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We are reporting on a recent experience with Health Informatics (HI) teaching at undergraduate degree level to an audience of HI and Pharmacy students. The important insight is that effective teaching of clinicalinformatics must involve highly interactive, applied components in addition to the traditional theoretical material. This is in agreement with general literature underlining the importance of simulations and role playing in teaching and is well supported by our student evaluation results. However, the viability and sustainability of such approaches to teaching hinges on significant course preparation efforts. These efforts consist of time-consuming investigations of informatics technologies, applications and systems followed by the implementation of workable solutions to a wide range of technical problems. In effect, this approach to course development is an involved process that relies on a special form of applied research whose technical complexity could explain the dearth of published reports on similar approaches in HI education. Despite its difficulties, we argue that this approach can be used to set a baseline for clinicalinformatics training at undergraduate level and that its implications for HI education in Canada are of importance. PMID:21335688
Clinical research informatics is the rapidly evolving sub-discipline within biomedical informatics that focuses on developing new informatics theories, tools, and solutions to accelerate the full translational continuum: basic research to clinical trials (T1), clinical trials to academic health center practice (T2), diffusion and implementation to community practice (T3), and ‘real world’ outcomes (T4). We present a conceptual model based on an informatics-enabled clinical research workflow, integration across heterogeneous data sources, and core informatics tools and platforms. We use this conceptual model to highlight 18 new articles in the JAMIA special issue on clinical research informatics.
This chapter gives an educational overview of: * health informatics competencies in medical, nursing and allied clinical health professions * health informatics learning cultures and just-in-time health informatics training in clinical work settings * major considerations in selecting or developing health informatics education and training programs for local implementation * using elearning effectively to meet the objectives of health informatics education. PMID:20407180
Clinical guidelines are a positive contribution to improving the quality of care and assuring its effectiveness. However, clinical guidelines need to be integrated with other quality improvement initiatives to fulfil their potential. We propose a model of how informatics can support the implementation of clinical guidelines and their integration into systems for decision support and clinical audit. Each element of
Clinical guidelines are heralded as a positive contribution to improving quality of care and ensuring the effectiveness of care. From the perspective of the health services researcher, the authors propose a model of how informatics can support the implementation of clinical guidelines and their integration into systems for decision support and clinical audit. Each element of the model is discussed
The Core Content for ClinicalInformatics defines the boundaries of the discipline and informs the Program Requirements for Fellowship Education in ClinicalInformatics. The Core Content includes four major categories: fundamentals, clinical decision making and care process improvement, health information systems, and leadership and management of change. The AMIA Board of Directors approved the Core Content for ClinicalInformatics in November 2008.
Gardner, Reed M.; Overhage, J. Marc; Steen, Elaine B.; Munger, Benson S.; Holmes, John H.; Williamson, Jeffrey J.; Detmer, Don E.
Describes a course in educational informatics for preservice teachers and students in educational software development that emphasizes the use of LOGO, and summarizes course modules that cover tools and methods for teachinginformatics, informatics curriculum design, introducing the basic notions of informatics, integrating informatics into the…
Within health and health care, medical informatics and its subspecialties of biomedical, clinical, and public health informatics have emerged as a new discipline with increasing demands for its own work force. Knowledge and skills in medical informatics are widely acknowledged as crucial to future success in patient care, research relating to biomedicine, clinical care, and public health, as well as health policy design. The maturity of the domain and the demand on expertise necessitate standardized training and certification of professionals. The American Medical Informatics Association (AMIA) embarked on a major effort to create professional level education and certification for physicians of various professions and specialties in informatics. This article focuses on the AMIA effort in the professional structure of medical specialization, e.g., the American Board of Medical Specialties (ABMS) and the related Accreditation Council for Graduate Medical Education (ACGME). This report summarizes the current progress to create a recognized sub-certificate of competence in ClinicalInformatics and discusses likely near term (three to five year) implications on training, certification, and work force with an emphasis on clinical applied informatics. PMID:23616825
Detmer, Don E; Munger, Benson S; Lehmann, Christoph U
Background: Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. Methods: The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012) and involved both local and visiting faculty and fellows. Results: Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Conclusions: Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions). Case studies have become an important component of our fellowship's educational platform.
Lee, Roy E.; McClintock, David S.; Balis, Ulysses J.; Baron, Jason M.; Becich, Michael J.; Beckwith, Bruce A.; Brodsky, Victor B.; Carter, Alexis B.; Dighe, Anand S.; Haghighi, Mehrvash; Hipp, Jason D.; Henricks, Walter H.; Kim, Jiyeon Y.; Klepseis, Veronica E.; Kuo, Frank C.; Lane, William J.; Levy, Bruce P.; Onozato, Maristela L.; Park, Seung L.; Sinard, John H.; Tuthill, Mark J.; Gilbertson, John R.
Informatics is a branch of computer science that concerns itself, in actuality, with the use of information systems. The objective of this paper is to focus on the business curriculum for graduate students and their gaining proficiency in informatics so that they can understand the concept of information, the access of information, the use of…
Healthcare has begun to flounder in the mounting flood of data available from automated monitoring equipment, microprocessor controlled life-support equipment, such as ventilators, ever more sophisticated laboratory tests, and the myriad of minor technological wonders that every hospital and clinic seem to collect. It is no longer enough to merely display the data in a large spreadsheet or on a complex, colorful time-sequence graph. The next generation of healthcare information systems must help the clinician to assimilate the myriad of data and to make fast and effective decisions. The following is a list of features that the next generation of computer systems will have to include if they are to have a significant impact on the quality of patient care: data acquisition, data storage, information display, data processing, and decision support. By automating or streamlining repetitive or complex tasks, correlating and presenting complex and potentially confusing data, and tracking patient outcomes, the computer can augment clinicians' skills to improve patient care.
The Cancer Imaging Program (CIP) is a driver of imaging informatics research at NCI. The CIP Informatics Team provides critical services and infrastructure to both the intramural and extramural imaging research communities. Major ongoing initiatives include:
Background: In 2007, our healthcare system established a clinical fellowship program in pathology informatics. In 2011, the program benchmarked its structure and operations against a 2009 white paper “Program requirements for fellowship education in the subspecialty of clinicalinformatics”, endorsed by the Board of the American Medical Informatics Association (AMIA) that described a proposal for a general clinicalinformatics fellowship program. Methods: A group of program faculty members and fellows compared each of the proposed requirements in the white paper with the fellowship program's written charter and operations. The majority of white paper proposals aligned closely with the rules and activities in our program and comparison was straightforward. In some proposals, however, differences in terminology, approach, and philosophy made comparison less direct, and in those cases, the thinking of the group was recorded. After the initial evaluation, the remainder of the faculty reviewed the results and any disagreements were resolved. Results: The most important finding of the study was how closely the white paper proposals for a general clinicalinformatics fellowship program aligned with the reality of our existing pathology informatics fellowship. The program charter and operations of the program were judged to be concordant with the great majority of specific white paper proposals. However, there were some areas of discrepancy and the reasons for the discrepancies are discussed in the manuscript. Conclusions: After the comparison, we conclude that the existing pathology informatics fellowship could easily meet all substantive proposals put forth in the 2009 clinicalinformatics program requirements white paper. There was also agreement on a number of philosophical issues, such as the advantages of multiple fellows, the need for core knowledge and skill sets, and the need to maintain clinical skills during informatics training. However, there were other issues, such as a requirement for a 2-year fellowship and for informatics fellowships to be done after primary board certification, that pathology should consider carefully as it moves toward a subspecialty status and board certification.
Gilbertson, John R.; McClintock, David S.; Lee, Roy E.; Onozato, Maristela; Kuo, Frank C.; Beckwith, Bruce A.; Yagi, Yukako; Dighe, Anand S.; Gudewicz, Tom M.; Le, Long P.; Wilbur, David C.; Kim, Ji Yeon; Brodsky, Victor B.; Black-Schaffer, Stephen
Background: In 2007, our healthcare system established a clinical fellowship program in Pathology Informatics. In 2010 a core didactic course was implemented to supplement the fellowship research and operational rotations. In 2011, the course was enhanced by a formal, structured core curriculum and reading list. We present and discuss our rationale and development process for the Core Curriculum and the role it plays in our Pathology Informatics Fellowship Training Program. Materials and Methods: The Core Curriculum for Pathology Informatics was developed, and is maintained, through the combined efforts of our Pathology Informatics Fellows and Faculty. The curriculum was created with a three-tiered structure, consisting of divisions, topics, and subtopics. Primary (required) and suggested readings were selected for each subtopic in the curriculum and incorporated into a curated reading list, which is reviewed and maintained on a regular basis. Results: Our Core Curriculum is composed of four major divisions, 22 topics, and 92 subtopics that cover the wide breadth of Pathology Informatics. The four major divisions include: (1) Information Fundamentals, (2) Information Systems, (3) Workflow and Process, and (4) Governance and Management. A detailed, comprehensive reading list for the curriculum is presented in the Appendix to the manuscript and contains 570 total readings (current as of March 2012). Discussion: The adoption of a formal, core curriculum in a Pathology Informatics fellowship has significant impacts on both fellowship training and the general field of Pathology Informatics itself. For a fellowship, a core curriculum defines a basic, common scope of knowledge that the fellowship expects all of its graduates will know, while at the same time enhancing and broadening the traditional fellowship experience of research and operational rotations. For the field of Pathology Informatics itself, a core curriculum defines to the outside world, including departments, companies, and health systems considering hiring a pathology informatician, the core knowledge set expected of a person trained in the field and, more fundamentally, it helps to define the scope of the field within Pathology and healthcare in general.
McClintock, David S.; Levy, Bruce P.; Lane, William J.; Lee, Roy E.; Baron, Jason M.; Klepeis, Veronica E.; Onozato, Maristela L.; Kim, JiYeon; Dighe, Anand S.; Beckwith, Bruce A.; Kuo, Frank; Black-Schaffer, Stephen; Gilbertson, John R.
Radiology and imaging informatics education have rapidly evolved over the past few decades. With the increasing recognition that future growth and maintenance of radiology practices will rely heavily on radiologists with fundamentally sound informatics skills, the onus falls on radiology residency programs to properly implement and execute an informatics curriculum. In addition, the American Board of Radiology may choose to include even more informatics on the new board examinations. However, the resources available for didactic teaching and guidance most especially at the introductory level are widespread and varied. Given the breadth of informatics, a centralized web-based interface designed to serve as an adjunct to standardized informatics curriculums as well as a stand-alone for other interested audiences is desirable. We present the development of a curriculum using PearlTrees, an existing web-interface based on the concept of a visual interest graph that allows users to collect, organize, and share any URL they find online as well as to upload photos and other documents. For our purpose, the group of "pearls" includes informatics concepts linked by appropriate hierarchal relationships. The curriculum was developed using a combination of our institution's current informatics fellowship curriculum, the Practical Imaging Informatics textbook1 and other useful online resources. After development of the initial interface and curriculum has been publicized, we anticipate that involvement by the informatics community will help promote collaborations and foster mentorships at all career levels.
Objective: Clinicalinformatics intervention research suffers from a lack of attention to external validity in study design, implementation, evaluation, and reporting. This hampers the ability of others to assess the fit of a clinicalinformatics intervention with demonstrated efficacy in one setting for implementation in their setting. The objective of this model formulation paper is to demonstrate the applicability of
The working group Didactics of Informatics at the University of Paderborn (Germany) develops and evaluates a multimedia exploration platform for information systems (MEPIS) to the needs of teaching and learning informatics at secondary schools. This paper describes the basic ideas within a system-oriented approach of didactics of informatics and…
Observational studies of clinical workers in a hospital setting suggest that communication problems are a significant source of inefficiency. The need to reduce interruptions, improve contactability, and the sharing of informal information suggests that a mobile communication system capable of supporting asynchronous messaging, role-based contact, and communication policies would be beneficial. A prototype of such a system is described.
Observational studies of clinical workers in a hospital setting suggest that communication problems are a significant source of inefficiency. The need to reduce interruptions, improve contactability, and the sharing of informal information suggests that a mobile communication system capable of supporting asynchronous messaging, role-based contact, and communication policies would be beneficial. A prototype of such a system is described.
Objective Clinicalinformatics intervention research suffers from a lack of attention to external validity in study design, implementation, evaluation, and reporting. This hampers the ability of others to assess the fit of a clinicalinformatics intervention with demonstrated efficacy in one setting for implementation in their setting. The objective of this model formulation paper is to demonstrate the applicability of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework with proposed extensions to clinicalinformatics intervention research and describe the framework's role in facilitating the translation of evidence into practice and generation of evidence from practice. Both aspects are essential to reap the clinical and public health benefits of clinicalinformatics research. Design We expanded RE-AIM through the addition of assessment questions relevant to clinicalinformatics intervention research including those related to predisposing, enabling, and reinforcing factors and validated it with two case studies. Results The first case study supported the applicability of RE-AIM to inform real world implementation of a clinicalinformatics intervention with demonstrated efficacy in randomized controlled trials (RCTs) - the Choice (Creating better Health Outcomes by Improving Communication about Patients' Experiences) intervention. The second, an RCT of a personal digital assistant–based decision support system for guideline-based care, illustrated how RE-AIM can be used to inform the design of an efficacy RCT that captures essential contextual details typically lacking in RCT design and reporting. Conclusion The case studies validate, through example, the applicability of RE-AIM to inform the design, implementation, evaluation, and reporting of clinicalinformatics intervention studies.
Branches of science and technical/engineering study have for a long time been the less favoured disciplines and students have not been interested in studying them. Informatics/computer education, based on its character, belongs to these disciplines, but on the contrary it belongs rather to the group of popular school subjects. The paper presents…
The Program Requirements for Fellowship Education identify the knowledge and skills that physicians must master through the course of a training program to be certified in the subspecialty of clinicalinformatics. They also specify accreditation requirements for clinicalinformatics training programs. The AMIA Board of Directors approved this document in November 2008.
Safran, Charles; Shabot, M. Michael; Munger, Benson S.; Holmes, John H.; Steen, Elaine B.; Lumpkin, John R.; Detmer, Don E.
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 clinicalinformatics professionals who can bridge the gap between the medical and information sciences. PMID:24696396
Simpao, Allan F; Ahumada, Luis M; Gálvez, Jorge A; Rehman, Mohamed A
In this manuscript, we present our experiences using the Apache Hadoop framework for high data volume and computationally intensive applications, and discuss some best practice guidelines in a clinicalinformatics setting. There are three main aspects in our approach: (a) process and integrate diverse, heterogeneous data sources using standard Hadoop programming tools and customized MapReduce programs; (b) after fine-grained aggregate results are obtained, perform data analysis using the Mahout data mining library; (c) leverage the column oriented features in HBase for patient centric modeling and complex temporal reasoning. This framework provides a scalable solution to meet the rapidly increasing, imperative “Big Data” needs of clinical and translational research. The intrinsic advantage of fault tolerance, high availability and scalability of Hadoop platform makes these applications readily deployable at the enterprise level cluster environment.
Health care providers have a basic responsibility to protect patients from accidental harm. At the institutional level, creating safe health care organizations necessitates a systematic approach. Effective use of informatics to enhance safety requires the establishment and use of standards for concept definitions and for data exchange, development of acceptable models for knowledge representation, incentives for adoption of electronic health records, support for adverse event detection and reporting, and greater investment in research at the intersection of informatics and patient safety. Leading organizations have demonstrated that health care informatics approaches can improve safety. Nevertheless, significant obstacles today limit optimal application of health informatics to safety within most provider environments. The authors offer a series of recommendations for addressing these challenges.
Biomedical informatics refers to the study of the application of computational and statistical algorithms, data structures, and methods to improve communication, understanding and management of biomedical information. Our objective through this chapter is to describe and demonstrate our research in the use of biomedical image databases - in both preclinical and clinical settings - to classify, predict, research, diagnose, and otherwise learn from the informational content encapsulated in historical image repositories. This will be accomplished by detailing our approach of describing image content in a Bayesian probabilistic framework to achieve learning from retrieved populations of similar images. We will use specific examples from two biomedical applications to describe anatomic segmentation, statistical feature generation and indexing, efficient retrieval architectures, and predictive results.
Tobin Jr, Kenneth William [ORNL; Chaum, Edward [ORNL; Gregor, Jens [ORNL; Karnowski, Thomas Paul [ORNL; Wall, Jonathan [ORNL; Price, Jeffery R [ORNL
ObjectiveClinicalinformatics intervention research suffers from a lack of attention to external validity in study design, implementation, evaluation, and reporting. This hampers the ability of others to assess the fit of a clinicalinformatics intervention with demonstrated efficacy in one setting for implementation in their setting. The objective of this model formulation paper is to demonstrate the applicability of the
The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population. PMID:24465229
Choi, In Young; Kim, Tae-Min; Kim, Myung Shin; Mun, Seong K; Chung, Yeun-Jun
Health care providers have a basic responsibility to protect patients from accidental harm. At the institutional level, creating safe health care organizations necessitates a systematic approach. Effective use of informatics to enhance safety requires the establishment and use of standards for concept definitions and for data exchange, development of acceptable models for knowledge representation, incentives for adoption of electronic health
TeachingClinical Psychology, created by Dr. John Suler of Rider University, is devoted to Ã¯Â¿Â½sharing ideas and resources for teachingclinical psychology.Ã¯Â¿Â½ Helpful for students and educators in the fields of mental health and human services counseling, this site contains practical in-class exercises, such as an exercise which illustrates what it is like to share secrets with strangers, and syllabi for courses in the clinical psychology curriculum. There are also larger projects for students, including an in-depth analysis of a psychotherapy case study and a role-play project which has students administer, score, and interpret a series of psychological tests given to a classmate.
Nursing homes have lagged in the development and use of technology and clinicalinformatics. This paper describes a practical model of translating clinicalinformatics research into practice. The Minimum Data Set (MDS) assessment data collected by nursing homes nationwide is translated into knowledge-based information that supports continuous quality improvement. It does so by providing timely Web-based reports alerting staff to
Christie Teigland; Richard Gardiner; Hailing Li; Colene Byrne
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. PMID:23065430
Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinicalinformatics. 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 clinicalinformatics 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.
Hersh, William R; Gorman, Paul N; Biagioli, Frances E; Mohan, Vishnu; Gold, Jeffrey A; Mejicano, George C
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In complex multisite clinical research trials, potential problems are compounded when multiple personnel at different sites are responsible for primary data collection, data entry, report form design, etc. This article describes how informatics tools can help identify and correct flawed procedures and data problems early, contributing to overall study success. For example, a value that is flagged as “bad” soon after data entry is more likely to be correctable because source documents and data originators are more readily available.
A partnership between a university school of nursing and a health care information technology supplier resulted in the Simulated E-hEalth Delivery System (SEEDS). This program enables nursing students to learn clinical skills in a state-of-the-art environment using a live-production, clinical information system designed for care delivery. (JOW)
Connors, Helen R.; Weaver, Charlotte; Warren, Judith; Miller, Karen L.
This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with diagnosis. There also is general consensus that a variety of systems are little
How does a healthcare organization undergo such transformation as described in the lead paper in eight short years? Just imagine being part of an organization that achieved the following transformations: (1) reduction in hospital and long-term-care beds from 92,000 to 53,000 and an increase in outpatient clinics from 200 to 850 (2) a 75% increase in the number of patients treated on an annual basis (from 2.8 million to 4.9 million) with only a 32% cumulative increase in budget (from $19 billion to $25 billion) (3) clinicians who have access to complete medical records for almost all patient visits and all care settings (4) clinicians who willingly enter medication orders 94% of the time (5) patients who are increasingly satisfied with their care, ranking the service consistently higher than the competition (6) improved patient outcomes, achieved at costs 25% less than the competition. Such transformation is impossible to achieve without vision, leadership, talent, teamwork and tools. I will restrict my comments to a discussion of the tools, specifically the VA's clinical information system (VistA, HealtheVet, My HealtheVet. However, it is important to note that the results described in this paper would not be possible without the VA's transformational leadership and dedicated teams of professionals capable of executing the vision. PMID:16088306
Clinical Research Informatics (CRI) is a rapidly developing sub-domain of Biomedical Informatics that has seen considerable growth in recent years. While there are numerous activities and initiatives ongoing in this domain, systematic consideration and analysis of the challenges and opportunities that exist in this area are lacking. To begin to address this gap in knowledge and inform next steps in advancing this developing domain, we conducted a facilitated discussion among a diverse group of interested participants attending a meeting of the Clinical Research Informatics Working Group at the AMIA 2006 annual symposium. Findings from our analysis of these data are presented here and indicate a broad array of challenges and opportunities facing this developing area. These findings add new information to the limited literature regarding CRI and should provide direction for those working to set the CRI research and development agenda.
Embi, Peter J.; Payne, Philip R.O.; Kaufman, Stanley E.; Logan, Judith R.; Barr, Charles E.
Student ratings of dental hygiene clinical instruction were analyzed to determine dimensions of clinical instruction and the effect of the faculty's teaching philosophy on the underlying components of teaching. A 31-item student evaluation instrument was developed to reflect the teaching philosophy of the Department of Dental Hygiene, University…
Objectives To assess pharmacy informatics education, identify current competencies, and develop a foundational set of recommendations. Methods Accredited pharmacy programs were contacted. Data were collected using a mixed-mode procedure. Didactic and experiential syllabi were analyzed for compliance with informatics competencies in Accreditation Council for Pharmacy Education (ACPE) Standards 2007. Results Thirty-two of 89 schools responded; 25 provided syllabi (36% response rate, 28% submission rate). Twenty-seven didactic and 9 experiential syllabi were received. The syllabi contained a diverse mix of educational content, some of which represented pharmacy informatics content as defined by ACPE. Schools are teachingclinical system terminology, applications, and evaluation. Conclusions Many professional programs are not providing instruction in pharmacy informatics. There may be confusion within the academy/profession between pharmacy informatics and drug information practice. Much work is required for programs to become compliant with the ACPE 2007 pharmacy informatics competencies.
Informatics and information technology do not appear to be valued by the health industry to the degree that they are in other industries. The agenda for health informatics should be presented so that value to the health system is linked directly to required investment. The agenda should acknowledge the foundation provided by the current health system and the role of financial issues, system impediments, policy, and knowledge in effecting change. The desired outcomes should be compelling, such as improved public health, improved quality as perceived by consumers, and lower costs. Strategies to achieve these outcomes should derive from the differentia of health, opportunities to leverage other efforts, and lessons from successes inside and outside the health industry. Examples might include using logistics to improve quality, mass customization to adapt to individual values, and system thinking to change the game to one that can be won. The justification for the informatics infrastructure of a virtual health care data bank, a national health care knowledge base, and a personal clinical health record flows naturally from these strategies.
In developing countries, the number of experts and students in geo-informatics domain are very limited compared to experts and students of sciences that could benefit from geo-informatics. In this research, we study the possibility of providing an online education system for teaching geo-informatics at under-graduate level. The hypothesis is that in developing countries, such as Iran, a web-based geo-education system can greatly improve the quantity and quality of knowledge of students in undergraduate level, which is an important step that has to be made in regard of the famous "Geo for all" motto. As a technology for conducting natural and social studies, geo-informatics offers new ways of viewing, representing and analysing information for transformative learning and teaching. Therefore, we design and present a conceptual framework of an education system and elaborate its components as well as the free and open source services and software packages that could be used in this framework for a specific case study: the Web GIS course. The goal of the proposed framework is to develop experimental GI-services in a service-oriented platform for education purposes. Finally, the paper ends with concluding remarks and some tips for future research direction.
