other scientific meetings.
... Corporation, DBA Tunstall, Clovis, New Mexico; Amended Certification Regarding Eligibility To Apply for Worker... reports that the information supplied during the investigation pertains to the location in Clovis, New... follows: All workers of American Medical Alert Corporation, doing business as Tunstall, Clovis, New Mexico...
Lapinsky, Jessica; Colonna, Caitlin; Sexton, Patricia; Richard, Mariah
The study examined the effectiveness of a workshop on Deaf culture and basic medical American Sign Language for increasing osteopathic student physicians' confidence and knowledge when interacting with ASL-using patients. Students completed a pretest in which they provided basic demographic information, rated their confidence levels, took a video…
The medical environment has changed greatly with the coming of the information age, and, increasingly, the operating procedures for medical services have been altered in keeping with the trend toward mobile, paperless services. Informatization has the potential to improve the working efficiency of medical personnel, enhance patient care safety, and give medical organizations a positive image. Informatics nurses play an important role in the decision-making processes that accompany informatization. As one of the decision-making links in the information technology lifecycle, this role affects the success of the development and operation of information systems. The present paper examines the functions and professional knowledge that informatics nurses must possess during the technology lifecycle, the four stages of which include: planning, analysis, design/development/revision, and implementation/assessment/support/maintenance. The present paper further examines the decision-making shortcomings and errors that an informatics nurses may make during the decision-making process. We hope that this paper will serve as an effective and useful reference for informatics nurses during the informatization decision-making process.
In WWI, the United States was segregated by custom and law, and the Army obeyed the laws, reducing opportunities for Black medical professionals to serve their country in uniform. This article surveys African-American medical personnel serving in the US Army in World War I. It includes physicians, dentists, veterinarians, and other commissioned officers, as well as medical enlisted men. Overall, despite segregation and associated professional limitations, determined individuals still served with distinction in a variety of roles, opening doors for future advances. Published by Elsevier Inc.
Williams, Marc S; Ritchie, Marylyn D; Payne, Philip R O
The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine.
Koch, S; Vimarlund, V
To provide a survey over significant developments in the area of linking personal health informatics and clinical informatics, to give insights into critical advances and to discuss open problems and opportunities in this area. A scoping review over the literature published in scientific journals and relevant conference proceedings in the intersection between personal health informatics and clinical informatics over the years 2010 and 2011 was performed. The publications analyzed are related to two main topics, namely "Sharing information and collaborating through personal health records, portals and social networks" and "Integration of personal health systems with clinical information systems". For the first topic, results are presented according to five different themes: "Patient expectations and attitudes", "Real use experiences", "Changes for care providers", "Barriers to adoption" and "Proposed technical infrastructures". For the second topic, two different themes were found, namely "Technical architectures and interoperability" and "Security, safety and privacy issues". Results show a number of gaps between the information needs of patients and the information care provider organizations provide to them as well as the lack of a trusted technical, ethical and regulatory framework regarding information sharing. Despite recent developments in the areas of personal health informatics and clinical informatics both fields have diverging needs. To support both clinical work processes and empower patients to effectively handle self-care, a number of issues remain unsolved. Open issues include privacy and confidentiality, including trusted sharing of health information and building collaborative environments between patients, their families and care providers. There are further challenges to meet around health and technology literacy as well as to overcome structural and organizational barriers. Frameworks for evaluating personal health informatics applications and
Fulton, Cathy R; Meek, Julie A; Walker, Patricia Hinton
Nursing informatics/health information technology are key components of graduate nursing education and an accreditation requirement, yet little is known about the extent to which doctor of nursing practice (DNP) curricula include these content domains. The purpose of this descriptive study was to elicit perceptions of DNP program directors relative to (a) whether and how the American Association of Colleges of Nursing's (AACN's) Essential IV standard has been met in their DNP programs; (b) whether the Technology Informatics Guiding Educational Reform Initiative Foundation's Phase II competencies have been integrated in their programs; and (c) the faculty and organizational characteristics associated with the adoption of the AACN's Essential IV. In 2011, an electronic survey was sent to all 138 DNP program directors identified on the AACN Web site with an 81.2% response rate. Findings include variation in whether and how programs have integrated informatics/health information technology content, a lack of informatics-certified and/or master's-prepared faculty, and a perceived lack of faculty awareness of informatics curricular guidelines. DNP program director and dean awareness and support of faculty informatics education, use of informatics competency guidelines, and national policy and stimulus funding support are recommended to promote curricular inclusion and the engagement of nurses in strong informatics practices. Copyright © 2014 Elsevier Inc. All rights reserved.
Philip J. Scott
Full Text Available Introduction: The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and 149 poster abstracts from the congress. Discussion: The twin programmes of “Big Data” and “Digital Health” are not always joined up by coherent policy and investment priorities. Substantial global investment in health IT and data science has led to sound progress but highly variable outcomes. Society needs an approach that brings together the science and the practice of health informatics. The goal is multi-level Learning Health Systems that consume and intelligently act upon both patient data and organizational intervention outcomes. Conclusions: Informatics for Health demonstrated the art of the possible, seen in the breadth and depth of our contributions. We call upon policy makers, research funders and programme leaders to learn from this joined-up approach.
Shindel, Alan W; Parish, Sharon J
Both the general public and individual patients expect healthcare providers to be knowledgeable and approachable regarding sexual health. Despite this expectation there are no universal standards or expectations regarding the sexuality education of medical students. To review the current state of the art in sexuality education for North American medical students and to articulate future directions for improvement. Evaluation of: (i) peer-reviewed literature on sexuality education (focusing on undergraduate medical students); and (ii) recommendations for sexuality education from national and international public health organizations. Current status and future innovations for sexual health education in North American medical schools. Although the importance of sexuality to patients is recognized, there is wide variation in both the quantity and quality of education on this topic in North American medical schools. Many sexual health education programs in medical schools are focused on prevention of unwanted pregnancy and sexually transmitted infection. Educational material on sexual function and dysfunction, female sexuality, abortion, and sexual minority groups is generally scant or absent. A number of novel interventions, many student initiated, have been implemented at various medical schools to improve the student's training in sexual health matters. There is a tremendous opportunity to mold the next generation of healthcare providers to view healthy sexuality as a relevant patient concern. A comprehensive and uniform curriculum on human sexuality at the medical school level may substantially enhance the capacity of tomorrow's physicians to provide optimal care for their patients irrespective of gender, sexual orientation, and individual sexual mores/beliefs. © 2013 International Society for Sexual Medicine.
Bruce P Levy
Informatics candidates. Increasingly, these fellowships must be able to accommodate the needs of candidates anticipating a wide range of Pathology Informatics career paths, be able to accommodate Pathology′s increasingly subspecialized structure, and do this in a way that respects the multiple fellowships needed to become a subspecialty pathologist and informatician. This is further complicated as Pathology Informatics begins to look outward and takes its place in the growing, and still ill-defined, field of Clinical Informatics, a field that is not confined to just one medical specialty, to one way of practicing medicine, or to one way of providing patient care.
Levy, Bruce P.; McClintock, David S.; Lee, Roy E.; Lane, William J.; Klepeis, Veronica E.; Baron, Jason M.; Onozato, Maristela L.; Kim, JiYeon; Brodsky, Victor; Beckwith, Bruce; Kuo, Frank; Gilbertson, John R.
candidates. Increasingly, these fellowships must be able to accommodate the needs of candidates anticipating a wide range of Pathology Informatics career paths, be able to accommodate Pathology's increasingly subspecialized structure, and do this in a way that respects the multiple fellowships needed to become a subspecialty pathologist and informatician. This is further complicated as Pathology Informatics begins to look outward and takes its place in the growing, and still ill-defined, field of Clinical Informatics, a field that is not confined to just one medical specialty, to one way of practicing medicine, or to one way of providing patient care. PMID:23024889
Full Text Available Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO has been initiated to integrate various vaccine data and support automated reasoning.
Naar-King, Sylvie; Lam, Phebe; Ellis, Deborah; Bruzzese, Jean-Marie; Secord, Elizabeth
To describe the asthma medication device skills of high-risk African American adolescents and associations between skills and other components of illness management, 170 African American adolescents, with at least one hospitalization or two emergency department visits in the last year, demonstrated how they use their asthma quick-relief and controller medication devices. Observations were scored using an in vivo observation asthma skills checklist. To assess other areas of asthma management, adolescents and their primary caregiver were interviewed using the Family Asthma Management System Scales, Only 5% of adolescents correctly demonstrated all controller skills, and none of the adolescents correctly showed all quick-relief inhaler skills (5% showed between 90 and 95% of skills). Several components of asthma management predicting controller medication skills were attendance at an asthma specialty clinic, collaboration with provider, medication adherence, and quick-relief medication skills. These variables accounted for a total of 24% of the variance in controller medication skills, Results indicate the need for interventions directly targeting observed asthma management skills and the importance of relationship with providers.
Hodge, Felicia Schanche; Cadogan, Mary; Itty, Tracy Line; Williams, Angela; Finney, Arneta
Caregivers play a special role in the management and control of cancer-related pain. For American Indians with cancer, caregivers can contribute to patient education, medication compliance, and can facilitate communication between the patient and the provider and the patient and the family. To identify the role(s) of caregivers of American Indian cancer survivors. As a part of a large randomized intervention designed to improve barriers to cancer symptom management, 13 focus groups were held among American Indian cancer survivors and their caregivers at Southwest reservations and urban sites. Focus groups, audiotaped and transcribed, used constant comparative methods in the analysis of caregiver dialogues. Caregivers are patient educators and provider culture-brokers and their communication strategies use a combination of cultural and conventional strategies in their care of American Indian cancer patients. Cultural communication styles include "talk stories" (storytelling), group (talking circles), and dialogue to manage cancer pain, educate the patient and community, and to protect the patient from stigma, reduce barriers to care, and provide support to patients and families. Active discussion with providers "re-packaged" the patient's reporting/responses to specific clinical measures (pain measure scores) and identified the need for pain medication and compliance-related issues. Findings are not generalizable to the American Indian population outside of the sites and focus groups from which data were collected. Caregivers are "cultural brokers" who inform providers of the cultural nuances associated with American Indian patient care. However, caregivers voiced that cultural restriction for not discussing illness openly was a sanction and an important barrier. ©2016 Frontline Medical Communications.
Full Text Available Internet, cloud computing, social networks and mobile technology, all facilitate information transfer. Healthcare professionals, physicians and patients can use informatic devices in order to simplify their access to medical information, to streamline testing, and to understand clinical results. The use of computers and software facilitate doctor-patient interactions by optimizing communication and information flow. However, digital interfaces also increase the risks that information specialists use information without fully complying with ethical principles and laws in force. Our premise is that these information specialists should: 1 be informed of the rights, duties, and responsibilities linked to their profession and laws in force; 2 have guidelines and ethical tutoring on what they need to do in order to avoid or prevent conflict or misconduct; 3 have renewed specific training on how to interpret and translate legal frameworks into internal rules and standards of good practice. The purpose of this paper was: 1 to familiarize professionals who work in healthcare informatics with the ethical and legal issues related to their work; 2 to provide information about codes of ethics and legal regulations concerning this specific area; 3 to summarize some risks linked to wrong or inadequate use of patient information, such as medical, genetic, or personal data.
Tucker-Seeley, Reginald D; Mitchell, Jamie A; Shires, Deirdre A; Modlin, Charles S
Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.
Freemon, F R
The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.
Tailakh, Ayman K; Evangelista, Lorraine S; Morisky, Donald E; Mentes, Janet C; Pike, Nancy A; Phillips, Linda R
The aim of this study was to examine the relationship between acculturation, medication adherence, lifestyle behaviors (e.g., physical activity, nutrition, weight control), and blood pressure control among hypertensive Arab Americans. The study utilized a cross-sectional descriptive design. A convenience sample of 126 participants completed questionnaires and had measures of blood pressure, weight, and height. Forty-six participants were hypertensive and were included in the analysis. Only 29.2% of participants reported high medication adherence. High medication adherence was associated with lower diastolic blood pressure, eating a healthy diet, and following lifestyle modifications. Acculturation was significantly associated with physical activity and body mass index. Our study found that acculturated participants were more adherent to medications and physical activity and had better blood pressure control. Further studies are needed to explore how acculturation improves adherence and what factors contribute to better adherence in order to design culturally sensitive interventions. © The Author(s) 2014.
Pearce, Christopher; Veil, Klaus; Williams, Peter; Cording, Andrew; Liaw, Siaw-Teng; Grain, Heather
Across the world, bodies representing health informatics or promoting health informatics are either societies of common interest or universities with health informatics courses/departments. Professional colleges in Health Informatics (similar to the idea of professional colleges in other health fields) are few and far between. The Australasian College of Health Informatics has been in existence since 2001, and has an increasing membership of nearly 100 fellows and members, acting as a national focal point for the promotion of Health Informatics in Australasia. Describing the activities of the college, this article demonstrates a need for increasing professionalization of Health informatics beyond the current structures.
Liao, Geraldine J; Nagy, Paul G; Cook, Tessa S
Imaging informatics (II) is an area within clinical informatics that is particularly important in the field of radiology. Provider groups have begun employing dedicated radiologist-informaticists to bridge medical, information technology and administrative functions, and academic institutions are meeting this demand through formal II fellowships. However, little is known about how these programs influence graduates' careers and perceptions about professional development. We electronically surveyed 26 graduates from US II fellowships and consensus leaders in the II community-many of whom were subspecialty diagnostic radiologists (68%) employed within academic institutions (48%)-about the perceived impact of II fellowships on career development and advancement. All graduates felt that II fellowship made them more valuable to employers, with the majority of reporting ongoing II roles (78%) and continued used of competencies (61%) and skills (56%) gained during fellowship in their current jobs. Other key benefits included access to mentors, protected time for academic work, networking opportunities, and positive impacts of annual compensation. Of respondents without II fellowship training, all would recommend fellowships to current trainees given the ability to gain a "still rare" but "essential skill set" that is "critical for future leaders in radiology" and "better job opportunities." While some respondents felt that II fellowships needed further formalization and standardization, most (85%) disagreed with requiring a 2-year II fellowship in order to qualify for board certification in clinical informatics. Instead, most believed that fellowships should be integrated with clinical residency or fellowship training while preserving formal didactics and unstructured project time. More work is needed to understand existing variations in II fellowship training structure and identify the optimal format for programs targeted at radiologists.
Sensmeier, Joyce; Anderson, Christel; Shaw, Toria
The TIGER Initiative aims to explain how to equip practicing nurses with informatics competencies. This chapter describes a collaborative effort to identify global informatics requirements in relation to core competencies and to match them with national and regional needs. Recommendations from the TIGER Informatics Competency Synthesis Project, described here, have implications for an international framework of informatics competencies for all types of health care professionals including nurses.
Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M
This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.
Keiser, K R; Jones, W
Despite the fact that ideology and party overshadow campaign contributions as determinants of congressional voting behavior, the thesis of this study is that the American Medical Association's contributions have an important policy impact. Their donations had a significant effect on an index of three votes in 1979 in the House of Representatives. The contributions of the AMA had more of an effect than did those of the AFL-CIO. The AMA's money was related to decision-making in the Ways and Means and Energy and Commerce Committees. While the medical lobby does not dominate health care policy, its power should not be underestimated.
Pohl, Lynn Marie
Much of what scholars know about race and medicine in the late-nineteenth-and early-twentieth-century South relates to the racial beliefs of white physicians and the segregated and exploitative treatment of black patients in hospitals and public health programs. This article shifts scholarly attention to the ways African American patients and their families took part in medical practice in commonplace settings of the home and office. The author examines how African Americans called upon local physicians in the rural and small-town South, how white physicians responded, and how they interacted in cases of serious illness, injury, and surgery. The claims of black southerners to physicians' treatments, in combination with small-town physicians' continuing reliance on interpersonal practices of medical care, made for an erratic but potentially distinctive cross-racial encounter-one involving a greater degree of negotiated authority and personal care than what generally has been recognized for this time and place.
Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle
BACKGROUND The contribution of masculinity to men’s healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). MEASUREMENTS Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60–0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45–0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34–5.20), blood pressure (OR: 3.03; 95% CI: 1.45–6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03–4.23). CONCLUSIONS Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men’s blood pressure and cholesterol screening. Routine
Kaltoft, Mette Kjer
-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how......All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities...... in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point...
Full Text Available Objective: To investigate American cockroaches' infection to various bacteria in Khorramshahr Vali-e-Asr hospital, which was done in 2008. Methods: In this descriptive cross-sectional study, 20 American cockroaches were caught via direct collection. Medically important bacteria were extracted from their outer surface of bodies by standard procedures. Results: Culturing outer surface wash of cockroaches resulted in the separation of Klebsiella, Pseudomonas, Escherichia coli, Staphylococcus, Proteus and Streptococcus. The main common bacteria were Klebsiella (35% and Pseudomonas (30%. Also, results of culture media showed that about 90% of cockroaches infected to at least one bacterium. Conclusions: American cockroaches can transmit pathogenic and potential pathogenic bacteria, therefore their presence in hospitals may be a sanitation challenge. It is recommended to assess plans in purpose to combat these pests in the hospitals.
Richesson, Rachel L; Green, Beverly B; Laws, Reesa; Puro, Jon; Kahn, Michael G; Bauck, Alan; Smerek, Michelle; Van Eaton, Erik G; Zozus, Meredith; Hammond, W Ed; Stephens, Kari A; Simon, Greg E
Pragmatic clinical trials (PCTs) are research investigations embedded in health care settings designed to increase the efficiency of research and its relevance to clinical practice. The Health Care Systems Research Collaboratory, initiated by the National Institutes of Health Common Fund in 2010, is a pioneering cooperative aimed at identifying and overcoming operational challenges to pragmatic research. Drawing from our experience, we present 4 broad categories of informatics-related challenges: (1) using clinical data for research, (2) integrating data from heterogeneous systems, (3) using electronic health records to support intervention delivery or health system change, and (4) assessing and improving data capture to define study populations and outcomes. These challenges impact the validity, reliability, and integrity of PCTs. Achieving the full potential of PCTs and a learning health system will require meaningful partnerships between health system leadership and operations, and federally driven standards and policies to ensure that future electronic health record systems have the flexibility to support research. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Prevedello, Luciano M; Andriole, Katherine P; Khorasani, Ryan Roobian Ramin
The RSNA Medical Imaging Resource Center (MIRC) software is an open-source program that allows users to identify, index, and retrieve images, teaching files, and other radiologic data that share a common underlying structure. The software is being continually improved as new challenges and different needs become apparent. Although version T30 is easily installed on a stand-alone computer, its implementation at healthcare enterprises with complex network architecture may be challenging with respect to security because users cannot log on by using a standard enterprise-wide authentication protocol. Instead, authentication takes place through the local MIRC database, creating security concerns and potential organizational problems. In this setting, the Lightweight Directory Access Protocol (LDAP) can be used to provide a single sign-on environment and increase authentication security. A commercial directory service using LDAP has been successfully integrated with MIRC in a large multifacility enterprise to provide single sign-on capability compatible with the institutional networking policies for password security. Copyright RSNA, 2009
Evans, Karla; Võ, Melissa L. -H.; Jacobson, Francine L.; Wolfe, Jeremy M.
Diagnostic accuracy for radiologists is above that expected by chance when they are exposed to a chest radiograph for only one-fifth of a second, a period too brief for more than a single voluntary eye movement. How do radiologists glean information from a first glance at an image? It is thought that this expert impression of the gestalt of an image is related to the everyday, immediate visual understanding of the gist of a scene. Several high-speed mechanisms guide our search of complex images. Guidance by basic features (such as color) requires no learning, whereas guidance by complex scene properties is learned. It is probable that both hardwired guidance by basic features and learned guidance by scene structure become part of radiologists’ expertise. Search in scenes may be best explained by a two-pathway model: Object recognition is performed via a selective pathway in which candidate targets must be individually selected for recognition. A second, nonselective pathway extracts information from global or statistical information without selecting specific objects. An appreciation of the role of nonselective processing may be particularly useful for understanding what separates novice from expert radiologists and could help establish new methods of physician training based on medical image perception. © RSNA, 2012 PMID:23104971
Willoughby, Christopher D
Relying on a close reading of more than 4,000 medicals student theses, this essay explores the evolving medical approaches to race and environment in the early national and antebellum United States and highlights the role that medical school pedagogy played in disseminating and elaborating racial theory. Specifically, it considers the influence of racial science on medical concepts of the relationship of bodies to climates. At their core, monogenesis-belief in a single, unified human race-and polygenesis-the belief that each race was created separately-were theories about the human body's connections to the natural world. As polygenesis became influential in Atlantic medical thought, physicians saw environmental treatments as a matter of matching bodies to their natural ecology. In the first decades of the nineteenth century, Atlantic physicians understood bodies and places as in constant states of flux. Through proper treatment, people and environments could suffer either degradation or improvement. Practitioners saw African Americans and whites as the same species with their differences being largely superficial and produced by climate. However, by the 1830s and 1840s medical students were learning that each race was inherently different and unalterable by time or temperature. In this paradigm, medical students articulated a vision of racial health rooted in organic relationships between bodies and climates. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin
Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.