Background In recent years, there have been numerous initiatives undertaken to describe critical information needs related to the collection, management, analysis, and dissemination of data in support of biomedical research (J Investig Med 54:327-333, 2006); (J Am Med Inform Assoc 16:316–327, 2009); (Physiol Genomics 39:131-140, 2009); (J Am Med Inform Assoc 18:354–357, 2011). A common theme spanning such reports has been the importance of understanding and optimizing people, organizational, and leadership factors in order to achieve the promise of efficient and timely research (J Am Med Inform Assoc 15:283–289, 2008). With the emergence of clinical and translational science (CTS) as a national priority in the United States, and the corresponding growth in the scale and scope of CTS research programs, the acuity of such information needs continues to increase (JAMA 289:1278–1287, 2003); (N Engl J Med 353:1621–1623, 2005); (Sci Transl Med 3:90, 2011). At the same time, systematic evaluations of optimal people, organizational, and leadership factors that influence the provision of data, information, and knowledge management technologies and methods are notably lacking. Methods In response to the preceding gap in knowledge, we have conducted both: 1) a structured survey of domain experts at Academic Health Centers (AHCs); and 2) a subsequent thematic analysis of public-domain documentation provided by those same organizations. The results of these approaches were then used to identify critical factors that may influence access to informatics expertise and resources relevant to the CTS domain. Results A total of 31 domain experts, spanning the Biomedical Informatics (BMI), Computer Science (CS), Information Science (IS), and Information Technology (IT) disciplines participated in a structured surveyprocess. At a high level, respondents identified notable differences in theaccess to BMI, CS, and IT expertise and services depending on the establishment of a formal BMI academic unit and the perceived relationship between BMI, CS, IS, and IT leaders. Subsequent thematic analysis of the aforementioned public domain documents demonstrated a discordance between perceived and reported integration across and between BMI, CS, IS, and IT programs and leaders with relevance to the CTS domain. Conclusion Differences in people, organization, and leadership factors do influence the effectiveness of CTS programs, particularly with regard to the ability to access and leverage BMI, CS, IS, and IT expertise and resources. Based on this finding, we believe that the development of a better understanding of how optimal BMI, CS, IS, and IT organizational structures and leadership models are designed and implemented is critical to both the advancement of CTS and ultimately, to improvements in the quality, safety, and effectiveness of healthcare.
Clinical trials usually have a demand to collect, track and analyze multimedia data according to the workflow. Currently, the clinical trial data management requirements are normally addressed with custom-built systems. Challenges occur in the workflow design within different trials. The traditional pre-defined custom-built system is usually limited to a specific clinical trial and normally requires time-consuming and resource-intensive software development. To provide a solution, we present a user customizable imaging informatics-based intelligent workflow engine system for managing stroke rehabilitation clinical trials with intelligent workflow. The intelligent workflow engine provides flexibility in building and tailoring the workflow in various stages of clinical trials. By providing a solution to tailor and automate the workflow, the system will save time and reduce errors for clinical trials. Although our system is designed for clinical trials for rehabilitation, it may be extended to other imaging based clinical trials as well.
A report on teaching in the clinical component of physician's assistant (PA) training programs is presented, based on information obtained through the authors' involvement in a PA faculty development project, and surveys of program directors and faculty. Topics include teacher qualifications, teaching methods and resources, and instructional…
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, clinicalinformatics, 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.
Structuring clinicalteaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinicalteaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinicalteaching and assessment.
Structuring clinicalteaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinicalteaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinicalteaching and assessment. PMID:24624002
Seven years' experience in teaching communication skills to first year clinical students at St Mary's Hospital School of Medicine is described. The first component consists of a day during the introductory clinical course; this is divided into a lecture and small seminar groups and involves behavioural scientists and clinicians from many departments. The second component uses simulated patients and video
Background: The need for informatics and genomics training in pathology is critical, yet limited resources for such training are available. In this study we sought to critically test the hypothesis that the incorporation of a wiki (a collaborative writing and publication tool with roots in “Web 2.0”) in a combined informatics and genomics course could both (1) serve as an interactive, collaborative educational resource and reference and (2) actively engage trainees by requiring the creation and sharing of educational materials. Materials and Methods: A 2-week full-time course at our institution covering genomics, research, and pathology informatics (GRIP) was taught by 36 faculty to 18 second- and third-year pathology residents. The course content included didactic lectures and hands-on demonstrations of technology (e.g., whole-slide scanning, telepathology, and statistics software). Attendees were given pre- and posttests. Residents were trained to use wiki technology (MediaWiki) and requested to construct a wiki about the GRIP course by writing comprehensive online review articles on assigned lectures. To gauge effectiveness, pretest and posttest scores for our course were compared with scores from the previous 7 years from the predecessor course (limited to informatics) given at our institution that did not utilize wikis. Results: Residents constructed 59 peer-reviewed collaborative wiki articles. This group showed a 25% improvement (standard deviation 12%) in test scores, which was greater than the 16% delta recorded in the prior 7 years of our predecessor course (P = 0.006). Conclusions: Our use of wiki technology provided a wiki containing high-quality content that will form the basis of future pathology informatics and genomics courses and proved to be an effective teaching tool, as evidenced by the significant rise in our resident posttest scores. Data from this project provide support for the notion that active participation in content creation is an effective mechanism for mastery of content. Future residents taking this course will continue to build on this wiki, keeping content current, and thereby benefit from this collaborative teaching tool.
Park, Seung; Parwani, Anil; MacPherson, Trevor; Pantanowitz, Liron
The aim of the present work was to see if storytelling in a clinical dental anatomy course would increase student satisfaction. We enhanced teaching by spontaneous storytelling in problem-based learning, in half of the third-year dentistry class. At the end of the course, we administered an anonymous questionnaire to the students in the class,…
Home-based clinicalinformatics technologies are being developed to facilitate health care provision and management. Given the novelty of these technologies, end users such as patients and their formal and informal caregivers may require support during use. This paper presents a case study within the United States of the service desk calls generated over a 31-month period by patients enrolled in a large randomized field experiment, HeartCare II. This case study provides future deployers of home-based clinical information technologies with an understanding of the types of support that may be required during use. Our analysis reveals that calls to the service desk originated as a result of user problems, hardware problems, software problems, and internal communication problems among individuals involved in the delivery and use of the technology. Implications of these needs for support during use are also discussed.
This master's thesis presents several instructional methods and techniques developed for each of eleven topics or subject areas in clinical chemistry: carbohydrate metabolism, lipid metabolism, diagnostic enzymology, endocrinology, toxicology, quality control, electrolytes, acid base balance, hepatic function, nonprotein nitrogenous compounds, and…
BACKGROUND Learner feedback is the primary method for evaluating clinical faculty, despite few existing standards for measuring learner assessments. OBJECTIVE To review the published literature on instruments for evaluating clinical teachers and to summarize themes that will aid in developing universally appealing tools. DESIGN Searching 5 electronic databases revealed over 330 articles. Excluded were reviews, editorials, and qualitative studies. Twenty-one articles describing instruments designed for evaluating clinical faculty by learners were found. Three investigators studied these papers and tabulated characteristics of the learning environments and validation methods. Salient themes among the evaluation studies were determined. MAIN RESULTS Many studies combined evaluations from both outpatient and inpatient settings and some authors combined evaluations from different learner levels. Wide ranges in numbers of teachers, evaluators, evaluations, and scale items were observed. The most frequently encountered statistical methods were factor analysis and determining internal consistency reliability with Cronbach's ?. Less common methods were the use of test-retest reliability, interrater reliability, and convergent validity between validated instruments. Fourteen domains of teaching were identified and the most frequently studied domains were interpersonal and clinical-teaching skills. CONCLUSIONS Characteristics of teacher evaluations vary between educational settings and between different learner levels, indicating that future studies should utilize more narrowly defined study populations. A variety of validation methods including temporal stability, interrater reliability, and convergent validity should be considered. Finally, existing data support the validation of instruments comprised solely of interpersonal and clinical-teaching domains.
Beckman, Thomas J; Ghosh, Amit K; Cook, David A; Erwin, Patricia J; Mandrekar, Jayawant N
The activities of the Dutch National Aerospace Laboratory Informatics Division are outlined. These include research in electronics, applied mathematics, computer programming, and data operations. Ground systems in support of aircraft and spacecraft operat...
Cancer Imaging Informatics encompasses the effort to consider the informatics of cancer imaging in the larger context of informatics. Reports and presentations from CIP workshops and meetings. Print This Page Cancer Imaging Informatics Programs & Resources
Pathologists routinely interpret gross and microscopic specimens to render diagnoses and to engage in a broad spectrum of investigative research. Multiple studies have demonstrated that imaging technologies have progressed to a level at which properly digitized specimens provide sufficient quality comparable to the traditional glass slides examinations. Continued advancements in this area will have a profound impact on the manner in which pathology is conducted from this point on. Several leading institutions have already undertaken ambitious projects directed toward digitally imaging, archiving, and sharing pathology specimens. As a result of these advances, the use of informatics in diagnostic and investigative pathology applications is expanding rapidly. In addition, the advent of novel technologies such as multispectral imaging makes it possible to visualize and analyze imaged specimens using multiple wavelengths simultaneously. As these powerful technologies become increasingly accepted and adopted, the opportunities for gaining new insight into the underlying mechanisms of diseases as well as the potential for discriminating among subtypes of pathologies are growing accordingly.
Seven years' experience in teaching communication skills to first year clinical students at St Mary's Hospital School of Medicine is described. The first component consists of a day during the introductory clinical course; this is divided into a lecture and small seminar groups and involves behavioural scientists and clinicians from many departments. The second component uses simulated patients and video feedback and takes place in small groups later in the year. Participation of the students through active critical discussion, role play, and interactive video feedback are important aspects in the success of the course. The methods have been refined through evaluation by students and tutors. This article aims to allow others, already running or considering such a course, to develop effective courses within the practical constraints of their own institutions. Images p1325-a
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Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture ar- chiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without
Aaron W. C. Kamauu; Scott L. DuVall; Reid J. Robison; Andrew P. Liimatta; Richard H. Wiggins III; David E. Avrin
Through the process of clinical supervision, systematic approaches permit effective change by the collaborative analysis of teaching. This guide's first section, "Beginnings," describes the process of clinical supervision. Emphasis is upon teachers working collaboratively to discover implicit teaching messages and to assimilate new approaches.…
Videotapes recorded ward rounds at the pediatric teaching hospital affiliated with McGill University. The study revealed a variety of educational problems that provided the basis for a workshop on clinicalteaching. The usefulness and practicality of the method as a tool for improving teacher effectiveness in a clinical setting was demonstrated.…
Although there is an abundance of literature about clinicalteaching in the health professions, a much smaller body of information focuses on the art and science of clinicalteaching in midwifery and women's health. We reviewed preceptor handbooks, training manuals, and Web sites created by nursing and nurse-midwifery education programs, medical and pharmacy schools, and national associations of health professionals.
This study analyzed 816 medical professors' perceptions of clinicalteaching, as measured with the online version of the ClinicalTeaching Perception Inventory, and examined difficulties that female professors faced in becoming the ideal clinical teacher. While describing themselves as a clinical teacher, female professors rated themselves lower…
This article reviews recent advances in genomics and informatics relevant to cardiovascular research. In particular, we review the status of (1) whole genome sequencing efforts in human, mouse, rat, zebrafish, and dog; (2) the development of data mining and analysis tools; (3) the launching of the National Heart, Lung, and Blood Institute Programs for Genomics Applications and Proteomics Initiative; (4) efforts to characterize the cardiac transcriptome and proteome; and (5) the current status of computational modeling of the cardiac myocyte. In each instance, we provide links to relevant sources of information on the World Wide Web and critical appraisals of the promises and the challenges of an expanding and diverse information landscape.
The science of nursing informatics is becoming increasingly important to delivering quality nursing care to all patient populations. Perioperative nursing informatics skills are practiced within the context of powerful and complex information systems that enhance nurses' ability to view and report clinical data in a manner that has never before been possible. This article explores how the analysis of several
The Human Genome Project (HGP) provided the initial draft of mankind's DNA sequence in 2001. The HGP was produced by 23 collaborating laboratories using Sanger sequencing of mapped regions as well as shotgun sequencing techniques in a process that occupied 13 years at a cost of ~$3 billion. Today, Next Generation Sequencing (NGS) techniques represent the next phase in the evolution of DNA sequencing technology at dramatically reduced cost compared to traditional Sanger sequencing. A single laboratory today can sequence the entire human genome in a few days for a few thousand dollars in reagents and staff time. Routine whole exome or even whole genome sequencing of clinical patients is well within the realm of affordability for many academic institutions across the country. This paper reviews current sequencing technology methods and upcoming advancements in sequencing technology as well as challenges associated with data generation, data manipulation and data storage. Implementation of routine NGS data in cancer genomics is discussed along with potential pitfalls in the interpretation of the NGS data. The overarching importance of bioinformatics in the clinical implementation of NGS is emphasized. We also review the issue of physician education which also is an important consideration for the successful implementation of NGS in the clinical workplace. NGS technologies represent a golden opportunity for the next generation of pathologists to be at the leading edge of the personalized medicine approaches coming our way. Often under-emphasized issues of data access and control as well as potential ethical implications of whole genome NGS sequencing are also discussed. Despite some challenges, it's hard not to be optimistic about the future of personalized genome sequencing and its potential impact on patient care and the advancement of knowledge of human biology and disease in the near future.
Gullapalli, Rama R.; Desai, Ketaki V.; Santana-Santos, Lucas; Kant, Jeffrey A.; Becich, Michael J.
In 1985 the International Commission on Mathematical Instruction (ICMI) published the first edition of a book of studies on the topic of the influence of computers on mathematics and the teaching of mathematics. This document is an updated version of that book and includes five articles from the 1985 ICMI conference at Strasbourg, France; reports…
A teaching model for personality theories based on and resulting from an evaluation and theoretical position of the field is described. After a review of the problems and diversity of the field and their limiting implications, especially for the professional psychologist teaching the graduate clinical student, some of the possible reasons behind the difficulties are explained. These include diminishing emphasis
We introduce the concept of a Medical Informatics Workup performed by fourth year medical students working in a busy inner-city Emergency Room. These students use portable computers (Macintosh PowerBook 170s connected to a removable cartridge hard drive and CD-ROM drive) to do the patient workups. The PowerBook 170 contains the automated medical record entry software (IMR-E), five expert system software packages, and a program that allows the PowerBook to emulate a PC-compatible computer. With this configuration the student has a portable system that allows for the creation of a computerized medical record at the patient's bedside, along with the ability to analyze the data and generate a list of differential diagnoses.
Naeymi-Rad, F.; Trace, D.; Shoults, K.; Suico, J.; O'Brien, M.; Evens, M.; Carmony, L.; Roberts, R.; Zelanski, R.
Objective Design, implement, and evaluate a standardized approach to teachingclinical toxicology for pharmacy students. Design An extensive review of the literature was conducted and a standardized approach to teachingClinical Toxicology, a 1-credit-hour elective course, was designed, consisting of 9 key questions to address any clinical poisoning. A patient-oriented and problem-solving approach to clinical toxicology was adopted throughout the course. Assessment Average performance on course examinations for the academic years 1996-2001 (N=604) when the course was required and the academic years 2002-2007 (N=37) when the course was changed to an elective was 83.4% and 81.7%, respectively. Conclusions A standardized, patient-oriented approach to teachingclinical toxicology allowed successful conversion of this material from a required course to an elective and facilitated students' exposure and interest in this important area of practice.
\\u000a The goal of infectious disease informatics is to optimize the clinical and public health management of infectious diseases\\u000a through improvements in the development and use of antimicrobials, the design of more effective vaccines, the identification\\u000a of biomarkers for life-threatening infections, a better understanding of host-pathogen interactions, and biosurveillance and\\u000a clinical decision support. Infectious disease informatics can lead to more targeted
TO TEST THE EFFECTIVENESS OF CLOSED-CIRCUIT TELEVISION IN TRAINING NURSES, THIS DEMONSTRATION PROJECT EVALUATED THREE EXPERIMENTAL GROUPS OF 15 STUDENTS AND FOUR CONTROL GROUPS OF 10 STUDENTS. IN ADDITION TO INCREASING TEACHING CAPACITY BY FIVE STUDENTS PER INSTRUCTOR, THE FOLLOWING BENEFITS WERE NOTED FROM SEVEN EVALUATIVE QUESTIONS POSED TO…
Objectives: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies. Methods: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service. Results: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included. Conclusions: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.
Learning how to "think like doctors" can be difficult for undergraduate medical students in their early clinical years. Our model of collaborative Integrated Case Learning (ICL) and simulated clinical reasoning aims to address these issues. Taking a socio-cultural perspective, this study investigates the reflective learning interactions and…
A clinical study was designed and used to show the relationship of health and medicine, in a typical clinical scenario, where many chemical principles are involved and that an integrated knowledge of chemistry and biology is essential to the understanding, diagnosing and treating of illnesses. A case study would be a positive learning experience…
Dewprashad, Brahmadeo; Kosky, Charles; Vaz, Geraldine S.; Martin, Charlotte L.
Thinking about nursing education implies articulating this issue with the expressions of theoretical frameworks, from the perspective of a pedagogical aspect that includes both constructivism and competencies. The objective was to characterize, from a longitudinal view, the construction of care competencies that exist in the teaching plans of nursing undergraduate programs. This exploratory-descriptive study used a qualitative approach. Documentary analysis was performed on the nine teaching plans of undergraduate care subjects. The ethical-legal aspects were guaranteed, so that data was collected only after the study had been approved by the Research Ethics Committee. The data evidenced a curriculum organization centered on subjects, maintaining internal rationales that seem to resist summative organizations. Signs emerge of hardly substantial links between any previous knowledge and the strengthening of critical judgment and clinical reasoning. As proposed, the study contributed with reconsiderations for the teaching-learning process and showed the influence of constructivism on the proposal of clinical competencies. PMID:19655664
Dell'Acqua, Magda Cristina Queiroz; Miyadahira, Ana Maria Kazue; Ide, Cilene Aparecida Costardi
Teachingclinic managers struggle to convert performance data into meaningful behavioral change in their trainees, and quality improvement measures in medicine have had modest results. This may be due to several factors including clinical performance being based more on team function than individual action, models of best practice that are over-simplified for real patients with multiple chronic diseases, and local features that influence behavior but are not aligned with core values. Many are looking for a new conceptual structure to guide them. In this paper we briefly review several theories of action from the social and complexity sciences, and synthesize these into a coherent 'ecological perspective'. This perspective focuses on stabilizing features and narrative, which select for behaviors in clinic much like organisms are selected for in an ecosystem. We have found this perspective to be a useful guide for design, measurement, and joint learning in the teachingclinic. PMID:18766451
Smith, C Scott; Francovich, Chris; Morris, Magdalena; Hill, William; Langlois-Winkle, Francine; Rupper, Randall; Roth, Craig; Wheeler, Stephanie; Vo, Anthony
A study of family medicine residents' preferences for the content areas of family medicine emphasized by those attending physicians perceived by the residents as the "best" clinical teachers is discussed. Specific teaching behaviors are identified, and a statistical analysis of the preferences of residents is provided. (Author/MLW)
This article summarizes the origins of informatics, which is based on the science, engineering, and technology of computer hardware, software, and communications. In just four decades, from the 1950s to the 1990s, computer technology has progressed from slow, first-generation vacuum tubes, through the invention of the transistor and its incorporation into microprocessor chips, and ultimately, to fast, fourth-generation very-large-scale-integrated silicon chips. Programming has undergone a parallel transformation, from cumbersome, first-generation, machine languages to efficient, fourth-generation application-oriented languages. Communication has evolved from simple copper wires to complex fiberoptic cables in computer-linked networks. The digital computer has profound implications for the development and practice of clinical medicine.
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.
As a first step in the development of a competency-based clinical toxicology clerkship, a set of terminal behavioral objectives were developed that reflect the anticipated role that clinical pharmacists should play as part of the clinical toxicology team. The evaluation approaches used at the University of Utah are presented. (LBH)
Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members’ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.
BACKGROUND: Although residents commonly manage substance abuse disorders, optimal approaches to teaching these specialized interviewing\\u000a and intervention skills are unknown.\\u000a \\u000a \\u000a OBJECTIVE: We developed a Substance Abuse Objective Structured Clinical Exam (OSCE) to teach addiction medicine competencies using immediate\\u000a feedback. In this study we evaluated OSCE performance, examined associations between performance and self-assessed interest\\u000a and competence in substance abuse, and assessed
Sharon J. Parish; Megha Ramaswamy; Melissa R. Stein; Elizabeth K. Kachur; Julia H. Arnsten
Background Although a variety of validity evidence should be utilized when evaluating assessment tools, a review of teaching assessments suggested that authors pursue a limited range of validity evidence. Objectives To develop a method for rating validity evidence and to quantify the evidence supporting scores from existing clinicalteaching assessment instruments. Design A comprehensive search yielded 22 articles on clinicalteaching assessments. Using standards outlined by the American Psychological and Education Research Associations, we developed a method for rating the 5 categories of validity evidence reported in each article. We then quantified the validity evidence by summing the ratings for each category. We also calculated weighted ? coefficients to determine interrater reliabilities for each category of validity evidence. Main Results Content and Internal Structure evidence received the highest ratings (27 and 32, respectively, of 44 possible). Relation to Other Variables, Consequences, and Response Process received the lowest ratings (9, 2, and 2, respectively). Interrater reliability was good for Content, Internal Structure, and Relation to Other Variables (? range 0.52 to 0.96, all P values <.01), but poor for Consequences and Response Process. Conclusions Content and Internal Structure evidence is well represented among published assessments of clinicalteaching. Evidence for Relation to Other Variables, Consequences, and Response Process receive little attention, and future research should emphasize these categories. The low interrater reliability for Response Process and Consequences likely reflects the scarcity of reported evidence. With further development, our method for rating the validity evidence should prove useful in various settings.
Beckman, Thomas J; Cook, David A; Mandrekar, Jayawant N
Objective The purpose of this study is to present radiograph utilization at a chiropractic college teachingclinic, the associated patient demographics, and the utilization rates by body region. Methods Data for outpatient services over a 3-year period were extracted from a college clinic administrative software program. Radiographic data were matched with patient demographic information providing the age, sex, and financial class for all patients. Results The overall radiograph utilization rate was 8%, with the highest frequency occurring in the spine in the order of lumbar, cervical, and then thoracic regions. Spinal radiographs made up 66% of the total radiographs taken. The utilization rate increased as the age of the patients increased. The average patient age was 46, and 48% were female. Conclusion The radiograph utilization rate at this teachingclinic was lower than previous studies. This study provides new information regarding overall and regional radiography rates and associated patient demographics from an American chiropractic college.
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 meeti...
Supplementary to matter and energy, information is the third essence for modeling the natural world. An emerging discipline known as cognitive informatics (CI) is developed recently that forms a profound interdisciplinary study of cognitive and information sciences, and tackles the common root problems sharing by informatics, computing, software engineering, artificial intelligence, cognitive science, neuropsychology, philosophy, linguistics, and life science. CI
Objectives To design an interdisciplinary course in health care informatics that enables students to: (1) understand how to incorporate technology into the provision of safe, effective and evidence-based health care; (2) make decisions about the value and ethical application of specific technologies; and (3) appreciate the perspectives and roles of patients and providers when using technology in care. Design An online, interdisciplinary elective course using a distributive learning model was created. Standard courseware was used to manage teaching and to facilitate student/instructor interactions. Interactive, multimedia lectures were developed using Internet communication software. Assessment Upon completion of the course, students demonstrated competency in identifying, analyzing, and applying informatics appropriately in diverse health settings. Conclusion Online education using multimedia software technology is effective in teaching students about health informatics and providing an innovative opportunity for interdisciplinary learning. In light of the growing need for efficient health care informatics training, additional study of this methodology is warranted.
Objectives 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). Methods The Health Informatics Forum is one of examples of MOOCs through a social networking site for educating health informatics students and professionals. 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. Results 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. Conclusions 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.
The first step in the nursing process is assessment. Facility with patient assessment skills precludes planning, implementing and evaluating patient care. Teaching patient assessment is time consuming and potentially anxiety-provoking. Classroom lectures and practice labs are not enough if students are to learn how to assess patients with pathophysiological responses. We found that clinical rounds on select patientw was a most important adjunct. Coordinating and conducting clinical rounds presents many problems but faculty and students are in complete agreement that the advantages far outweigh the disadvantages. We are hoping that others can "go to school" on some of our experiences as we will continue to do so. PMID:14229
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The relevance of medicinal chemistry to pharmacy practice has been questioned by many pharmacy educators as more emphasis has been placed on linking clinical knowledge and practice to pharmacy student educational outcomes. Faculty teaching in medicinal chemistry and other biomedical and pharmaceutical science courses have embraced this challenge. Various teaching methods and approaches within medicinal chemistry that emphasize application of this knowledge have been sought to improve the usefulness of this scientific discipline to the future careers of students. The newly revised ACPE guidelines and standards have reemphasized the role of the sciences in the curriculum. With this mandate, it is essential that all science faculty members adjust the way they teach to meet the new desired outcomes for pharmacy graduates. This manuscript describes an instructional model for teaching medicinal chemistry explicitly designed to meet these outcomes. A process of collaboration between experienced pharmacy faculty scholars was used to derive this approach. Pedagogy for cognitive and affective learning was incorporated. A case study using a representative drug class is presented to illustrate this model.
Alsharif, Naser Z.; Galt, Kimberly A.; Mehanna, Ahmed; Chapman, Robert; Ogunbadeniyi, Alaba M.
Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in the 1960s and medical informatics was identified as a new specialty in the 1970s.
Two beginning nurse educators used reflective practice to shape ideas about clinicalteaching. Techniques such as journal writing, audiotaped debriefing, and a "critical friend" helped support and inform their reflection and improve teaching and learning. (SK)
Background Commonly cited barriers to effective teaching in emergency medicine include lack of time, competing demands for patient care, and a lack of formal teaching experience. Teaching may be negatively affected by demands for increased clinical productivity, or positively influenced by clinical experience. Objective To examine the association between faculty teaching scores and clinical productivity, years of clinical experience, and amount of clinical contact with resident physicians. Methods We conducted a retrospective, observational study with existing data on full-time faculty at a high-volume, urban emergency medicine residency training program for academic year 2008–2009. Residents rated faculty on 9 domains of teaching, including willingness to teach, enthusiasm for teaching, medical knowledge, preparation, and communication. Clinical productivity data for relative value units per hour and number of patients per hour, years of clinical experience, and annual clinical hours were obtained from existing databases. Results For the 25 core faculty members included in the study, there was no relationship between faculty teaching scores and clinical productivity measures (relative value units per hour: r2??=??0.01, P??=??.96, patients per hour: r2??=??0.00, P??=??.76), or between teaching scores and total clinical hours with residents (r2??=??0.07, P??=??.19). There was a significant negative relationship between years of experience and teaching scores (r2??=??0.27, P?.01). Conclusions Our study demonstrated that teaching scores for core emergency medicine faculty did not correlate with clinical productivity or amount of clinical contact with residents. Teaching scores were inversely related to number of years of clinical experience, with more experienced faculty earning the lowest teaching scores. Further study is necessary to determine if there are clinical measures that identify good educators.
Clyne, Brian; Smith, Jessica L.; Napoli, Anthony M.
The Cancer Imaging Program leverages a number of existing informatics resources. These resources include numerous software tools, data archives, and organizations which set standards and policies useful for imaging research. Software Tools & Data Archives
The volume comprises extended abstracts of the papers selected for the presentation at the Third International Andrei Ershov Memorial Conference Perspectives of System Informatics, Akademgorodok (Novosibirsk, Russia), July 6- 9, 1999. The main goal of the...
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.
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.
He, Yongqun; Rappuoli, Rino; De Groot, Anne S.; Chen, Robert T.
Clinical imaging plays an essential role in cancer care and research for diagnosis, prognosis and treatment response assessment. Major advances have been made over the last several decades in imaging informatics to support medical imaging. More recent informatics advances focus on the special needs of oncologic imaging, yet gaps still remain. We review the current state, limitations, and future trends in imaging informatics for oncology care including clinical and clinical research systems. We review information systems to support cancer clinical workflows including oncologist ordering of radiology studies, radiologist review and reporting of image findings, and oncologist review and integration of imaging information for clinical decision making. We discuss informatics approaches to oncologic imaging including but not limited to controlled terminologies, image annotation, and image processing algorithms. With the ongoing development of novel imaging modalities and imaging biomarkers, we expect these systems will continue to evolve and mature.
The 2001 U.S. Army Medical Research and Materiel Command (USAMRMC) Biomedical Informatics Roadmap Meeting was devoted to developing a strategic plan in four focus areas: Hospital and ClinicalInformatics, E-Health, Combat Health Informatics, and Bioinformatics and Biomedical Computation. The driving force of this Roadmap Meeting was the recent accelerated pace of change in biomedical informatics in which emerging technologies have the potential to affect significantly the Army research portfolio and investment strategy in these focus areas. The meeting was structured so that the first two days were devoted to presentations from experts in the field, including representatives from the three services, other government agencies, academia, and the private sector, and the morning of the last day was devoted to capturing specific biomedical informatics research needs in the four focus areas. This white paper summarizes the key findings and recommendations and should be a powerful tool for the crafting of future requests for proposals to help align USAMRMC new strategic research investments with new developments and emerging technologies. PMID:12223503
Reifman, Jaques; Gilbert, Gary R; Fagan, Lawrence; Satava, Richard
Purpose: We compare patient populations attending chiropractors in the field to those in teachingclinics to allow educational institutions to determine if students are exposed to a similar case mix. The purpose of our study was to describe and compare descriptively the clinical case mix of a recently opened community-based teachingclinic to previously published practice data. Methods: A retrospective descriptive cross-sectional study was conducted using new patient records completed at a clinic. Data were extracted using a specifically designed abstraction form. Results: We manually abstracted 649 files. A total of 580 new patient files was included in the analysis, among which 57.7% included female patients with a mean age of 43 years (SD 18), and 42.1% presented with a chief complaint of more than one year in duration. The vast majority of patients complained of spinal pain (81.4%), most commonly low back pain. Almost 92% of the diagnoses were classified as simple (sprain/strain). The average number of visits per patient was 7.4 (SD 11.3); 54.7% received spinal manipulation on their first visit. The majority of patients were referred by the treating intern (64.8%) and about 24% of patients were local residents. Conclusions: Our study contributed to the few studies detailing patients attending chiropractic academic teachingclinics. It provided benchmark demographic and clinical data that may be used for operational planning. Our study suggested that the case mix of this teachingclinic provides interns with appropriate learning opportunities to achieve entry to practice competencies.
This paper discuss the development of the new curriculum (bachelor, master) for clinical skills (history taking, physical examination, patient communication, professionalism) at the Medical School in Lausanne. Some specific aspects are reviewed: a structured and longitudinal curriculum, improving bedside clinicalteaching, assessment of clinical competences, integrating teaching into the institutional values. PMID:19968028
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.
? Abstract Pharmacogenomics requires the integration and analysis of genomic, molecular, cellular, and clinical data, and it thus offers a remarkable set of challenges to biomedical informatics. These include infrastructural challenges such as the creation of data models and databases for storing these data, the integration of these data with external databases, the extraction of information from natural language text,
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.
Anholt, R. Michele; Berezowski, John; Ribble, Carl S.; Russell, Margaret L.; Stephen, Craig
The advent of digital imaging and information management within the radiology department has prompted the growth of a new radiology subspecialty: Radiology Informatics. With appropriate training, radiologists can become leaders in Medical Informatics and guide the growth of this technology throughout the medical enterprise. Radiology Informatics fellowships, as well as radiology residency programs, provide inconsistent exposure to all the elements
Barton F. Branstetter IV; Brian J. Bartholmai; David S. Channin
Interest in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence.
R. L. Hulsman; W. J. G. Ros; J. A. M. Winnubst; J. M. Bensing
Informatics is the study of the application of information technology. The focus of studies within an Informatics program is on particular problem domain areas, including scientific domains like biology or chemistry, but also nonscientific domains like music, fine arts, or business. In this paper we describe our experience with the development of a capstone course for undergraduate Informatics students. In
Diabetes mellitus presenting in adolescents age 10 to 20 years accounts for less than 5% of all diabetes in tropical African countries. Consequently, inadequate attention is paid to the medical and psychosocial problems attendant on adolescent diabetes in those countries. This article highlights our clinical experience in the management of 30 adolescent diabetic subjects who presented consecutively in the diabetic clinic of a major Nigerian teaching hospital. In these patients, adolescent diabetes appeared heterogeneous, comprising classical insulin-dependent diabetes mellitus (IDDM) in approximately 80%; the remaining fraction (20%) was contributed variably by malnutrition-related diabetes (MRDM) and an "atypical" form of IDDM. The most common medical complications were recurrent hypoglycemia, ketoacidosis, and infections. About 80% of the patients were poor, and up to two thirds had to withdraw from school or trade because of recurrent illness. One third of the girls had a history of unwanted pregnancies. Almost all (93%) had a history of general rebelliousness and clinic truancy. Therefore, the high prevalence of acute metabolic decompensation may be related to the increased frequency of psychosocial problems, especially poverty, in these patients. It is suggested that agencies in tropical Africa increase welfare facilities for adolescent chronic disease, and also establish and encourage clinics dedicated to adolescent diabetes care.
Informatics is a field that is gaining importance around the globe, and the National Institute of Informatics (NII) in Japan seeks "to advance integrated research and development activities in information-related fields, including networking, software, and content." First-time visitors should note that most of the materials in the site can be located in sections such as "Research & Project" and "Services". Before delving into these areas, visitors may wish to take a look at the most recent issue of "NII Today" via the homepage. Afterwards, visitors should look over the "Research" area. Here they will find summaries of research projects, working papers, and information about their international partnerships. The "Services" area is well worth a look as it contains links to additional informatics databases that will be of use to scholars and students within the field.
The advent of digital imaging and information management within the radiology department has prompted the growth of a new radiology subspecialty: Radiology Informatics. With appropriate training, radiologists can become leaders in Medical Informatics and guide the growth of this technology throughout the medical enterprise. Radiology Informatics fellowships, as well as radiology residency programs, provide inconsistent exposure to all the elements of this subspecialty, in part because of the lack of a common curriculum. The Society for Computer Applications in Radiology (SCAR) has developed a curriculum intended to guide training in Radiology Informatics. This article is the first in a series presented by SCAR and the Journal of Digital Imaging, titled "Reviews in Radiology Informatics." The series is designed to sample from each of the major components in the Radiology Informatics Curriculum, to spark further interest in the field and provide content for informatics education. PMID:15692866
Branstetter, Barton F; Bartholmai, Brian J; Channin, David S
The advantages of massively parallel sequencing are quickly being realized through the adoption of comprehensive genomic panels across the spectrum of genetic testing. Despite such widespread utilization of next generation sequencing (NGS), a major bottleneck in the implementation and capitalization of this technology remains in the data processing steps, or bioinformatics. Here we describe our approach to defining the limitations of each step in the data processing pipeline by utilizing artificial amplicon data sets to simulate a wide spectrum of genomic alterations. Through this process, we identified limitations of insertion, deletion (indel), and single nucleotide variant (SNV) detection using standard approaches and described novel strategies to improve overall somatic mutation detection. Using these artificial data sets, we were able to demonstrate that NGS assays can have robust mutation detection if the data can be processed in a way that does not lead to large genomic alterations landing in the unmapped data (i.e., trash). By using these pipeline modifications and a new variant caller, AbsoluteVar, we have been able to validate SNV mutation detection to 100% sensitivity and specificity with an allele frequency as low 4% and detection of indels as large as 90 bp. Clinical validation of NGS relies on the ability for mutation detection across a wide array of genetic anomalies, and the utility of artificial data sets demonstrates a mechanism to intelligently test a vast array of mutation types. PMID:24528889
Daber, Robert; Sukhadia, Shrey; Morrissette, Jennifer J D
Informatics Workshop September 25-27, 2002 Ellen Feigal, M.D. Acting Director, Division of Cancer Treatment and Diagnosis, NCI Imaging is Key to Cancer Research The ability to detect, through imaging, the molecular changes associated with a tumor cell will improve our ability to detect and stage tumors, select appropriate treatments, monitor the effectiveness of a treatment, and determine prognosis.
The ability to create a big picture of a knowledge domain is valuable to both experts and newcomers, who can use such a picture to orient themselves in the field’s intellectual space, track the dynamics of the field, or discover potential new areas of research. In this chapter we present an overview of medical informatics research by applying domain visualization
Shauna Eggers; Zan Huang; Hsinchun Chen; Lijun Yan; Cathy Larson; Asraa Rashid; Michael Chau; Chienting Lin
ABSTRACT Cognitive informatics (CI) is a new discipline that studies the natural intelligence and internal information processing mechanisms of the brain, as well as the processes involved in perception and cognition. CI provides a coherent set of fundamental theories, and contemporary mathematics, which form the foundation for most information and knowledge based science and engineering disciplines such as computer science,
In 2006, The American Association of Colleges of Nursing approved a new doctoral degree for clinical leaders, the Doctor of Nursing Practice. These new advanced practice leaders will need sophisticated skills in informatics to acquire and use data, information, and knowledge in their roles. This paper proposes a foundational course for all Doctor of Nursing Practice students and some strategies for integrating informatics throughout the curriculum.
Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into actionable information is limited. One reason is that the proprietary nature of medical devices and software often prevents neuro-ICUs from capturing and centrally storing high-density data. Also, ICU alarm systems are often unreliable because the data that are captured are riddled with artifacts. Informatics is the process of acquiring, processing, and interpreting these complex arrays of data. The development of next-generation informatics tools allows for detection of complex physiologic events and brings about the possibility of decision support tools to improve neurocritical care. Although many different approaches to informatics are discussed and considered, here we focus on the Bayesian probabilistic paradigm. It quantifies the uncertainty inherent in neurocritical care instead of ignoring it, and formalizes the natural clinical thought process of updating prior beliefs using incoming patient data. We review this and other opportunities, as well as challenges, for the development and refinement of informatics tools in neurocritical care. PMID:23884510
Sivaganesan, Ahilan; Manley, Geoffrey T; Huang, Michael C
Context.-The mechanics of the practice of medicine in general and of pathology in particular is evolving rapidly with the rise in the use of electronic information systems for managing the care of individual patients, including the ordering and reporting of laboratory tests, maintaining the health of served populations, and documenting the full range of health care activities. Pathologists currently in practice and those in training need to acquire additional skills in informatics to be prepared to maintain a central role in patient care. Objective.-To summarize the evolving landscape of pathology informatics, with particular attention to the preparation of pathologists for this discipline and to the possible influence of the new subspecialty certification in clinicalinformatics. Data Sources.-Most of the information discussed is drawn from the authors' direct experience with informatics, resident and fellow education, and the organizations supporting these activities in pathology. Conclusions.-The increasing reliance of medical practice on electronic health records and other clinical information systems is creating a greater need for physicians skilled in the use and management of these tools. The establishment of clinicalinformatics as a formal subspecialty in medicine will likely help secure a role for physicians within information management structures at health care institutions. Pathologists must actively engage in informatics to assure that our specialty is appropriately recognized and represented in this growing discipline. PMID:24678681
Sinard, John H; Powell, Suzanne Z; Karcher, Donald S
The sequencing of the human genome, completed at the dawn of the twenty-first century, allows researchers to integrate new data on genetic risk factors with demographic and lifestyle data collected via modern communication technologies. The technical prerequisites now exist for merging these cascades of molecular genetic information, not only to national health registers, but also to epidemiology and clinical data. Long-term storage of biological materials and data is a critical component of any epidemiological or clinical study. In designing Biobanks, informatics plays a vital role for the handling of samples and data in a timely fashion. Biobank Informatics contains important elements concerning definition, structure, and standardization of information that has been gathered from a multitude of sources from population-based registries, biobanks, patient records, and from large-scale molecular measurements. PMID:20949402
Over the last decade undergraduate training in clinical procedures has moved from 'learning on patients' towards simulation-based training. Simulation was intended to be an adjunct rather than a replacement for experiential learning and several initiatives have emerged to redress this balance. With these initiatives in mind, we evaluated the impact of our undergraduate skills training programme and considered the need to change our teaching and learning strategy in this area. Outcomes-based data was accrued from the performance-based assessment of 64 medical students in four key procedures. Attitudinal data was gleaned from 130 responses to an electronic questionnaire and student self-efficacy ratings taken immediately before assessment. Students performed best in venepuncture. Performance in the other skills revealed 1 in 3 did not reach competence in i.v. cannulation and more than 1 in 2 were below standard when measuring a BM stix and priming an i.v. giving set. The data on self-efficacy and competence was analysed and a Spearman's Rank Correlation coefficient of 0.36 calculated. Students in final year were poor self-assessors and unaware that their skills often fell below standard. These results suggest a need to increase students' self-awareness and promote ward-based learning. This article considers how these objectives might be achieved. PMID:17594585
Morton, Jeremy; Anderson, Lisa; Frame, Fiona; Moyes, Janette; Cameron, Helen
A study was done to examine the relationships between medical residents' beliefs about their clinicalteaching roles and their teaching behaviors within the context of work rounds. The research was conceptually based on theories of symbolic interactionism and reasoned action. Fourteen residents in general internal medicine, representing four…
There are many studies about nursing clinical settings and their problems, but the teaching style as a whole has not been widely studied. Therefore, this study aimed to explore nursing teachers' perceptions about teaching style in the clinical settings in Iran. A grounded theory approach was used to conduct this study. Fifteen nursing teachers were interviewed individually, 2006-2007. The interviews were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using Strauss and Corbin's method. Three main and 12 sub themes emerged from data and these could explain the nature of the teaching style in clinical education of the Mashhad Faculty of Nursing and probably others in Iran. The main themes included: multiplicity in teaching style, nature of clinicalteaching, and control and adaptation in education atmosphere. Multiplicity in teaching style was the dominant concept in this study. Each educator had a personal and individualized style which was flexible according to the situation, type of the skill (course content), education environment and facilities, and level of the learner. This study can guide nurse educators to know more about teaching styles and use them appropriately in the clinical settings. Further research into the themes of this study are recommended. PMID:19251481
As a concerted move toward closer integration of the clinical and preclinical aspects of the undergraduate medical curriculum at the University of Auckland, the Department of Anatomy with Radiology has implemented a number of clinical procedures, pathological observations and diagnostic methods into the course resulting in a structured program of clinically based teaching of gross anatomy to second- and third-year
Background: Assessment of faculty teaching and clinical skills is often based on learners' ratings. It is not clear that differences between the constructs are detectable in the results.Purpose: The purpose is to examine relationships between (a) residents' ratings of faculty clinical excellence and teaching effectiveness and (b) track-related performance differences.Methods: There were 3,713 evaluations for 399 faculty provided by 436
Katherine S. McOwen; Lisa M. Bellini; Judy A. Shea
Objectives. To determine which teaching method in a drug-induced diseases and clinical toxicology course was preferred by students and whether their preference correlated with their learning of drug-induced diseases. Design. Three teaching methods incorporating active-learning exercises were implemented. A survey instrument was developed to analyze students’ perceptions of the active-learning methods used and how they compared to the traditional teaching method (lecture). Examination performance was then correlated to students’ perceptions of various teaching methods. Assessment. The majority of the 107 students who responded to the survey found traditional lecture significantly more helpful than active-learning methods (p=0.01 for all comparisons). None of the 3 active-learning methods were preferred over the others. No significant correlations were found between students’ survey responses and examination performance. Conclusions. Students preferred traditional lecture to other instructional methods. Learning was not influenced by the teaching method or by preference for a teaching method.
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…
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. PMID:19605651
Prevedello, Luciano M; Andriole, Katherine P; Khorasani, Ryan Roobian Ramin
A method developed at Tufts University School of Dental Medicine for teaching modification of cavity design to large numbers of preclinical students in operative dentistry is reported. It standardizes the learning process for this complex problem-solving skill. (MLW)
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.