Haynes, Douglas M
In May 1870 the American Medical Association (AMA) voted to deny the admission of black delegates and their white colleagues to the national meeting in Washington, D.C. Historians of race and medicine have customarily viewed this decision as marking a crucial milestone in the formation of the nexus between racism and the development of the American medical profession in the era after the Civil War (1861-64). This study recasts this narrative by locating the 1870 decision in relation to the antebellum practices of the association and their social consequences for American medicine. It argues that the viability of the AMA as the national voice of the profession was critically dependent on rejecting racial equality. Indeed, at a moment when the question of the abolition of slavery polarized the nation, the AMA was founded in 1847 to create a voluntary professional organization, national in scope, dedicated to raising the standards of medical training and practice. To this end, the AMA elected presidents and selected host cities for annual meetings in the North, South, and West. Seven out of the fourteen meetings and six out of fourteen presidents were from slave and/or border states. These institutional practices together with the representation of blacks as different and enjoying an appropriate status as slaves grounded the national identity of the profession in black subordination. Similarly, the gendered discourses about healing and practices of female exclusion privileged medical authority as male by drawing on and reinforcing patriarchy. In the wake of the war, leaders hoped to restore the national character of the organization by resuming antebellum practices. In response to the new possibilities for blacks in medicine--as represented by the biracial National Medical Society--the AMA took steps to vigorously police the racial boundaries of the national profession. As this study will show, the 1870 decision reflected the logic of the racial politics at the heart
Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C
The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.
Full Text Available The Transfusion Medicine Service (TMS covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.
Sharma, Gaurav; Parwani, Anil V.; Raval, Jay S.; Triulzi, Darrell J.; Benjamin, Richard J.; Pantanowitz, Liron
The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS. PMID:21383927
Sharma, Gaurav; Parwani, Anil V; Raval, Jay S; Triulzi, Darrell J; Benjamin, Richard J; Pantanowitz, Liron
The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.
Jetté, Sylvie; Tribble, Denise St-Cyr; Gagnon, Johanne; Mathieu, Luc
This article presents the findings of a doctoral study about the internal and external resources required to develop nursing informatics competencies in student nurses. Colleges and universities are responsible for training nursing students, including in the area of nursing informatics. Even though nursing informatics is a specialty recognized by the American Nursing Association (2001), it has received limited attention in Quebec, Canada. A total of 131 college-level nursing students were randomly surveyed with a mail questionnaire designed to describe their perceptions about their internal and external resources in nursing informatics. Nursing students perceive that their internal and external resources necessary to ensure "knowledge to act" in nursing informatics is moderately high. They said they lacked knowledge about using spreadsheet programs, presentation software, and courseware, about data security, and about how to analyze the quality of a health-related Web site and search electronic scientific databases. These results show that, even if nursing students have access to a computer and the Internet at home and even if they feel competent using informatics in nursing, they still lack important resources for developing competencies in nursing informatics. We recommend that faculties and colleges focus on these elements. Copyright © 2010 Elsevier Ltd. All rights reserved.
The dominance of biomedical science in medical education has been contested throughout the past century, with recurring calls for more social science and humanities content. The centrality of biomedicine is frequently traced back to Abraham Flexner's 1910 report, 'Medical Education in the United States and Canada'. However, Flexner advocated for a scientist-doctor, rather than a curriculum filled with science content. Examination of the discourses of science since Flexner allows us to explore the place of various knowledge forms in medical education. A Foucauldian critical discourse analysis was performed, examining the discourses of scientific medicine in Flexner's works and North American medical education articles in subsequent decades. Foucault's methodological principles were used to identify statements, keywords and metaphors that emerged in the development of the discourses of scientific medicine, with particular attention to recurring arguments and shifts in the meaning and use of terms. Flexner's scientist-doctor was an incisive thinker who drew upon multiple forms of knowledge. In the post-Flexner medical education reforms, the perception of science as a discursive object embedded in the curriculum became predominant over that of the scientist as the discursive subject who uses science. Science was then considered core curricular content and was discursively framed as impossibly vast. A parallel discourse, one of the insufficiency of biomedical science for the proper training of doctors, has existed over the past century, even as the humanities and social sciences have remained on the margins in medical school curricula. That discourses of scientific medicine have reinforced the centrality of biomedicine in medical education helps to explain the persistent marginalisation of other important knowledge domains. Medical educators need to be aware of the effects of these discourses on understandings of medical knowledge, particularly when contemplating
Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A
Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.
Chen, Jiajia; Lin, Yuxin; Shen, Bairong
The past decade has witnessed great advances in biomedical informatics. Biomedical informatics is an emerging field of healthcare that aims to translate the laboratory observation into clinical practice. Smart healthcare has also developed rapidly with ubiquitous sensor and communication technologies. It is able to capture the online patient-centric phenotypic variables, thus providing a rich information base for translational biomedical informatics. Biomedical informatics and smart healthcare represent two interrelated disciplines. On one hand, biomedical informatics translates the bench discoveries into bedside, and, on the other hand, it is reciprocally informed by clinical data generated from smart healthcare. In this chapter, we will introduce the major strategies and challenges in the application of biomedical informatics technology in precision medicine and healthcare. We highlight how the informatics technology will promote the precision medicine and therefore promise the improvement of healthcare.
Schofferman, Jerome A; Eskay-Auerbach, Marjorie L; Sawyer, Laura S; Herring, Stanley A; Arnold, Paul M; Muehlbauer, Eric J
Recently the financial relationships between industry and professional medical associations have come under increased scrutiny because of the concern that industry ties may create real or perceived conflicts of interest. Professional medical associations pursue public advocacy as well as promote medical education, develop clinical practice guidelines, fund research, and regulate professional conduct. Therefore, the conflicts of interest of a professional medical association and its leadership can have more far-reaching effects on patient care than those of an individual physician. Few if any professional medical associations have reported their experience with implementing strict divestment and disclosure policies, and among the policies that have been issued, there is little uniformity. We describe the experience of the North American Spine Society (NASS) in implementing comprehensive conflicts of interest policies. A special feature article. We discuss financial conflicts of interest as they apply to professional medical associations rather than to individual physicians. We describe the current policies of disclosure and divestment adopted by the NASS and how these policies have evolved, been refined, and have had no detrimental impact on membership, attendance at annual meetings, finances, or leadership recruitment. No funding was received for this work. The authors report no potential conflict-of-interest-associated biases in the text. The NASS has shown that a professional medical association can manage its financial relationships with industry in a manner that minimizes influence and bias. The NASS experience can provide a template for other professional medical associations to help manage their own possible conflicts of interest issues. Copyright © 2013 Elsevier Inc. All rights reserved.
Kohli, Marc D; Warnock, Max; Daly, Mark; Toland, Christopher; Meenan, Chris; Nagy, Paul G
Over the past 20 years, imaging informatics has been driven by the widespread adoption of radiology information and picture archiving and communication and speech recognition systems. These three clinical information systems are commonplace and are intuitive to most radiologists as they replicate familiar paper and film workflow. So what is next? There is a surge of innovation in imaging informatics around advanced workflow, search, electronic medical record aggregation, dashboarding, and analytics tools for quality measures (Nance et al., AJR Am J Roentgenol 200:1064-1070, 2013). The challenge lies in not having to rebuild the technological wheel for each of these new applications but instead attempt to share common components through open standards and modern development techniques. The next generation of applications will be built with moving parts that work together to satisfy advanced use cases without replicating databases and without requiring fragile, intense synchronization from clinical systems. The purpose of this paper is to identify building blocks that can position a practice to be able to quickly innovate when addressing clinical, educational, and research-related problems. This paper is the result of identifying common components in the construction of over two dozen clinical informatics projects developed at the University of Maryland Radiology Informatics Research Laboratory. The systems outlined are intended as a mere foundation rather than an exhaustive list of possible extensions.
Full Text Available The shortage in Latin-American Primary Care (PC workforce may be due to negative perceptions about it. These perceptions might be probably influenced by particular features of health systems and academic environments, thus varying between countries.Observational, analytic and cross-sectional multicountry study that evaluated 9,561 first and fifth-year medical students from 63 medical schools of 11 Latin American countries through a survey. Perceptions on PC work was evaluated through a previously validated scale. Tertiles of the scores were created in order to compare the different countries. Crude and adjusted prevalence ratios were calculated using simple and multiple Poisson regression with robust variance.Approximately 53% of subjects were female; mean age was 20.4±2.9 years; 35.5% were fifth-year students. Statistically significant differences were found between the study subjects' country, using Peru as reference. Students from Chile, Colombia, Mexico and Paraguay perceived PC work more positively, while those from Ecuador showed a less favorable position. No differences were found among perceptions of Bolivian, Salvadoran, Honduran and Venezuelan students when compared to their Peruvian peers.Perceptions of PC among medical students from Latin America vary according to country. Considering such differences can be of major importance for potential local specific interventions.
Physicians figured prominently in the resurgence of nuclear weapons activism and cultural awareness that swept the US in the early 1980s. This discussion seeks to place this activism in historical context. It explores the American medical profession's shifting engagement with the issue of nuclear war. Attention is focused on the period 1945 to 1954, with a brief evaluation of the period 1954 to 1963, the years to which the activism of the 1980s may be traced. Radiation studies are reviewed including Hiroshima and Nagasaki survivors. Radiological studies were begun within days of Japan's surrender. The delayed effects of radiation exposure on some 14,000 persons in Hiroshima and Nagasaki include hemorrhage, leukocyte destruction, bone marrow damage, anemia, sterility, and the suppression of menstruation. In contrast, the American medical profession in the late 1940s focused much attention on the atom's potential medical benefits, especially the diagnostic and treatment value of radioisotopes. 90 references.
Mayta-Tristán, Percy; Montenegro-Idrogo, Juan José; Mejia, Christian R.; Abudinén A., Gabriel; Azucas-Peralta, Rita; Barrezueta-Fernandez, Jorge; Cerna-Urrutia, Luis; DaSilva-DeAbreu, Adrián; Mondragón-Cardona, Alvaro; Moya, Geovanna; Valverde-Solano, Christian D.; Theodorus-Villar, Rhanniel; Vizárraga-León, Maribel
Background The shortage in Latin-American Primary Care (PC) workforce may be due to negative perceptions about it. These perceptions might be probably influenced by particular features of health systems and academic environments, thus varying between countries. Methods Observational, analytic and cross-sectional multicountry study that evaluated 9,561 first and fifth-year medical students from 63 medical schools of 11 Latin American countries through a survey. Perceptions on PC work was evaluated through a previously validated scale. Tertiles of the scores were created in order to compare the different countries. Crude and adjusted prevalence ratios were calculated using simple and multiple Poisson regression with robust variance. Results Approximately 53% of subjects were female; mean age was 20.4±2.9 years; 35.5% were fifth-year students. Statistically significant differences were found between the study subjects’ country, using Peru as reference. Students from Chile, Colombia, Mexico and Paraguay perceived PC work more positively, while those from Ecuador showed a less favorable position. No differences were found among perceptions of Bolivian, Salvadoran, Honduran and Venezuelan students when compared to their Peruvian peers. Conclusions Perceptions of PC among medical students from Latin America vary according to country. Considering such differences can be of major importance for potential local specific interventions. PMID:27414643
Smilowitz, Jennifer B; Avery, Stephen; Gueye, Paul; Sandison, George A
The American Association of Physicists in Medicine (AAPM) sponsors two summer undergraduate research programs to attract top performing undergraduate students into graduate studies in medical physics: the Summer Undergraduate Fellowship Program (SUFP) and the Minority Undergraduate Summer Experience (MUSE). Undergraduate research experience (URE) is an effective tool to encourage students to pursue graduate degrees. The SUFP and MUSE are the only medical physics URE programs. From 2001 to 2012, 148 fellowships have been awarded and a total of $608,000 has been dispersed to fellows. This paper reports on the history, participation, and status of the programs. A review of surveys of past fellows is presented. Overall, the fellows and mentors are very satisfied with the program. The efficacy of the programs is assessed by four metrics: entry into a medical physics graduate program, board certification, publications, and AAPM involvement. Sixty-five percent of past fellow respondents decided to pursue a graduate degree in medical physics as a result of their participation in the program. Seventy percent of respondents are currently involved in some educational or professional aspect of medical physics. Suggestions for future enhancements to better track and maintain contact with past fellows, expand funding sources, and potentially combine the programs are presented.
Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira
The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.
Whitehead, Cynthia R; Hodges, Brian D; Austin, Zubin
Medical educators develop student selection criteria and design curricula based on underlying assumptions about who is best suited to the profession and how these learners should be taught. Often these assumptions are not made explicit but instead are embedded in the words and phrases used to describe trainees and curricula. They may then be considered inevitable, rather than being seen as particular social constructs. Using Foucauldian critical discourse analysis methodology, the authors examined a major shift in language in the late 1950s in North American medical education texts. The discourse of the good doctor as a man of character, which had been present since the 1910 Flexner Report, was replaced by a new discourse of characteristics. Analysis of this sudden discursive shift shows a change in thinking about the medical trainee and learning environment from a personal journey of discovery to a dissectible set of component parts that could be individually measured and manipulated. Understanding the discursive effects of language that we use will allow medical educators greater insight into the implications and consequences of different constructions of important issues in medical education.
Health IT is expected to have a positive impact on the quality and efficiency of health care. But reports on negative impact and patient harm continue to emerge. The obligation of health informatics is to make sure that health IT solutions provide as much benefit with as few negative side effects as possible. To achieve this, health informatics as a discipline must be able to learn, both from its successes as well as from its failures. To present motivation, vision, and history of evidence-based health informatics, and to discuss achievements, challenges, and needs for action. Reflections on scientific literature and on own experiences. Eight challenges on the way towards evidence-based health informatics are identified and discussed: quality of studies; publication bias; reporting quality; availability of publications; systematic reviews and meta-analysis; training of health IT evaluation experts; translation of evidence into health practice; and post-market surveillance. Identified needs for action comprise: establish health IT study registers; increase the quality of publications; develop a taxonomy for health IT systems; improve indexing of published health IT evaluation papers; move from meta-analysis to meta-summaries; include health IT evaluation competencies in curricula; develop evidence-based implementation frameworks; and establish post-marketing surveillance for health IT. There has been some progress, but evidence-based health informatics is still in its infancy. Building evidence in health informatics is our obligation if we consider medical informatics a scientific discipline.
Lassen, Jens Vejrup; Simonsen, Jesper
We present an ethnographic study of the organizational aspects of the use of an electronic whiteboard (EW) system implemented in a Danish hospital located in Nykøbing Falster (NFH). The EW system had originally been developed for the emergency department (ED), but had later been extended to the e...
Barber, Barry; Scholes, Maureen
The recording of numbers appears to pre-date the emergence of writing and excavations of the clay tablets of civilisations in the Middle East have shown that clay tablets were used to keep account of activities undertaken in a systematic fashion. Correspondingly, various forms of abacus have been used types of calculation from the Sumerian abacus dating from about 4 ½ thousand years ago to the Chinese abacus (Suanpan) from around 2 thousand years ago. As time passed various forms of writing were developed using animal hides, which were developed as vellum and papyrus which eventually developed into paper. Wood block printing, also, was a very ancient art and movable type printing had been utilised in the far East but the development of movable type page setting in Europe transformed the process of printing.
Summary Objective What are the determining factors for good research in medical informatics or, from a broader perspective, in biomedical and health informatics? Method From the many lessons learned during my professional career, I tried to identify a fair sampling of such factors. On the occasion of giving the IMIA Award of Excellence lecture during MedInfo 2013, they were presented for discussion. Results Sixteen determining factors (df) have been identified: early identification and promotion (df1), appropriate education (df2), stimulating persons and environments (df3), sufficient time and backtracking opportunities (df4), breadth of medical informatics competencies (df5), considering the necessary preconditions for good medical informatics research (df6), easy access to high-quality knowledge (df7), sufficient scientific career opportunities (df8), appropriate conditions for sustainable research (df9), ability to communicate and to solve problems (df10), as well as to convey research results (df11) in a highly inter- and multidisciplinary environment, ability to think for all and, when needed, taking the lead (df12), always staying unbiased (df13), always keeping doubt (df14), but also always trying to provide solutions (df15), and, finally, being aware that life is more (df16). Conclusions Medical Informatics is an inter- and multidisciplinary discipline “avant la lettre”. Compared to monodisciplinary research, inter- and multidisciplinary research does not only provide significant opportunities for solving major problems in science and in society. It also faces considerable additional challenges for medical informatics as a scientific field. The determining factors, presented here, are in my opinion crucial for conducting successful research and for developing a research career. Since medical informatics as a field has today become an important driving force for research progress, especially in biomedicine and health care, but also in fields like
What are the determining factors for good research in medical informatics or, from a broader perspective, in biomedical and health informatics? From the many lessons learned during my professional career, I tried to identify a fair sampling of such factors. On the occasion of giving the IMIA Award of Excellence lecture during MedInfo 2013, they were presented for discussion. Sixteen determining factors (df) have been identified: early identification and promotion (df1), appropriate education (df2), stimulating persons and environments (df3), sufficient time and backtracking opportunities (df4), breadth of medical informatics competencies (df5), considering the necessary preconditions for good medical informatics research (df6), easy access to high-quality knowledge (df7), sufficient scientific career opportunities (df8), appropriate conditions for sustainable research (df9), ability to communicate and to solve problems (df10), as well as to convey research results (df11) in a highly inter- and multidisciplinary environment, ability to think for all and, when needed, taking the lead (df12), always staying unbiased (df13), always keeping doubt (df14), but also always trying to provide solutions (df15), and, finally, being aware that life is more (df16). Medical Informatics is an inter- and multidisciplinary discipline "avant la lettre". Compared to monodisciplinary research, inter- and multidisciplinary research does not only provide significant opportunities for solving major problems in science and in society. It also faces considerable additional challenges for medical informatics as a scientific field. The determining factors, presented here, are in my opinion crucial for conducting successful research and for developing a research career. Since medical informatics as a field has today become an important driving force for research progress, especially in biomedicine and health care, but also in fields like computer science, it may be helpful to consider such
Hwang, Jee-In; Park, Hyeoun-Ae
Informatics competency has become an essential requirement for nurses to fulfill their professional roles. This study examined the factors affecting informatics competency to help develop strategies to improve nurses' informatics practice. A cross-sectional survey was conducted in two tertiary teaching hospitals in Seoul, Korea. A questionnaire was designed to collect data on nurses' informatics competency, basic computer skills, attitudes toward computerization, and general characteristics. The response rate was 96.4% (350/363). Multiple regression analysis was performed to determine the characteristics affecting informatics competency. More than two-thirds of the nurses (69.2%) considered their overall informatics competency to be below average. They scored the highest on the informatics topics of security and confidentiality, and the lowest on telehealth. More than half (58.9%) rated their computer skills to be below average. Nurses had favorable attitudes toward computerization. Significant factors associated with informatics competency were basic computer skills and formal informatics education. The study findings suggest that the enhancement of basic computer skills and incorporation of informatics into formal nursing curricula are needed to improve the nurses' competency in managing and using healthcare information.
Asif, Irfan M; Stovak, Mark; Ray, Tracy; Weiss-Kelly, Amanda
The American Medical Society for Sports Medicine recognises a need to provide direction and continually enhance the quality of sports medicine fellowship training programmes. This document was developed to be an educational resource for sports medicine physicians who teach in a 1-year primary care sports medicine fellowship training programme. It is meant to provide high standards and targets for fellowship training programmes that choose to re-assess their curriculum and seek to make improvements. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
A. A. Kosolapov
Full Text Available Purpose.Computerization and informatization in recent decades gave the mankind automated electronic document management systems, automated process of production, Internet and network information resources WWW, expanded the communications capabilities and led to the globalization of the information society. At the same time gives rise to a number of processes of informatization philosophical and anthropological problems, that has become an existential character. It is necessary to identify and understanding of these issues on the basis of the gnoseological model of the evolution informatization paradigms and determine their main characteristics. Methodology. The system-activity approach was used; it allowed identifying and analyzing the impact of the main components of information and communication technologies (ICT for educational activities. And further to present them as a unified system of human activity in conditions computerization/informatization. The philosophical principles: a comprehensive review of the subject, the unity of the logical and historical, ascending from the abstract to the concrete was used. The general scientific principles: unity and development of the system, the decomposition hierarchy, individualization and cooperation, diversity and taxonomy were applied. Findings.The three-stage gnoseological model of the paradigms computerization/informatization evolution was proposed by the author. It is based on three information system characteristics: speed, interface and data access. The seven-bar anthrop-centric model, which is called the architecture of information systems (AIS, which describes the changes in their types of procuring, was proposed for each paradigm. The philosophical-anthropological problems that affect negatively its progress were formulated for each stage of modern information society transformation. Originality. The gnoseological model of development processes of informatization in the form of three
Ariño Arturo H
Full Text Available Abstract Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a the intrinsic biodiversity potential (the biological richness or ecological diversity of a country; (b the capacity of the country to generate biodiversity data records; and (c the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a identifying
Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to
Ariño, Arturo H; Chavan, Vishwas; King, Nick
Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most nonparticipant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. The BIP Index could potentially help in (a) identifying countries most likely to contribute to filling gaps in digitized
Williams, Marc S.; Ritchie, Marylyn D.; Payne, Philip R.O.
The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied resea...
Sarnquist, F H
The American Medical Research Expedition to Everest had a wide variety of medical problems, ranging from leech bites to high-altitude pulmonary edema. Preventive measures, however, such as careful attention to ingesting only pure water and food at the lower elevations and adequate personal hydration, nutrition and rest at extremely high altitude minimized the morbidity suffered by the group. Prophylactic administration of doxycycline was effective in reducing the severity of diarrheal illness in the group. Every member of the expedition suffered upper respiratory tract infections and many other infections, some of which were resistant to all therapy until the patient moved down from high altitude. Despite careful acclimatization, several cases of acute mountain sickness occurred and required descent to a lower altitude for treatment. Frostbite was avoided entirely.
Maccabe, Andrew T; Crawford, Lester; Heider, Lawrence E; Hooper, Billy; Mann, Curt J; Pappaioanou, Marguerite
The mission of the Association of American Veterinary Medical Colleges (AAVMC) is to advance the quality of academic veterinary medicine. Founded in 1966 by the 18 US colleges of veterinary medicine and 3 Canadian colleges of veterinary medicine then in existence, the AAVMC is celebrating 50 years of public service. Initially, the AAVMC comprised the Council of Deans, the Council of Educators, and the Council of Chairs. In 1984, the tri-cameral structure was abandoned and a new governing structure with a board of directors was created. In 1997, the AAVMC was incorporated in Washington, DC and a common application service was created. Matters such as workforce issues and the cost of veterinary medical education have persisted for decades. The AAVMC is a champion of diversity in the veterinary profession and a strong advocate for One Health. The AAVMC has adopted a global perspective as more international colleges of veterinary medicine have earned COE accreditation and become members.
Although human need for various nutrients is well-established, the exact requirements for the different nutrients are not well-known. Nutrient requirements are affected by genetics; environment; nature of the diet; and hemeostatic demands under changing physiological conditions expressed as growth, reproduction and response to the stress of injury or disease. Pregnant and lactating women should be properly nourished if well-nourished infants are desired. Nutrient and energy needs are considerably increased during pregnancy and lactation. The most rapid growth of infants occurs during the 1st 4 to 6 months of life. Because of the many advantages of breast milk over artificial milk, full-term newborn infants should be breastfed, unless there are specific contraindications or breastfeeding is unsuccessful. The American Medical Association (AMA) urges that better efforts be made to educate the public and the medical profession as to the advantages of breastfeeding. The 4th to the 6th months of life constitute the transitional period in infant feeding. The baby should be introduced to single-ingredient foods in small quantities, one at a time, to isolate food sensitivities. Good eating habits can be formed early in life through the proper and gradual introduction of varied and nutritional meal patterns. Energy balance is a nutritional problem in late childhood and once maturity is achieved, while calorically and nutritionally inadequate diets are a growing concern for the elderly. Immoderate eating habits (e.g., overeating) may aggravate or contribute to the development of degenerative diseases and should be discouraged. The AMA recommends that the American public focus on the achievement and maintenance of the most desirable body weight through a proper combination of dietary control and exercise. Specific dietary modifications (sodium restriction, weight control) are necessary in the management of hypertension, diabetes, coronary heart diseases and other medical
Hardeman, Rachel R; Perry, Sylvia P; Phelan, Sean M; Przedworski, Julia M; Burgess, Diana J; van Ryn, Michelle
Diversification of the physician workforce continues to be a national priority; however, a paucity of knowledge about the medical school experience for African American medical students limits our ability to achieve this goal. Previous studies document that African American medical students are at greater risk for depression and anxiety. This study moves beyond these findings to explore the role of racial identity (the extent to which a person normatively defines her/himself with regard to race) and its relationship to well-being for African American medical students in their first year of training. This study used baseline data from the Medical Student Cognitive Habits and Growth Evaluation (CHANGE) Study; a large national longitudinal cohort study of 4732 medical students at 49 medical schools in the US racial identity for African American students (n = 301) was assessed using the centrality sub-scale of the Multidimensional Inventory of Black Identity. Generalized linear regression models with a Poisson regression family distribution were used to estimate the relative risks of depression, anxiety, and perceived stress. First year African American medical students who had lower levels of racial identity were less likely to experience depressive and anxiety symptoms in their first year of medical school. After controlling for other important social predictors of poor mental health (gender and SES), this finding remained significant. Results increase knowledge about the role of race as a core part of an individual's self-concept. These findings provide new insight into the relationship between racial identity and psychological distress, particularly with respect to a group of high-achieving young adults.
Newman, Lisa A; Pollock, Raphael E; Johnson-Thompson, Marian C
In the United States, breast cancer mortality rates are significantly higher among African-American women than among women of other ethnic backgrounds. Research efforts to evaluate the socioeconomic, environmental, biologic, and genetic mechanisms explaining this disparity are needed. Data regarding patterns in the ethnic distribution of physicians and oncologists were accumulated from a review of the literature and by contacting cancer-oriented professional societies. This information was evaluated by participants in a national meeting, "Summit Meeting Evaluating Research on Breast Cancer in African American Women." Results of the data collection and the conference discussion are summarized. Ethnic minority specialists are underrepresented in academic medicine in general, and in the field of oncology in particular. This fact is unfortunate because ethnic minority students are more likely to express a commitment to providing care to medically underserved communities and, thus, they need to be better represented in these professions. Correcting these patterns of underrepresentation may favorably influence the design and implementation of culturally and ethnically sensitive research. Efforts to improve the ethnic diversity of oncology specialists should begin at the level of recruiting an ethnically diverse premed and medical student population. These recruitment efforts should place an emphasis on the value of mentoring.
Molina, Yamile; Scherman, Ashley; Constant, Tara Hayes; Hempstead, Bridgette; Thompson-Dodd, Jacci; Richardson, Shayla; Weatherby, Shauna Rae; Reding, Kerryn W.; Ceballos, Rachel M.
Purpose Medical advocacy at multiple levels (self, community/interpersonal, national/public health interest) may be helpful to address the disproportionate burden of breast cancer African American women encounter. Little however is known about the interplay of medical advocacy at different levels. Methods We analyzed qualitative data from two studies focused on the psychosocial experiences of breast cancer among 38 African American women living in Western Washington State. Results Emergent themes suggested that survivors received community/interpersonal advocacy from different members of social networks in the form of social support (appraisal, emotional, informational, instrumental). Survivors indicated that receiving this advocacy was associated with greater self advocacy in terms of their own care experiences as well as greater community/interpersonal advocacy on their part as resources to other women diagnosed with breast cancer, their family, friends, and larger communities. Conclusion Our findings suggest that community/interpersonal advocacy, including providing different types of support, may lead to improved self advocacy as well as health-protective impacts for the networks in which survivors are embedded. Future quantitative research is warranted to support these findings and assess how this interplay is associated with improved outcomes among this marginalized and resilient population. PMID:26891843
Shaw, Nicola; McGuire, Suzanne
The purpose of this literature review is to understand geographical information systems (GIS) and how they can be applied to public health informatics, medical informatics, and epidemiology. Relevant papers that reflected the use of geographical information systems (GIS) in health research were identified from four academic databases: Academic Search Complete, BioMed Central, PubMed Central, and Scholars Portal, as well as Google Scholar. The search strategy used was to identify articles with "geographic information systems", "GIS", "public health", "medical informatics", "epidemiology", and "health geography" as main subject headings or text words in titles and abstracts. Papers published between 1997 and 2014 were considered and a total of 39 articles were included to inform the authors on the use of GIS technologies in health informatics research. The main applications of GIS in health informatics and epidemiology include disease surveillance, health risk analysis, health access and planning, and community health profiling. GIS technologies can significantly improve quality and efficiency in health research as substantial connections can be made between a population's health and their geographical location. Gains in health informatics can be made when GIS are applied through research, however, improvements need to occur in the quantity and quality of data input for these systems to ensure better geographical health maps are used so that proper conclusions between public health and environmental factors may be made.
Thiébaut, R; Thiessard, F
Objectives: To summarize current research in the field of Public Health and Epidemiology Informatics. Methods : The complete 2016 literature concerning public health and epidemiology informatics has been searched in PubMed and Web of Science, and the returned references were reviewed by the two section editors to select 14 candidate best papers. These papers were then peer-reviewed by external reviewers to allow the editorial team an enlightened selection of the best papers. Results : Among the 829 references retrieved from PubMed and Web of Science, three were finally selected as best papers. The first one compares Google, Twitter, and Wikipedia as tools for Influenza surveillance. The second paper presents a Geographic Knowledge-Based Model for mapping suitable areas for Rift Valley fever transmission in Eastern Africa. The last paper evaluates the factors associated with the visit of Facebook pages devoted to Public Health Communication. Conclusions: Surveillance is still a productive topic in public health informatics but other very important topics in public health are appearing. Georg Thieme Verlag KG Stuttgart.
Perry, Sylvia P; Hardeman, Rachel; Burke, Sara E; Cunningham, Brooke; Burgess, Diana J; van Ryn, Michelle
Positive psychological well-being is an important predictor of and contributor to medical student success. Previous work showed that first-year African American medical students whose self-concept was highly linked to their race (high racial identity centrality) were at greater risk for poor well-being. The current study extends this work by examining (a) whether the psychological impact of racial discrimination on well-being depends on African American medical students' racial identity centrality and (b) whether this process is explained by how accepted students feel in medical school. This study used baseline data from the Medical Student Cognitive Habits and Growth Evaluation (CHANGE) Study, a large national longitudinal cohort study of 4732 medical students at 49 medical schools in the USA (n = 243). Regression analyses were conducted to test whether medical student acceptance mediated an interactive effect of discrimination and racial identity centrality on self-esteem and well-being. Both racial identity centrality and everyday discrimination were associated with negative outcomes for first-year African American medical students. Among participants who experienced higher, but not lower, levels of everyday discrimination, racial identity centrality was associated with negative outcomes. When everyday discrimination was high, but not low, racial identity was negatively related to perceived acceptance in medical school, and this in turn was related to increased negative outcomes. Our results suggest that discrimination may be particularly harmful for African American students who perceive their race to be central to their personal identity. Additionally, our findings speak to the need for institutional change that includes commitment and action towards inclusivity and the elimination of structural racism.
Full Text Available The objective, necessity, means and estimated efficiency of information security cost modeling are presented. The security requirements of distributed informatics applications are determined. Aspects regarding design, development and implementation are established. Influence factors for informatics security are presented and their correlation is analyzed. The costs associated to security processes are studied. Optimal criteria for informatics security are established. The security cost of the informatics application for validating organizational identifiers is determined using theoretical assumptions made for cost models. The conclusions highlight the validity of research results and offer perspectives for future research.
Yang, Li; Cui, Dan; Zhu, Xuemei; Zhao, Qiuli; Xiao, Ningning; Shen, Xiaoying
Nurse managers are in an excellent position for providing leadership and support within the institutions they serve and are often responsible for accessing information that is vital to the improvement of health facility processes and patients' outcomes. Therefore, competency in informatics is essential. The purposes of this study are to examine current informatics competency levels of nurse managers and to identify the variables that influence these competencies. A questionnaire designed to assess demographic information and nursing informatics competency was completed by 68 nurse managers. Multiple linear regression analysis was conducted to analyze the factors influencing informatics competency. Descriptive analysis of the data revealed that informatics competency of these nurse managers was in the moderate range (77.65 ± 8.14). Multiple linear regression analysis indicated that level of education, nursing administration experience, and informatics education/training were significant factors affecting competency levels. The factors identified in this study can serve as a reference for nurse managers who were wishing to improve their informatics competency, hospital administrators seeking to provide appropriate training, and nursing educators who were making decisions about nursing informatics curricula. These findings suggest that efforts to enhance the informatics competency of nurse managers have marked potential benefits.
Anderson, Diana C; Jackson, Ashley A; Halpern, Neil A
Advanced informatics systems can help improve health care delivery and the environment of care for critically ill patients. However, identifying, testing, and deploying advanced informatics systems can be quite challenging. These processes often require involvement from a collaborative group of health care professionals of varied disciplines with knowledge of the complexities related to designing the modern and "smart" intensive care unit (ICU). In this article, we explore the connectivity environment within the ICU, middleware technologies to address a host of patient care initiatives, and the core informatics concepts necessary for both the design and implementation of advanced informatics systems.
Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used. Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades. This article summarizes the findings of a literature review on women’s experiences with medical abortion in Latin American countries where voluntary abortion is illegal. Women’s personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1 a medically supervised abortion in a clandestine clinic or 2 complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support. Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it
Song, Insu; Yellowlees, Peter; Diederich, Joachim
This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).
Alarcón, Renato D; Suarez-Richards, Manuel; Sarabia, Silvana
Medical education has incorporated psychiatric or mental health components more consistently during the last decades thanks to various factors such as: advances in neurobiological research; the increasing prevalence of mental disorders in global health; the increasingly close relationship between mental health and public health; comorbidities with medical conditions and the impact of sociocultural phenomena in clinical manifestations, diagnosis, treatment, prognosis and prevention. Based on acquisition of core competencies and ethical principles of universal acceptance, the teaching process examined in this article proposes an education based on the provision of clinical experiences integrated throughout the collection of adequate information, the development of diagnostic capabilities, and exposure to a wide variety of forms of academic assessment of students and residents in training. The cultural components of psychiatric education receive special mention; we provide examples of their systematic integration with the acquisition of general skills. The teaching tools include theoretical and applied activities and supervision. Particular attention is paid to how the principles of modern psychiatric medical education, including cultural aspects and practice of holistic health care objectives, can and should be in effect in Latin American countries.
Clough, S; Shehabi, Z; Morgan, C
Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.
Full Text Available General practitioners (GPs need to feel that they are doing a good job in providing care of high quality in a humane manner – that they are ‘good’ doctors. The General Medical Council booklet Good Medical Practice is full of imperatives, but short on values that are the determinants of behaviour. Much has been written on doctors’ professional values in the past decade, but it is not easy for individual GPs and teams to define their own values and consider to what extent they live up to them. Values and informatics, at first glance, might seem to have little in common, or even to be mutually antipathetic, and this is possible within the limitations of current technology. However, providing high-quality care involves the application of knowledge, evidence and guidelines, as well as auditing outcomes. For all these tasks, informatics provides the essential means of discovering whether we, as individuals and teams, are living up to our espoused values so that they become values-in-action that drive behaviour. Application of advanced informatics has the potential to improve and measure diagnostic and therapeutic skills. Technical advances are impressive, but their application lags. The next logical step would seem to be a comprehensive and easy-to-use knowledge-based decision support (KBDS system in a convenient format. Locally based KBDS could facilitate self-audit and provide a step towards the ideal of a ‘self-organising system’ requiring little external audit.
Snyder, Claire F; Wu, Albert W; Miller, Robert S; Jensen, Roxanne E; Bantug, Elissa T; Wolff, Antonio C
Patient-centered care is an important aspect of high-quality care. Health informatics, particularly advances in technology, has the potential to facilitate, or detract from, patient-centered cancer care. Informatics can provide a mechanism for patients to provide their clinician(s) with critical information and to share information with family, friends, and other patients. This information may enable patients to exert greater control over their own care. Clinicians may use information systems (e.g., electronic medical records) to coordinate care and share information with other clinicians. Patients and clinicians may use communication tools and information resources to interact with one another in new ways. Caution in using new information resources is warranted to avoid reliance on biased or inappropriate data, and clinicians may need to direct patients to appropriate information resources. Perhaps the greatest challenge for both patients and providers is identifying information that is high quality and that enhances (and does not impede) their interactions.
Marc S. Williams
Full Text Available The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine.
Finnoff, Jonathan T; Berkoff, David; Brennan, Fred; DiFiori, John; Hall, Mederic M; Harmon, Kimberly; Lavallee, Mark; Martin, Sean; Smith, Jay; Stovak, Mark
The American Medical Society for Sports Medicine (AMSSM) developed a musculoskeletal ultrasound curriculum for sports medicine fellowships in 2010. As the use of diagnostic and interventional ultrasound in sports medicine has evolved, it became clear that the curriculum needed to be updated. Furthermore, the name 'musculoskeletal ultrasound' was changed to 'sports ultrasound' (SPORTS US) to reflect the broad range of diagnostic and interventional applications of ultrasound in sports medicine. This document was created to outline the core competencies of SPORTS US and to provide sports medicine fellowship directors and others interested in SPORTS US education with a guide to create a SPORTS US curriculum. By completing this SPORTS US curriculum, sports medicine fellows and physicians can attain proficiency in the core competencies of SPORTS US required for the practice of sports medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Langella, Stephen; Oster, Scott; Hastings, Shannon; Siebenlist, Frank; Phillips, Joshua; Ervin, David; Permar, Justin; Kurc, Tahsin; Saltz, Joel
Security is a high priority issue in medical domain, because many institutions performing biomedical research work with sensitive medical data regularly. This issue becomes more complicated, when it is desirable or needed to access and analyze data in a multi-institutional setting. In the NCI cancer Biomedical Informatics Grid (caBIG) program, several security issues were raised that existing security technologies could not address. Considering caBIG is envisioned to span a large number of cancer centers and investigator laboratories, these issues pose considerable challenge. In this paper we present these issues and the infrastructure, referred to as GAARDS, which has been developed to address them.
Langella, Stephen; Oster, Scott; Hastings, Shannon; Siebenlist, Frank; Phillips, Joshua; Ervin, David; Permar, Justin; Kurc, Tahsin; Saltz, Joel
Security is a high priority issue in medical domain, because many institutions performing biomedical research work with sensitive medical data regularly. This issue becomes more complicated, when it is desirable or needed to access and analyze data in a multi-institutional setting. In the NCI cancer Biomedical Informatics Grid (caBIG™) program, several security issues were raised that existing security technologies could not address. Considering caBIG is envisioned to span a large number of cancer centers and investigator laboratories, these issues pose considerable challenge. In this paper we present these issues and the infrastructure, referred to as GAARDS, which has been developed to address them. PMID:18693873
PROF. BARTH EKWEME
This paper examines the current state of nursing informatics education and use in Nigeria and proffer solutions .... science; this places emphasis on the human factor in ..... Health Informatics in Africa—HELINA. 93: Proceedings of the First International. Conference. Ile-Ife, Nigeria. National League for Nursing (NLN)., 2008.
Health informatics programs usually are evaluated by national accreditation committees. Not always are the members of these committees well informed about the international level of (education in) health informatics. Therefore, when a program is accredited by a national accreditation committee, this
Perez, M. R.; Valverde, N.; Sanhueza, S.; Di Tramo, J. L.; Gisone, P.; Cardenas, J.
In Latin America exists a wide application of the nuclear techniques in different fields. These tendencies, to the increasing use of nuclear techniques, should carry out the invigoration of the infrastructures and the development of the authorities in radiation protection charge of the regulate and control the sources and practical, associated to ionizing radiation, guided to guarantee their safe use and in consequence to minimize the derived risks of the same ones. In spite of the efforts before mentioned a potential possibility of occurrence of accidental radiological events linked to human errors and violation's of the principles of the radiation protection exists. Reason that they advise to have response capacities to confront and to mitigate the consequences in situations of radiological accidents, including in the same ones the medical assistance of the accident victims. However, the radiological accidents happened in the international environment in the last decades, they have demonstrated inability paradoxically to confront with effectiveness these fortuitous events. Being characterized additionally by the insufficient training of the medical professionals to interpret and to act in consequence before the prejudicial effects to the health of the ionizing radiation. In our geographical context this situation is even more complicated, if we consider the happened radiological accidents of span that put in risk the life and the health of people involved in the same ones, for examples: Argentina (1968, 1963), Brazil (1985, 1987, 1995), Costa Rica (1996). El Salvador (1989), Mexico (1962, 1983, 1984) and Peru (1984, 1999). These reasons justify the development of an action program with the purpose of the consolidate and to integrate the capacity of response of our countries as regards radiological emergencies. Regrettably in Latin American subsist inequalities the development radiation protection programs, that propitiate the possibility of accidental situations
Garcia, Edna; Ali, Asma M; Soles, Ryan M; Lewis, D Grace
To determine the extent and distribution of workforce shortages within the nation's medical laboratories. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2014 Vacancy Survey was conducted through collaboration between American Society for Clinical Pathology's Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, Illinois. Data were collected via an Internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Data reveal increased overall vacancy rates since 2012 for all departments surveyed except cytology and cytogenetics. Also, results show higher anticipated retirement rates for both staff and supervisors. Overall certification rates are highest among laboratory personnel in cytogenetics, hematology/coagulation, and flow cytometry departments and lowest among phlebotomy, specimen processing, and anatomic pathology. Factors such as retirement and the improving economy are driving the need for more laboratory professionals. Recruitment of qualified laboratory professionals in the workforce and students in laboratory programs will be the key in fulfilling the higher vacancies revealed from the survey results in 2014. Copyright© by the American Society for Clinical Pathology.