A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole. PMID:1921663
Community-based clinicalteaching programmes are now an established feature of most UK dental school training programmes. Appropriately implemented, they enhance the educational achievements and competences achieved by dental students within the earlier part of their developing careers, while helping students to traverse the often-difficult transition between dental school and vocational/foundation training and independent practice. Dental school programmes have often been criticised for 'lagging behind' developments in general dental practice - an important example being the so-called 'business of dentistry', including clinical audit. As readers will be aware, clinical audit is an essential component of UK dental practice, with the aims of improving the quality of clinical care and optimising patient safety. The aim of this paper is to highlight how training in clinical audit has been successfully embedded in the community-based clinicalteaching programme at Cardiff. PMID:21617672
Nursing faculty play an important role in facilitating nursing student learning and shaping student experience in the clinical setting. Emotional intelligence (EI) in clinical nursing faculty may be one avenue to develop teaching effectiveness. This study investigated the relationship between EI and clinicalteaching effectiveness of nursing faculty in an undergraduate nursing program. Using a cross-sectional correlation design, data were collected from a convenience sample of nursing faculty (N = 47) using the BarOn Emotional Quotient Inventory: Short (EQ-i:S), the Nursing Clinical Teacher Effectiveness Inventory (NCTEI) and a demographic data page. The results indicated a statistically significant positive relationship between the EQ-i:S and the NCTEI total scores (rs = .599, P < .01) and between many subscales of these tools. These findings contribute new knowledge to nursing education, including the following: (a) a significant relationship between EI and clinicalteaching effectiveness exists, (b) faculty exhibit effective overall EI functioning with room to enhance competencies, and (c) faculty members see themselves as effective in their clinicalteaching. Implications for clinicalteaching practice include the need for faculty development and strengthening the faculty-student relationship. Possibilities for future research are discussed. PMID:22818193
Informatics and information technology do not appear to be valued by the health industry to the degree that they are in other industries. The agenda for health informatics should be presented so that value to the health system is linked directly to required investment. The agenda should acknowledge the foundation provided by the current health system and the role of financial issues, system impediments, policy, and knowledge in effecting change. The desired outcomes should be compelling, such as improved public health, improved quality as perceived by consumers, and lower costs. Strategies to achieve these outcomes should derive from the differentia of health, opportunities to leverage other efforts, and lessons from successes inside and outside the health industry. Examples might include using logistics to improve quality, mass customization to adapt to individual values, and system thinking to change the game to one that can be won. The justification for the informatics infrastructure of a virtual health care data bank, a national health care knowledge base, and a personal clinical health record flows naturally from these strategies. PMID:10495093
A patient-centred clinicalteaching profile in the undergraduate dental curriculum at The University of Tromsø is described. This teaching profile implies that treatment planning is primarily based on the patients' perceived needs and the students are trained to retrieve information from the patients in this context. The role of the clinical instructor is primarily as a facilitator rather than an expert. The 'best interest of the patient' is not always easy to disclose and consequences related to the patients' levels of understanding, students competence, educational challenges and professional ethics are topics for discussion through the clinical education programme. PMID:18666899
Model C clinical nurse leader (CNL) programs are complex because they must meet the The Essentials of Baccalaureate Education for Professional Nursing Practice and The Essentials of Master's Education in Nursing, as well as the graduate level competencies outlined in the white paper Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice. Faculty assigned to teach in these programs may be experts in education or areas of clinical specialty, but they may not have a clear understanding of the CNL role to teach and mentor CNL students. This article describes a faculty development model that includes an introduction to the CNL role, course mapping of the essentials, integration of CNL professional values into clinical evaluation, consultation with practicing model C graduates, and participation in a comprehensive CNL certification review course. The model was effective in preparing faculty to teach and mentor students in a model C CNL program. [J Nurs Educ. 2014;53(7):421-425.]. PMID:24971734
BACKGROUND: Considering the increasing use of alternative therapies for children, it is appropriate to determine the demographic profile of pediatric patients entering a chiropractic clinic. METHODS: Collection of demographic data including age, gender, condition at presentation, previous clinicians consulted and medical referral rates of pediatric patients presenting to a chiropractic teachingclinic between 2006 and 2010. RESULTS: Over-all, 20.5% of
This article describes a new approach to clinical pharmacy practice teaching for undergraduate students using a clinical tutor model at the school of pharmacy and pharmaceutical sciences at the University of Manchester. The results of an evaluation of the first year of the course are also reported T he Government's continuing aim to modernise the National Health Service suggests that
Lyn Hanning; Justine Scanlan; Jennifer Silverthorne; Judy Cantrill; Richard Hey; Stephen Freeborn; Jonathan Cooke
Basic and superior reasoning skills are woven into the clinical reasoning process just as they are used to solve any problem. As clinical reasoning is the central competence of medical education, development of these reasoning skills should occur throughout the undergraduate medical curriculum. The authors describe here a method of teaching…
Elizondo-Omana, Rodrigo Enrique; Morales-Gomez, Jesus Alberto; Morquecho-Espinoza, Orlando; Hinojosa-Amaya, Jose Miguel; Villarreal-Silva, Eliud Enrique; Garcia-Rodriguez, Maria de los Angeles; Guzman-Lopez, Santos
Discusses clinical problem analysis (CPA) in medical education, an approach to solving complex clinical problems. Outlines the five step CPA model and examines the value of CPA's content-independent (methodical) approach. Argues that teaching students to use CPA will enable them to avoid common diagnostic reasoning errors and pitfalls. Compares…
Custers, Eugene J. F. M.; Robbe, Peter F. De Vries; Stuyt, Paul M. J.
Development of an inexpensive but powerful computer program to teachclinical periodontal diagnosis using epidemiological principles is described. Using probabilistic thinking, the student is guided from application of raw research data to derivation of likelihood ratios and how they affect clinical decision making. Student response was found to…
Web-based student evaluations of clinical faculty were collected over an 8-year period. There were 19,881 medical student evaluations over the 8-year period for all clinical clerkships, representing a total of 952 faculty. Students used a 5-point Likert scale to rate the teaching effectiveness of faculty. Criterion-based methods and standard…
Chandrasekhar, Arcot J.; Durazo-Arvizu, Ramon; Hoyt, Amy; McNulty, John A.
This paper discusses using human patient simulation (HPS) to expose students to complex dynamic patient cases that require clinical judgment, problem-solving skills, and teamwork skills for success. An example of an HPS exercise used to teach multifaceted clinical concepts in a therapeutics course also is provided.
Vyas, Deepti; Ottis, Erica J.; Caligiuri, Frank J.
Since 1987, McGill University's Department of Family Medicine has invited new faculty to an orientation workshop. Workshop topics cover learning agreements and principles of adult learning, effective teaching methods, and feedback and evaluation. Workshop methods aim to promote active participation and experiential learning.
The teaching of human anatomy has had to respond to significant changes in medical curricula, and it behooves anatomists to devise alternative strategies to effectively facilitate learning of the discipline by medical students in an integrated, applied, relevant, and contextual framework. In many medical schools, the lack of cadaver dissection as…
Until recently, standards to guide nursing education and practice in Vietnam were nonexistent. This paper describes the development and implementation of a clinicalteaching capacity building project piloted in Hanoi, Vietnam. The project was part of a multi-component capacity building program designed to improve nurse education in Vietnam. Objectives of the project were to develop a collaborative clinically-based teaching model that encourages evidence-based, student-centred clinical learning. The model incorporated strategies to promote development of nursing practice to meet national competency standards. Thirty nurse teachers from two organisations in Hanoi participated in the program. These participants attended three workshops, and completed applied assessments, where participants implemented concepts from each workshop. The assessment tasks were planning, implementing and evaluating clinicalteaching. On completion of the workshops, twenty participants undertook a study tour in Australia to refine the teaching model and develop an action plan for model implementation in both organisations, with an aim to disseminate the model across Vietnam. Significant changes accredited to this project have been noted on an individual and organisational level. Dissemination of this clinicalteaching model has commenced in Ho Chi Minh, with further plans for more in-depth dissemination to occur throughout the country. PMID:22381381
The developing countries have common problems-problems of hunger, poverty, elimination of illiteracy, and the identification and management of resources. The role of informatics will vary significantly from one country to the other. The technologies devel...
In this chapter, we outline a vision of Web Intelligence (WI) research from the viewpoint of Brain Informatics (BI), a new\\u000a interdisciplinary field that systematically studies the mechanisms of human information processing from both the macro and\\u000a micro viewpoints by combining experimental cognitive neuroscience with advanced information technology. BI studies human brain\\u000a from the viewpoint of informatics (i.e., human brain
Ning Zhong; Jiming Liu; Yiyu Yao; Jing-long Wu; Shengfu Lu; Yulin Qin; Kuncheng Li; Benjamin W. Wah
As health care becomes more information-intensive and diverse, there is a need to integrate information technology (IT) into clinical education. Little is known, however, about how to design instructional strategies for integrating information technology into clinical nursing education. This article outlines the instructional strategies used by faculty in five nursing programs who taught students to use a point-of-care information technology system. The article also reports students' computer acceptance and summarizes IT clinicalteaching recommendations. PMID:11111570
Elfrink, V L; Davis, L S; Fitzwater, E; Castleman, J; Burley, J; Gorney-Moreno, M J; Sullivan, J; Nichols, B; Hall, D; Queen, K; Johnson, S; Martin, A
The authors describe and discuss clinical problem analysis (CPA), an approach to solving complex clinical problems. They outline the five steps of the CPA model and the essential elements of each step. Next, they discuss the value of CPA's content-independent (methodical) approach and argue that teaching students to use CPA will enable them to avoid some common diagnostic reasoning errors and pitfalls. Finally, they compare CPA with two existing approaches to clinical problem solving. PMID:10724322
\\u000a In the Biomedical Engineering domain, Clinical Engineering has a crucial role requiring specialization and training in the\\u000a clinical setting of hospitals and clinics, to gain real-world experience with respect to safe and effective application of\\u000a biomedical equipment, technologies and systems to result in efficacious and high quality patient care. The academic training\\u000a coupled with internship in a teaching hospital gives
Background Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Methods Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. Results A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n?=?7) of schools had skills laboratories, 76% (n?=?22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital. Teachers were concerned with poor practical exposure and lack of teaching material. Conclusions Pre-service FP teaching in Tanzania is theoretical, poorly guided, and skewed toward short acting methods; a majority of the schools are unable to produce competent FP service providers. Pre-service FP training should be strengthened with more focus on practical skills.
There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching. PMID:25012332
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.
Dezelic, Gjuro; Kern, Josipa; Petrovecki, Mladen; Ilakovac, Vesna; Hercigonja-Szekeres, Mira
Evolving information technology has had profound effects on business operations and the marketplace. The health care services industry, particularly hospitals, clinics, and medical offices, has historically lagged behind other industries in the implementation of comprehensive, integrated, computerized data management tools. Health care reformers are looking to the promises of the information technology "revolution" as a means of improving systemic efficiency and health care quality. This study discusses the impact of informatics, or information technology, on the delivery of health care services. We present the evolution of informatics and the predicted future benefits of integrated computerized patient records and point-of-care systems. PMID:10162811
Although preceptorship is the leading approach to the clinical education of senior undergraduate nursing students in the westernized world, few specific nursing preceptor-focused clinicalteaching techniques are reported in the literature. One promising preceptor-specific teaching strategy is the Five Step "Microskills" Model of ClinicalTeaching (J.O. Neher, K.C. Gordon, B. Meyer, & N. Stevens, 1992). This technique, also known as the One Minute Preceptor (OMP; J.O. Neher & N. Stevens, 2003), has been used for more than 15 years in clinical medical education. In this article, we trace the origins of the OMP and describe an adaptation to nursing education, referred to as the Five Minute Preceptor (5MP). The 5MP steps are the following: (1) get the student to take a stand, (2) probe for supporting evidence, (3) teach general rules, (4) reinforce the positives, and (5) correct errors or misinterpretations. In addition, we explore the relationship between the 5MP and experiential learning and provide a detailed example of the 5MP's use in undergraduate clinical nursing education. Recommendations are provided for the development of a 5MP educational package and the evaluation of the 5MP's use in baccalaureate nursing programs. PMID:21272834
Learning in the clinical setting is the cornerstone of medical school education, but there are strong imperatives to optimise the ways in which students acquire clinical expertise. Deliberate practice is characterised by attention, concentration, effort and repetition of skills; it is an important tool for developing and maintaining professional expertise. Research has led to a greater understanding of how medical students develop core clinical skills, especially in the areas of diagnostic reasoning, communication and physical examination. Advances in information technology and instructional design are helping to strengthen the links between formal educational activities and opportunistic learning in the clinical setting. PMID:22571313
Conn, Jennifer J; Lake, Fiona R; McColl, Geoffrey J; Bilszta, Justin L C; Woodward-Kron, Robyn
Informatics is essential for biomedical research. There is, however, a lack of skilled practitioners and training programmes in developing countries. We have established a cross-disciplinary Biomedical Informatics Training programme in South Africa (www.biomedinfo.org) with the support of the Informatics Training for Global Health Programme of the Fogarty International Centre, National Institutes of Health, USA. The Informatics Training Programme is one
Christopher J Seebregts; Maurice Mars; Deshendran Moodley; Hamish SF Fraser; Sarie P Human; Carl Fourie; Yashik Singh; Milan Hajek; Woolaganathan Pillay; Jules-Raymond Tapamo; Hugh Murrell; Tulio de Oliveira; Donnie McGrath; Michael L. Bennish
This report describes the evaluation of a faculty development program implemented to address the deficit in physicians' clinical and teaching competence regarding substance abuse. Participants in the university hospital program included faculty fellows from five departments. Annual, random chart audits assessed changes in rates of substance use documentation by residents supervised and not supervised by the fellows. Paired t tests
Antonnette V. Graham; Mary Altpeter; Stephanie Emmitt-Myers; Theodore V. Parran Jr; Stephen Zyzanski
This article describes a novel approach to teaching gross anatomy to medical students. The article explains an explorative learning approach that builds students analytical, reasoning and communication (written and oral). The methods used require students to develop a patient case based on clinical outcomes.
Dr. Christo T Philip (Mayo Clinic College of Medicine); Dr. Kenneth P Unruh (Mayo Clinic College of Medicine)
This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost-effective facilities that would address widespread concerns over anatomy teaching, and support other activities…
Examines advantages and disadvantages of multimedia simulation in nursing education. Provides an example of a modular design with an integrated intelligent agent and knowledge base for teachingclinical decision making. Concludes that this approach overcomes some of the problems of intelligent tutoring systems. Contains 40 references. (SK)
Learning to counsel patients in a teachingclinic or hospital occurs in the presence of the competing agendas of patient care\\u000a and student education. We wondered about the challenges that these tensions create for clinical novices learning to deliver\\u000a bad news to patients. In this preliminary study, we audio-taped and transcribed the interviews of seven senior optometry students\\u000a and six
Marlee M. Spafford; Catherine F. Schryer; Stefan Creutz
abstractions also are attractive for defining the core contributions of basic research in informatics We can understand many central activities within informatics in terms defining, refining, applying, and evaluating domain ontologies and problem - solving methods Conclusion: Construing work in medical informatics in terms of actions involving ontologies and problem - solving methods may move us closer to a theoretical
Medical informatics is defined as the scientific discipline concerned with the systematic processing of data, information and knowledge in medicine and health care. The domain of medical informatics (including health informatics), its aim, methods and tools, and its relevance to other disciplines in medicine and health sciences are outlined. It is recognized that one of the major tasks of medical
Over the last twenty years there have been great advances in light microscopy with the result that multi-dimensional imaging has driven a revolution in modern biology. The development of new approaches of data acquisition are reportedly frequently, and yet the significant data management and analysis challenges presented by these new complex datasets remains largely unsolved. Like the well-developed field of genome bioinformatics, central repositories are and will be key resources, but there is a critical need for informatics tools in individual laboratories to help manage, share, visualize, and analyze image data. In this article we present the recent efforts by the bioimage informatics community to tackle these challenges and discuss our own vision for future development of bioimage informatics solution.
Swedlow, Jason R.; Goldberg, Ilya G.; Eliceiri, Kevin W.
Aims: Evaluation of the effectiveness of clinicalteaching is an important contribution for the quality control of medical teaching. This should be evaluated using a reliable instrument in order to be able to both gauge the status quo and the effects of instruction. In the Stanford Faculty Development Program (SFDP), seven categories have proven to be appropriate: Establishing the Learning Climate, Controlling a Teaching Session, Communication of Goals, Encouraging Understanding and Retention, Evaluation, Feedback and Self-directed Learning. Since 1998, the SFDP26 questionnaire has established itself as an evaluation tool in English speaking countries. To date there is no equivalent German-language questionnaire available which evaluates the overall effectiveness of teaching. Question: Development and theoretical testing of a German-language version of SFDP26 (SFDP26-German), Check the correlation of subscale of SFDPGerman against overall effectiveness of teaching. Methods: 19 anaesthetists (7 female, 12 male) from the University of Lübeck were evaluated at the end of a teaching seminar on emergency medical care using SFDP-German. The sample consisted of 173 medical students (119 female (68.8%) and 54 male (31.2%), mostly from the fifth semester (6.6%) and sixth semester (80.3%). The mean age of the students was 23±3 years. Results: The discriminatory power of all items ranged between good and excellent (rit=0.48-0.75). All subscales displayed good internal consistency (?=0.69-0.92) and significant positive inter-scale correlations (r=0.40-0.70). The subscales and “overall effectiveness of teaching” showed significant correlation, with the highest correlation for the subscale “communication of goals (p< 0.001; r = 0.61). Conclusion: The analysis of SFDP26-German confirms high internal consistency. Future research should investigate the effectiveness of the individual categories on the overall effectiveness of teaching and validate according to external criteria.
Iblher, Peter; Zupanic, Michaela; Hartel, Christoph; Heinze, Hermann; Schmucker, Peter; Fischer, Martin R.
An academic general medicine clinic (GMC) was studied and profiles were generated to determine current patterns, shortcomings, and potential solutions. Conclusions include that GMC offers insufficient variety of patient presentations for optimal postgraduate medical education and inadequate accessibility for comprehensive medical care. (Author/JMD)
The primary objective of education in evidence-based clinical practice (EBCP) is to provide a resident or student with the requisite skills to satisfactorily solve real everyday clinical problems throughout their careers and to translate those solutions into better care for patients. At the University of Western Ontario in London, Canada, there is a well-developed and highly successful evidence-based neurology curriculum primarily aimed at residents. This article summarizes the current context of EBCP postgraduate training in the neurological sciences and a detailed description of its purpose, learning outcomes, required resources, content, teaching strategies, and assessment tools. In this program, we teach the principles of EBCP through the review of pertinent neurological clinical questions. The summary of each topic is recorded on our website in the form of critically appraised topics (CATs) in electronically accessible CAT banks. PMID:17418941
A common thread throughout the clinical and translational research domains is the need to collect, manage, integrate, analyze, and disseminate large-scale, heterogeneous biomedical data sets. However, well-established and broadly adopted theoretical and practical frameworks and models intended to address such needs are conspicuously absent in the published literature or other reputable knowledge sources. Instead, the development and execution of multidisciplinary, clinical, or translational studies are significantly limited by the propagation of “silos” of both data and expertise. Motivated by this fundamental challenge, we report upon the current state and evolution of biomedical informatics as it pertains to the conduct of high-throughput clinical and translational research and will present both a conceptual and practical framework for the design and execution of informatics-enabled studies. The objective of presenting such findings and constructs is to provide the clinical and translational research community with a common frame of reference for discussing and expanding upon such models and methodologies.
The prevailing view of medical informatics as a primarily subservient discipline in health care is challenged. Developments in both general informatics and medical informatics are described to identify desirable properties of modeling languages and tools needed to solve key problems in the application field. For progress in medical informatics, it is considered essential to develop far more formal modeling languages, modeling techniques, and tools. A major aim of this development should be to expel ambiguity from concepts essential to medicine, positioning medical informatics “at the heart of health care.”
van der Maas, Arnoud A.F.; Ten Hoopen, A. Johannes; Ter Hofstede, Arthur H.M.
The prevailing view of medical informatics as a primarily subservient discipline in health care is challenged. Developments in both general informatics and medical informatics are described to identify desirable properties of modeling languages and tools needed to solve key problems in the application field. For progress in medical informatics, it is considered essential to develop far more formal modeling languages, modeling techniques, and tools. A major aim of this development should be to expel ambiguity from concepts essential to medicine, positioning medical informatics "at the heart of health care." PMID:11230381
van der Maas, A A; ten Hoopen, A J; ter Hofstede, A H
As we have advanced in medical informatics and created many impressive innovations, we also have learned that technologic developments are not sufficient to bring the value of computer and information technologies to health care systems. This paper proposes a model for improving how we develop and deploy information technology. The authors focus on trends in people, organizational, and social issues (POI/OSI), which are becoming more complex as both health care institutions and information technologies are changing rapidly. They outline key issues and suggest high-priority research areas. One dimension of the model concerns different organizational levels at which informatics applications are used. The other dimension draws on social science disciplines for their approaches to studying implications of POI/OSI in informatics. By drawing on a wide variety of research approaches and asking questions based in social science disciplines, the authors propose a research agenda for high-priority issues, so that the challenges they see ahead for informatics may be met better.
Kaplan, Bonnie; Brennan, Patricia Flatley; Dowling, Alan F.; Friedman, Charles P.; Peel, Victor
Background/Context: This concluding article identifies the policy implications of education informatics and explores impacts of current copyright laws, legislative structures, publishing practices, and education organizations. Synthesizing the discussions in the preceding articles, this article highlights the importance of designing information…
With the aid of the detection on the multimedia messaging service (MMS) of the laser accidents, novel insecurity factors in laser safety informatics are investigated. By using continuously improved laser self-organization safety system, new concepts of laser safety are developed. Various kinds of accidents can be avoided when comprehensive protective measures are taken.
During the 1980s, Turkey laid the foundation for its transition to an information-based economy (IBE). Nevertheless, when compared to peer-group countries that targeted informatics as a catalyst for economic modernization, Turkey has not yet adequately de...
The complexity and cost of isolating the root cause of system problems in large parallel computers generally scales with the size of the system. Syslog messages provide a primary source of system feedback, but manual review is tedious and error prone. Informatic analysis can be used to detect subtle anomalies in the syslog message stream, thereby increasing the availability of
Increased availability of large repositories of chemical compounds is creating new challenges and opportunities for the application of machine learning methods to problems in computational chemistry and chemical informatics. Because chemical compounds are often represented by the graph of their covalent bonds, machine learning methods in this domain must be capable of processing graphical structures with variable size. Here we
Liva Ralaivola; Sanjay Joshua Swamidass; Hiroto Saigo; Pierre Baldi
The Belgian Society for Medical Informatics (MIM) organized a survey in 1986 in order to assess the present state of development of medical informatics in Belgium. Questionnaires were sent to hospitals, laboratories, private practitioners and pharmacists, as well as to social security organizations and software industries. The response rate was higher in hospitals (93%) than in any other category. Results showed a large number of computerized hospitals (93% of general acute care hospitals and 91% of psychiatric hospitals). There has been a sharp increase (+ 15%) in computerization of the admission, accounting and billing procedures since 1985, most likely in relation with administrative rules issued by the Belgian Government. The same trend (+ 20%) has been observed for computer applications in clinical laboratories, between 1984 and 1985. There is almost one computer terminal for ten beds in the hospitals with more than 200 beds in 1986. This figure exemplifies the present trend to on-line access to data. Computerized instrumental aids to medicine such as text processing, imaging or computerized interpretation of signals have known a rapid extension during recent years, although less comprehensive than administrative applications in hospitals and in social security organizations. The present state of other applications in medicine (general practice, pharmacy, etc.) was more difficult to assess as those information systems remain more pinpointed. In all medical fields, there appears to be a new rise in computer programs offered by software companies. PMID:3441153
Roger, F H; Behets, M; Andre, J; de Moor, G; Sevens, C; Willems, J L
The efficacy of video recording in transmitting clinical knowledge and skills to medical students was tested by recording on videotape demonstrations of physical examinations given by five clinicians to a randomly selected group of 12 students (personal group) from the first clinical year and then showing these recordings, under identical conditions, to 13 students from the same year (video group). The efficacy of both the personal and video mediums in terms of whether content was retained was tested by a questionnaire completed by all students at the end of the sessions and by a structured clinical assessment in which students were asked to demonstrate some of the same clinical tasks three weeks after the demonstration. In answering the questionnaire the video group obtained a mean (SD) score of 20.8 (7.0) (maximum possible score 40), which was not significantly different from the score achieved by the personal group (17.4 (7.7)). The video group was able to reproduce 44 (10)% of the total clinical steps demonstrated and the personal group 45 (14)%. Videotaped demonstrations can be as effective as personal teaching of clinical methods, and video should be developed as a medium for first line clinicalteaching.
Mir, M A; Marshall, R J; Evans, R W; Hall, R; Duthie, H L
Clinical phenotypes are very complex and not well described. For instance, more than 100.000 biomedical concepts are needed to describe clinical properties of patients. At present, information systems dealing with clinical phenotype data are based on secret, heterogeneous and incompatible data models. This is the root cause for the well-known grand challenge of semantic interoperability in healthcare: data exchange and analysis of medical information systems has major limitations. This problem slows down medical progressand wastes time of health care professionals. A large-scale open metadata initiative can foster exchange, discussion and consensus regarding data models for clinical phenotypes. This would be an important contribution to improve information systems in healthcare and to solve the grand challenge of semantic interoperability. PMID:23920688
Objectives. To design, implement, and evaluate student performance on clinically relevant chemical and spectral laboratory exercises on antibiotics. Design. In the first of 2 exercises, second-year pharmacy students enrolled in an integrated laboratory sequence course studied the aqueous stability of ß-lactam antibiotics using a spectral visual approach. In a second exercise, students studied the tendency of tetracycline, rifamycins, and fluoroquinolones to form insoluble chelate complexes (turbidity) with polyvalent metals. Assessment. On a survey to assess achievement of class learning objectives, students agreed the laboratory activities helped them better retain important information concerning antibiotic stability and interactions. A significant improvement was observed in performance on examination questions related to the laboratory topics for 2012 and 2013 students compared to 2011 students who did not complete the laboratory. A 1-year follow-up examination question administered in a separate course showed >75% of the students were able to identify rifamycins-food interactions compared with <25% of students who had not completed the laboratory exercises. Conclusion. The use of spectral visual approaches allowed students to investigate antibiotic stability and interactions, thus reinforcing the clinical relevance of medicinal chemistry. Students’ performance on questions at the 1-year follow-up suggested increased retention of the concepts learned as a result of completing the exercises.
Requirements for information technology 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 modernization, 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. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerized order entry, data security and recovery, and audit. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this paper. PMID:15117430
Summary Background Medicine and biomedical sciences have become data-intensive fields, which, at the same time, enable the application of data-driven approaches and require sophisticated data analysis and data mining methods. Biomedical informatics provides a proper interdisciplinary context to integrate data and knowledge when processing available information, with the aim of giving effective decision-making support in clinics and translational research. Objectives To reflect on different perspectives related to the role of data analysis and data mining in biomedical informatics. Methods On the occasion of the 50th year of Methods of Information in Medicine a symposium was organized, that reflected on opportunities, challenges and priorities of organizing, representing and analysing data, information and knowledge in biomedicine and health care. The contributions of experts with a variety of backgrounds in the area of biomedical data analysis have been collected as one outcome of this symposium, in order to provide a broad, though coherent, overview of some of the most interesting aspects of the field. Results The paper presents sections on data accumulation and data-driven approaches in medical informatics, data and knowledge integration, statistical issues for the evaluation of data mining models, translational bioinformatics and bioinformatics aspects of genetic epidemiology. Conclusions Biomedical informatics represents a natural framework to properly and effectively apply data analysis and data mining methods in a decision-making context. In the future, it will be necessary to preserve the inclusive nature of the field and to foster an increasing sharing of data and methods between researchers.
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 contribute to filling gaps in digitized biodiversity data; (b) assisting countries potentially in need (for example mega-diverse) to mobilize resources and collect data that could be used in decision-making; and (c) allowing identification of which biodiversity informatics-resourced countries could afford to assist countries lacking in biodiversity informatics capacity, and which data-rich countries should benefit most from such help.
Objective: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area. Design: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation. Measurements: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions. Results: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students. Conclusion: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented.
Hersh, William R.; Junium, Katherine; Mailhot, Mark; Tidmarsh, Patricia
The Integrating the Healthcare Enterprise (IHE) Teaching File and Clinical Trial Export (TCE) integration profile describes\\u000a a standard workflow for exporting key images from an image manager\\/archive to a teaching file, clinical trial, or electronic\\u000a publication application. Two specific digital imaging and communication in medicine (DICOM) structured reports (SR) reference\\u000a the key images and contain associated case information. This paper
Aaron W. C. Kamauu; Scott L. Duvall; Andrew P. Liimatta; Richard H. Wiggins III; David E. Avrin
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.
Health Informatics (HI) is a dynamic discipline based upon the medical sciences, information sciences, and cognitive sciences. Its domain is 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 utilized 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.
For the practicing physician, the behavioral implications of preventing, diagnosing, and treating cancer are many and varied. Fortunately, an enhanced capacity in informatics may help create a redesigned ecosystem in which applying evidence-based principles from behavioral medicine will become a routine part of care. Innovation to support this evolution will be spurred by the “meaningful use” criteria stipulated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and by focused research and development efforts within the broader health information ecosystem. The implications for how to better integrate evidence-based principles in behavioral medicine into oncology care through both spheres of development are discussed within the framework of the cancer control continuum. The promise of using the data collected through these tools to accelerate discovery in psycho-oncology is also discussed. If nurtured appropriately, these developments should help accelerate successes against cancer by altering the behavioral milieu.
A new category has been added to the AGU index terms to allow indexing of items related to areas such as data management and analysis, large-scale computational experimentation and modeling, and hardware and software infrastructure. Topics included in the “1900 Informatics” category, compiled by representatives of AGU's Earth and Space Science Informatics (ESSI) focus group, include metadata, ontologies, virtual globes, semantic technology, and virtualization. The AGU index terms have many uses. For example, they are the controlled vocabulary for indexing AGU journal papers, book chapters, meeting abstracts, and Eos articles, as well as some external systems and data sets. The vocabulary also forms the basis of AGU’s “virtual journal” subsets, e-mail alerts, and RSS (“Really Simple Syndication”) Web feeds, and is also useful for browsing and searching AGU articles and abstracts. For more information on AGU index terms, visit http://www.agu.org/pubs/indexterms/.
Description logics and related formalisms are being applied in at least v e applica- tions in medical informatics|terminology, intelligent user interfaces, decision sup- port and semantic indexing, language technology, and systems integration. Impor- tant issues include size, complexity, connectivity, and the wide range of granularity required|medical terminologies require on the order of 250,000 concepts, some in- volving a dozen or
An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as "novice" and "advanced beginners" in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice. PMID:16046276
McNeil, Barbara J; Elfrink, Victoria L; Pierce, Susan T; Beyea, Suzanne C; Bickford, Carol J; Averill, Carolyn
Background and Purpose. 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. Methods. 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. Results. 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. Conclusion. 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.
The American Medical Informatics Association 2001 Spring Congress brought together the public health and informatics communities to develop a national agenda for public health informatics. Discussions on funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes: (1) all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research and (2) informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health. PMID:11713752
Yasnoff, W A; Overhage, J M; Humphreys, B L; LaVenture, M; Goodman, K W; Gatewood, L; Ross, D A; Reid, J; Hammond, W E; Dwyer, D; Huff, S M; Gotham, I; Kukafka, R; Loonsk, J W; Wagner, M M
There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference's findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a “wired” world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented.
There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference's findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a "wired" world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented. PMID:20190052
Intra-aortic balloon pump (IABP) is one of the most important treatment strategies for patients with heart failure in the intensive care unit (ICU). To ensure quality of treatment, clinical preceptors must employ effective teaching strategies to acquaint nurses with the proper use of IABPs. Many nurses are hesitant to use IABPs due to lack of knowledge regarding their use. Classroom lectures and instruction manual-style materials are often ineffective strategies for teaching novice nurses to use IABPs properly and have resulted in unsatisfactory patient treatment quality. This study developed a creative, pithy rhyme to help nurses remember the key elements of IABP support as part of their IABP learning process. This innovative tool uses rhymes and mental images to instill critical information related to IABP use and help nurses become fluent IABP users. PMID:22851398
The pluralism of methodologies and severe time constraints pose important challenges to pedagogy in clinical ethics. We designed a step-by-step student handbook to operate within such constraints and to respect the methodological pluralism of bioethics and clinical ethics. The handbook comprises six steps: Step 1: What are the facts of the case?; Step 2: What are your obligations to your
Introduction Simulation-based medical education (SBME) is increasingly being utilized for teachingclinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teachingclinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS) is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students’ knowledge acquisition, comfort, and perceived competence with regards to the AMS patient. Methods AMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS. Results A total of 154 students completed the post-test and survey and 65 (42%) attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (p<0.001). Students who participated in a simulation session were more comfortable in their overall approach to treating AMS patients (p=0.05). They were also more likely to state that they could articulate a differential diagnosis (p=0.03), know what initial diagnostic tests are needed (p=0.01), and understand what interventions are useful in the first few minutes (p=0.003). Students who participated in a simulation session were more likely to find the overall AMS curriculum useful (p<0.001). Conclusion Students who participated in a simulation exercise performed better on a knowledge-based test and reported increased comfort and perceived competence in their clinical approach to AMS. SBME shows significant promise for teachingclinical skills to medical students during pre-clinical curriculum.
The course "Management of Fluid and Electrolyte Disorders" is an applied physiology course taught using lectures and paper-based cases. The course approaches fluid therapy from both basic science and clinical perspectives. While paper cases provide a basis for application of basic science concepts, they lack key components of genuine clinical cases that, by nature, are diverse, change over time, and respond in unique ways to therapeutic interventions. We developed a dynamic model using STELLA software that simulates normal and abnormal fluid and electrolyte balance in the dog. Students interact, not with the underlying model, but with a user interface that provides sufficient data (skin turgor, chemistry panel, etc.) for the clinical assessment of patients and an opportunity for treatment. Students administer fluids and supplements, and the model responds in "real time," requiring regular reassessment and, potentially, adaptation of the treatment strategy. The level of success is determined by clinical outcome, including improvement, deterioration, or death. We expected that the simulated cases could be used to teach both the clinical and basic science of fluid therapy. The simulation provides exposure to a realistic clinical environment, and students tend to focus on this aspect of the simulation while, for the most part, ignoring an exploration of the underlying physiological basis for patient responses. We discuss how the instructor's expertise can provide sufficient support, feedback, and scaffolding so that students can extract maximum understanding of the basic science in the context of assessing and treating at the clinical level.
Richard E. Rawson (Cornell University College of Veterinary Medicine Department of Biomedical Sciences)
Summary Evidence-based medicine (EBM) is the clinical use of current best available evidence from relevant, valid research. Provision of evidence-based healthcare is the most ethical way to practise as it integrates up-to-date patient-oriented research into the clinical decision-making to improve patients' outcomes. This article provides tips for teachers to teachclinical trainees the final two steps of EBM: integrating evidence with clinical judgement and bringing about change.
Defines informatics as both a pure and an applied science dealing with information technology and its uses and examines the organization of education from two different perspectives: how applications of informatics may impact on education, forcing it to change; and how the educational system may deal with problems to effectively integrate…
Discusses the problems, methods, and domains that help define social informatics and considers how it relates to information science. Topics include the relationship between uses of information and communication technologies (ICT) and organizational effects; the role of the social context; methodological pluralism; and trends in social informatics…
Ten major long-term aims and tasks, so to speak ‘grand challenges’, for research in the field of medical informatics, including health informatics, are proposed and described. These are the further development of methods and tools of information processing for: (1) diagnostics (‘the visible body’); (2) therapy (‘medical intervention with as little strain on the patient as possible’); (3) therapy simulation;
The role of clinical instructors in preparing student nurses for the realities and dynamics of clinical practice cannot be underestimated. Previous literature has identified scaffolding as a diagnostic tool that enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use (Spouse, 1998). The pivotal role of scaffolding in the teaching-learning process cannot be underestimated. However, literature pertaining to its use in nursing is hard to locate (Dickieson, Carter and Walsh, 2008; Spouse, 1998). Hence, this qualitative study was conducted to capture nursing students' views and experiences of the scaffolding moves of their clinical instructors as they learn medication administration. From the thickness and richness of the descriptions of a select group of nursing students (n=31) in a comprehensive university in the Philippines, three interesting and yet intersecting themes surfaced relative to the scaffolding moves employed by clinical instructors, which include: (1) thought-provoking; (2) focus-steering; and (3) action-enabling. The said moves are carried out in a timely fashion to facilitate students' acquisition of knowledge, skills and attitudes pertaining to medication administration. Through the understanding of clinical instructors' scaffolding behaviors, this study provides a platform for more effective clinical instruction aimed at supporting future nurses' role in medication safety. PMID:22818953
Valdez, Les Paul M; de Guzman, Allan B; Escolar-Chua, Rowena L
Background The h-index is a commonly used metric for evaluating the publication performance of researchers. However, in a multidisciplinary field such as medical informatics, interpreting the h-index is a challenge because researchers tend to have diverse home disciplines, ranging from clinical areas to computer science, basic science, and the social sciences, each with different publication performance profiles. Objective To construct a reference standard for interpreting the h-index of medical informatics researchers based on the performance of their peers. Methods Using a sample of authors with articles published over the 5-year period 2006–2011 in the 2 top journals in medical informatics (as determined by impact factor), we computed their h-index using the Scopus database. Percentiles were computed to create a 6-level benchmark, similar in scheme to one used by the US National Science Foundation, and a 10-level benchmark. Results The 2 benchmarks can be used to place medical informatics researchers in an ordered category based on the performance of their peers. A validation exercise mapped the benchmark levels to the ranks of medical informatics academic faculty in the United States. The 10-level benchmark tracked academic rank better (with no ties) and is therefore more suitable for practical use. Conclusions Our 10-level benchmark provides an objective basis to evaluate and compare the publication performance of medical informatics researchers with that of their peers using the h-index.
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. (Konica-Minolta), Japan, in the 1980-1990s. Major support from the US National Institutes of Health and other federal agencies and private medical imaging industry are appreciated. The NATO (North Atlantic Treaty Organization) Advanced Study Institute (ASI) sponsored the International PACS Conference at Evian, France, in 1990, the contents and presentations of which convinced a half dozen high-level US military healthcare personnel, including surgeons and radiologists, that PACS was feasible and would greatly streamline the current military healthcare services. The impact of the post-conference summary by these individuals to their superiors opened the doors for long-term support of PACS development by the US Military Healthcare Services. PACS and imaging informatics have thus emerged as a daily clinical necessity. PMID:24311236
The Laboratory of Applied Informatics Research (LAIR ) at Indiana University, Bloomington (IUB) conducts research on information retrieval, machine learning, and human-computer interaction. The website provides links to information on various projects that address topics such as "agent-based information management, agent-user interaction, concept discovery and analysis, and information customization for effective online information delivery." Project descriptions, technical reports, and related resources are posted for each of the 10 projects currently supported through this laboratory. Some course syllabi and course materials are also posted in the Courses section of the website.
In 2009 China Enterprise Informatization composite index 40.46, China's overall informatization companies in the lower-middle maturity state. At present, most Chinese enterprises are in the transition period which means from the informatization critical application phase to the expansion of integration and optimization phase. The transition period is the critical period of the improvement of the maturity of informatization companies. Therefore,
Through studying the informatization index systems of both domestic and foreign enterprises, this essay sets up an informatization evaluation index system for enterprises in Henan Province, based on their essential characteristics and present situation. The evaluation index system includes application status of informatization, construction level of enterprise infrastructure, strategic planning level and informatization level of staff. Next, in accordance with
Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…
Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.
As health care job opportunities continue to expand, a number of institutions have been developing online training materials to help support academic public health programs. One such program is the Michigan Informatics (MI-INFO) website, which contains a variety of tutorials that deal with health information and computer skills. All told, the site contains nine tutorials which include titles like "Evidence Based Public Health", "Finding Health Statistics Online", and "Searching the Public Health Literature". Each of the tutorials features key concept overviews, exercises, and case studies. Near the bottom of the site, visitors can find a user manual for the tutorials, and a place where they can offer their own feedback. The site is rounded out by the "Other Resources" area, which contains links to other relevant sites, such as the Michigan Public Health Training Center and the Greater Midwest Region of the National Network of Libraries of Medicine.
Current methods for new materials development focus on either deeper fundamental-level studies or generation of large quantities of data. The data challenge in materials science is not only the volume of data being generated by many independent investigators, but its heterogeneity and also its complexity that must be transformed, analyzed, correlated and communicated. Materials informatics addresses these issues. Materials informatics is an emerging information-based field combining computational, statistical, and mathematical approaches with materials sciences for accelerating discovery and development of new materials. Within the informatic framework, the various different forms of information form a system architecture, an iterative cycle for transforming data into knowledge.
Ferris, Kim F.; Peurrung, Loni M.; Marder, James M.
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 of problem-solving and powerful case matching mechanisms), technical solutions are challenging. Finally, we discuss the major challenges for a technical solution: case record comprehensiveness, organization of information on similarity principles, development of pattern recognition and solving ethical issues. Summary Medical Informatics is an applied science that should be committed to advancing patient-centered medicine through individual knowledge processing. Case-based reasoning is the technical solution that enables a continuous individual knowledge processing and could be applied providing that challenges and ethical issues arising are addressed appropriately.
Pantazi, Stefan V; Arocha, Jose F; Moehr, Jochen R
Supervising learners communicate places faculty preceptors in a classic educational dilemma. What should a preceptor do when the learner is not communicating well and is not asking for help? What usually happens, in our experience, is that the preceptor decides at some point that they can't stand it anymore—then they interrupt the learner and takes over the conversation. Interrupting in this way, however, comes at the cost of deskilling the learner. Thus the authors have developed an alternative teaching strategy designed for communication tasks such as giving serious or bad news. In the strategy recommended here, the preceptor `sets up' the possibility that the preceptor may intervene in the encounter. If the preceptor does intervene, the preceptor explicitly hands the conversation back to the learner; and afterwards, debriefs the learner. This method is designed to decrease the risk to the patient while maximizing learning. It offers a way to teach communication skills more effectively in clinic using intentional goal setting with learners, careful observations, intervention when the conversation is not going well, and reflective feedback based on the learner's goals.
Back, Anthony L; Arnold, Robert M; Tulsky, James A; Baile, Walter F; Fryer-Edwards, Kelly
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. PMID:23823379
Pereira, Samáris Ramiro; Duarte, Jacy Marcondes; Bandiera-Paiva, Paulo
Nursing informatics actively supports nursing by providing standard language systems, databases, decision support, readily accessible research results, and technology assessments. Through normalized datasets spanning an entire enterprise or other large demographic, nursing informatics tools support improvement of healthcare by answering questions about patient outcomes and quality improvement on an enterprise scale, and by providing documentation for business process definition, business process engineering, and strategic planning. Nursing informatics tools provide a way for advanced practice nurses to examine their practice and the effect of their actions on patient outcomes. Analysis of patient outcomes may lead to initiatives for quality improvement. Supported by nursing informatics tools, successful advance practice nurses leverage their quality improvement initiatives against the enterprise strategic plan to gain leadership support and resources. PMID:12909796
National Informatics Centre (NIC), a project of the Government of India under the Department of Electronics, has been given the responsibility of creating appropriate information systems to facilitate the planning and decisionmaking process in the Ministr...
Informatics is the scientific discipline which studies the structure and properties (but not specific content) of scientific information and also the laws of scientific information activity, its theory, history, methodology and organization. The purpose o...
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 i...
This paper examines the value of using intelligent multimedia simulation for the teaching of nursing clinical decision-making skills. The possibilities of multimedia-based educational resources are examined and the rapid growth and questionable effectiveness of current multimedia computer-based learning applications for nursing students are discussed. The advantages and disadvantages of this technology and the problems developing intelligent agent-based systems are examined. A case study is presented which uses a modular design with an integrated intelligent agent and knowledge base. It is argued that by using this type of approach, the real value of intelligent CBL to provide individual formative advice to students in a simulated experience can be realized. PMID:11403585
Formal teaching in clinical pharmacology was never part of the curriculum at the American University of Beirut Faculty of Medicine. Based on feedback from students and on recommendations of academic bodies, we have introduced, since June 2008, twice-monthly "rational prescribing" sessions during the required internal medicine rotation in year 4 of medical school. All sessions were designed according to the innovative Team-based Learning format and concluded by having the students practice prescription writing and personal formulary development based on the World Health Organization criteria. Our 18-month experience showed that students were very satisfied with the course and the teaching approach, and that their performance on prescription writing and formulary development had improved. Although further studies are needed to explore the impact of team-based learning on additional performance measures, we recommend it as an effective alternative for teachingclinical pharmacology in medical schools. PMID:20671296
This presentation attempts to analyze the trends in Medical Informatics along half a century, in the European socio-political and technological development context. Based on the major characteristics which seem dominant in some periods, a staging is proposed, with a description of each period – the context, major ideas, views and events. A summary of major features of each period is also added. This paper has an original presentation of the evolution of major trends in medical informatics.
Objective: Clinical pharmacy services are improving in hospitals. For assessing the impact of these services, first it is important to exactly describe them by categorizing into types, severity, resolution, and accuracy. The objective of this study is to provide a detailed analysis of the clinical pharmacists’ services performed on in-patients in a teaching hospital during 28 months. Setting: Masih Daneshvari hospital, Tehran, Iran. Methods: This is a descriptive study. The authors retrospectively reviewed the notes of all services and entered them in a designed SPSS sheet. Documentation was carried out based on the “findings, assessment, resolution, and monitoring” method. The data were descriptively analyzed. Main outcome measure: Types, subtypes, severities, resolutions, and accuracies of services were defined, documented, and analyzed. Findings: In total 3152 records (2227 interventions and 925 visits with no intervention) were classified and analyzed in this study. Among all types of interventions, “improper medication use” (36.2%) was the most frequent intervention and among categories (subgroups) of “improper medication use,” “untreated indication” was the most frequent (23.7%). From the aspect of severity, 75.4% of interventions were estimated as of minor potential inconvenience to the patient (severity degree 1). Most interventions (78%) were finally recommended to the prescriber and 97.6% of interventions were considered accurate on further evaluation. Conclusion: Clinical pharmacists’ interventions are highly demanded in the hospitals. Based on the results of this study, conditions needing medication to prevent later complications in the course of therapy are sometimes ignored, which emphasizes the positive role of the clinical pharmacists’ involvements in clinical teams to improve outcome.
A central focus of the NCIP mission is the provision of a wide array of informatics resources — applications, data collections, analytical algorithms, standards, and infrastructure components, to name only the most obvious — needed to sustain the broad cancer-research and biomedical-informatics community.
The successful integration of technology in antimicrobial stewardship programs has made it possible for clinicians to function more efficiently. With government endorsement of electronic health records (EHRs), EHRs and clinical decision support systems (CDSSs) are being used as decision support tools to aid clinicians in efforts to improve antibiotic use. Likewise, medical applications (apps) have provided educational tools easily accessible to clinicians through their mobile devices. In this article, the impact that informatics and technology have had on promoting antibiotic stewardship is described, focusing on EHRs and CDSSs, apps, electronic resources, and social media. PMID:24857394
In-service teachers are often lack sufficient teaching experience (Block et al., 2010) that leads to being psychologically unprepared to confront many challenges in teaching. Providing ample experiences for Physical Education Teacher Education (PETE) students in a pedagogical setting parallel to that which they will one day teach (Kirk &…
The 1998 Scientific Symposium of the American College of Medical Informatics (ACMI) was devoted to developing visions for the future of health care and biomedicine and a strategic agenda for health and biomedical informatics in support of those visions. This symposium focus was prompted by the many major changes currently underway in health care delivery, education, and research, as well as in our health and biomedical enterprises, and by the constantly increasing role of information technology in both shaping and enabling these changes. The three audacious goals developed for 2008 are a virtual health care databank, a national health care knowledge base, and a personal clinical health record.
The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest.