""This book will be a terrific introduction to the field of clinical IT and clinical informatics"" -- Kevin Johnson ""Dr. Braunstein has done a wonderful job of exploring a number of key trends in technology in the context of the transformations that are occurring in our health care system"" -- Bob Greenes ""This insightful book is a perfect primer for technologists entering the health tech field."" -- Deb Estrin ""This book should be read by everyone."" -- David Kibbe This book provides care providers and other non-technical readers with a broad, practical overview of the changi
Technological advancements in the health care field have always impacted the health care practices. Nursing practice has also been greatly influenced by the technology. In the recent years, use of information technology including computers, handheld digital devices, internet has advanced the nursing by bridging the gap from nursing as an art to nursing as science. In every sphere of nursing practice, nursing research, nursing education and nursing informatics play a very important role. If used properly it is a way to save time, helping to provide quality nursing care and increases the proficiency of nursing personnel.
Sirintrapun, S Joseph; Zehir, Ahmet; Syed, Aijazuddin; Gao, JianJiong; Schultz, Nikolaus; Cheng, Donavan T
Translational bioinformatics and clinical research (biomedical) informatics are the primary domains related to informatics activities that support translational research. Translational bioinformatics focuses on computational techniques in genetics, molecular biology, and systems biology. Clinical research (biomedical) informatics involves the use of informatics in discovery and management of new knowledge relating to health and disease. This article details 3 projects that are hybrid applications of translational bioinformatics and clinical research (biomedical) informatics: The Cancer Genome Atlas, the cBioPortal for Cancer Genomics, and the Memorial Sloan Kettering Cancer Center clinical variants and results database, all designed to facilitate insights into cancer biology and clinical/therapeutic correlations. Copyright © 2015 Elsevier Inc. All rights reserved.
Friedman, Charles P
The term informatics is currently enveloped in chaos. One way to clarify the meaning of informatics is to identify the competencies associated with training in the field, but this approach can conceal the whole that the competencies atomistically describe. This work takes a different approach by offering three higher-level visions of what characterizes the field, viewing informatics as: (1) cross-training between basic informational sciences and an application domain, (2) the relentless pursuit of making people better at what they do, and (3) a field encompassing four related types of activities. Applying these perspectives to describe what informatics is, one can also conclude that informatics is not: tinkering with computers, analysis of large datasets per se, employment in circumscribed health IT workforce roles, the practice of health information management, or anything done using a computer.
Tanner, Andrea; Kim, Sei-Hill; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D
Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.
Huang, Grace C; Sacks, Heather; Devita, Michael; Reynolds, Robby; Gammon, Wendy; Saleh, Michael; Gliva-McConvey, Gayle; Owens, Tamara; Anderson, Julie; Stillsmoking, Kristina; Cantrell, Mary; Passiment, Morgan
In September 2011, the Association of American Medical Colleges released the results of a survey conducted in 2010 on simulation activities at its member medical schools and teaching hospitals. In this commentary, we offer a synthesis of data and conclude that (1) simulation is used broadly at Association of American Medical Colleges member institutions, for many types of learners, including other health care professionals; (2) it addresses core training competencies and has many educational purposes; (3) its use in learner assessment is more prevalent at medical schools but is still significant at teaching hospitals; and (4) it requires a considerable investment of money, space, personnel, and time. These data confirm general perceptions about the state of simulation in North America for physician training. Future endeavors should include a more granular examination of how simulation is integrated into curricula, a similar survey of other health care-related institutions and professions, and a periodic assessment to characterize trends over time.
Web 3.0 promises us smart computer services that will interact with each other and leverage knowledge about us and our immediate context to deliver prioritised and relevant information to support decisions and actions. Healthcare must take advantage of such new knowledge-integrating services, in particular to support better co-operation between professionals of different disciplines working in different locations, and to enable well-informed co-operation between clinicians and patients. To grasp the potential of Web 3.0 we will need well-harmonised semantic resources that can richly connect virtual teams and link their strategies to real-time and tailored evidence. Facts, decision logic, care pathway steps, alerts, education need to be embedded within components that can interact with multiple EHR systems and services consistently. Using Health Informatics 3.0 a patient's current situation could be compared with the outcomes of very similar patients (from across millions) to deliver personalised care recommendations. The integration of EHRs with biomedical sciences ('omics) research results and predictive models such as the Virtual Physiological Human could help speed up the translation of new knowledge into clinical practice. The mission, and challenge, for Health Informatics 3.0 is to enable healthy citizens, patients and professionals to collaborate within a knowledge-empowered social network in which patient specific information and personalised real-time evidence are seamlessly interwoven.
Field, Karl; Bailey, Michele; Foresman, Larry L; Harris, Robert L; Motzel, Sherri L; Rockar, Richard A; Ruble, Gaye; Suckow, Mark A
Medical records are considered to be a key element of a program of adequate veterinary care for animals used in research, teaching, and testing. However, prior to the release of the public statement on medical records by the American College of Laboratory Animal Medicine (ACLAM), the guidance that was available on the form and content of medical records used for the research setting was not consistent and, in some cases, was considered to be too rigid. To address this concern, ACLAM convened an ad hoc Medical Records Committee and charged the Committee with the task of developing a medical record guideline that was based on both professional judgment and performance standards. The Committee provided ACLAM with a guidance document titled Public Statements: Medical Records for Animals Used in Research, Teaching, and Testing, which was approved by ACLAM in late 2004. The ACLAM public statement on medical records provides guidance on the definition and content of medical records, and clearly identifies the Attending Veterinarian as the individual who is charged with authority and responsibility for oversight of the institution's medical records program. The document offers latitude to institutions in the precise form and process used for medical records but identifies typical information to be included in such records. As a result, the ACLAM public statement on medical records provides practical yet flexible guidelines to assure that documentation of animal health is performed in research, teaching, and testing situations.
Fox, Brent I; Flynn, Allen; Clauson, Kevin A; Seaton, Terry L; Breeden, Elizabeth
Computerization is transforming health care. All clinicians are users of health information technology (HIT). Understanding fundamental principles of informatics, the field focused on information needs and uses, is essential if HIT is going to support improved patient outcomes. Informatics education for clinicians is a national priority. Additionally, some informatics experts are needed to bring about innovations in HIT. A common approach to pharmacy informatics education has been slow to develop. Meanwhile, accreditation standards for informatics in pharmacy education continue to evolve. A gap remains in the implementation of informatics education for all pharmacy students and it is unclear what expert informatics training should cover. In this article, we propose the first of two complementary approaches to informatics education in pharmacy: to incorporate fundamental informatics education into pharmacy curricula for all students. The second approach, to train those students interested in becoming informatics experts to design, develop, implement, and evaluate HIT, will be presented in a subsequent issue of the Journal .
Martin-Sanchez, F; Maojo, V
To analyze the role that biomedical informatics could play in the application of the NBIC Converging Technologies in the medical field and raise awareness of these new areas throughout the Biomedical Informatics community. Review of the literature and analysis of the reference documents in this domain from the biomedical informatics perspective. Detailing existing developments showing that partial convergence of technologies have already yielded relevant results in biomedicine (such as bioinformatics or biochips). Input from current projects in which the authors are involved is also used. Information processing is a key issue in enabling the convergence of NBIC technologies. Researchers in biomedical informatics are in a privileged position to participate and actively develop this new scientific direction. The experience of biomedical informaticians in five decades of research in the medical area and their involvement in the completion of the Human and other genome projects will help them participate in a similar role for the development of applications of converging technologies -particularly in nanomedicine. The proposed convergence will bring bridges between traditional disciplines. Particular attention should be placed on the ethical, legal, and social issues raised by the NBIC convergence. These technologies provide new directions for research and education in Biomedical Informatics placing a greater emphasis in multidisciplinary approaches.
Gaona, E.; Huitron, B.G.
This book composes the works received for the 1st Ibero-Latin American and the Caribbean Congress on Medical Physics. There are 68 works which represent a sample of the recent advances of the medical physics which are indicators about the level of development of the speciality in these regions of the world. Thus, the Congress represents the greatest event of medical physics of Ibero-Latin America and the Caribbean besides its consolidation and regional organization. The book also contains useful counsels for the education, yours researches and the daily hospitable practice. (Author)
Pereira, Samáris Ramiro; Duarte, Jacy Marcondes; Bandiera-Paiva, Paulo
From the hypothesis that the development of scientific papers, mainly in interdisciplinary areas such as Health Informatics, may bring difficulties to the author, as had its communicative efficacy decreased or compromising their approval for publication; we aim to make considerations on the main items to good players making this kind of text. The scientific writing has peculiarities that must be taken into consideration when it writes: general characteristics, such as simplicity and objectivity, and characteristics of each area of knowledge, such as terminology, formatting and standardization. The research methodology adopted is bibliographical. The information was based on literature review and the authors' experience, teachers and assessors of scientific methodology in peer review publications in the area. As a result, we designed a checklist of items to be checked before submission of a paper to a scientific publication vehicle in order to contribute to the promotion of research, facilitating the publication and increase its capacity in this important area of knowledge.
Shirai, Hiroki; Prades, Catherine; Vita, Randi
to the antibody science in every project in antibody drug discovery. Recent experimental technologies allow for the rapid generation of large-scale data on antibody sequences, affinity, potency, structures, and biological functions; this should accelerate drug discovery research. Therefore, a robust bioinformatic...... infrastructure for these large data sets has become necessary. In this article, we first identify and discuss the typical obstacles faced during the antibody drug discovery process. We then summarize the current status of three sub-fields of antibody informatics as follows: (i) recent progress in technologies...... for antibody rational design using computational approaches to affinity and stability improvement, as well as ab-initio and homology-based antibody modeling; (ii) resources for antibody sequences, structures, and immune epitopes and open drug discovery resources for development of antibody drugs; and (iii...
Scott J. N McNabb
Full Text Available Over the past decade, the world has radically changed. New advances in information and communication technologies (ICT connect the world in ways never imagined. Public health informatics (PHI leveraged for public health surveillance (PHS, can enable, enhance, and empower essential PHS functions (i.e., detection, reporting, confirmation, analyses, feedback, response. However, the tail doesn't wag the dog; as such, ICT cannot (should not drive public health surveillance strengthening. Rather, ICT can serve PHS to more effectively empower core functions. In this review, we explore promising ICT trends for prevention, detection, and response, laboratory reporting, push notification, analytics, predictive surveillance, and using new data sources, while recognizing that it is the people, politics, and policies that most challenge progress for implementation of solutions.
McMahon, Christopher Alan
In the past 50 years, digital technologies have transformed many aspects of our lives, especially our engineered products and systems. They continue to be an area of enormous interest as we consider the potential of cyber-physical systems, ‘Big Data’ and the Internet of Things. Digital technologies...... have also become deeply embedded in the processes by which we design and develop products and systems. Information is the lifeblood of design, and thus design informatics - the application of information technologies in design – has been a central focus in design research for many years. This paper...... envisage computer-based Product Lifecycle Management (PLM) as “a central source for all data regarding a product, from the initial idea and production to sales and marketing” (2) and we consider that we are close to achieving “digital twins” for example that are “ultrarealistic in geometric detail...
Wilson, Michael P; Nordstrom, Kimberly; Anderson, Eric L; Ng, Anthony T; Zun, Leslie S; Peltzer-Jones, Jennifer M; Allen, Michael H
The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area. The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.
The International Academy of Health Sciences Informatics (IAHSI) is established by International Medical Informatics Association (IMIA) which is the world body for health and biomedical informatics. The Academy will serve as an honor society that recognizes expertise in biomedical and health informatics internationally. Academy membership will be one of the highest honors in the international field of biomedical and health informatics. To present scientometric analysis of founding members of the International Academy of Health Sciences Informatics, to evaluate members and their scientific rating. The work has an analytical character and presents analysis of the data obtained from the Google Scholar and Scopus database. Results are shown through number of cases, percentage and graphically. The analysis showed a significant correlation between the Academy and the country (continent) of origin of the academician. In IAHSI are mainly represented academics originating from Europe - 40 members (33,3%), North America - 39 members (32,5%), Asia - 20 members (16,6%), South America - 9 members (7,5%), Australia - 7 members (5,8%), while only 5 members or 4,16% come from Africa. Criteria for number of representatives of each continent to main academic communities are relatively questionable, as this analysis showed. Development of Health Sciences Informatics should be the main purpose, and it should be evenly distributed with slight deviations in number of representatives of each continent.
Kenny, Stephen C
Prior to the American Civil War, museums were enthusiastically promoted in the annual circulars of southern medical colleges as valuable aids to medical education. Using case history narratives, medical college circulars, and announcements, this article examines the social origins of the region's collections of anatomical and pathological specimens and explores the professional agents and organizations responsible for their maintenance and development. The article is also concerned with exploring the racial framework in which these bodies and specimens were sourced and displayed. The social relations embodied in natural history and medical museum collections, and the emerging specialism of "negro medicine," were all elements of a context that subordinated and objectified blackness, as well as permitting and legitimizing the exploitation of black bodies. Medical museums function as a key case study for examining power relations among physicians, slaves, and slave owners, as well as underscoring southern medicine's dependence on slavery for its development.
Kahn, Linda G; Morabia, Alfredo
To review James Jackson's analysis of bloodletting among pneumonitis patients at the newly founded Massachusetts General Hospital, in which he implemented the numerical method advocated by Pierre-Charles-Alexandre Louis. The study sample included 34 cases of clinically diagnosed pneumonitis admitted to Massachusetts General Hospital between April 19, 1825, and May 10, 1835, and discharged alive. Patient data were extracted from meticulously kept case books. Jackson calculated mean number of venesections, ounces of blood taken, and days of convalescence within groups stratified by day of the disease when first bloodletting occurred. He also calculated average convalescence within groups stratified by age, sex, prior health, vesication, and day of the disease when the patients were admitted to the hospital. To Jackson's surprise, it "seemed to be of less importance, whether our patients were bled or not, than whether they entered the hospital early or late" after the onset of the pneumonitis. Bloodletting was ineffective. Our multivariate reanalysis of his data confirms his conclusion. Outstandingly for his time, Jackson ruled out unwarranted effects of covariates by tabulating their numerical relations to the duration of pneumonia. Using novel gathering of patient clinical data from hospital records and quantitative analytical methods, Jackson contributed results that challenged conventional wisdom and bridged French therapeutic epistemology and American medical pragmatism. Copyright © 2015 Elsevier Inc. All rights reserved.
Quinn, Andrew M; Klepeis, Veronica E; Mandelker, Diana L; Platt, Mia Y; Rao, Luigi K F; Riedlinger, Gregory; Baron, Jason M; Brodsky, Victor; Kim, Ji Yeon; Lane, William; Lee, Roy E; Levy, Bruce P; McClintock, David S; Beckwith, Bruce A; Kuo, Frank C; Gilbertson, John R
The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows' ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the
Andrew M Quinn
Full Text Available The Partners HealthCare system′s Clinical Fellowship in Pathology Informatics (Boston, MA, USA faces ongoing challenges to the delivery of its core curriculum in the forms of: (1 New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2 taxing electronic health record (EHR and laboratory information system (LIS implementations; and (3 increasing interest in the subspecialty at the academic medical centers (AMCs in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows′ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship′s core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among
Jenkins, Carol G; Bader, Shelley A
The Association of Academic Health Sciences Libraries has made collaboration with other organizations a fundamental success strategy throughout its twenty-five year history. From the beginning its relationships with Association of American Medical Colleges and with the Medical Library Association have shaped its mission and influenced its success at promoting academic health sciences libraries' roles in their institutions. This article describes and evaluates those relationships. It also describes evolving relationships with other organizations including the National Library of Medicine and the Association of Research Libraries.
Gennady N. Zverev
Full Text Available This paper defines the goals and problems of fundamental informatics, formulates principal laws of information universe and constructive bases of information objects and processes. The classification of semantics types of knowledge and skills is presented.
Magnuson, J A
In a revised edition, this book covers all aspects of public health informatics, and discusses the creation and management of an information technology infrastructure that is essential in linking state and local organizations in their efforts to gather data.
.... Amsterdam: lOS Press, Studies in Health Technology and Informatics 1997; 42, with permission. This book is printed on acid-free paper. (~ Copyright 92006, Elsevier Inc. All rights reserved. No part ...
When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.
Haux, R; Lehmann, C U
In 2009, Applied Clinical Informatics (ACI)--focused on applications in clinical informatics--was launched as a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of the International Medical Informatics Association. To explore which congruencies and interdependencies exist in publications from theory to practice and from practice to theory and to determine existing gaps. Major topics discussed in ACI and MIM were analyzed. We explored if the intention of publishing companion journals to provide an information bridge from informatics theory to informatics practice and vice versa could be supported by this model. In this manuscript we will report on congruencies and interdependences from practice to theory and on major topics in MIM. Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 were indexed and analyzed. Hundred and ninety-six publications were analyzed (ACI 87, MIM 109). In MIM publications, modelling aspects as well as methodological and evaluation approaches for the analysis of data, information, and knowledge in biomedicine and health care were frequently raised - and often discussed from an interdisciplinary point of view. Important themes were ambient-assisted living, anatomic spatial relations, biomedical informatics as scientific discipline, boosting, coding, computerized physician order entry, data analysis, grid and cloud computing, health care systems and services, health-enabling technologies, health information search, health information systems, imaging, knowledge-based decision support, patient records, signal analysis, and web science. Congruencies between journals could be found in themes, but with a different focus on content. Interdependencies from practice to theory, found in these publications, were only limited. Bridging from informatics theory to practice and vice versa remains a major component of successful
The Intelligent Systems Series comprises titles that present state of the art knowledge and the latest advances in intelligent systems. Its scope includes theoretical studies, design methods, and real-world implementations and applications. Traditionally, Intelligence and Security Informatics (ISI) research and applications have focused on information sharing and data mining, social network analysis, infrastructure protection and emergency responses for security informatics. With the continuous advance of IT technologies and the increasing sophistication of national and international securi
This is a description of the software design for the 2013 edition of the Advanced Extravehicular Mobility Unit (AEMU) Informatics computer assembly. The Informatics system is an optional part of the space suit assembly. It adds a graphical interface for displaying suit status, timelines, procedures, and caution and warning information. In the future it will display maps with GPS position data, and video and still images captured by the astronaut.
Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.
Lapane, Kate L; Cameron, Kathleen; Feinberg, Janice
.... While clinical informatics systems have focused on the reduction of medication errors at the point of prescribing, dispensing, or administration, few have proposed the use of information technology...
Johnson, S B
Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions. Georg Thieme Verlag KG Stuttgart.
Ammenwerth, E; Hackl, W O
Biomedical informatics programs exist in many countries. Some analyses of the skills needed and of recommendations for curricular content for such programs have been published. However, not much is known of the job profiles and job careers of their graduates. To analyse the job profiles and job careers of 175 graduates of the biomedical informatics bachelor and master program of the Tyrolean university UMIT. Survey of all biomedical informatics students who graduated from UMIT between 2001 and 2013. Information is available for 170 graduates. Eight percent of graduates are male. Of all bachelor graduates, 86% started a master program. Of all master graduates, 36% started a PhD. The job profiles are quite diverse: at the time of the survey, 35% of all master graduates worked in the health IT industry, 24% at research institutions, 9% in hospitals, 9% as medical doctors, 17% as informaticians outside the health care sector, and 6% in other areas. Overall, 68% of the graduates are working as biomedical informaticians. The results of the survey indicate a good job situation for the graduates. The job opportunities for biomedical informaticians who graduated with a bachelor or master degree from UMIT seem to be quite good. The majority of graduates are working as biomedical informaticians. A larger number of comparable surveys of graduates from other biomedical informatics programs would help to enhance our knowledge about careers in biomedical informatics.