Dealing with the continuum of malocclusions in general practice requires diagnostic skills that, according to the Council on Dental Education guidelines, should include an ability to evaluate the severity of malocclusions and to assess the degree of treatment difficulty. This level of diagnostic skills is predicated upon the ability to make a judgment on the basis of inherently ill-defined and insufficient data or, in other words, upon the ability to use rules and procedures of clinical inference. However, conventional methods of predoctoral orthodontic instruction appear to be unsuitable for transmitting these complex skills to dental students. For ten years, alternative instructional strategies involving guided discovery learning, repetitive practice in application of facts and principles to real-life problems, and eventually a prescriptive diagnostic model were employed at our institution. Both classroom instruction and evaluation were focused on attaining mastery in two narrowly specified domains: "Evaluating the Severity of Malocclusions" and "Assessing the Degree of Treatment Difficulty." The large proportion of items mastered by students and the high percent correct recorded on multiple-choice examinations suggest that these instructional methods may be effective for teachingclinical inference at the predoctoral level of dental education. PMID:3162919
Objectives With the objective of bringing clinical decision support systems to reality, this article reviews histopathological whole-slide imaging informatics methods, associated challenges, and future research opportunities. Target audience This review targets pathologists and informaticians who have a limited understanding of the key aspects of whole-slide image (WSI) analysis and/or a limited knowledge of state-of-the-art technologies and analysis methods. Scope First, we discuss the importance of imaging informatics in pathology and highlight the challenges posed by histopathological WSI. Next, we provide a thorough review of current methods for: quality control of histopathological images; feature extraction that captures image properties at the pixel, object, and semantic levels; predictive modeling that utilizes image features for diagnostic or prognostic applications; and data and information visualization that explores WSI for de novo discovery. In addition, we highlight future research directions and discuss the impact of large public repositories of histopathological data, such as the Cancer Genome Atlas, on the field of pathology informatics. Following the review, we present a case study to illustrate a clinical decision support system that begins with quality control and ends with predictive modeling for several cancer endpoints. Currently, state-of-the-art software tools only provide limited image processing capabilities instead of complete data analysis for clinical decision-making. We aim to inspire researchers to conduct more research in pathology imaging informatics so that clinical decision support can become a reality.
Kothari, Sonal; Phan, John H; Stokes, Todd H; Wang, May D
Informatics can be defined as the discipline of structuring, storing, accessing, and distributing information describing complex systems. In the fields of Bioinformatics and Geoinformatics, specific tools have been developed through wide community requirements analysis and consensus. In Geoinformatics, the GIS toolset is nearly universal. In Bioinformatics, tools such as BLAST and FASTA are commonly used. One of the key enablers of these science research and analysis systems is a nearly universal acceptance (hence, standardization) of the basic data unit in each field. In Bioinformatics, the gene sequence is the basic data unit. In GIS, the basic unit is gridded data consisting of points, vectors, and polygons. We believe that the time has come for a robust Space Science Informatics field of research, parallel to that of Bioinformatics in the fields of Biology and Medicine, and to that of Geoinformatics in the fields of Geography and Earth Science. In particular, we are investigating the specific case of Astroinformatics as a new paradigm for science research in Astronomy. Any Space Science Informatics discipline must include common methods and standards for spatio-temporal data, metadata, taxonomies, ontologies, data structures, data integration, data cleansing and preparation, data transmission and handling, and more. The need for informatics is driven and motivated by the flood of data coming now and the avalanche of data coming soon within all of our science disciplines. The two traditional approaches to science research (experiment and theory) are making room now for this third stream of research - informatics - which is data-driven and information-centric. We discuss the modalities of space science data that form the basis of informatics: raster (images), spectroscopic, time series, distribution functions, and catalogs. We then discuss specific concepts for Astroinformatics. Finally, we present our emerging view of how a field of Space Science Informatics could grow to stature as a stand-alone subdiscipline.
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 context of very large data-producing science projects, such as the petascale LSST (Large Synoptic Survey Telescope), and we describe how an X-informatics research approach is essential for data-intensive science frameworks, including sensor networks, virtual observatories, and volunteer (citizen) science.
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.
Li, Fuhai; Yin, Zheng; Jin, Guangxu; Zhao, Hong; Wong, Stephen T. C.
The development level of enterprises' informatization marks their competitive force. With the rapid growth of convention and exhibition in China, informatization construction becomes one of important approaches for enterprises engaged in convention and exhibition field to enhance their overall strength and competitiveness. The paper presents three countermeasures for informatization operation according to the characteristics of convention and exhibition activities. These
As in other areas of society, the Internet and the World Wide Web are becoming important topics in medical informatics. This is evident from the recent American Medical Informatics Association's 1996 Annual Fall Symposium, where the theme was “Beyond the Superhighway: Exploiting the Internet with Medical Informatics.” Of the over 330 papers and abstracts published in the Proceedings, one third
Informatics is the study of the application of information technology. The focus of studies within an Informatics program is on particular problem domain areas, including scientific domains like biology or chemistry, but also non-scientific domains like music, fine arts, or business. In this paper we describe our experience with the development of a capstone course for undergraduate Informatics students. In
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.
Requirements and approaches of Software Engineering education in the field of Medical Informatics are described with respect to the impact of (1) experiences characterizing the "software misery", (2) status and tendencies in software methodology, and (3) educational status and needs in computer science education influenced by the controversy "theoretical versus practical education". Special attention is directed toward the growing importance of analysis, design methods, and techniques in the professional spectrum of Medical Informatics, the relevance of general principles of systems engineering in health care, the potential of non-procedural programming paradigms, and the intersection of Artificial Intelligence and education. Realizations of and experiences with programs in the field of Software Engineering are reported with respect to special requirements in Medical Informatics. PMID:2695780
The complexity of the health care environment is increasing with the explosion of technology, coupled with the issues of patients' access, equity, time efficiency, and cost containment. Nursing education must focus on means that enable students to develop the processes of active learning, problem-solving, and critical thinking, in order to enable them to deal with the complexities. This study aims at identifying the nursing students' perceptions about the effectiveness of utilized teaching and learning strategies of clinical education, in improving students' knowledge, skills, and attitudes. A descriptive cross sectional study design was utilized using both qualitative and quantitative approaches. Data were collected from 74 students, using a questionnaire that was developed for the purpose of the study and analyzed using descriptive and non-parametric statistics. The findings revealed that demonstration was the most effective strategy for improving students' skills; reflection, for improving attitudes; and problem based learning and concept map for improving their knowledge. Students' responses to open-ended questions confirmed the effectiveness of these strategies in improving their learning outcomes. Recommendations have been provided based on the findings. PMID:21333417
Background: Antibiotic resistance is not only a problem for the individual patient; it also reduces the effectiveness of established treatment and has become a major threat to public health by increasing the complexity and cost of treatment and reducing the probability of a successful outcome. Aim: A prospective cross sectional study was carried out with the aim of identifying prescription pattern of antibiotics in a tertiary care teaching hospital in Northern India. Materials and Methods: A total of 300 prescriptions were collected, collated and analysed from the indoor patients of MG hospital, Jaipur, India from the department of Medicine, Surgery and Orthopaedics. The prescribing and dispensing details of antibiotics from each prescription were recorded in the tabular form as mentioned in Data Acquisition form. Comparison of antibiotic prescribing practices among all the three departments was made by using Percentage method. Results: Majority of prescriptions (51%) with single drug was prescribed in Medicine department, followed by 16% in surgery and only 2% in Orthopaedics. Prescriptions with 3 drugs were prescribed mostly in Orthopaedics (66%) followed by 46% in Surgery and 10% in Medicine. 51% prescriptions in Orthopaedics department were of Ceftriaxone+ Sulbactam+ Amikacin. Thirty four percent prescriptions in Medicine department were of Ceftriaxone. 18% prescriptions in Surgery department were of Ceftriaxone+ Sulbactam+ Tobramycin. Conclusion: This study clearly highlights the practice of Poly-Pharmacy and injudicious usage of antibiotics in hospital settings. The Government of India is planning to revise the antibiotic policy issued in 2011 and put a ban on over the counter availability of third generation antibiotics. General public awareness and sensitization of doctors and revision of clinical drug policy is the need of the hour to bring the changes at all possible level for the longterm and better clinical outcome in medical practice.
Background Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED). Methods/design We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. Discussion Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study would contribute to the development of implementation science and be employed by boards and executives governing other clinical settings to facilitate CG implementation.
The Informatics Visualization for Neuroimaging (INVIZIAN) framework allows one to graphically display image and meta-data information from sizeable collections of neuroimaging data as a whole using a dynamic and compelling user interface. Users can fluidly interact with an entire collection of cortical surfaces using only their mouse. In addition, users can cluster and group brains according in multiple ways for subsequent comparison using graphical data mining tools. In this article, we illustrate the utility of INVIZIAN for simultaneous exploration and mining a large collection of extracted cortical surface data arising in clinical neuroimaging studies of patients with Alzheimer's Disease, mild cognitive impairment, as well as healthy control subjects. Alzheimer's Disease is particularly interesting due to the wide-spread effects on cortical architecture and alterations of volume in specific brain areas associated with memory. We demonstrate INVIZIAN's ability to render multiple brain surfaces from multiple diagnostic groups of subjects, showcase the interactivity of the system, and showcase how INVIZIAN can be employed to generate hypotheses about the collection of data which would be suitable for direct access to the underlying raw data and subsequent formal statistical analysis. Specifically, we use INVIZIAN show how cortical thickness and hippocampal volume differences between group are evident even in the absence of more formal hypothesis testing. In the context of neurological diseases linked to brain aging such as AD, INVIZIAN provides a unique means for considering the entirety of whole brain datasets, look for interesting relationships among them, and thereby derive new ideas for further research and study. PMID:24203652
Van Horn, John Darrell; Bowman, Ian; Joshi, Shantanu H; Greer, Vaughan
Biological imaging is now a quantitative technique for probing cellular structure and dynamics and is increasingly used for cell-based screens. However, the bioinformatics tools required for hypothesis-driven analysis of digital images are still immature. We are developing the Open Microscopy Environment (OME) as an informatics solution for the storage and analysis of optical microscope image data. OME aims to automate image analysis, modeling, and mining of large sets of images and specifies a flexible data model, a relational database, and an XML-encoded file standard that is usable by potentially any software tool. With this design, OME provides a first step toward biological image informatics.
Jason Swedlow (University of Dundee;); Ilya Goldberg (National Institutes of Health;Laboratory of Genetics, National Institute on Aging); Erik Brauner (Harvard Medical School;Institute of Chemistry and Cell Biology); Peter K. Sorger (Harvard Medical School/Massachusetts Institute of Technology;)
Analysis of direct costs to teach a 10-week Introduction to Clinical Medicine course to 26 students in the spring of 1995 found that attending physicians worked a total of 736.5 hours, for a cost of $37,303; residents worked 314 hours, at a cost of $4,396; and miscellaneous costs totaled $2,019. The per-student cost was $1,681. (Author/MSE)
Learning to use the toilet is an important developmental step for a child's independence, health and dignity. It can be particularly difficult to teach continence skills to disabled children with aggressive or challenging behaviour. This study showed how Azrin & Foxx's (1971) basic toilet training procedure could be modified to teach a 13-year-old…
The Informatics Technology transfer process has specific characteristics which are additional to the general aspects of technology transfer problems. Current scientific and technical progress attributes a key role to technology, in its various fields, for...
Alcohol use and other drug use affect patient healthcare outcomes. This article describes a classroom-to-clinical approach teaching nursing students to utilize motivational interviewing techniques to support patient behavior change. Through the lens of a universal prevention method, nursing students learned about reward circuit activation leading to risky substance use and the difference between addiction and at-risk use. Specific assessment tools and motivational interviewing techniques were presented in the classroom. Students then applied their knowledge in simulation laboratories and clinical rotations. PMID:24743176
Kane, Irene; Mitchell, Ann M; Puskar, Kathryn R; Hagle, Holly; Talcott, Kimberly; Fioravanti, Marie; Droppa, Mandy; Luongo, Peter F; Lindsay, Dawn
Given the large-scale deployment of Electronic Health Records (EHR), secondary use of EHR data will be increasingly needed in all kinds of health services or clinical research. This paper reports some data quality issues we encountered in a survival analysis of pancreatic cancer patients. Using the clinical data warehouse at Columbia University Medical Center in the City of New York, we mined EHR data elements collected between 1999 and 2009 for a cohort of pancreatic cancer patients. Of the 3068 patients who had ICD-9-CM diagnoses for pancreatic cancer, only 1589 had corresponding disease documentation in pathology reports. Incompleteness was the leading data quality issue; many study variables had missing values to various degrees. Inaccuracy and inconsistency were the next common problems. In this paper, we present the manifestations of these data quality issues and discuss some strategies for using emerging informatics technologies to solve these problems.
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.
As one of the most important concerns in the training of library and informatics-experts, information provision requires a thorough knowledge of professional texts used in different fields. This is, however, due to the sheer number of publications appearing in various periodicals, which is a difficult goal to accomplish when making a thorough…
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.
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.
The Centre for Molecular and Biomolecular Informatics is the Dutch national centre for computational molecular sciences. The CMBI is strongly committed to a series of educational projects, ranging from high school to postgraduate courses and from local university student courses to international workshops.
The program, for development and methodologies, was a 3-year interdisciplinary effort to develop an interactive, integrated Internet Website named GEMINI (Geo-Engineering Modeling through Internet Informatics) that would build real-time geo-engineering reservoir models for the Internet using the latest technology in Web applications.
The human brain is the most complicated organ in the universe and a new frontier yet to be explored by an interdisciplinary approach. This paper attempts to develop logical and cognitive models of the brain by using cognitive informatics and formal methodologies. This paper adopts a memory-based approach to explore the brain and to demonstrate that memory is the foundation
A fundamental finding in computer science is that software, as an artifact of human creativity, is not constrained by the laws and principles discovered in the physical world. Thus, a natural question we have to ask is: What are the constraints that software obeys? This paper attempts to demonstrate that software obeys the laws of informatics, because software is a
In this article, we discussed the emerging informatics issues of high-throughput screening (HTS) using automated fluorescence microscopy technology, otherwise known as high-content screening (HCS) in the pharmaceutical industry. Optimal methods of scoring biomarkers and identifying candidate hits have been actively studied in academia and industry, with the exception of data modeling topics. To find candidate hits, we need to score
ABSTRACT Cognitive Informatics (CI) is a transdisciplinary enquiry of the internal information processing mechanisms and processes of the brain and natural intelligence shared by almost all science and engineering disciplines. This article presents an intensive review of the new field of CI. The structure of the theoretical framework of CI is described encompassing the Layered Reference Model of the Brain
Recent developments in medical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present formidable challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users. Since medical practice is a human endeavor, there is a need for bridging
This paper highlights potential benefits and more pressing social and legal problems facing Latin American nations in the area of informatics and small computers. Discussion covers potential uses (education, office applications, agriculture, national planning); role of central governments; implications for economic development; and transborder…
The program, for development and methodologies, was a 3-year interdisciplinary effort to develop an interactive, integrated Internet Website named GEMINI (Geo-Engineering Modeling through Internet Informatics) that would build real-time geo-engineering reservoir models for the Internet using the latest technology in Web applications.
Objectives 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 does not always mean that the program is of an international level. The International Medical Informatics Association (IMIA) has expertise in the field of education. The IMIA Recommendations on Education in Biomedical and Health Informatics guide curricula development. The goal of this article is to show that IMIA can also play the role of accreditation agency and to present the IMIA accreditation protocol and experiences obtained with it. Methods The accreditation procedure used in the Netherlands and Belgium was taken as a template for the design of the IMIA accreditation protocol. In a trial period of one and a half year the protocol is tested out on six health informatics programs. Results An accreditation protocol was designed. For judging the curriculum of a program the IMIA Recommendations are used. The institution has to write a self-assessment report and a site visit committee visits the program and judges its quality, supported by the self-assessment report and discussions with all stakeholders of the program. Conclusions After having visited three programs it appears that the IMIA accreditation procedure works well. Only a few changes had to be introduced. Writing the self-assessment report already appears to be beneficial for the management of the program to obtain a better insight in the quality of their program.
Because healthcare delivery increasingly mandates data-driven decision-making, it is imperative that informatics knowledge and skills are integrated into nursing education curricula for all future nurse clinicians and educators. A national online survey of deans/directors of 266 baccalaureate and higher nursing education programs in the U.S. identified perceived informatics competencies and knowledge of under-graduate and graduate nursing students; determined the preparedness of nurse faculty to teach and use informatics tools; and elicited perceptions of informatics requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of the programs reported requiring word processing and email skills upon entry into the nursing major. The use of standardized languages and the nurse's role in the life cycle of an information system were the least visible informatics content at all levels. Half of program faculty, rated as "novice" or "advanced beginners", are teaching information literacy skills. Findings have major implications for nurse educators, staff developers, and program administrators who are planning faculty/staff development opportunities and designing nursing education curricula that prepare nurses for professional practice. PMID:15360943
McNeil, Barbara J; Elfrink, Victoria L; Pierce, Susan T
Objectives This article seeks to describe the current state of informatics supported collaborative care and to point out areas of future research in this highly interdisciplinary field. Methods In this article, person-centered collaborative care is seen as a concept addressing both the provision of care over organizational borders between health and social care, and within care teams as well as the changed patient/client-care provider relationship characterized by increased patient/client involvement. Results From a health systems perspective, there are several attempts to describe the conceptual and theoretical basis for collaborative care indicating that agreement on core concepts and terminology is difficult. From an informatics perspective, focus is on standardization of clinical content models and terminology to achieve interoperability of information technology systems and to support standardized care pathways. Few examples look into how ad-hoc collaborative care processes can be supported using information technology and informatics standards. Nevertheless, promising examples do exist showing that integrational Information Communication Technology services can be supportive for collaborative care developments. However, the current landscape consists of many fragmented, often technology-driven eHealth solutions targeting specific diagnostic groups in geographically and/or organizationally restricted settings. Conclusions A systematic approach incorporating organizational, clinical, informatics and social science knowledge is needed to perform further research in areas such as virtual team partnerships, new paradigms of care delivery, data and knowledge management as well as its secure sharing. Also organizational and legal aspects need to be further researched in order to facilitate the coordinated provision of health and social care to citizens including self-management, utilizing informatics support in a societal context.
Health information technology is revolutionizing the way we interact with health-related data. One example of this can be seen in the rising adoption rates of electronic health records by healthcare providers. Nursing plays a vital role in electronic health record adoption, not only because of their numbers but also their intimate understanding of workflow. The success of an electronic health record also relies on how usable the software is for clinicians, and a thorough usability evaluation is needed before implementing a system within an organization. Not all nurses have the knowledge and skills to perform extensive usability testing; therefore, the informatics nurse specialist plays a critical role in the process. This article will discuss core usability principles, provide a framework for applying these concepts, and explore the role of the informatics nurse specialist in electronic health record evaluation. Health information technology is fundamentally changing the clinical practice environment, and many nurses are seeking leadership positions in the field of informatics. As technology and software become more sophisticated, usability principles must be used under theguidance of the informatics nurse specialist to provide a relevant, robust, and well-designed electronic health record to address the needs of the busy clinician. PMID:24473121
Objective Multi-disciplinary and multi-site biomedical research programs frequently require infrastructures capable of enabling the collection, management, analysis, and dissemination of heterogeneous, multi-dimensional, and distributed data and knowledge collections spanning organizational boundaries. We report on the design and initial deployment of an extensible biomedical informatics platform that is intended to address such requirements. Methods A common approach to distributed data, information, and knowledge management needs in the healthcare and life science settings is the deployment and use of a service-oriented architecture (SOA). Such SOA technologies provide for strongly-typed, semantically annotated, and stateful data and analytical services that can be combined into data and knowledge integration and analysis “pipelines.” Using this overall design pattern, we have implemented and evaluated an extensible SOA platform for clinical and translational science applications known as the Translational Research Informatics and Data-management grid (TRIAD). TRIAD is a derivative and extension of the caGrid middleware and has an emphasis on supporting agile “working interoperability” between data, information, and knowledge resources. Results Based upon initial verification and validation studies conducted in the context of a collection of driving clinical and translational research problems, we have been able to demonstrate that TRIAD achieves agile “working interoperability” between distributed data and knowledge sources. Conclusion Informed by our initial verification and validation studies, we believe TRIAD provides an example instance of a lightweight and readily adoptable approach to the use of SOA technologies in the clinical and translational research setting. Furthermore, our initial use cases illustrate the importance and efficacy of enabling “working interoperability” in heterogeneous biomedical environments.
Payne, P.; Ervin, D.; Dhaval, R.; Borlawsky, T.; Lai, A.
The V. N. Vinogradov Faculty Therapy Clinic of the Imperial Moscow University (IMU) (then Moscow State University--I. M. Sechenov Moscow Medical Academy) was opened under this name in 1846 simultaneously with the Surgery Clinic on Rozhdestvenka Street. The paper shows the continuity of the idea for bedside clinicalteaching, whose need was clearly realized just by S. G. Zybelin and which was first done in practice by his follower and the first Director of the Clinical Institute, IMU, F. G. Politkovsky, as well as that of specific forms of implementing of this idea. It is shown that just early internal medicine teaching provided the principles that were stated by M. Ya. Mudrov and that subsequently formed the basis of a course taught at the Department of Faculty Clinic. The original teaching of a theoretical course without a clinic one at the Department of Particular Pathology and Therapy, which was stipulated by the 1835 Charter, gradually lost its importance as clinicalteaching was formed. The succession of the Clinical Institute and the Faculty Clinic was also shown in the staff the director of the newly-opened Clinic and Therapy Department Professor was A. I. Over, M. Ya. Mudrov's favorite disciple and the last Director of the Clinical Institute; the adjuvant teacher at the Therapeutic Department of the Clinical Institute was K. Ya. Mlodzeyevsky. This all permits the V. N. Vinogradov Faculty Therapy Clinic to be regarded a competent descendant of the first clinical institutes. In conclusion, there is a clinical analysis of division of an internal medicine course into faculty and hospital courses at the present stage and prospects for teaching therapy are discussed. PMID:20364704
The Health Sciences Library and the Department of Health Informatics & Information Management at the University of Tennessee Health Science Center in Memphis piloted an embedded librarian project in summer 2012. The value and effectiveness of the pilot project was evaluated by analyzing the content of e-mail questions received from the students and the students' answers to the pre- and post-class surveys. The project received positive feedback from the students and course faculty. Librarians collaborating with teaching faculty and interacting one-on-one with students in health information-intensive courses proved to be helpful for student learning. PMID:24528264
The rapid expansion of computer use for various nursing activities has made computer technology an important part of the curriculum in many schools of nursing across the world. Computer technology has become an alternative tool for teaching practice skills to students in a variety of educational settings and disciplines. Information technology (IT) is not yet well recognized in the Lebanese nursing curricula. This article traces the events of planning, developing, integrating, and evaluating nursing informatics on the Bachelor of Science in Nursing (BSN) Program of the School of Nursing (SON), at The American University of Beirut (AUB), Lebanon. PMID:11016103
Objectives To evaluate an instructional model for teachingclinically relevant medicinal chemistry. Methods An instructional model that uses Bloom's cognitive and Krathwohl's affective taxonomy, published and tested concepts in teaching medicinal chemistry, and active learning strategies, was introduced in the medicinal chemistry courses for second-professional year (P2) doctor of pharmacy (PharmD) students (campus and distance) in the 2005-2006 academic year. Student learning and the overall effectiveness of the instructional model were assessed. Student performance after introducing the instructional model was compared to that in prior years. Results Student performance on course examinations improved compared to previous years. Students expressed overall enthusiasm about the course and better understood the value of medicinal chemistry to clinical practice. Conclusion The explicit integration of the cognitive and affective learning objectives improved student performance, student ability to apply medicinal chemistry to clinical practice, and student attitude towards the discipline. Testing this instructional model provided validation to this theoretical framework. The model is effective for both our campus and distance-students. This instructional model may also have broad-based applications to other science courses.
There are three grand challenges for medical informatics policy: (1) What is it? (2) What should it be? (3) How can we influence its development? To address these challenges requires: (1) an historical analysis of medical informatics policies in a representative sample of countries. This should include an account of major events, the roles of technology, individuals, culture and social settings. Pioneers have been led by visions of what medical informatics should achieve. The role of these visions and the reactions to unmet expectations thus also need to be analysed; (2) a generally applicable medical informatics policy that places the needs of its stakeholders and clients first. Top priorities are to support quality health care delivery and quality management of health care facilities; (3) an explanation of how policies in medical informatics are created and implemented together with a strategy to guide medical informatics professionals in their lobbying efforts. PMID:10805010
Improving healthcare quality while simultaneously reducing cost has become a high priority of healthcare reform. Informatics is crucial in tackling this challenge. The American Recovery and Reinvestment Act of 2009 mandates adaptation and “meaningful use (MU)” of health information technology. In this review, we will highlight several areas in which informatics can make significant contributions, with a focus on radiology. We also discuss informatics related to the increasing imperatives of state and local regulations (such as radiation dose tracking) and quality initiatives.
Based on the studies of existing informatization maturity model at home and abroad, the paper puts forward a new enterprise\\u000a Informatization Maturity Model. The authors collected the opinions of fifteen well-known Chinese informatization experts about\\u000a the model by Delphi method. Through statistical analysis, it can be found that the extent of the experts’ acceptance is very\\u000a high. According to the
The computer-based PlanAlyzer program was designed to teachclinical diagnosis to medical students, taking into account several characteristics common to the clinical problem solver: limited capacity for short-term memory; use of heuristic strategies; sequential information seeking; and problem conceptualization. Six years of development and…
Background The number of households in the United States that are not proficient in the English language is growing and presenting a challenge to the health care system. Over nineteen percent of the US population speak a language other than English in the home. This increase in language discordance generates a greater need to find and implement accommodations in the clinical setting to insure accurate and efficient diagnosis and treatment as well as provide for patient safety. Aim: The purpose of this study is to determine the percentage of patients accessing the chiropractic college teachingclinics who are not proficient in the English language and to what extent the colleges provide accommodations for that language disparity. Methods The clinic directors and deans of the Association of Chiropractic Colleges were surveyed via an on-line survey engine. The survey queried the percentage of the patient population that is not English language proficient, the accommodations the college currently has in place, if the college has a language specific consent to treat document and if the college has a written policy concerning patients without English proficiency. Results Fifty percent of the contacted chiropractic colleges responded to the survey. In the respondent college clinics 16.5% of the patient population is not proficient in English, with over 75% speaking Spanish. All but one of the respondents provide some level of accommodation for the language non-concordance. Forty five percent of the responding colleges employ a language specific consent to treat form. The implementation of accommodations and the use of a language specific consent to treat form is more prevalent at colleges with a higher percentage of non-English speaking patients. Conclusions The percentage of patients with limited English proficiency accessing services at the teachingclinics of the chiropractic colleges mirrors the numbers in the general population. There is a wide disparity in the accommodations that the individual colleges make to address this language discordance. There is a need to further develop accurate and meaningful accommodations to address language disparity in the chiropractic teachingclinics.
... 2003 NSF Speakers to Keynote Symposium on Intelligence and Security Informatics Like researchers in ... enforcement, forensic analysis and intelligence communities face significant information overload as ...
An inexpensive computer graphics systems (Commodore PET), used as a video aid for teaching students advanced case analysis, is described. The course provides students with the analytical tools for evaluating with graphical and statistical techniques and treating with lenses, prisms, and orthoptics various anomalies of binocular vision. (MLW)
A study is reported that examined whether the status of preceptors was related to the rating of their teaching ability in a history-taking course by first-year medical students and whether the students' performances were affected by preceptor status. (MLW)
Purpose: There is a paucity of evaluation forms specifically developed and validated for outpatient settings. The purpose of this study was to develop and validate an instrument specifically for evaluating outpatient teaching, to provide reliable and valid ratings for individual and group feedback to faculty, and to identify outstanding teachers…
Zuberi, Rukhsana W.; Bordage, Georges; Norman, Geoffrey R.
In preparing healthcare professionals to work in the field of informatics, there are many online programs of study. These programs of students include a variety of educational tools. This poster describes the experiences of four student located across the globe learning how to work as a collaborative team. The team used Second Life as a platform to participate in a system life cycle course. The benefits and challenges of the Virtual Clinic environment are highlighted.
In preparing healthcare professionals to work in the field of informatics, there are many online programs of study. These programs of students include a variety of educational tools. This poster describes the experiences of four student located across the globe learning how to work as a collaborative team. The team used Second Life as a platform to participate in a system life cycle course. The benefits and challenges of the Virtual Clinic environment are highlighted. PMID:24199062
The epilepsy community increasingly recognizes the need for a modern classification system that can also be easily integrated with effective informatics tools. The 2010 reports by the United States President's Council of Advisors on Science and Technology (PCAST) identified informatics as a critical resource to improve quality of patient care, drive clinical research, and reduce the cost of health services. An effective informatics infrastructure for epilepsy, which is underpinned by a formal knowledge model or ontology, can leverage an ever increasing amount of multimodal data to improve (1) clinical decision support, (2) access to information for patients and their families, (3) easier data sharing, and (4) accelerate secondary use of clinical data. Modeling the recommendations of the International League Against Epilepsy (ILAE) classification system in the form of an epilepsy domain ontology is essential for consistent use of terminology in a variety of applications, including electronic health records systems and clinical applications. In this review, we discuss the data management issues in epilepsy and explore the benefits of an ontology-driven informatics infrastructure and its role in adoption of a "data-driven" paradigm in epilepsy research. PMID:23647220
Sahoo, Satya S; Zhang, Guo-Qiang; Lhatoo, Samden D
Healthcare faculty members have come to depend on the advantages of teaching with clinical simulation, but not all faculty are competent in their ability to manage students during the simulation experience. This federally funded proposal provided the opportunity for nursing faculty to participate in a synchronous learning event using the virtual reality world of Second Life (SL). Based on competencies, faculty participants were guided through the simulation process by a "Master Teacher." Participants then became the teacher and chose the settings, objectives, and clinical data to manage their own simulation using avatar role assignments. Feedback populated the participant informatics dashboard, so that progress towards their competencies was recorded. Another unique informatics application was the use of the Synthetic Derivative project to use de-identified patient data to promote better clinical realism. Additional evaluation activities regarding content, appropriate use of the technology, and design features were assessed. The development of the SL environment for this educational study provides the setting in which to pilot test the provision of actual clinical care that does not require "hands-on" interventions. PMID:20841760
Purpose: To provide the types, frequency and clinical information on common cranial nerve palsies seen at the Eye Clinic at the University of Port Harcourt Teaching Hospital. Materials and Methods: A chart review was performed of patients who presented with cranial nerve palsy at the Eye Clinic over a 3-year period (January 2009-December 2011). Data were collected on age, sex, type of cranial nerve palsy, a history of systemic disease such as diabetes mellitus (DM), hypertension and cerebrovascular disease. Exclusion criteria included medical charts with incomplete data. Data was analyzed using Epi-info Version 6.04D. Statistical significance was indicated by P < 0.05. Results: Twenty-four patients had cranial nerve palsies. There were 11 males and 13 females with a mean age of 34.50 ± 18.41 years. Four patients (26.6%) had exotropia while three patients (20%) had esotropia. Complete ophthalmoplegia was noted in two patients (13.3%). The 3rd and 6th cranial nerves were affected in seven patients each (29.2%) and five patients (20.8%) had 7th cranial nerve palsy. Approximately 38% of patients with cranial nerve palsies had systemic disorders (16.7% systemic hypertension; 12.5% DM). The relationship between cranial nerve palsy and systemic disorder was statistically significant (P < 0.01). Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6th cranial nerve palsy.
Pedro-Egbe, Chinyere Nnenne; Fiebai, Bassey; Awoyesuku, Elizabeth Akon
Purpose: There is a paucity of evaluation forms specifically developed and validated for outpatient settings. The purpose of this\\u000a study was to develop and validate an instrument specifically for evaluating outpatient teaching, to provide reliable and valid\\u000a ratings for individual and group feedback to faculty, and to identify outstanding teachers in that setting. Method: By literature reviews and pilot studies
Rukhsana W. Zuberi; Georges Bordage; Geoffrey R. Norman
The First TeachingClinic in Clinical Pharmacology, sponsored by the American College of Clinical Pharmacology in September 1992, was designed for the preparation and development of new clinical pharmacology problem-solving (CPPS) units. CPPS units are case histories that illustrate pertinent principles in clinical pharmacology. Each unit consists of the following sections: introduction, learning objectives, pretest, four clinical pharmacology scenarios, posttest,
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 will be critical to assuring their success as leaders in the era of big data and personalized medicine.
Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T.; Becich, Michael J.
Background Dedicated out-patient preanaesthetic clinics are relatively recent phenomenon and information is sparse from developing world. This study attempted to evaluate the utilization of adult and paediatric preanaesthetic clinics and its impact on the cancellations of surgery in Trinidad. Methods All patients scheduled to have elective surgery during the period of twelve weeks were enrolled for prospective collection of data including demographics, the admitting diagnoses, surgical procedure, category of surgery and specialty, and the patients' attendance to preanaesthetic clinics. Cancellations on the day of surgery along with reasons were recorded. The difference between patients who attended and did not attend the clinic was analysed. Results Of 424 patients scheduled for procedures during the study period, 213 were adults and 211 were children. Overall 39% of adults and 46% of the children scheduled for surgery had previously attended the preanaesthetic clinic. Among adults, general surgery patients were the largest majority to attend the preanaesthetic clinic. The paediatric preanaesthetic clinic was mostly utilized by paediatric general surgery. Overall 30% of procedures in adults and 26% of those in children were cancelled. There was a statistically significant difference in cancellations between patients who attended and did not attend the preanaesthetic clinic (p = 0.004). There was a 52% more chance of the procedure getting cancelled if the patient did not attend the clinic. Conclusion The study highlights the inadequate use of the preanaesthetic clinics and the impact of the clinics on last-minute cancellations.
Huge political, economical and social changes have occurred in Russia to the current moment. These changes led to restructuring of Russian healthcare as a whole and caused new demands on healthcare informatics. The state priority program of informatics of Russian healthcare has been created by the Ministry of Health in order to respond to the new tasks. During the last
In 2008, 11 new fellows were elected to the American College of Medical Informatics, and were inducted into the College at a ceremony held in conjunction with the American Medical Informatics Association conference in Washington, DC on Nov 9, 2008. A brief synopsis of the background and accomplishments of each of the new fellows is provided here, in alphabetical order.
Background: 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. Methods and Results: 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. Conclusions: 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.
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.
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.
Lipid mediator informatics is an emerging area denoted to the identification of bioactive lipid mediators (LMs) and their biosynthetic profiles and pathways. LM informatics and proteomics applied to inflammation, systems tissues research provides a powerful means of uncovering key biomarkers for novel processes in health and disease. By incorporating them with system biology analysis, we review here our initial steps
Yan Lu; Song Hong; Katherine Gotlinger; Charles N. Serhan
Abstract The Collaboratory for Multi - scale Chemical Science (CMCS) is developing a powerful informatics - based approach to synthesizing multi - scale information to support a systems - based research approach and is applying it in support of combustion research An open source multi - scale informatics toolkit is being developed that addresses a number of issues core to
James D. Myers; Thomas C. Allison; Sandra Bittner; Brett T. Didier; Michael Frenklach; William H. Green Jr.; Yen-ling Ho; John C. Hewson; Wendy S. Koegler; Carina S. Lansing; David Leahy; Michael Lee; Renata Mccoy; Michael Minkoff; Sandeep Nijsure; Gregor Von Laszewski; David W. Montoya; Carmen M. Pancerella; Reinhardt Pinzon; William Pitz; Larry A. Rahn; Branko Ruscic; Karen L. Schuchardt; Eric G. Stephan; Albert F. Wagner; Theresa L. Windus; Christine L. Yang
Background: Tobacco-attributable mortality in India is estimated to be at least 10%. Tobacco cessation is more likely to avert millions of deaths before 2050 than prevention of tobacco use initiation. Objective: To describe the clinico-epidemiological profile of attendees of a tobacco cessation clinic in a teaching hospital in Bangalore city. Materials and Methods: A descriptive study of 189 attendees seen over 2 years in the Tobacco Cessation Clinic of a tertiary-care teaching hospital in Bangalore, with information on socio demographic characteristics, tobacco-use details, nicotine dependence, family/medical history, past quit attempts, baseline stage-of-change, and treatment initiated. Results: Only 5% were ‘walk-in’ patients; 98% of attendees were smokers; 97% were males. The mean (±SD) age of attendees was 48.0 (±14.0) years. Most participants were married (88%), and predominantly urban (69%). About 62% had completed at least 8 years of schooling. Two-thirds of smokers reported high levels of nicotine dependence (Fagerström score >5/10). About 43% of patients had attempted quitting earlier. Four-fifths (79%) of tobacco-users reported a family member using tobacco. Commonly documented comorbidities included: Chronic respiratory disease (44%), hypertension (23%), diabetes (12%), tuberculosis (9%), myocardial infarction (2%), stroke (1%), sexual dysfunction (1%) and cancer (0.5%). About 52% reported concomitant alcohol use. At baseline, patients’ motivational stage was: Precontemplation (14%), contemplation (48%), preparation/action (37%) and maintenance (1%). Treatment modalities started were: Counseling alone (41%), nicotine replacement therapy alone (NRT) (34%), medication alone (13%), and NRT+medication (12%). Conclusions: This is the first study of the baseline profile of patients attending a tobacco cessation clinic located within a chest medicine department in India. Important determinants of outcome have been captured for follow-up and prospective documentation of outcomes.
The National Library of Medicine (NLM) funds training programs in medical informatics and plans to significantly increase the number of program sites in the future. The authors surveyed all NLM-funded trainees at the nine sites supported in the spring of 1988 to determine their backgrounds, current research interests, and career plans. Forty-three fellows were identified, of whom 39 returned a mailed questionnaire. All but four were physicians (89.7%), 82.1% had at least one year of postdoctoral clinical training, and 61.5% had completed a residency. Seventy-one percent of those completing residency had done so in internal medicine. The most common areas of current research were decision support/decision analysis, knowledge representation, and artificial intelligence. The overwhelming majority of the fellows planned to seek positions in a medical school on completion of their fellowships, and most preferred affiliation with a department of medical informatics or medicine. PMID:2034071
We introduce the Applied Health Informatics Bootcamp. This is an intense, interactive on-site program, augmented by approximately 80 hours of online material. The Bootcamp is intended to introduce those with little or no knowledge of Health Informatics (HI) to the nature, key concepts, and applications of this discipline to addressing challenges in the health field. The focus of the program is on Applied Health Informatics (AHI), the discipline addressing the preparation for, and the procurement, deployment, implementation, resourcing, effective usage, and evaluation of informatics solutions in the health system. Although no program of this duration can cover all topics, we target the high profile areas of Health Informatics and point the participants in the direction of broader and deeper explorations.
Purpose 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. Methods 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. Results 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. Conclusion 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.
There were three schools of medicine in Mexico at the beginning of the Independence time where the doctors and surgeons could learn. In the Faculty of Medicine of the University of Mexico, the most ancient and traditional, the humoral model balance based on medieval knowledge and scholastic method was the rule. At the end of the XVIII century, the Nueva España enrollment in the Illustration movement, this led to an opening period and development of the scientific world. Botany was incorporated to curriculum in medicine school and the students could through the courses of the Surgery College approached to new medical theories and other teaching model without restrictions. PMID:20929619
It is argued that the progress of information processing and information technology changes our societies. Examples are given that there is a significant economic relevance of information technology for medicine and healthcare and for the quality of healthcare as well. In order to adequately pursue the goal of 'Transforming healthcare through innovative use of information technology for the 21st century' (the topic of the 6th International Conference on Health and Medical Informatics Education and of this special issue of the International Journal of Medical Informatics), health professionals are needed who are well-educated in health informatics or medical informatics, respectively. Raising the scope and the quality of education in the field of health and medical informatics would help to raise the quality and efficiency of healthcare. In this context the International Medical Informatics Association (IMIA) and its working group 1 (WG1) on Health and Medical Informatics Education can make a contribution by disseminating information and by elaborating recommendations on courses and programs in health and medical informatics. For this purpose IMIA WG1 has established a WWW site (http://www.imia.org/wg1) with information on health and medical informatics programs and courses. All teachers and institutions are encouraged to submit information about courses and programs offered and to set pointers to their own WWW sites. In addition, a mailing list was installed to facilitate communication between all persons involved in health and medical informatics education. For subscription, a message has to be sent to 'firstname.lastname@example.org'. The body of the message should read 'SUBSCRIBE IMIA-WG1'. PMID:9726488
Background: Regular student evaluations at the Technical University Munich indicate the necessity for improvement of the clinical examination course. The aim of this study was to examine if targeted measures to restructure and improve a clinical examination course session lead to a higher level of student satisfaction as well as better self-assessment of the acquired techniques of clinical examination. Methods: At three medical departments of the Technical University Munich during the 2010 summer semester, the quantitative results of 49 student evaluations (ratings 1-6, German scholastic grading system) of the clinical examination course were compared for a course before and a course after structured measures for improvement. These measures included structured teaching instructions, handouts and additional material from the Internet. Results: 47 evaluations were completed before and 34 evaluations after the measures for improvement. The measures named above led to a significant improvement of the evaluative ratings in the following areas: short introduction to the topic of each clinical examination course (from 2.4±1.2 to1.7±1.0; p=0.0020) and to basic measures of hygiene (from 3.8±1.9 to 2.5±1.8; p=0.004), structured demonstration of each clinical examination step (from 2.9±1.5 to 1.8±1.0; p=0.001), sufficient practice of each clinical examination step (from 3.1±1.8 to 2.2±1.4; p=0.030) structured feedback on each clinical examination step (from 3.0±1.4 to 2.3±1.0; p=0.0070), use of handouts (from 5.2±1.4 to 1.8±1.4; p<0.001), advice on additional learning material (from 5.0±1.4 to 3.4±2.0; p<0.001), general learning experience (from 2.4±0.9 to 1.9±0.8; p=0.017), and self-assessment of the acquired techniques of clinical examination (from 3.5±1.3 to 2.5±1.1; p<0.01). Conclusion: Structured changes led to significant improvement in the evaluative ratings of a clinical examination course session concerning preparation of the tutors, structure of the course, and confidence in performing physical examinations.
Objectives The study aimed to review the prescribing knowledge of first-year postgraduate doctors in a medical college in India, using the principles of good prescribing, to suggest strategies to improve rational prescribing, and to recommend what curriculum planners can do to accomplish this objective. Methods Fifty first-year postgraduate doctors were asked to fill in a structured questionnaire that sought information regarding their undergraduate training in clinical pharmacology and therapeutics, prescribing habits, and commonly consulted drug information sources. Also, the questionnaire assessed any perceived deficiencies in their undergraduate clinical pharmacology teaching and sought feedback regarding improvement in the teaching. Results Eighty-eight percent of residents said that they were taught prescription writing in undergraduate pharmacology teaching; 48% of residents rated their prescribing knowledge at graduation as average, 28% good, 4% excellent, 14% poor, and 4% very poor; 58% felt that their undergraduate training did not prepare them to prescribe safely, and 62% felt that their training did not prepare them to prescribe rationally. Fifty-eight percent of residents felt that they had some specific problems with writing a prescription during their internship training, while 92% thought that undergraduate teaching should be improved. Their suggestions for improving teaching methods were recorded. Conclusions This study concludes that efforts are needed to develop a curriculum that encompasses important aspects of clinical pharmacology and therapeutics along with incorporation of the useful suggestions given by the residents.
The course "Management of Fluid and Electrolyte Disorders" is an applied physiology course taught using lectures and paper-based cases. The course approaches fluid therapy from both basic science and clinical perspectives. While paper cases provide a basis for application of basic science concepts, they lack key components of genuine clinical…
Rawson, Richard E.; Dispensa, Marilyn E.; Goldstein, Richard E.; Nicholson, Kimberley W.; Vidal, Noni Korf
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; implement, monitor, and enforce safe food systems. Currently, standardized technologies have not been implemented to efficiently establish "near-in-time" or "just-in-time" electronic awareness to enhance early detection of public health threats regarding food safety. To address the potential impact of collection, organization and analyses of data in a foodservice operation, a wireless food safety informatics (FSI) tool was pilot tested at a university student foodservice center. The technological platform in this test collected data every six minutes over a 24 hour period, across two primary domains: time and temperatures within freezers, walk-in refrigerators and dry storage areas. The results of this pilot study briefly illustrated how technology can assist in food safety surveillance and monitoring by efficiently detecting food safety abnormalities related to time and temperatures so that efficient and proper response in "real time" can be addressed to prevent potential foodborne illnesses. PMID:23569605
Tucker, Cynthia A; Larkin, Stephanie N; Akers, Timothy A
Ocean researchers must work across disciplines to provide clear and understandable assessments of the state of the ocean. With advances in technology, not only in observation, but also communication and computer science, we are in a new era where we can answer questions at the time and space scales that are relevant to our state of the art research needs. This presentation will address three areas of the informatics of the end-to-end process: sensors and information extraction in the sensing environment; using diverse data for understanding selected ocean processes; and supporting open data initiatives. A National Science Foundation funded Ocean Observations Research Coordination Network (RCN) is addressing these areas from the perspective of improving interdisciplinary research. The work includes an assessment of Open Data Access with a paper in preparation. Interoperability and sensors is a new activity that couples with European projects, COOPEUS and NeXOS, in looking at sensors and related information systems for a new generation of measurement capability. A working group on synergies of in-situ and satellite remote sensing is analyzing approaches for more effective use of these measurements. This presentation will examine the steps forward for data exchange and for addressing gaps in communication and informatics.
Pearlman, Jay; Delory, Eric; Pissierssens, Peter; Raymond, Lisa; Simpson, Pauline; Waldmann, Christoph; Williams 3rd, Albert; Yoder, Jim
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. Method: 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. Results: 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.
Objective: To compare simulator-based teaching with traditional instruction among clinical medical students. Methods: Randomized controlled trial with written pre-post testing. Third-year medical students (n = 38) received either a myocardial infarction (MI) simulation followed by a reactive airways disease (RAD) lecture, or a RAD simulation…
Gordon, James A.; Shaffer, David W.; Raemer, Daniel B.; Pawlowski, John; Hurford, William E.; Cooper, Jeffrey B.
Advances in informatics, particularly the implementation of electronic health records (EHR), in dentistry have facilitated the exchange of information. The majority of dental schools in North America use the same EHR system, providing an unprecedented opportunity to integrate these data into a repository that can be used for oral health education and research. In 2007, fourteen dental schools formed the Consortium for Oral Health-Related Informatics (COHRI). Since its inception, COHRI has established structural and operational processes, governance and bylaws, and a number of work groups organized in two divisions: one focused on research (data standardization, integration, and analysis), and one focused on education (performance evaluations, virtual standardized patients, and objective structured clinical examinations). To date, COHRI (which now includes twenty dental schools) has been successful in developing a data repository, pilot-testing data integration, and sharing EHR enhancements among the group. This consortium has collaborated on standardizing medical and dental histories, developing diagnostic terminology, and promoting the utilization of informatics in dental education. The consortium is in the process of assembling the largest oral health database ever created. This will be an invaluable resource for research and provide a foundation for evidence-based dentistry for years to come.
Stark, Paul C.; Kalenderian, Elsbeth; White, Joel M.; Walji, Muhammad F.; Stewart, Denice C.L.; Kimmes, Nicole; Meng, Thomas R.; Willis, George P.; DeVries, Ted; Chapman, Robert J.