Roy-Chowdhuri, Sinchita; Roy, Somak; Monaco, Sara E; Routbort, Mark J; Pantanowitz, Liron
The rapid adoption of next-generation sequencing (NGS) in clinical molecular laboratories has redefined the practice of cytopathology. Instead of simply being used as a diagnostic tool, cytopathology has evolved into a practice providing important genomic information that guides clinical management. The recent emphasis on maximizing limited-volume cytology samples for ancillary molecular studies, including NGS, requires cytopathologists not only to be more involved in specimen collection and processing techniques but also to be aware of downstream testing and informatics issues. For the integration of molecular informatics into the clinical workflow, it is important to understand the computational components of the NGS workflow by which raw sequence data are transformed into clinically actionable genomic information and to address the challenges of having a robust and sustainable informatics infrastructure for NGS-based testing in a clinical environment. Adapting to needs ranging from specimen procurement to report delivery is crucial for the optimal utilization of cytology specimens to accommodate requests from clinicians to improve patient care. This review presents a broad overview of the various aspects of informatics in the context of NGS-based testing of cytology specimens. Cancer Cytopathol 2017;125:236-244. © 2016 American Cancer Society. © 2016 American Cancer Society.
Full Text Available The present article describes the informatization process of a hospital service, taking as an example the implementation of a prescription writing software. This tool allows doctors to prescribe via computer the pharmaceutical regimen to be prepared and dispensed by the nursing personnel. The ethnographic study in the hospital service describes the introduction process of this tool from the perspective of the daily activities of the nursing staff. The article highlights a number of difficulties the users are facing and describes the solutions they create, in particular the “compensation strategies” they develop for turning the tool operational, reliable and efficient. The article also shows that the compensation strategies the users are creating in situ are partly invisible for the designers of the software. Distant from the daily activities of the users, the software designers neither perceive the problems involved with the use of the product, nor do they perceive the locally created solutions. They ascribe the performance of the tool to the quality of its conception and possibilities of improvement. This article invites the readers to reflect about what turns an information system efficient and effective and about the lessons learned for the conception of these tools.
Gee, Gilbert C; Delva, Jorge; Takeuchi, David T
We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.
Borne, K. D.
The discipline of data science is merging with multiple science disciplines to form new X-informatics research disciplines. They are almost too numerous to name, but they include geoinformatics, bioinformatics, cheminformatics, biodiversity informatics, ecoinformatics, materials informatics, and the emerging discipline of astroinformatics. Within any X-informatics discipline, the information granules are unique to that discipline -- e.g., gene sequences in bio, the sky object in astro, and the spatial object in geo (such as points, lines, and polygons in the vector model, and pixels in the raster model). Nevertheless the goals are similar: transparent data re-use across subdisciplines and within education settings, information and data integration and fusion, personalization of user interactions with the data collection, semantic search and retrieval, and knowledge discovery. The implementation of an X-informatics framework enables these semantic e-science research goals. We describe the concepts, challenges, and new developments associated with the new discipline of astroinformatics, and how geoinformatics provides valuable lessons learned and a model for practical semantic science within a traditional science discipline through the accretion of data science methodologies (such as formal metadata creation, data models, data mining, information retrieval, knowledge engineering, provenance, taxonomies, and ontologies). The emerging concept of data-as-a-service (DaaS) builds upon the concept of smart data (or data DNA) for intelligent data management, automated workflows, and intelligent processing. Smart data, defined through X-informatics, enables several practical semantic science use cases, including self-discovery, data intelligence, automatic recommendations, relevance analysis, dimension reduction, feature selection, constraint-based mining, interdisciplinary data re-use, knowledge-sharing, data use in education, and more. We describe these concepts within the
Nam, Sanggon; Snih, Soham Al; Markides, Kyriakos
We investigated the effect of chronic medical conditions including obesity on self-reported disability and mobility in Mexican Americans aged 75 or over using data from the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE) Wave 5 (2004–2005). Disability was assessed with a modified version of the Katz activities of daily living (ADL) scale and mobility was assessed with the Rosow Breslau scale of gross mobility function. The percentage of participan...
Kovatz, Susy; Kutz, Ilan; Rubin, Gil; Dekel, Rachel; Shenkman, Louis
Medical school is a very stressful environment with multiple sources of stress, including academic, social and other issues. International medical students are exposed to additional stressors such as homesickness and culture shock. In order to assess the influence of cultural background on the level of perceived distress, we examined Israeli and American students studying at the same university during a period of terror. We found clear differences between the 2 groups of students, with Americans reporting a higher level of anxiety and a poorer level of social functioning than the Israelis. Although there was no significant difference between the 2 groups in terms of their sense of safety, the American students reported a higher level of fear and more change in their daily activities to a greater extent than did the Israelis. These findings underscore the effect of culture on students' responses to the same stressful stimuli and to a perceived dangerous environment. Faculty needs to be aware that cultural factors may affect students' adjustment to the medical school environment.
Conclusions: Our study showed use of Calcium channel blockers to have a protective effect against progression of diastolic dysfunction in this African American cohort. Identifying factors that can mediate disease progression is particularly important for hypertensive African Americans, who have significantly higher rates of developing disease complications such as diastolic heart failure.
Ko, Linda K; Taylor, Victoria M; Yoon, Jihye; Copeland, Wade K; Hwang, Joo Ha; Lee, Eun Jeong; Inadomi, John
Colorectal cancer (CRC) remains the most commonly diagnosed cancer among Korean Americans (KAs) in part due to low screening rates. Recent studies suggest that some KA patients engage in medical tourism and receive medical care in their home country. The impact of medical tourism on CRC screening is unknown. The purpose of this paper was to 1) investigate the frequency of medical tourism, 2) examine the association between medical tourism and CRC screening, and 3) characterize KA patients who engage in medical tourism. This is a community-based, cross-sectional study involving self-administered questionnaires conducted from August 2013 to October 2013. Data was collected on 193 KA patients, ages 50-75, residing in the Seattle metropolitan area. The outcome variable is up-to-date with CRC screening, defined as having had a stool test (Fecal Occult Blood Test or Fecal Immunochemical Test) within the past year or a colonoscopy within 10 years. Predictor variables are socio-demographics, health factors, acculturation, knowledge, financial concerns for medical care costs, and medical tourism. In multi-variate modeling, medical tourism was significantly related to being up-to-date with CRC screening. Participants who engaged in medical tourism had 8.91 (95% CI: 3.89-23.89) greater odds of being up-to-date with CRC screening compared to those who did not travel for healthcare. Factors associated with engaging in medical tourism were lack of insurance coverage (P = 0.008), higher levels of education (P = 0.003), not having a usual place of care (P = 0.002), older age at immigration (P = 0.009), shorter years-of-stay in the US (P = 0.003), and being less likely to speak English well (P = 0.03). This study identifies the impact of medical tourism on CRC screening and characteristics of KA patients who report engaging in medical tourism. Healthcare providers in the US should be aware of the customary nature of medical tourism among KAs and consider
Valverde, Nelson; Cardenas, Juan; Perez, Maria del Rosario; Trano, Jose Luiz Di; Gisone, Pablo
The objective of this program is to have a system, in order to assure an appropriate medical response in the case of radiological accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations in risk assessment of radiation workers, medical exposures, potential effects of prenatal irradiation
Full Text Available Recent advances in automated high-resolution fluorescence microscopy and robotic handling have made the systematic and cost effective study of diverse morphological changes within a large population of cells possible under a variety of perturbations, e.g., drugs, compounds, metal catalysts, RNA interference (RNAi. Cell population-based studies deviate from conventional microscopy studies on a few cells, and could provide stronger statistical power for drawing experimental observations and conclusions. However, it is challenging to manually extract and quantify phenotypic changes from the large amounts of complex image data generated. Thus, bioimage informatics approaches are needed to rapidly and objectively quantify and analyze the image data. This paper provides an overview of the bioimage informatics challenges and approaches in image-based studies for drug and target discovery. The concepts and capabilities of image-based screening are first illustrated by a few practical examples investigating different kinds of phenotypic changes caEditorsused by drugs, compounds, or RNAi. The bioimage analysis approaches, including object detection, segmentation, and tracking, are then described. Subsequently, the quantitative features, phenotype identification, and multidimensional profile analysis for profiling the effects of drugs and targets are summarized. Moreover, a number of publicly available software packages for bioimage informatics are listed for further reference. It is expected that this review will help readers, including those without bioimage informatics expertise, understand the capabilities, approaches, and tools of bioimage informatics and apply them to advance their own studies.
Cesnik, Branko; Kidd, Michael R
In considering a 'history' of Health Informatics it is important to be aware that the discipline encompasses a wide array of activities, products, research and theories. Health Informatics is as much a result of evolution as planned philosophy, having its roots in the histories of information technology and medicine. The process of its growth continues so that today's work is tomorrow's history. A 'historical' discussion of the area is its history to date, a report rather than a summation. As well as its successes, the history of Health Informatics is populated with visionary promises that have failed to materialise despite the best intentions. For those studying the subject or working in the field, the experiences of others' use of Information Technologies for the betterment of health care can provide a necessary perspective. This chapter starts by noting some of the major events and people that form a technological backdrop to Health Informatics and ends with some thoughts on the future. This chapter gives an educational overview of: * The history of computing * The beginnings of the health informatics discipline.
Liu, Chia-Hui; Lee, Ting-Ting; Mills, Mary Etta
Despite recent progress in information technology, health care institutions are constantly confronted with the need to adapt to the resulting new processes of information management and use. Facilitating an effective technology implementation requires dedication from informatics nurses (INs) to bridge the gap between clinical care and technology. The purpose of this study was to explore the working experiences of INs, and alternatives to assist the growth and development of the specialty. This qualitative study recruited 8 participants, and data were collected in 2009 by use of interview guides related to work roles, responsibilities, competencies, and challenges. The emerged themes included (a) diversified roles and functions, (b) vague job description, (c) no decision-making authority, (d) indispensable management support, and (e) searching resources for work fulfillment. Findings indicate that for organizations where nursing informatics development is ongoing, the IN role should be clearly defined as a specialist with identified support resources and decision-making authority. Nursing informatics interest groups should further develop training and certification programs to validate the professional image of the role. Concepts of nursing informatics should be included seamlessly throughout the educational curricula and informatics competency-based courses designed to strengthen student's technology use and data management capabilities. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Background: Blacks’ diminished return is defined as smaller protective effects of socioeconomic status (SES on health of African Americans compared to Whites. Aim: Using a nationally representative sample, the current study aimed to examine if the protective effect of income on chronic medical conditions (CMC differs for African Americans compared to Whites. Methods: With a cross-sectional design, the National Survey of American Life (NSAL, 2003, included 3570 non-Hispanic African Americans and 891 non-Hispanic Whites. The dependent variable was CMC, treated as a continuous measure. The independent variable was income. Race was the focal moderator. Age, education, and marital status were covariates. Linear regressions were used to test if the protective effect of income against CMC varies by race. Results: High income was associated with a lower number of CMC in the pooled sample. We found a significant interaction between race and income, suggesting that income has a smaller protective effect against CMC for African Americans than it does for Whites. Conclusion: Blacks’ diminished return also holds for the effects of income on CMC. Blacks’ diminished return is a contributing mechanism to the racial disparities in health in the United States that is often overlooked. More research is needed on the role of diminished health return of SES resources among other minority groups.
Background: Blacks' diminished return is defined as smaller protective effects of socioeconomic status (SES) on health of African Americans compared to Whites. Using a nationally representative sample, the current study aimed to examine if the protective effect of income on chronic medical conditions (CMC) differs for African Americans compared to Whites. Methods: With a cross-sectional design, the National Survey of American Life (NSAL), 2003, included 3570 non-Hispanic African Americans and 891 non-Hispanic Whites. The dependent variable was CMC, treated as a continuous measure. The independent variable was income. Race was the focal moderator. Age, education, and marital status were covariates. Linear regressions were used to test if the protective effect of income against CMC varies by race. Results: High income was associated with a lower number of CMC in the pooled sample. We found a significant interaction between race and income, suggesting that income has a smaller protective effect against CMC for African Americans than it does for Whites. Conclusion: Blacks' diminished return also holds for the effects of income on CMC. Blacks' diminished return is a contributing mechanism to the racial disparities in health in the United States that is often overlooked. More research is needed on the role of diminished health return of SES resources among other minority groups.
U.S. Department of Health & Human Services — The Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system is an extensible, scalable informatics platform for TBI relevant imaging,...
Liyanage, H; Correa, A; Liaw, S-T; Kuziemsky, C; Terry, A L; de Lusignan, S
Primary care delivers patient-centred and coordinated care, which should be quality-assured. Much of family practice now routinely uses computerised medical record (CMR) systems, these systems being linked at varying levels to laboratories and other care providers. CMR systems have the potential to support care. To achieve a consensus among an international panel of health care professionals and informatics experts about the role of informatics in the delivery of patient-centred, coordinated, and quality-assured care. The consensus building exercise involved 20 individuals, five general practitioners and 15 informatics academics, members of the International Medical Informatics Association Primary Care Informatics Working Group. A thematic analysis of the literature was carried out according to the defined themes. The first round of the analysis developed 27 statements on how the CMR, or any other information system, including paper-based medical records, supports care delivery. Round 2 aimed at achieving a consensus about the statements of round one. Round 3 stated that there was an agreement on informatics principles and structures that should be put in place. However, there was a disagreement about the processes involved in the implementation, and about the clinical interaction with the systems after the implementation. The panel had a strong agreement about the core concepts and structures that should be put in place to support high quality care. However, this agreement evaporated over statements related to implementation. These findings reflect literature and personal experiences: whilst there is consensus about how informatics structures and processes support good quality care, implementation is difficult.
Jeon, Eunjoo; Kim, Jeongeun; Park, Hyeoun-Ae; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran
Objectives This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. Methods A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via ...
Kinnunen, Ulla-Mari; Rajalahti, Elina; Cummings, Elizabeth; M., Elizabeth
Nursing informatics competencies are fundamental to nursing practice in all areas of nursing work, including direct patient care, administration and education. The recent activity relating to the development of nursing informatics competencies for beginning level nurses has exposed a paucity of understanding of the requirements for nursing informatics competencies for nurse educators. So, whilst the challenge of educating faculty to teach informatics has been limited, research into such compe...
Wright, James R; Baskin, Leland B
Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort. Available primary and secondary sources related to American Expeditionary Forces' laboratory services were analyzed and contrasted with the British and German approaches. The United States entered the war in April 1917. Colonel Joseph Siler, MD, a career medical officer, was the director, and Colonel Louis B. Wilson, MD, head of pathology at the Mayo Clinic, was appointed assistant director of the US Army Medical Corps Division of Laboratories and Infectious Disease, based in Dijon, France. During the next year, they organized 300 efficient laboratories to support the American Expeditionary Forces. Autopsies were performed to better understand treatment of battlefield injuries, effects of chemical warfare agents, and the influenza pandemic; autopsies also generated teaching specimens for the US Army Medical Museum. Bacteriology services focused on communicable diseases. Laboratory testing for social diseases was very aggressive. Significant advances in blood transfusion techniques, which allowed brief blood storage, occurred during the war but were not primarily overseen by laboratory services. Both Siler and Wilson received Distinguished Service Medals. Wilson's vision for military pathology services helped transform American civilian laboratory services in the 1920s.
impressive for people with similar degrees in medicine, computer science, and business administration. Another challenge is to design an engagement with health informatics that will generate insights which often requires time, while also providing quick results for project sponsors or collaborators......What kind of knowledges, skills and competences may be required by Techno-Anthropology engaging with health informatics? If we understand Techno-Anthropology to mean conducting anthropological analyses of the interwoven and mutually shaping relationship between organizing, technologies and actors...... and determine social development, whereas detailed studies reveal that determinants and causes are both technical and social. The challenges include the one of making one's knowledge and skills legitimate and relevant to health informatics. Having a degree from arts or social sciences is not necessarily...
Full Text Available Even though informatics is a term used commonly in healthcare, it can be a confusing and disengaging one. Many definitions exist in the literature, and attempts have been made to develop a clear taxonomy. Despite this, informatics is still a term that lacks clarity in both its scope and the classification of sub-terms that it encompasses.This paper reviews the importance of an agreed taxonomy and explores the challenges of establishing exactly what is meant by health informatics (HI. It reviews what a taxonomy should do, summarises previous attempts at categorising and organising HI and suggests the elements to consider when seeking to develop a system of classification.The paper does not provide all the answers, but it does clarify the questions. By plotting a path towards a taxonomy of HI, it will be possible to enhance understanding and optimise the benefits of embracing technology in clinical practice.
Jodha, Siri; Khalsa, S.; Ramachandran, Rahul
The volume and complexity of Earth science data have steadily increased, placing ever-greater demands on researchers, software developers and data managers tasked with handling such data. Additional demands arise from requirements being levied by funding agencies and governments to better manage, preserve and provide open access to data. Fortunately, over the past 10-15 years significant advances in information technology, such as increased processing power, advanced programming languages, more sophisticated and practical standards, and near-ubiquitous internet access have made the jobs of those acquiring, processing, distributing and archiving data easier. These advances have also led to an increasing number of individuals entering the field of informatics as it applies to Geoscience and Remote Sensing. Informatics is the science and technology of applying computers and computational methods to the systematic analysis, management, interchange, and representation of data, information, and knowledge. Informatics also encompasses the use of computers and computational methods to support decisionmaking and other applications for societal benefits.
Wright, Graham; Verbeke, Frank; Nyssen, Marc; Betts, Helen
Since 2011, the Regional e-Health Center of Excellence in Rwanda (REHCE) has run an MSc in Health Informatics programme (MSc HI). A programme review was commissioned in February 2014 after 2 cohorts of students completed the post-graduate certificate and diploma courses and most students had started preparatory activity for their master dissertation. The review developed a method for mapping course content on health informatics competences and knowledge units. Also the review identified and measured knowledge gaps and content redundancy. Using this method, we analyzed regulatory and programme documents combined with stakeholder interviews, and demonstrated that the existing MSc HI curriculum did not completely address the needs of the Rwandan health sector. Teaching strategies did not always match students' expectations. Based on a detailed Rwandan health informatics needs assessment, International Medical Informatics Association (IMIA)'s Recommendations on Education in Biomedical and Health Informatics and the IMIA Health Informatics Knowledge Base, a new curriculum was developed and provided a better competences match for the specifics of healthcare in the Central African region. The new approved curriculum will be implemented in the 2014/2015 academic year and options for regional extension of the programme to Eastern DRC (Bukavu) and Burundi (Bujumbura) are being investigated.
Moskowitz, Gordon B; Stone, Jeff; Childs, Amanda
We investigated whether stereotypes unconsciously influence the thinking and behavior of physicians, as they have been shown to do in other professional settings, such as among law enforcement personnel and teachers. We conducted 2 studies to examine whether stereotypes are implicitly activated in physicians. Study 1 assessed what diseases and treatments doctors associate with African Americans. Study 2 presented these (and control terms) to doctors as part of a computerized task. Subliminal images of African American and White men appeared prior to each word, and reaction times to words were recorded. When primed with an African American face, doctors reacted more quickly for stereotypical diseases, indicating an implicit association of certain diseases with African Americans. These comprised not only diseases African Americans are genetically predisposed to, but also conditions and social behaviors with no biological association (e.g., obesity, drug abuse). We found implicit stereotyping among physicians; faces they never consciously saw altered performance. This suggests that diagnoses and treatment of African American patients may be biased, even in the absence of the practitioner's intent or awareness.
Espinoza, Henry; Abuabara, Katrina; Ellertson, Charlotte
To examine physicians' knowledge and attitudes in regard to medication abortion, we conducted focus-group discussions with general practice physicians and obstetrician-gynecologists in Honduras, Mexico, Nicaragua and Puerto Rico. Physicians were familiar with the practice of several types of medication and surgical abortion methods. Medication abortion with misoprostol is most common among women of higher socioeconomic status and is prescribed by physicians, pharmacists or self-administered. Conflicting opinions regarding safety, efficacy, cost, potential for self-medication and acceptability emerged; some participants expressed hope that medical abortion would reduce the risks associated with unsafe abortion, while others contended that drug distribution and self-medication without proper counseling could be problematic. Participants noted a lack of reliable sources of information for both providers and women, and expressed interest in strategic dissemination of information.
Villwock, Jennifer A.; Sobin, Lindsay B.; Koester, Lindsey A.; Harris, Tucker M.
Objectives To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Methods Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor e...
Lehmann, C U; Haux, R
In 2009, the journal Applied Clinical Informatics (ACI) commenced publication. Focused on applications in clinical informatics, ACI was intended to be a companion journal to METHODS of Information in Medicine (MIM). Both journals are official journals of IMIA, the International Medical Informatics Association. To explore, after five years, which congruencies and interdependencies exist in publications of these journals and to determine if gaps exist. To achieve this goal, major topics discussed in ACI and in MIM had to be analysed. Finally, we wanted to explore, whether the intention of publishing these companion journals to provide an information bridge from informatics theory to informatics practice and from practice to theory could be supported by this model. In this manuscript we will report on congruencies and interdependencies from practise to theory and on major topis in ACI. Further results will be reported in a second paper. Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 from these journals were indexed and analysed. Hundred and ninety-six publications have been analysed (87 ACI, 109 MIM). In ACI publications addressed care coordination, shared decision support, and provider communication in its importance for complex patient care and safety and quality. Other major themes included improving clinical documentation quality and efficiency, effectiveness of clinical decision support and alerts, implementation of health information technology systems including discussion of failures and succeses. An emerging topic in the years analyzed was a focus on health information technology to predict and prevent hospital admissions and managing population health including the application of mobile health technology. Congruencies between journals could be found in themes, but with different focus in its contents. Interdependencies from practise to theory found in these publications, were
Michael P. Koster
Full Text Available Global health initiatives from academic medical centers have rapidly proliferated over the last decade. This paper endeavors to describe our 5-year experience as an academic medical collaborative supporting healthcare delivery, medical training, and research at Hôpital Saint Damien-Nos Petits Frères et Soeurs, the only freestanding children’s hospital in Haiti. Descriptions of the history and current activities of our academic medical collaborative, its partnership and communication structure, its evolution to fill the expressed needs of our host site, its funding mechanisms, and its challenges and opportunities for the future are included.
Pardalos, Panos M; Xanthopoulos, Petros
This volume covers some of the topics that are related to the rapidly growing field of biomedical informatics. In June 11-12, 2010 a workshop entitled 'Optimization and Data Analysis in Biomedical Informatics' was organized at The Fields Institute. Following this event invited contributions were gathered based on the talks presented at the workshop, and additional invited chapters were chosen from world's leading experts. In this publication, the authors share their expertise in the form of state-of-the-art research and review chapters, bringing together researchers from different disciplines
Hawkins, Richard E; Weiss, Kevin B
In this issue, Lipner and colleagues describe research supporting the value of the examinations used in the maintenance of certification (MOC) programs of the American Board of Internal Medicine and the American Board of Surgery. The authors of this commentary review the contribution of this research and previous investigations that underscore the value of this component of the American Board of Medical Specialties (ABMS) MOC program. In addition, they point out that the MOC examination is one element of a comprehensive approach to physician lifelong learning, assessment, and quality improvement. The ABMS MOC program requires diplomates of the ABMS member boards to engage in continuous professional development in the six domains of competence and performance previously defined by the ABMS and the Accreditation Council for Graduate Medical Education. Although evidence and a sound rationale exist to support educational and assessment methods that target all six domains, it will be important to continue to build the body of evidence demonstrating the value of MOC to the public and to the profession.
Cipriano, Sarah D; Dybbro, Eric; Boscardin, Christy K; Shinkai, Kanade; Berger, Timothy G
Multiple studies have shown that both current and future primary care providers have insufficient education and training in dermatology. To address the limitations and wide variability in medical student dermatology instruction, the American Academy of Dermatology (AAD) created a standardized, online curriculum for both dermatology learners and educators. We sought to determine the impact of the integration of the AAD online curriculum into a 2-week introductory dermatology clerkship for fourth-year medical students. In addition to their clinical duties, we assigned 18 online modules at a rate of 1 to 3 per day. We evaluated knowledge acquisition using a 50-item, multiple-choice pretest and posttest. Postmodule and end-of-course questionnaires contained both closed and open-ended items soliciting students' perceptions about usability and satisfaction. All 51 participants significantly improved in their dermatology knowledge (P dermatology clerkship. Without a control group who did not experience the online curriculum, we are unable to isolate the specific impact of the online modules on students' learning. This study demonstrates the successful integration of this educational resource into a 2-week, university-based dermatology clerkship. Students' perceptions regarding usability and satisfaction were overwhelmingly positive, suggesting that the online curriculum is highly acceptable to learners. Widespread use of this curriculum may be a significant advancement in standardized dermatology learning for medical students. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Wiesner, Martin; Griebel, Lena; Becker, Kurt; Pobiruchin, Monika
Consumer Health Informatics (CHI) is a relatively new and interdisciplinary field in Medical Informatics. It focuses on consumer- rather than professional-centered services. However, the definitions and understanding of a) what is a "consumer"? or b) what is health technology in the context of CHI? and c) what factors and actors influence the usage of eHealth services? vary widely. The CHI special interest group (SIG) - associated with the German Association for Medical Informatics, Biometry and Epidemiology - conducted two workshops in 2015 to improve the common understanding on these topics. The workshop outcomes, the derived CHI-specific meta model and examples how to apply this model are presented in this paper. The model supports the definition of multi-actor contexts, as it not solely reflects the conventional patient-physician relationship but also allows for the description of second health market providers.
Hasman, A.; Safran, C.; Takeda, H.
OBJECTIVE: To discuss in what ways computer systems can contribute to the quality of healthcare and on which principles of informatics successful systems are based. METHODS: Part of the information was obtained via a literature search and part is based on the knowledge of the authors. RESULTS: The
Jayarajah, Kasthuri; Subbaraju, Vigneshwaran; Weerakoon, Dulanga; Misra, Archan; Tam, La Thanh; Athaide, Noel
Singapore's "smart city" agenda is driving the government to provide public access to a broader variety of urban informatics sources, such as images from traffic cameras and information about buses servicing different bus stops. Such informatics data serves as probes of evolving conditions at different spatiotemporal scales. This paper explores how such multi-modal informatics data can be used to establish the normal operating conditions at different city locations, and then apply appropriate outlier-based analysis techniques to identify anomalous events at these selected locations. We will introduce the overall architecture of sociophysical analytics, where such infrastructural data sources can be combined with social media analytics to not only detect such anomalous events, but also localize and explain them. Using the annual Formula-1 race as our candidate event, we demonstrate a key difference between the discriminative capabilities of different sensing modes: while social media streams provide discriminative signals during or prior to the occurrence of such an event, urban informatics data can often reveal patterns that have higher persistence, including before and after the event. In particular, we shall demonstrate how combining data from (i) publicly available Tweets, (ii) crowd levels aboard buses, and (iii) traffic cameras can help identify the Formula-1 driven anomalies, across different spatiotemporal boundaries.
Thomas, Dennis G; Klaessig, Fred; Harper, Stacey L; Fritts, Martin; Hoover, Mark D; Gaheen, Sharon; Stokes, Todd H; Reznik-Zellen, Rebecca; Freund, Elaine T; Klemm, Juli D; Paik, David S; Baker, Nathan A
There are several issues to be addressed concerning the management and effective use of information (or data), generated from nanotechnology studies in biomedical research and medicine. These data are large in volume, diverse in content, and are beset with gaps and ambiguities in the description and characterization of nanomaterials. In this work, we have reviewed three areas of nanomedicine informatics: information resources; taxonomies, controlled vocabularies, and ontologies; and information standards. Informatics methods and standards in each of these areas are critical for enabling collaboration; data sharing; unambiguous representation and interpretation of data; semantic (meaningful) search and integration of data; and for ensuring data quality, reliability, and reproducibility. In particular, we have considered four types of information standards in this article, which are standard characterization protocols, common terminology standards, minimum information standards, and standard data communication (exchange) formats. Currently, because of gaps and ambiguities in the data, it is also difficult to apply computational methods and machine learning techniques to analyze, interpret, and recognize patterns in data that are high dimensional in nature, and also to relate variations in nanomaterial properties to variations in their chemical composition, synthesis, characterization protocols, and so on. Progress toward resolving the issues of information management in nanomedicine using informatics methods and standards discussed in this article will be essential to the rapidly growing field of nanomedicine informatics. Copyright © 2011 John Wiley & Sons, Inc.
Rwanda Journal Series F: Medicine and Health Sciences Vol. 3 No. 1, 2016. Assessment of Health Informatics Competencies in Undergraduate Training of. Healthcare Professionals in Rwanda. Nishimwe Aurore1*, Mbarushimana Valens1, Ngenzi Joseph Lune1, Marc Nyssen2. 1College of Medicine and Health Sciences, ...
Ilieva, Sylvia; Nikolov, Roumen
The paper presents some real experiences, emerging models and lessons learnt based on the case of Sofia University - Faculty of Mathematics and Informatics (FMI), and its partners. Some experience in developing a layer of MSc programs as a live link to the professional ICT society and ICT industry
Robertson, Hamish; Nicholas, Nick; Georgiou, Andrew; Johnson, Julie; Travaglia, Joanne
Health systems globally are undergoing significant changes. New systems are emerging in developing countries where there were previously limited healthcare options, existing systems in emerging and developed economies are under significant resource pressures and population dynamics are creating significant pressures for change. As health systems expand and intensify, information quality and timeliness will be central to their sustainability and continuity. Information collection and transfer across diverse systems and international borders already presents a significant challenge for health system operations and logistics. Geographic information science (giscience) has the potential to support and enhance health informatics in the coming decades as health information transfers become increasingly important. In this article we propose a spatially enabled approach to support and increasingly globalised health informatics environment. In a world where populations are ageing and urbanising and health systems are linked to economic and social policy shifts, knowing where patients, diseases, health care workers and facilities are located becomes central to those systems operational capacities. In this globalising environment, health informatics needs to be spatially enabled informatics.
The purpose of the International Conference on Health Informatics is to bring together researchers and practitioners interested in the application of information and communication technologies (ICT) to healthcare and medicine in general and to the support of persons with special needs in particular.
Mantas, John; Hasman, Arie
The updated version of the IMIA educational recommendations has given an adequate guidelines platform for developing educational programs in Biomedical and Health Informatics at all levels of education, vocational training, and distance learning. This chapter will provide a brief introduction of the
Gatewood, L.; Limburg, M.; Gardner, R.; Haux, R.; Jaspers, M.; Schmidt, D.; Wetter, T.
Master Classes arose within the performing arts and are now being offered in system sciences. The IPhiE group of faculty from six universities in Europe and the United States has offered Master Classes in health informatics to provide an integrative forum for honors students. Featured are
Thomas, Dennis G.; Klaessig, Fred; Harper, Stacey L.; Fritts, Martin; Hoover, Mark D.; Gaheen, Sharon; Stokes, Todd H.; Reznik-Zellen, Rebecca; Freund, Elaine T.; Klemm, Juli D.; Paik, David S.; Baker, Nathan A.
There are several issues to be addressed concerning the management and effective use of information (or data), generated from nanotechnology studies in biomedical research and medicine. These data are large in volume, diverse in content, and are beset with gaps and ambiguities in the description and characterization of nanomaterials. In this work, we have reviewed three areas of nanomedicine informatics: information resources; taxonomies, controlled vocabularies, and ontologies; and information standards. Informatics methods and standards in each of these areas are critical for enabling collaboration, data sharing, unambiguous representation and interpretation of data, semantic (meaningful) search and integration of data; and for ensuring data quality, reliability, and reproducibility. In particular, we have considered four types of information standards in this review, which are standard characterization protocols, common terminology standards, minimum information standards, and standard data communication (exchange) formats. Currently, due to gaps and ambiguities in the data, it is also difficult to apply computational methods and machine learning techniques to analyze, interpret and recognize patterns in data that are high dimensional in nature, and also to relate variations in nanomaterial properties to variations in their chemical composition, synthesis, characterization protocols, etc. Progress towards resolving the issues of information management in nanomedicine using informatics methods and standards discussed in this review will be essential to the rapidly growing field of nanomedicine informatics. PMID:21721140
Frazer, Eva; Mitchell, Roger A; Nesbitt, LaQuandra S; Williams, Mallory; Mitchell, Edith P; Williams, Richard Allen; Browne, Doris
While much progress has occurred since the civil rights act of 1964, minorities have continued to suffer disparate and discriminatory access to economic opportunities, education, housing, health care and criminal justice. The latest challenge faced by the physicians and public health providers who serve the African American community is the detrimental, and seemingly insurmountable, causes and effects of violence in impoverished communities of color. According to statistics from the Centers for Disease Control (CDC), the number one killer of black males ages 10-35 is homicide, indicating a higher rate of violence than any other group. Black females are four times more likely to be murdered by a boyfriend or girlfriend than their white counterparts, and although intimate partner violence has declined for both black and white females, black women are still disproportionately killed. In addition, anxiety and depression that can lead to suicide is on the rise among African American adolescents and adults. Through an examination of the role of racism in the perpetuation of the violent environment and an exploration of the effects of gang violence, intimate partner violence/child maltreatment and police use of excessive force, this work attempts to highlight the repercussions of violence in the African American community. The members of the National Medical Association have served the African American community since 1895 and have been advocates for the patients they serve for more than a century. This paper, while not intended to be a comprehensive literature review, has been written to reinforce the need to treat violence as a public health issue, to emphasize the effect of particular forms of violence in the African American community and to advocate for comprehensive policy reforms that can lead to the eradication of this epidemic. The community of African American physicians must play a vital role in the treatment and prevention of violence as well as advocating for
Tucker-Seeley, Reginald D.; Mitchell, Jamie A.; Shires, Deirdre A.; Modlin, Charles S., Jr.
Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet…
Full Text Available Following the approval of OxyContin (Purdue Pharma, Canada for medical use, the media began to report the use of OxyContin as a street drug, representing the phenomenon as a social problem. Meanwhile, the pain medicine community has criticized the inaccurate and one-sided media coverage of the OxyContin problem. The authors of this study aimed to contribute to an understanding of both sides of this controversy by analyzing the coverage of OxyContin in newspapers and medical journals. The analyses revealed inconsistent messages about the drug from physicians in the news media and in medical journals, which has likely contributed to the drug’s perception as a social problem. The authors suggest ways to address the lack of medical consensus surrounding OxyContin. The results of this study may help resolve the concerns and conflicts surrounding this drug and other opioids.
Garvey, W Timothy; Mechanick, Jeffrey I; Brett, Elise M; Garber, Alan J; Hurley, Daniel L; Jastreboff, Ania M; Nadolsky, Karl; Pessah-Pollack, Rachel; Plodkowski, Raymond
Development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and the American College of Endocrinology (ACE) Board of Trustees and adheres to published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent review of clinical evidence with transparent incorporation of subjective factors. There are 9 broad clinical questions with 123 recommendation numbers that include 160 specific statements (85 [53.1%] strong [Grade A]; 48 [30.0%] intermediate [Grade B], and 11 [6.9%] weak [Grade C], with 16 [10.0%] based on expert opinion [Grade D]) that build a comprehensive medical care plan for obesity. There were 133 (83.1%) statements based on strong (best evidence level [BEL] 1 = 79 [49.4%]) or intermediate (BEL 2 = 54 [33.7%]) levels of scientific substantiation. There were 34 (23.6%) evidence-based recommendation grades (Grades A-C = 144) that were adjusted based on subjective factors. Among the 1,790 reference citations used in this CPG, 524 (29.3%) were based on strong (evidence level [EL] 1), 605 (33.8%) were based on intermediate (EL 2), and 308 (17.2%) were based on weak (EL 3) scientific studies, with 353 (19.7%) based on reviews and opinions (EL 4). The final recommendations recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life. The detailed evidence-based recommendations allow for nuanced clinical decision-making that addresses real-world medical care of patients with obesity, including screening, diagnosis, evaluation, selection of therapy, treatment goals, and individualization of care. The goal is to facilitate high-quality care of patients with obesity and provide a rational, scientific approach to management that optimizes health outcomes and safety. A1C = hemoglobin A1c AACE = American
Sarnquist, Frank H.
The American Medical Research Expedition to Everest had a wide variety of medical problems, ranging from leech bites to high-altitude pulmonary edema. Preventive measures, however, such as careful attention to ingesting only pure water and food at the lower elevations and adequate personal hydration, nutrition and rest at extremely high altitude minimized the morbidity suffered by the group. Prophylactic administration of doxycycline was effective in reducing the severity of diarrheal illness in the group. Every member of the expedition suffered upper respiratory tract infections and many other infections, some of which were resistant to all therapy until the patient moved down from high altitude. Despite careful acclimatization, several cases of acute mountain sickness occurred and required descent to a lower altitude for treatment. Frostbite was avoided entirely. Images PMID:6649596
Vaccaro, Joan A; Huffman, Fatma G
This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men with diabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.
Larenas-Linnemann, Désirée E S; Hauswirth, David W; Calabria, Christopher W; Sher, Lawrence D; Rank, Matthew A
Little data in the literature exist concerning patients with certain underlying medical conditions who receive allergen subcutaneous immunotherapy (SCIT). To survey allergists' experience with SCIT in patients with medical conditions considered to impose an elevated risk for untoward outcomes. A Web-based survey was conducted among members of the American Academy of Allergy, Asthma & Immunology to query about their experience with SCIT in patients with certain medical conditions. There were 1085 replies (21% response), of whom, 86% were U.S. based, 51% were suburban, 31% were academic, 42% were medium-sized practices, and 54% had >15 years' experience. In responders' opinion, SCIT was "contraindicated" in patients with the following: acquired immune deficiency syndrome (AIDS) (48%), cancer (and still receiving active treatment) (33%), severe asthma (32%), and a history of transplantation (30%). Even so, survey responders collectively gave SCIT to >2400 patients for each of these conditions: severe asthma, coronary artery disease, cancer in remission, and autoimmune disorders; and to ≥5400 patients with hypertension and ≥4100 women who became pregnant. The experience of colleagues with these patients rarely resulted in major problems (i.e., activation of underlying disease, systemic reactions to SCIT, or SCIT discontinuation), with the exception of severe asthma (12.5%), initiation of SCIT during pregnancy (5.4%), and AIDS (4.2%). For most other conditions, it was ≤1.5% (e.g., continue during pregnancy, cancer in remission, history of transplantation, positive human immunodeficiency virus and no AIDS). According to the experience of a large group of practicing allergists, the American Academy of Allergy, Asthma & Immunology members, few medical conditions seemed to pose an elevated risk for untoward outcomes from SCIT. Because these are survey results, prospective research might yield even more solid data.
Eickmeyer, Sarah M; Do, Kim D; Kirschner, Kristi L; Curry, Raymond H
To determine the nature and frequency of impairments and related underlying conditions of medical students with physical and sensory disabilities (PSDs), and to assess medical schools' use of relevant publications in setting admission criteria and developing appropriate accommodations. A 25-item survey addressed schools' experiences with students known to have PSDs and their related policies and practices. The survey instrument was directed to student affairs deans at all 163 accredited American and Canadian medical schools. The authors limited the survey to consideration of PSDs, excluding psychiatric, cognitive, and learning disabilities. Eighty-six schools (52.8%) responded, representing an estimated 83,327 students enrolled between 2001 and 2010. Of these students, 0.56% had PSDs at matriculation and 0.42% at graduation. Although 81% of respondents were familiar with published guidelines for technical standards, 71% used locally derived institutional guidelines for the admission of disabled applicants. The most commonly reported accommodations for students with PSDs included extra time to complete tasks/exams (n = 62), ramps, lifts, or accessible entrances (n = 43), and dictated/audio-recorded lectures (n = 40). All responding schools required students' demonstration of physical examination skills; requirements for other technical skills, with or without accommodations, varied considerably. The matriculation and graduation rates of medical students with PSDs remain low. The most frequent accommodations reported were among those required of any academic or clinical setting by the Americans with Disabilities Act. There is a lack of consensus regarding technical standards for admission, suggesting a need to reexamine this critical issue.
Maragh-Bass, Allysha C; Denison, Julie A; Thorpe, Roland J; Knowlton, Amy R
Research suggests a syndemic of substance use, mental illness, and familial conflict is associated with poor HIV medical outcomes among African American persons living with HIV (PLHIV). Social support may facilitate positive health outcomes. This study explores psychosocial correlates of HIV medical outcomes, defined as undetectable viral load (UVL) and acute care minimization. Data were from baseline of the BEACON study (N = 351). UVL was ≤40 copies/mL. Acute care minimization was defined as no ER visits and/or hospitalizations in 6 months. Descriptive statistics and Poisson regression were implemented (N = 351). Moderate syndemic burden was associated with viral suppression. Individuals with main partner caregivers had 35% higher likelihood of viral suppression than individuals whose main supporters were neither kin nor main partners (adjusted point-prevalence rate ratio [APR] = 1.35; 95% CI [1.05, 1.74]). Surprisingly, individuals with more health-related support were more likely to use acute care than individuals with less health-related support (pInteraction analyses showed that physical function modified the relationship between main supporter type and acute care minimization. Results suggest that social support receipt was not consistently associated with HIV medical outcomes. Conversely, higher syndemic burden may have facilitated positive outcomes through necessitating increased rates of health care engagement. Health care professionals should elicit discussion of social support to strengthen PLHIVs' and their supporters' relationships to improve their health. Results highlight the need for culturally tailored interventions to improve HIV medical outcomes among African American PLHIV substance users.
Jeon, Eunjoo; Kim, Jeongeun; Park, Hyeoun-Ae; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran
This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses.
Bignall, Orville Newton-Ray; Raglin Bignall, Whitney J; Vaughn, Lisa M; Unaka, Ndidi I
Despite nearly three in four African American (AA) children being born to unwed mothers, AA fathers maintain relatively high levels of parenting engagement, whether or not they live with their children. While father involvement correlates with decreased adverse child health outcomes, the nature of AA father involvement in child health-including engagement in the pediatric medical home-remains largely unexplored. Our study aimed to assess perceptions of pediatric medical home participation among a cohort of urban, AA fathers. Group level assessments (GLA; N = 17) were conducted among AA fathers in an urban, Midwestern neighborhood to examine perceptions regarding pediatric medical home involvement. Study participants generated themes based on GLA responses, and study staff used grounded theory as a framework for qualitative analysis of thematic data. Fathers desired to have their parental role acknowledged by mothers and pediatricians. They perceived unrecognized parenting strengths, including being role models, teachers, and providers for their children. Respondents endorsed uncertainty navigating the pediatric health care system, unawareness of their children's pediatric appointments, and feeling excluded from health care decision-making by their children's mothers and pediatric providers. In our cohort, AA fathers have a strong desire to be involved in their children's healthy development, but feel marginalized in their parenting role. AA fathers want improved communication with physicians and their children's mothers and to be actively included in health care decision-making. Enhanced efforts to engage fathers in the pediatric medical home may lead to improved health outcomes and reduced disparities for minority children.
Rings, Edmond H. H. M.; Escher, Bohanna C.; Buller, Hans A.; Heymans, Hugo S. A.
Objectives: To evaluate the impact on career development of a program for scientific training of Dutch medical students in an American academic division for pediatric gastroenterology and nutrition. Materials and Methods: A survey was undertaken of medical students who were trained in the division
Rings, Edmond H. H. M.; Escher, Johanna C.; Büller, Hans A.; Heymans, Hugo S. A.
OBJECTIVES: To evaluate the impact on career development of a program for scientific training of Dutch medical students in an American academic division for pediatric gastroenterology and nutrition. MATERIALS AND METHODS: A survey was undertaken of medical students who were trained in the division
Joy, Javed A.; Julius, Rose J.; Akter, Rashida; Baron, David A.
Purpose: Every year increasing numbers of candidates request special accommodations for high-stakes medical licensing examinations, due to ADHD, on the basis of the Americans with Disabilities Act (ADA). This poses significant challenges for both the applicant and the medical boards and has significant financial, legal, and ethical implications.…
Pena, J. J.; Rossell, M. A.; Calvo, J. L.; Vega, J. M.
The Ibero-American Group of Scientific Societies of Radiological Protection (GRIAPRA) was constituted on 30-September-1996 as the end of a process that the SEPR began in its V National Congress (Santiago de Compostela, 1994). In this work are presented some of the results of the experience accumulated by the SEPR (GRIAPRA) in training and professional update of latin-american radiologists,medical physicists and technician during these last six years:Cuba (La Habana 1998), Peru (Lima 1999), Mexico (Guadalajara 2000), Brazil (Recife, 2001), Peru (Lima 2002) and Cuba (La Habana 2003). They are shown the professional profiles of the american colleagues that in number superior to 300 persons have been accepted in these training courses imparted by members very qualified of the SEPR and SEFM, the theoric-practical structure of these courses, the design of their programming, documentation, the sources of financing, the general analysis of the wisdoms and mistakes and the proposal to continue with this cooperation in the future. (Author)
Zurada, Anna; Gielecki, Jerzy St; Osman, Nilab; Tubbs, R Shane; Loukas, Marios; Zurada-Zielińska, Agnieszka; Bedi, Neru; Nowak, Dariusz
Past research in medical education has addressed the study of gross anatomy, including the most effective learning techniques, comparing the use of cadavers, dissection, anatomy atlases, and multimedia tools. The aim of this study was to demonstrate similarities and differences among American, Asian, and European medical students (MS) regarding different study methods and to see how these methods affected their clinical skills. To analyze the varying study methods of European, American, and Asian MS in our program and in order to elucidate any ethnic and cultural differences a survey was conducted. A total of 705 international MS, from the Polish (PD), American (AD), and Taiwanese (TD) divisions, were asked to voluntarily participate in the questionnaire. Students were asked the following questions: which methods they used to study anatomy, and which of the methods they believed were most efficient for comprehension, memorization, and review. The questions were based on a 5-point Likert scale, where 5 was 'strongly agree', and 1 was 'strongly disagree'. The PD and AD preferred the use of dissections and prosected specimens to study anatomy. The TD showed less interest in studying from prosected specimens, but did acknowledge that this method was more effective than using atlases, plastic models, or CD-ROMs. Multimedia tools were mainly used for radiological anatomy and review and also for correctly typing proper names of structures using exact anatomical terminology. The findings highlight the differences in study techniques among students from different ethnic backgrounds. The study approaches used in order to accomplish learning objectives was affected by cultural norms that influenced each student group. These differences may be rooted in technological, religious, and language barriers, which can shape the way MS approach learning.
This book is a timely report on current neurotechnology research. It presents a snapshot of the state of the art in the field, discusses current challenges and identifies new directions. The book includes a selection of extended and revised contributions presented at the 2nd International Congress on Neurotechnology, Electronics and Informatics (NEUROTECHNIX 2014), held October 25-26 in Rome, Italy. The chapters are varied: some report on novel theoretical methods for studying neuronal connectivity or neural system behaviour; others report on advanced technologies developed for similar purposes; while further contributions concern new engineering methods and technological tools supporting medical diagnosis and neurorehabilitation. All in all, this book provides graduate students, researchers and practitioners dealing with different aspects of neurotechnologies with a unified view of the field, thus fostering new ideas and research collaborations among groups from different disciplines.
Simpao, Allan F; Ahumada, Luis M; Gálvez, Jorge A; Rehman, Mohamed A
Federal investment in health information technology has incentivized the adoption of electronic health record systems by physicians and health care organizations; the result has been a massive rise in the collection of patient data in electronic form (i.e. "Big Data"). Health care systems have leveraged Big Data for quality and performance improvements using analytics-the systematic use of data combined with quantitative as well as qualitative analysis to make decisions. Analytics have been utilized in various aspects of health care including predictive risk assessment, clinical decision support, home health monitoring, finance, and resource allocation. Visual analytics is one example of an analytics technique with an array of health care and research applications that are well described in the literature. The proliferation of Big Data and analytics in health care has spawned a growing demand for clinical informatics professionals who can bridge the gap between the medical and information sciences.
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules
Gharib, H; Papini, E; Paschke, R
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances....
Lloyd, James A.; Steinberger, Emil
The current status of teaching reproductive biology and human sexuality was surveyed in 118 medical schools, with an 82 percent response rate. Only 34 percent of those responding had organized courses in reproductive biology, and overall training was found to be inadequate. (LBH)
Schoenthaler, Antoinette; Ogedegbe, Gbenga; Allegrante, John P.
Many studies have documented the negative effects of depression on adherence to recommended treatment; however, little is known about the mechanism underlying this relationship. Using the Kenny and Baron analytic framework of mediation, the authors assessed whether self-efficacy mediated the relationship between depression and medication adherence…
Ponce, Rachel N
This paper investigates the origins of the practice of dissection in American medical education in order to both understand the function of dissection in medical education and challenge conventional wisdom about that function. In the late eighteenth and early nineteenth centuries, American medical schools increasingly made human dissection a crucial part of their curricula, privileging use of the human cadaver over any other anatomical model. In this paper, I break apart the claims that American physicians made at that time regarding the unique pedagogic usefulness of the cadaver, and I juxtapose those claims against the realities of the dissection process. In doing so, I show how the realities of dissection differed sharply from the depictions given by physicians. In the conclusion, I argue that the cadaver still remained epistemologically and ontologically useful to the medical profession, although not necessarily for the reasons physicians explicitly stated.
Villwock, Jennifer A; Sobin, Lindsay B; Koester, Lindsey A; Harris, Tucker M
To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Anonymous survey administered online in 2014 that included demographic data, the Maslach Burnout Inventory and an IS screening questionnaire. Main outcome measures were level of burnout, and presence or absence of imposter syndrome. The presence of IS and burnout components were analyzed across age, gender, race, year of training, intention to pursue fellowship training, and greater than one year of work experience outside of medicine using chi-squared tests. The association between burnout and IS was also compared using chi-squared tests. One hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ 2 (3) =10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ 2 (2) =5.9, p=0.045), cynicism (χ 2 (2) =9.4, p=0.004), emotional exhaustion (χ 2 (2) =8.0, p=0.018), and depersonalization (χ 2 (2) =10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ 2 (3) =10.5, p=0.015). Almost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.
Campbell, Jayne M; Roderer, Nancy K
Preparing librarians to meet the information challenges faced in the current and future health care environments is critical. At Johns Hopkins University, three NLM-funded fellowship programs provide opportunities for librarians to utilize the rich environments of the Welch Medical Library and the Division of Health Sciences Informatics in support of life-long learning.
Garcia, Edna; Fisher, Patrick B
To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois. Electronic survey invitations were sent to individuals who are currently practicing in the field. Data reveal increased salaries since 2013 for all staff-level laboratory professionals surveyed except phlebotomists and pathologists' assistants. Laboratory assistants and phlebotomists, regardless of level, continue to have lower salaries while pathologists' assistants and administration personnel have higher salaries than the rest of the laboratory professions surveyed. Survey results put emphasis on strategic recruitment and retention by laboratory training programs and institutions that hire laboratory professionals. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: email@example.com
Dalstrom, Matthew D
Rising medical costs and decreasing health insurance coverage are fueling the health care crisis in the United States. Often, patients have to make tough decisions about whether to forgo care or risk bankruptcy. This conundrum has encouraged some patients to use Mexican health care as an alternative to the high costs in the United States. While medical travel enables some patients to access affordable care, others perceive it as risky and thus not a viable option. This article explores how those concerns are mitigated and Mexican health care usage is increased by (1) outlining how Mexican health care information is disseminated and used within a community of winter Texans living along the US/Mexico border; and (2) discussing how Mexican pharmacies and dental clinics have broadened their appeal through association with US health care standards and practices. Research for this article was conducted during 11 months of fieldwork in the Lower Rio Grande Valley.
Sisson, Gretchen; Rowland, Brenly
To examine the portrayal of complications and long-term health consequences associated with abortion on television, recognizing the impact that fictional stories can have on public beliefs about abortion's safety. Using a systematic online search, we identified all instances of abortion on US television from 2005 to 2016. We qualitatively coded these plotlines to identify any occurrences of complications, interventions or long-term health consequences associated with abortion care, with 95% intercoder reliability. We calculated the frequencies and rates of these occurrences in Microsoft Excel. Our search identified 80 abortion plot lines. A percentage of 37.5 of characters who obtained an abortion experienced complications, interventions and/or negative health consequences. This rate contrasts with the 2.1% of real patients who experience complications or require intervention as a result of their abortions. Most onscreen complications were major events (e.g., hemorrhage), as opposed to real women, whose complications are mostly minor. Major medical interventions (e.g., hysterectomy) were similarly overportrayed, while the most commonly used interventions for real patients (e.g., medication) were not depicted at all. Finally, 22.5% of characters faced a long-term adverse health consequence, including mental illness, infertility or death. The onscreen abortion mortality rate was 5%, about 7000 times the actual mortality rate. Overall, television dramatically exaggerates the risk associated with abortion procedures, overportraying medical complications - particularly major and life-threatening complications - and long-term adverse health consequences. This pattern of misrepresentation may be partially attributable to the occurrence of stories about illegal abortions or abortions taking place outside of modern medical contexts. Onscreen abortion portrayals may contribute to inaccurate beliefs about abortion's risk that are common among the public, broadly, and abortion
22 Churchman, J. W. 1906. The use of quinine show of the big show. Inge, M. T. (ed.) Plume, during the Civil War. Johns Hopkins Hospital Penguin... malaria in 1807 (Bryan Yellow Fever Commission and became et al. 2004). Doctor Josiah Nott had extremely influential in the growth and expressed similar...Disease - Mosquitoes and the consequences of inadequate medical Malaria " before the Washington resources, particularly in preventive Philosophical
Wilbanks, Lindsey; Spollen, John; Messias, Erick
Various factors influence choice of medical specialty. Previous research grouped specialties into controllable lifestyle, primary care, and surgical. This study compared factors influencing individuals to choose psychiatry versus other specialties. Data came from the 2011-2013 Association of American Medical Colleges Graduation Questionnaire. The authors grouped responses, ranging from no influence to minor, moderate, and strong influence, into psychiatry and controllable lifestyle, primary care, and surgical specialties and analyzed the data using one-way analysis of variance. The analyses included 29,227 students, of which 1329 (4.5%) elected psychiatry; 10,998 (37.6%), controllable lifestyle specialties; 12,320 (42.2%), primary care specialties; and 4580 (15.7%), surgical specialties. Students choosing psychiatry reported less influence of competitiveness, student debt, and salary expectations than those choosing controllable lifestyle and surgical specialties (p work/life balance than those choosing primary care and surgical specialties (p personality than controllable lifestyle, primary care, and surgical specialties (p < 0.004). Students entering psychiatry do not fit the traditional categories of controllable lifestyle, primary care, and surgical profiles, but fall between controllable lifestyle and primary care specialties. Recruitment efforts may need to address this different pattern of influences.
Oh, Kyeung Mi; Jun, Jungmi; Zhou, Qiuping; Kreps, Gary
Cancer is the leading cause of death for Korean-Americans (KAs), while cancer screening rates among KAs have been consistently low. Seven semi-structured focus group interviews with 34 KA women aged 40 or older in the Washington, DC metropolitan area were conducted to explore the perceptions of KA women about seeking physical examinations and cancer screening services in Korea. Data were analyzed using a framework approach. Informants positively perceived the use of health screening services in Korea in comparison to seeking such services in the US. Decision-making factors included cost benefits, high quality services, and more convenient screening procedures in Korea. These benefits outweighed the risks of delaying health care and travelling a vast distance with incurring additional travel costs. Motivations to seek these services in Korea included opportunities to visit their homeland and to enjoy comfortable communication with their native language. The increase of available information about Korean medical services due to the industry's aggressive marketing/PR was identified as a facilitator. Most informants did not recognize possible negative health outcomes of obtaining services in Korea such as inappropriate follow up care if having abnormal findings. Educational programs are needed to educate KAs about the benefits and risks of getting the services in Korea and proper follow up care in the US. Health care providers need to know the different cancer risks and screening needs for this population.
Cybernetics and informatics being a high-profile and fast-moving fields, the papers included in this proceedings will command a wide professional and academic readership. This book covers the very latest developments in the field of cybernetics and informatics. The 2012 conference in Chongqing, China, combined a focus on innovative technologies with an emphasis on sustainable solutions and strategies. Attended by leading figures from academia and industry whose work is represented here, the conference allowed effective cross-pollination between the theoretical and applied sectors of the field. Conference organizers received more than 1,000 papers, of which only ten percent were chosen to be featured in this publication. All of the papers are at the leading edge of developments, and so this book will not only ensure that the very best current work is disseminated, but that it also acts as a spur to future research.
Full Text Available In this paper different aspects regarding smart metering systems integration have been depicted. Smart metering systems, renewable energy sources integration and advanced tariff systems implementation require informatics solution that could automatically collect and process data, forecast the behavior of electricity consumers, analyze trends regarding electricity prices, optimize the consumption of consumers, provide friendly interfaces, etc. They are advanced technologies that represent solutions for insufficient conventional primary energy sources, gas emissions, dependency on energy sources located outside European Union and issues related to energy efficiency. This paper mainly describes several informatics solutions correlated with operational requirements for smart metering system and our proposal for simplified architecture of smart metering systems, with three distinct levels (base level, middle level and top level and load profile calculation methods.
This book deals with present situation and view of research and development project by industry, which includes general machinery industry, the steel industry, non ferrous metal industry, petrochemistry industry, auto industry, shipbuilding industry, aerospace engineering industry, daily supplies industry, fine chemistry industry, the ceramic industry, plate glass industry, biology life industry, electron industry, information industry, and semiconductor industry. It also describes project management of R and D and informatization of industry.367
Tucker, Cynthia A.; Larkin, Stephanie N.; Akers, Timothy A.
To date, little has been written about the implementation of utilizing food safety informatics as a technological tool to protect consumers, in real-time, against foodborne illnesses. Food safety outbreaks have become a major public health problem, causing an estimated 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths in the U.S. each year. Yet, government inspectors/regulators that monitor foodservice operations struggle with how to collect, organize, and analyze data; impleme...
The construction and management of exhibition informatization is the main task and choke point during the process of Chinese exhibition industry’s transformation and promotion. There are three key points expected to realize a breakthrough during the construction of Chinese exhibition informatization, and the three aspects respectively are adopting service outsourcing to construct and maintain the database, adopting advanced chest card technology to collect various kinds of information, developing statistics analysis to maintain good cutomer relations. The success of Chinese exhibition informatization mainly calls for mature suppliers who can provide construction and maintenance of database, the proven technology, a sense of data security, advanced chest card technology, the ability of data mining and analysis and the ability to improve the exhibition service basing on the commercial information got from the data analysis. Several data security measures are expected to apply during the process of system developing, including the measures of the terminal data security, the internet data security, the media data security, the storage data security and the application data security. The informatization of this process is based on the chest card designing. At present, there are several types of chest card technology: bar code chest card; two-dimension code card; magnetic stripe chest card; smart-chip chest card. The information got from the exhibition data will help the organizers to make relevant service strategies, quantify the accumulated indexes of the customers, and improve the level of the customer’s satisfaction and loyalty, what’s more, the information can also provide more additional services like the commercial trips, VIP ceremonial reception.
Roč. 20, č. 6 (2009), s. 743-750 ISSN 1180-4009. [TIES 2007. Annual Meeting of the International Environmental Society /18./. Mikulov, 16.08.2007-20.08.2007] Institutional research plan: CEZ:AV0Z10300504 Keywords : biomedical informatics * biomedical statistics * genetic information * forensic dentistry Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.000, year: 2009
Cummings, Elizabeth; Shin, Eun Hee; Mather, Carey; Hovenga, Evelyn
Alongside the rapid rise in the adoption of electronic health records and the use of technology to support nursing processes, there is a requirement for nursing students, new graduate nurses, and nursing educators to embrace nursing informatics. Whilst nursing informatics has been taught at post graduate levels for many years, the integration of it into undergraduate studies for entry level nurses has been slow. This is made more complex by the lack of explicit nursing informatics competencies in many countries. Australia has now mandated the inclusion of nursing informatics into all undergraduate nursing curricula but there continues to be an absence of a relevant set of agreed nursing competencies. There is a resulting lack of consistency in nursing curricula content nationally. This paper describes the process used by one Australian university to integrate nursing informatics throughout the undergraduate nursing degree curriculum to ensure entry level nurses have a basic level of skills in the use of informatics.
Koch, Timothy R; Kirsner, Joseph B
In a recent study, a large proportion of veterans seen for chronic heartburn or dyspepsia after the Persian Gulf War had evidence for Helicobacter pylori. Thomas Jackson was born and raised in an area of West Virginia that has a high prevalence of H. pylori. He suffered chronic dyspeptic symptoms following his service in the Mexican-American War. Therapies that he tried included treatment with a variant of the Sippy diet. Following a bullet wound to the left arm at the battle of Chancellorsville on Saturday, May 2, 1863, Thomas Jackson underwent amputation of the left arm below the left shoulder. He died 1 week later with a diagnosis of pleuropneumonia. The records of the postsurgical course are incomplete. The available clinical information raises the hypothesis that his chronic dyspepsia and his cause of death could have been related to chronic peptic ulcer disease due to gastric H. pylori infection.
Hambly, Kevin; Danzer, Joseph; Muskal, Steven; Debe, Derek A
Structural genomics projects are producing protein structure data at an unprecedented rate. In this paper, we present the Target Informatics Platform (TIP), a novel structural informatics approach for amplifying the rapidly expanding body of experimental protein structure information to enhance the discovery and optimization of small molecule protein modulators on a genomic scale. In TIP, existing experimental structure information is augmented using a homology modeling approach, and binding sites across multiple target families are compared using a clique detection algorithm. We report here a detailed analysis of the structural coverage for the set of druggable human targets, highlighting drug target families where the level of structural knowledge is currently quite high, as well as those areas where structural knowledge is sparse. Furthermore, we demonstrate the utility of TIP's intra- and inter-family binding site similarity analysis using a series of retrospective case studies. Our analysis underscores the utility of a structural informatics infrastructure for extracting drug discovery-relevant information from structural data, aiding researchers in the identification of lead discovery and optimization opportunities as well as potential "off-target" liabilities.
Objectives To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. Design/Setting/Participants A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Main Outcomes/Measures Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Results Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of
Chadaga, Amar R; Villines, Dana; Krikorian, Armand
To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5'8 and BMI ≥ 25 individuals. Many trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of healthcare.
The subjects covered are the following: Low energy X rays qualities, medical physicist, simulation of irradiation X, dosimetry, radiotherapy, calibration, digital mammography, management of radioactive specimens, radio-surgery, genetic algorithm for the ventricular volume mensuration, SPECT systems, electronic paramagnetic resonance, radio-diagnose service, bra qui-therapy, radio sensibility, mammographic systems, thermoluminescent dosimetry, magnetic resonance, radiological protection, radiological safety, Venezuelan legislation, tomographic images, linear energy transfer (LET), regional master in physics medicine, heart function in nuclear medicine, renography, protons beam, nuclear medicine equipment. Individual papers have been analysed and submitted to INIS separately [es
Wilkerson, J D; Carrell, D
We examine contributions by the American Medical Association's political action committee (AMPAC) to candidates for seats in the U.S. House of Representatives during two electoral cycles (1989-1990 and 1991-1992). In contrast to earlier studies, we do not find any systematic evidence to support the conventional wisdom that AMPAC contributes to influence legislators' positions on roll call votes or that AMPAC's contribution decisions are influenced by legislators' voting positions. We do find that AMPAC contributes to promote access to decision makers and to help elect (or reelect) legislators who would be expected to be more generally sympathetic to the economic and practice concerns of AMA physicians. As points of comparison, we also examine contributions from the top five tobacco PACs and the National Rifle Association's (NRA) PAC and find that legislators' roll call voting positions are strongly related to contributions received from these organizations.
Stennett, R A; Bongiovi, M E
The July 1989 US Supreme Court decision in Webster v Reproductive Health Services restricts both women's access to legal abortion and physicians' latitude when performing abortions. We surveyed 197 medical students at the Columbia University College of Physicians and Surgeons regarding their general attitudes toward abortion as well as their specific opinions concerning the Webster decision and the possible restriction of minors' access to abortion represented by three then undecided cases. Of those surveyed, 85.8% were pro-choice by self-description as compared with 14.2% pro-life. The antiabortion group was predominantly male (78.6%) and of Catholic background, while there were no significant gender and/or religious correlates among the pro-choice group. The majority of the respondents (83.2%) disagreed with either one or both stipulated restrictions of Webster and 81.4% did not support limiting minors' access to abortion in any way. Moreover, only 19.8% admitted to a change in general attitude toward abortion during their medical education.
In this presentation author deals with next problems of Slovenske elektrarne, Plc (SE): - Centralisation and optimisation of informatics management; - New technologies within Integrated Informatics System IIS-SE: presentation of preliminary Project of 2 nd generation IIS-SE; - Centralisation of the selected data processing. At the present the intensive process of restructuring is taking place in SE, Plc, focused on increasing of the effectiveness of the pursued activities. In connection with this the Informatics section solves two projects: More effective self-management and human resources; Change of Informatics system architecture from decentralised to the centralised ones with an aim to consolidate all information and to make new conditions for higher mobility
Luz Dalia Sanchez, MD, MCP, MHA, PhD
Full Text Available Objective: to describe cultural beliefs and medication-taking-behavior about pregnancy in African-American and Latina women. Design: qualitative study using phenomenological methodology; face-to-face, semi structured interviews and focus group. Thematic analysis was done to obtain themes consistent with the research objective. Setting: Maricopa County, Arizona, Department of Public-health Programs, November 2008 through April 2009.Participants: women seeking public-health services in the greater Phoenix, Arizona.Results: fifteen adult women representing two ethnic groups (seven African-Americans and eight Latinas participated. Themes derived from the interview data included: “The Dilemma: To Become or Not to Become Pregnant;” “The Ideal Stress-free World: Support System;” “Changing Worlds: Wanting Dependency;” and “The Health care System: Disconnection from Pregnancy to Postpartum.”Conclusions: based on the cultural themes: 1. pregnancies were not planned; 2. healthy life-style changes were not likely to occur during pregnancy; 3. basic facts about the biology of sexual intercourse and pregnancy were not understood, and there was no usage of any preconceptional or prenatal medications; and 4. professional health care was not desired or considered necessary (except during delivery. These cultural beliefs can contribute to negative birth outcomes, and need to be considered by pharmacists and other health-care providers. The information gained from this study can guide the implementation of educational programs developed by pharmacists that are more sensitive to the cultural beliefs and points of view of these particular women. Such programs would thus be more likely to be favorably received and utilized.
Sy, Angela U; Lim, Eunjung; Ka'opua, Lana Sue; Kataoka-Yahiro, Merle; Kinoshita, Yumiko; Stewart, Susan L
Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61% of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. Whites had the highest prevalence of screening (62.3%), followed by Filipinos (55.0%), Chinese (50.9%), and Asian Indians (48.6%). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51. © 2018 American Cancer Society. © 2018 American Cancer Society.
Sapci, A H; Sapci, H A
This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course. Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories. All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum. This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices. Schattauer GmbH Stuttgart.
Miguel A. Serra Valdés
Full Text Available Introduction: One of the infectious illnesses that have repercussion in Latin America are the Chagas illness. Objective: with the objective of identifying the students with positive serology for the illness of Chagas and describe the characteristics in the same thing with focussing epidemiological carried out to him the present study. Method: It become fulfilled a observational investigation, descriptive and prospectival. It decided the prevalencial in the Latin American students of medicine that resides in the school Salvador Allende in the period understanded between October of the 2009 to January of the 2010 by means of serology, other clinical studieses and examination. They took shelter the variables of the clinical records and of personal interview.. Results: Affected 50 of the Bolivian delegation. The prevalence went of 6.6% of this delegation. Have clinical symptoms. The detected alterations went the ventricular hypertrophy left and the disorders of transportation and of the rhythm for electrocardiogram. It predominated the masculine sex and the rural origin. It found variability in the results of laboratory, being positive in their country and negative in Cuba and vice versa. Single 56% fulfilled the treatment. The adverse reactions went minims. Conclusion: It constitutes a sanitary problem and demands a better diagnosis, control and follow-up.
Oleg M. Spirin
Full Text Available In the article on the basis of analysis of such concepts as information, informative and informatics processes, system and technology, and competences, the definitions of "information and communication competence" and "informatics competence " are specified. It is determined the structure and place of such competences in the system of professional- specialized competence of informatics teacher. New determination of concept "information and communication technologies" is offered.
McGowan, Julie J; Cusack, Caitlin M
While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887
Full Text Available Malaz Boustani1, Stephanie Munger1, Robin Beck2, Noll Campbell3, Michael Weiner11Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; 2Indiana University School of Medicine, Indianapolis, IN, USA; 3Wishard Health Services, Indianapolis, IN, USAAbstract: Approximately 50% of hospitalized elders have cognitive impairment (CI that increases their vulnerability to hospital-acquired complications. Matching geriatric evaluation and recommendations to the true pace of hospital care may improve the care of elders in general, in particular those with CI. Integrating information technology into geriatric services (gero-informatics might allow reduction of the time to implementation of geriatric recommendations and prevent the initiation of potentially harmful medications and procedures during the critical first 48 hours of hospitalization. This paper reviews our local gero-informatics early experience of developing a computerized decision support system (CDSS to enhance hospital care for elders with CI by reducing inappropriate use of anticholinergic medications, urinary catheters, and physical restraints.Keywords: gero-informatics, cognitive impairment, hospital, decision support
Wageih, Mohamed A; Marcano-Cedeño, Alexis; Gómez, Enrique J; Mantas, John
Biomedical & Health Informatics (BMHI) is relatively new in Arab States. However, several programs/ tracks are running, with high promises of expansion. Programs are evaluated by national authorities, not by a specialized body/association. This does not always mean that the program is of an international standard. One of the possible ways of ensuring the quality of these programs is to be evaluated by international agencies. The International Medical Informatics Association (IMIA) has the expertise in the evaluation BMHI education programs. Accredited programs staffs will have the opportunities for Internationalization and to be engaged with other top-notch organizations, which will have great impacts on the overall implementations of the BMHI in the Arab World. The goal of this document is to show to Arab Universities (pilot: Egypt) how to apply for IMIA Accreditation for their programs.
This paper describes the results of a two year project to design a model curriculum of health care informatics for Dutch higher professional education. The core of the curriculum are sixteen modules which cover the broad range of medical informatics and which are closely related to the profiles of the professions involved (nursing, physiotherapy, speech therapy, occupational therapy and dietetics). The curriculum emphasizes the need of using structured data and information to perform tasks in health care delivery and management, for which modern information technology is indispensable. The model curriculum will enable faculty to redesign existing undergraduate programs and to select the contents they see appropriate. In this way we hope that the model curriculum will contribute to an innovative attitude of future graduating health care professionals. A new three year project just has started to develop learning materials using professional health care software based on the sixteen modules of the curriculum. PMID:8563329
Mønsted, Troels Sune
’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...
Stein, Howard F
This paper explores the contexts and relationships in which EMR/EHR technology is used in healthcare settings. It approaches the EMR/EHR as an issue in clinical ethics. The author recognizes the immense contribution that healthcare informatics makes to coordinating and integrating medical care at the level of individual physician, nurse, and institutions. At the same time the author raises a cautionary note about some unrecognized dimensions of the use and experience of the EMR/EHR. The author argues that the EMR/EHR can consciously and unconsciously become an instrument of assembly line-like physician "productivity" and "production reports" that depersonalize patient and physician alike. Construed this way, the EMR/EHR can narrow the clinician's imagination, relationships, clinical decision-making, and documentation into oversimplified, and potentially distorting, clinical narratives and categories such as fit into CPT, ICD-9, DRG, DSM-IV and other codes, EBM protocols, and clinical algorithms. By contrast, the author uses a vignette and one of his own clinical poems to illustrate the rich weave of relationship and meaning that are foreground rather than background in clinical assessment, decision-making, treatment, outcome, and satisfaction. The author concludes with a call to imaginatively use the EMR/EHR as an instrument of physician-patient communication, and to include in it and make available vital narrative data (evidence) about patient, family, culture, occupation, socioeconomic status, physician, disease, and their relationships.
Farnan, Jeanne M; Snyder Sulmasy, Lois; Worster, Brooke K; Chaudhry, Humayun J; Rhyne, Janelle A; Arora, Vineet M
User-created content and communications on Web-based applications, such as networking sites, media sharing sites, or blog platforms, have dramatically increased in popularity over the past several years, but there has been little policy or guidance on the best practices to inform standards for the professional conduct of physicians in the digital environment. Areas of specific concern include the use of such media for nonclinical purposes, implications for confidentiality, the use of social media in patient education, and how all of this affects the public's trust in physicians as patient-physician interactions extend into the digital environment. Opportunities afforded by online applications represent a new frontier in medicine as physicians and patients become more connected. This position paper from the American College of Physicians and the Federation of State Medical Boards examines and provides recommendations about the influence of social media on the patient-physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician-physician communication that preserve confidentiality while best using these technologies.
Continuing medical education effect on physician knowledge application and psychomotor skills: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.
O'Neil, Kevin M; Addrizzo-Harris, Doreen J
Recommendations for optimizing continuing medical education (CME) effectiveness in improving physician application of knowledge and psychomotor skills are needed to guide the development of processes that effect physician change and improve patient care. The guideline panel reviewed evidence tables and a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ Evidence Report). The panel considered studies relevant to the effect of CME on physician knowledge application and psychomotor skill development. From the 136 studies identified in the systematic review, 15 articles, 12 addressing physician application of knowledge and 3 addressing psychomotor skills, were identified and reviewed. Recommendations for optimizing CME were developed using the American College of Chest Physicians guideline grading system. The preponderance of evidence demonstrated improvement in physician application of knowledge with CME. The quality of evidence did not allow specific recommendations regarding optimal media or educational techniques or the effectiveness of CME in improving psychomotor skills. CME is effective in improving physician application of knowledge. Multiple exposures and longer durations of CME are recommended to optimize educational outcomes.
Giuse, Nunzia B; Williams, Annette M; Giuse, Dario A
The Vanderbilt University paper discusses how the Eskind Biomedical Library at Vanderbilt University Medical Center transitioned from a simplistic approach that linked resources to the institutional electronic medical record system, StarPanel, to a value-added service that is designed to deliver highly relevant information. Clinical teams formulate complex patient-specific questions via an evidence-based medicine literature request basket linked to individual patient records. The paper transitions into discussing how the StarPanel approach acted as a springboard for two additional projects that use highly trained knowledge management librarians with informatics expertise to integrate evidence into both order sets and a patient portal, MyHealth@Vanderbilt.
Goldwein, Joel W.; Jaspan, Greg; Schenker, Mathew; Hark, Lisa; Morrison, Gail
Herein we describe an online medical school curriculum consisting of a supporting database linked to course material, virtual lectures, schedules, medical informatics and medical education resources. Evaluation by students using surveys, utilization statistics and informal email suggests that it has improved their informatics competencies.
This paper outlines a new method of teaching health informatics to large numbers of students from around the world through a Massive Open Online Course (MOOC). The Health Informatics Forum is a social networking site for educating health informatics students and professionals [corrected]. It is running a MOOC for students from around the world that uses creative commons licenced content funded by the US government and developed by five US universities. The content is delivered through narrated lectures with slides that can be viewed online with discussion threads on the forum for class interactions. Students can maintain a professional profile, upload photos and files, write their own blog posts and post discussion threads on the forum. The Health Informatics Forum MOOC has been accessed by 11,316 unique users from 127 countries from August 2, 2012 to January 24, 2014. Most users accessed the MOOC via a desktop computer, followed by tablets and mobile devices and 55% of users were female. Over 400,000 unique users have now accessed the wider Health Informatics Forum since it was established in 2008. Advances in health informatics and educational technology have both created a demand for online learning material in health informatics and a solution for providing it. By using a MOOC delivered through a social networking platform it is hoped that high quality health informatics education will be able to be delivered to a large global audience of future health informaticians without cost.
Mandelker, Diana; Lee, Roy E; Platt, Mia Y; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K F; Klepeis, Veronica E; Mahowald, Michael; Lane, William J; Beckwith, Bruce A; Baron, Jason M; McClintock, David S; Kuo, Frank C; Lebo, Matthew S; Gilbertson, John R
Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
Across the landscape of informat- ics, particularly biological and eco- logical informatics, are quite a few women in leadership positions at im- portant organizations, such as the Na- tional Center for Ecological Analysis and Synthesis, the National Evolution- ary Synthesis Center, and the National. Ecological Observatory ...
Clinical informatics has enormous potential to ensure healthcare quality in both developed and developing countries. This paper examines the status and challenges of clinical informatics in the South African health care sector, In a recent survey of major international research databases such as Scopus, it was observed ...
Habiballa, Hashim; Jendryscik, Radek
The article presents capabilities of the formal rewrite logic system - Bachelor - for teaching theoretical computer science (mathematical informatics). The system Bachelor enables constructivist approach to teaching and therefore it may enhance the learning process in hard informatics essential disciplines. It brings not only detailed description of formal rewrite process but also it can demonstrate algorithmical principles for logic formulae manipulations.
Li, Ian; Froehlich, Jon; Larsen, Jakob Eg
Personal informatics is a class of systems that help people collect personal information to improve selfknowledge. Improving self-knowledge can foster selfinsight and promote positive behaviors, such as healthy living and energy conservation. The development of personal informatics applications p...
Hasman, A.; Haux, R.
OBJECTIVE: Modeling is a significant part of research, education and practice in biomedical and health informatics. Our objective was to explore which types of models of processes are used in current biomedical/health informatics research, as reflected in publications of scientific journals in this
Gundlapalli, Adi V; Gundlapalli, Aditya V; Greaves, William W; Kesler, Denece; Murray, Peter; Safran, Charles; Lehmann, Christoph U
Clinical informatics workforce development is a high priority for medicine. Professional board certification for physicians is an important tool to demonstrating excellence. The recent recognition of clinical informatics as a subspecialty board in the U.S. has generated interest and excitement among the U.S. informatics community. To determine the extent of similar programs in countries around the world, we performed literature searches with relevant keywords and internet searches of websites of informatics societies around the world for mentions or descriptions of certifications and reviewed publicly available sources. The U.S. certification was prominent in the recent published literature. Germany and Belgium have long-standing certifications with South Korea and Sri Lanka considering similar programs. This is the first global view of clinical informatics board certification for physicians. Training and certification for non-physician informatics professionals in allied areas are widespread. Official recognition and certification for physicians and all informatics professionals represents a key component of capacity building and a means of addressing the shortage of a skilled informatics workforce. Wider adoption of certification programs may further attracting talent and accelerate growth of the field.
Nykänen, Pirkko; Brender, Jytte; Ammenwerth, Elske; Talmon, Jan; de Keizer, Nicolette; Rigby, Michael
Good evaluation practice guidelines have been developed through a consensus making process by a core team and the health informatics community. A set of 60 issues has been identified that is relevant for planning, implementation and execution of an evaluation study in the health informatics domain.
The U.S. Geological Survey (USGS) Office of Biological Informatics and Outreach (OBIO) in Reston, Virginia, and its Center for Biological Informatics (CBI) in Denver, Colorado, provide leadership in the development and use of geospatial technologies to advance the Nation's biological science activities.
C-L. Chang (Chia-Lin); M.J. McAleer (Michael); W.-K. Wong (Wing-Keung)
textabstractThis short communication reviews some of the literature in econometrics and financial economics that is related to informatics and data mining. We then discuss some of the research on econometrics and financial economics that could be extended to informatics and data mining beyond the
Demiris, George; Thompson, Hilaire J; Reeder, Blaine; Wilamowska, Katarzyna; Zaslavsky, Oleg
The aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of older adults' wellness. A theoretical framework is presented that informs the design of a technology enhanced screening platform for wellness. We highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies (including a telehealth component to capture vital signs and customized questionnaires, a gait analysis component and cognitive assessment software) to assess the multiple aspects of wellness of older adults. A demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for older adults. Subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance, physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks. Data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness. Preliminary findings indicate that older adults are willing to participate in technology-enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers. Informatics can advance health care for older adults and support a holistic assessment of older adults' wellness. The described framework can support decision making, link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events. Copyright © 2011 Elsevier Ireland
Daniel, C; Choquet, R
To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select best papers published in 2015. A bibliographic search using a combination of MeSH and free terms search over PubMed on Clinical Research Informatics (CRI) was performed followed by a double-blind review in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the editorial team was finally organized to conclude on the selection of best papers. Among the 579 returned papers published in the past year in the various areas of Clinical Research Informatics (CRI) - i) methods supporting clinical research, ii) data sharing and interoperability, iii) re-use of healthcare data for research, iv) patient recruitment and engagement, v) data privacy, security and regulatory issues and vi) policy and perspectives - the full review process selected four best papers. The first selected paper evaluates the capability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) to support the representation of case report forms (in both the design stage and with patient level data) during a complete clinical study lifecycle. The second selected paper describes a prototype for secondary use of electronic health records data captured in non-standardized text. The third selected paper presents a privacy preserving electronic health record linkage tool and the last selected paper describes how big data use in US relies on access to health information governed by varying and often misunderstood legal requirements and ethical considerations. A major trend in the 2015 publications is the analysis of observational, "nonexperimental" information and the potential biases and confounding factors hidden in the data that will have to be carefully taken into account to validate new predictive models. In addiction, researchers have to understand
Schieffer, Kathleen M; Peters, Douglas G; Richter, Chesney K; Loc, Welley S; Pawelczyk, James A
As part of the Clinical and Translational Science Institute predoctoral TL1 training program at the Pennsylvania State University, a multidisciplinary team of predoctoral trainees representing the Chemistry, Neurosurgery, Nutritional Sciences, and Public Health Sciences departments were introduced to the NIH-sponsored Informatics for Integrating Biology and the Bedside (i2b2) database to test the following student-generated hypothesis: children with iron deficiency anemia (IDA) are at increased risk of attention deficit-hyperactivity disorder (ADHD). Children aged 4-12 and 4-17 years were categorized into IDA and control groups. De-identified medical records from the Penn State Milton S. Hershey Medical Center (HMC) and the Virginia Commonwealth University Medical Center (VCUMC) were used for the analysis. Overall, ADHD prevalence at each institution was lower than 2011 state estimates. There was a significant association between IDA and ADHD in the 4-17-year-old age group for all children (OR: 1.902 [95% CI: 1.363-2.656]), Caucasian children (OR: 1.802 [95% CI: 1.133-2.864]), and African American children (OR: 1.865 [95% CI: 1.152-3.021]). Clinical and Translational Science Award (CTSA) infrastructure is particularly useful for trainees to answer de novo scientific questions with minimal additional training and technical expertise. Moreover, projects can be expanded by collaborating within the CTSA network. © 2015 Wiley Periodicals, Inc.
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive Summary of recommendations
Gharib, H; Papini, E; Paschke, R
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...