Advances in health information technology and biomedical informatics have laid the groundwork for significant improvements in healthcare and biomedical research. For instance, Electronic Health Records can help improve the delivery of evidence-based care, enhance quality, and contribute to discoveries and evidence generation. Despite this promise, there are many challenges to achieving the vision and missions of our healthcare and research enterprises. Given the challenges inherent in doing so, institutions are increasingly moving to establish dedicated leadership and governance models charged with designing, deploying and leveraging various information resources to advance research and advanced care activities at AHCs. Some institutions have even created a new leadership position to oversee such activities, such as the Chief Research Information Officer. This panel will include research informatics leaders discussing their experiences from the proverbial trenches as they work to operationalize such cross-mission governance models. Panelists will start by providing an overview their respective positions and environments, discuss their experiences, and share lessons learned through their work at the intersection of clinical and translational research informatics and Health IT.
Embi, Peter J.; Tachinardi, Umberto; Lussier, Yves; Starren, Justin; Silverstein, Jonathan
The Columbia University Informatics for Diabetes Education and Telemedicine IDEATel) project is a four-year demonstration project funded by the Centers for Medicare and Medicaid Services with the overall goal of evaluating the feasibility, acceptability, effectiveness, and cost-effectiveness of telemedicine. The focal point of the intervention is the home telemedicine unit (HTU), which provides four functions: synchronous videoconferencing over standard telephone lines, electronic transmission for fingerstick glucose and blood pressure readings, secure Web-based messaging and clinical data review, and access to Web-based educational materials. The HTU must be usable by elderly patients with no prior computer experience. Providing these functions through the HTU requires tight integration of six components: the HTU itself, case management software, a clinical information system, Web-based educational material, data security, and networking and telecommunications. These six components were integrated through a variety of interfaces, providing a system that works well for patients and providers. With more than 400 HTUs installed, IDEATel has demonstrated the feasibility of large-scale home telemedicine.
Starren, Justin; Hripcsak, George; Sengupta, Soumitra; Abbruscato, C.R.; Knudson, Paul E.; Weinstock, Ruth S.; Shea, Steven
This talk discusses the unique demands that informatics applications, particularly graph-theoretic applications, place on computer systems. These applications tend to pose significant data movement challenges for conventional systems. Worse, underlying technology trends are moving computers to cost-driven optimization points that exacerbate the problem. The X-caliber architecture is an economically viable counter-example to conventional architectures based on the integration of innovative technologies that support the data movement requirements of large-scale informatics applications. This talk will discuss the technology drivers and architectural features of the platform, and present analysis showing the benefits for informatics applications, as well as our traditional science and engineering HPC applications.
The theme chosen for the 2001 American Medical Informatics Association (AMIA) Annual Symposium, which was the 25th anniversary of the Symposium, was 'AMIA 2001: A Medical Informatics Odyssey - Envisioning the Future, Lessons from the Past'. The Symposium ...
Susannah Tringe of the DOE Joint Genome Institute talks about the Program Overview and Program Informatics at the Metagenomics Informatics Challenges Workshop held at the DOE JGI on October 12-13, 2011
Susannah Tringe of the DOE Joint Genome Institute talks about the Program Overview and Program Informatics at the Metagenomics Informatics Challenges Workshop held at the DOE JGI on October 12-13, 2011
Background. Acute kidney injury in adults is a common cause of hospitalization, associated with high morbidity and mortality especially in developing countries. In spite of RRT the in-hospital mortality rates remain high even in the developed countries. Though a proportion of our patients receive renal replacement therapy as part of their management, data on outcomes are sparse. Study Objective. To determine the clinical outcomes of dialysis-treated AKI in our hospital. Methods. A retrospective analysis of the clinical data of all adult AKI patients treated with haemodialysis at the University of Teaching Hospital during an interrupted six-year period was conducted. Analysis was done using SPSS version 17.0. Results. 34 males and 28 females with mean age of 41.3?±?18.5 years were studied. The leading causes of AKI were sepsis (22.7%), acute glomerulonephritis (20.5%), acute gastroenteritis (15.9%), and toxic nephropathies (11.4%) and presented with mean e-GFR of 14.7 ± 5.8?mls/min/1.73?m2. Of the 62 patients, 29 (46.8%) were discharged from the hospital, 27 (43.5%) died in hospital, while 6 (9.7%) absconded from treatment. Survivors had better Rifle grade than those who died (P < 0.001). Conclusion. Hospital mortality rate of dialysis-treated AKI patients is high and the severity of renal damage at presentation may be an important factor.
Emem-Chioma, Pedro Chimezie; Alasia, Datonye Dennis; Wokoma, Friday Samuel
Background: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications. Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH). Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed. Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all medical admissions. Only 424 (15.2%) had complete records and were analyzed. Record keeping was poor. There were 173 (41%) males and 251 (59%) females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9%) hypertensive complications. Heart failure occurred in 97 (22%) cases while renal failure and encephalopathy accounted for 40 (9.4%) and 7 (1.7%) hypertensive complications respectively. There were 99 deaths out of which 51 (51.5%) were due to stroke, 14 (14.12%) were due to heart failure, and 12 (12.1%) were due to renal failure. Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.
Students in advanced psychopathology courses can learn key concepts by administering semistructured interviews designed to identify specific mental disorders. Such an active learning approach potentially can help students gain fundamental knowledge about psychopathology and begin to develop clinical and research skills. To explore the value of…
Balsis, Steve; Eaton, Nicholas R.; Zona, Denise Martin; Oltmanns, Thomas F.
Population ageing is the demographic process that characterises the first half of the twenty-first century. Australia's population is already ageing and the states and territories are ageing at different rates. Our understanding of the dementias remains limited and diagnosis in primary care settings is poor. Locating where older people with dementia are and how they are coping is an emerging need in health information management. In this paper we discuss how a spatially informed health information management system could support population ageing and the disconnected systems that address ageing. We illustrate this with examples from our work to show how spatial informatics can advance our understanding of and response to the implications of population ageing. PMID:23823296
This project highlight reports on the 2004 workshop , as well as follow-up activities in 2005 and 2006, regarding how informatics tools can help manage natural resources and decide policy. The workshop was sponsored jointly by sponsored by the NSF, NBII, NASA, and EPA, and attended by practitioners from government and non-government agencies, and university researchers from the computer, social, and ecological sciences. The workshop presented the significant information technology (IT) problems that resource managers face when integrating ecological or environmental information to make decisions. These IT problems fall into five categories: data presentation, data gaps, tools, indicators, and policy making and implementation. To alleviate such problems, we recommend informatics research in four IT areas, as defined in this abstract and our final report: modeling and simulation, data quality, information integration and ontologies, and social and human aspects. Additionally, we recommend that funding agencies provide infrastructure and some changes in funding habits to assure cycles of innovation in the domain were addressed. Follow-on activities to the workshop subsequent to dg.o 2005 included: an invited talk presenting workshop results at DILS 2005, publication of the workshop final report by the NBII , and a poster at the NBII All Hands Meeting (Oct. 2005). We also expect a special issue of the JIIS to appear in 2006 that addresses some of these questions. As we go to press, no solicitation by funding agencies has as yet been published, but various NASA and NBII, and NSF cyber-infrastructure and DG research efforts now underway address the above issues.
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. PMID:24743088
Hercigonja-Szekeres, Mira; Simi?, Diana; Božikov, Jadranka; Vondra, Petra
This paper does not describe the approach of any single country towards integrating the informatics industry into an industrial strategy; still less does it attempt to prescribe some ideal policy for achieving this goal. It reviews rather the general ques...
This article discusses the ongoing development of a health informatics capstone program in a Midwest university from the hiring of a program coordinator to the development of a capstone course, through initial student results. University health informatics programs require a strong academic program to be successful but also require a spirited program coordinator to manage resources and organize an effective capstone course. This is particularly true of health informatics master's programs that support health industry career fields, whereby employers can locate and work with a pool of qualified applicants. The analysis of students’ logs confirms that students’ areas of focus and concern are consistent with course objectives and company work requirements during the work-study portion of the student capstone project. The article further discusses lessons learned and future improvements to be made in the health informatics capstone course.
Abstract People and organizational issues are critical in both implementing medical informatics systems and in dealing with the altered organizations that new systems often create. The people and organizational issues area—like medical informatics itself—is a blend of many disciplines. The academic disciplines of psychology, sociology, social psychology, social anthropology, organizational behavior and organizational development, management, and cognitive sciences are rich with research with significant potential to ease the introduction and on-going use of information technology in today's complex health systems. These academic areas contribute research data and core information for better understanding of such issues as the importance of and processes for creating future direction; managing a complex change process; effective strategies for involving individuals and groups in the informatics effort; and effectively managing the altered organization. This article reviews the behavioral and business referent disciplines that can potentially contribute to improved implementations and on-going management of change in the medical informatics arena.
Lorenzi, Nancy M.; Riley, Robert T.; Blyth, Andrew J. C.; Southon, Gray; Dixon, Bradley J.
This essay assesses the principal literature published on the theory of information science during 1971-1976. This literature is compared to the article, 'From Information Science to Informatics: A Terminological Investigation,' by Hans Wellisch. What has...
Our retrospective study presents and evaluates clinical ethics consultations (CECs) in pediatrics as a structure for implementing hospital-wide ethics. We performed a descriptive and statistical analysis of clinical ethics decision making and its implementation in pediatric CECs at Zurich University Children's Hospital. Ninety-five CECs were held over 5 years for 80 patients. The care team reached a consensus treatment recommendation after one session in 75 consultations (89 %) and on 82 of 84 ethical issues (98 %) after two or more sessions (11 repeats). Fifty-seven CECs recommended limited treatment and 23 maximal treatment. Team recommendations were agreed outright by parents and/or patient in 59 of 73 consultations (81 %). Initial dissensus yielded to explanatory discussion or repeat CEC in seven consultations (10 %). In a further seven families (10 %), no solution was found within the CEC framework: five (7 %) required involvement of the child protection service, and in two families, the parents took their child elsewhere. Eventual team-parent/patient consensus was reached in 66 of 73 families (90 %) with documented parental/patient decisions (missing data, n?=?11). Patient preference was assessable in ten CECs. Patient autonomy was part of the ethical dilemma in only three CECs. The Zurich clinical ethics structure produced a 98 % intra-team consensus rate in 95 CECs and reduced initial team-parent dissensus from 21 to 10 %. Success depends closely on a standardized CEC protocol and an underlying institutional clinical ethics framework embodying a comprehensive set of transparently articulated values and opinions, with regular evaluation of decisions and their consequences for care teams and families. PMID:24323344
The world in which today's graduates will provide care is changing, as are expectations about caregivers' performance. Learning how to improve quality of care must occur during, and as part of, learning about patient care. In this article, I describe a continuous quality improvement learning program that was integrated into nursing students' education and a study evaluating the students' experiences with the implementation of the program through open-ended questions and focus groups. The program consisted of three parts: participating in a personal improvement project; observing and describing a patient process from the patient's perspective; and working in teams with process improvement in clinical practice. The findings indicated the students learned improvement methods and tools during their personal improvement projects, but their ability to translate that knowledge into action, and thereby improve patient care, was insufficiently developed through coaching, reflection, and role modeling. In other words, the experience was not integrated into the students' general education. In addition, faculty and clinical staff did not seem to be adequately informed and had limited knowledge of the students' clinical improvement projects. PMID:16562800
The Collaboratory for Multi-scale Chemical Science (CMCS) is developing a powerful informatics- based approach to synthesizing multi-scale information to support a systems-based research approach and is applying it in support of combustion research. An open source multi-scale informatics toolkit is being developed that addresses a number of issues core to the emerging concept of knowledge grids including provenance tracking and
James D. Myers; Thomas C. Allison; Sandra J. Bittner; Brett T. Didier; Michael Frenklach; William H. Green Jr.; Yen-ling Ho; John C. Hewson; Wendy S. Koegler; Carina S. Lansing; David Leahy; Michael Lee; Renata Mccoy; Michael Minkoff; Sandeep Nijsure; Gregor Von Laszewski; David Montoya; Luwi Oluwole; Carmen M. Pancerella; Reinhardt Pinzon; William Pitz; Larry A. Rahn; Branko Ruscic; Karen L. Schuchardt; Eric G. Stephan; Al Wagner; Theresa L. Windus; Christine L. Yang
As new directions and priorities emerge in health care, nursing informatics leaders must prepare to guide the profession appropriately. To use an analogy, where a road bends or changes directions, guideposts indicate how drivers can stay on course. The AMIA Nursing Informatics Working Group (NIWG) produced this white paper as the product of a meeting convened: 1) to describe anticipated nationwide changes in demographics, health care quality, and health care informatics; 2) to assess the potential impact of genomic medicine and of new threats to society; 3) to align AMIA NIWG resources with emerging priorities; and 4) to identify guideposts in the form of an agenda to keep the NIWG on course in light of new opportunities. The anticipated societal changes provide opportunities for nursing informatics. Resources described below within the Department of Health and Human Services (HHS) and the National Committee for Health and Vital Statistics (NCVHS) can help to align AMIA NIWG with emerging priorities. The guideposts consist of priority areas for action in informatics, nursing education, and research. Nursing informatics professionals will collaborate as full participants in local, national, and international efforts related to the guideposts in order to make significant contributions that empower patients and providers for safer health care.
In the Region Vastra Gotaland (VGR), Sweden, sharing of data from 4 PACS system has been done through the Radiology Information Infrastructure that where deployed in 2007, and during 2008 and 2009 also including the information obtained from three different RIS systems installed in the region. The RIS information stored in the Radiology Information Infrastructure is Structured Reports (SR) objects that derivatives from the regional information model. In practice, the Enterprise solution now offers new ways of social collaboration through information sharing within a region. Interoperability was developed according to the IHE mission, i.e. applying standards such as digital imaging and communication in medicine (DICOM) and Health Level 7 (HL7) to address specific clinical communication needs and support optimal patient care. Applying standards and information has shown to be suitable for interoperability, but not appropriate for implementing social collaboration i.e. first and second opinion, as there is no user services related to the standards. The need for social interaction leads to a common negotiated interface and in contrary with interoperability the approach will be a common defined semantic model. Radiology informatics is the glue between the technical standards, information models,semantics, social ruleworks and regulations used within radiology and their customers to share information and services.
The peer-review organizations (PROs) were created by Congress in 1984 to monitor the cost and quality of care received by Medicare beneficiaries. In order to do this, the Health Care Financing Administration (HCFA) contracted with the PROs through a series of contracts referred to as "Scopes of Work." Under the Fourth Scope of Work, the HCFA initiated the Health Care Quality Improvement Program (HCQIP) in 1990, as an application of the principles of continuous quality improvement. Since then, the PROs have participated with health care providers in cooperative projects to improve the quality of primarily inpatient care provided to Medicare beneficiaries. Through HCFA-supplied administrative data and clinical data abstracted from patient records, the PROs have been able to identify opportunities for improvements in patient care. In May 1995, the HCFA proposed a new Fifth Scope of Work, which will shift the focus of HCQIP from inpatient care projects to projects in outpatient and managed care settings. This article describes the HCQIP process, the types of data used by the PROs to conduct cooperative projects with health care providers, and the informatics challenges in improving the quality of care received by Medicare beneficiaries.
Grant, J B; Hayes, R P; Pates, R D; Elward, K S; Ballard, D J
Retention of information concerning steroid medication dosage, side effects, and course of action to follow when certain danger signs or side effects occur was tested prospectively in multiple sclerosis patients about to be treated with alternate-day steroid medication. Each patient received identical oral instruction from both a physician and a clinical nurse specialist, followed by a written pretest of the orally imparted information. Alternate patients then received a written instruction booklet to reinforce the information concerning steroid medications. After one month, a written posttest was given. Patients who received the written instructional booklet showed a significant increase in retained knowledge concerning steroids. PMID:2936841
In the light of the growing importance of informatics and its applications in various fields, UNESCO's activities in informatics have been strengthened for the 1981/1983 triennium. This growth in the informatics programme is particularly geared towards pr...
Traumatic Brain Injury (TBI) is a problem of major medical and socioeconomic significance, although the pathogenesis of its sequelae is not completely understood. As part of a large, multi-center project to study mild and moderate TBI, a database and informatics system to integrate a wide-range of clinical, biological, and imaging data is being developed. This database constitutes a systems-based approach to TBI with the goals of developing and validating biomarker panels that might be used to diagnose brain injury, predict clinical outcome, and eventually develop improved therapeutics. This paper presents the architecture for an informatics system that stores the disparate data types and permits easy access to the data for analysis.
Alaoui, Adil; Kim, Dongkyu; Levine, Betty; Cleary, Kevin; Federoff, Howard J.; Mhyre, Timothy
Background Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers’ communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients. Methods A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants’ confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures. Results Improvements were statistically significant in both years in all measures except in simulated patients’ assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant. Conclusions The program’s positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients.
Background: Tobacco addiction is an important public health issue. It is important for health professional to counsel the tobacco users for cessation. Aim: To enhance communication skills of MBBS (Bachelor of Medicine and Bachelor of Surgery) students in counseling of tobacco users by using interactive teaching methods and examine it by using OSCE. Materials and Methods: It was a before and after comparison study. Communication skills of students were examined by standardized patients (investigators) by objective structured clinical examination (OSCE) method before and after intervention. All the students were trained to enhance the communication skills by role play, interactive session, anecdotes. Statistical analysis was done by using Paired t-test. Results: The difference in scores at all the 3 stations before and after the intervention and also global scores before and after the intervention was statistically highly significant (P = 0.0001). Conclusion and Recommendation: Communication skills of students in counseling tobacco users improved after they were given role play, interactive session, anecdotes. Similar model can be used to improve the communication/counseling skills in other important health hazards.
Fernandez, Kevin; Pandve, Harshal T.; Debnath, Dhrubajyoti J.
The summer component of the Stanford Teacher Education Program (STEP) emphasizes reflective teaching in a six-week clinical experience. The merger of STEP with the Upward Bound Program provides student teachers with daily opportunities to apply and reflect upon the pedagogical theory developed in their coursework. (MT)
BACKGROUND: Deficits in clinical microbiology infrastructure exacerbate global infectious disease burdens. This paper examines how commodity computation, communication, and measurement products combined with open-source analysis and communication applications can be incorporated into laboratory medicine microbiology protocols. Those commodity components are all now sourceable globally. An informatics model is presented for guiding the use of low-cost commodity components and free software
Quinolone resistance is an emerging problem in China. To investigate the prevalence of the plasmid- mediated quinolone resistance genes qnr and aac(6)-Ib-cr, a total of 265 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, and Enterobacter cloacae with ciprofloxacin MICs of >0.25 g\\/ml were screened at nine teaching hospitals in China. The qnrA, qnrB, qnrS, and aac(6)-Ib genes were
Hong Yang; Hongbin Chen; Qiwen Yang; Minjun Chen; Hui Wang
We examined the molecular characteristics of 13 phenotypically confirmed carbapenemase-positive Enterobacteriaceae clinical isolates, including the relationships between plasmid-mediated quinolone-resistance genes (qnr), 6'-N-aminoglycoside acetyltransferase-encoding genes [aac(6')] and AmpC-encoding genes (pAmpC). Twelve isolates were bla(IMP-1) positive (92.3%), while one was bla(IMP-11) positive (7.7%). We detected qnr, aac(6') and pAmpC genes designated bla(ACT-1)-like in 76.9%, 100% and 53.8%, respectively, of the 13 isolates. Plasmids were transferred successfully for three of the 13 metallo-?-lactamase (MBL)-producing isolates, and the sizes of plasmids extracted from these donors and transconjugants were deduced to be 65 kb or 70 kb. OmpC or OmpF protein expression was reduced in all Enterobacter cloacae, and one Klebsiella oxytoca lacked OmpK36. We demonstrate what appears to be the first evidence that, in Japan, Enterobacteriaceae producing MBLs carry various plasmid-mediated resistance genes, which may cause a further decrease in carbapenem susceptibility through reduction of the expression of outer-membrane proteins. PMID:23161765
Background Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital. This study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse drug events (ADE). The types of interventions identified are also analysed. Methods Interventions recorded by a team of hospital pharmacists over a one year time period were included in the study. Interventions were assigned a rating score, determined by the probability that an ADE would have occurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost benefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed. Results A total cost avoidance of €708,221 was generated. Input costs were calculated at €81,942. This resulted in a net cost benefit of €626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the identification of medication omissions, followed by dosage adjustments and requests to review therapies. Conclusion This study provides further evidence that pharmacist interventions provide substantial cost avoidance to the healthcare payer. There is a serious issue of patient’s regular medication being omitted on transfer to an inpatient setting in Irish hospitals.
Comprehensive clinical imaging data and additional relevant information are crucial for the planning and delivery of radiation therapy in patients with cancer. Multiple stand-alone systems that make use of technologic advances in imaging, treatment planning, and treatment delivery acquire or generate key data during the course of radiation therapy. However, the data are scattered in various systems throughout the radiation therapy department, thereby compromising efficient clinical work flow. In 1997 and 1999, the Digital Imaging and Communications in Medicine (DICOM) standard was extended from radiology to radiation therapy with the ratification of seven DICOM-RT objects. These objects helped set the standard for (a) data integration and interoperability between radiation therapy equipment and information systems from different manufacturers, and (b) the use of DICOM diagnostic images in radiation therapy. More recently, key radiation therapy imaging and informatics data have been integrated to form an open-architecture comprehensive radiation therapy electronic patient record (ePR) system. The benefits of such a DICOM-RT-based ePR system are threefold: it can be used as a foundation for performing effective and efficient clinical services, as a common platform for radiation therapy data exchange and expert consultation, and for medical imaging informatics research in developing innovative decision support tools and a knowledge base for improved treatment with radiation therapy. PMID:19448106
Stroke is a major cause of adult disability. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (I-CARE) clinical trial aims to evaluate a therapy for arm rehabilitation after stroke. A primary outcome measure is correlative analysis between stroke lesion characteristics and standard measures of rehabilitation progress, from data collected at seven research facilities across the country. Sharing and communication of brain imaging and behavioral data is thus a challenge for collaboration. A solution is proposed as a web-based system with tools supporting imaging and informatics related data. In this system, users may upload anonymized brain images through a secure internet connection and the system will sort the imaging data for storage in a centralized database. Users may utilize an annotation tool to mark up images. In addition to imaging informatics, electronic data forms, for example, clinical data forms, are also integrated. Clinical information is processed and stored in the database to enable future data mining related development. Tele-consultation is facilitated through the development of a thin-client image viewing application. For convenience, the system supports access through desktop PC, laptops, and iPAD. Thus, clinicians may enter data directly into the system via iPAD while working with participants in the study. Overall, this comprehensive imaging informatics system enables users to collect, organize and analyze stroke cases efficiently.
Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal before medical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient.
Hartley, Craig J.; Naghavi, Morteza; Parodi, Oberdan; Pattichis, Constantinos S.; Poon, Carmen C. Y.; Zhang, Yuan-Ting
Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health by effective response management and coordination. As new pressures for early detection of disease outbreaks have arisen, particularly for outbreaks of possible bioterrorism (BT) origin, and as electronic health data have become increasingly available, so has the demand for public health situation awareness systems. Although these systems are valuable for early warning of public health emergencies, there remains the cost of developing and managing such large and complex systems and of investigating inevitable false alarms. Whether these systems are dependable and cost effective enough and can demonstrate a significant and indispensable role in detection or prevention of mass casualty events of BT origin remains to be proven. This article will focus on the complexities of design, analysis, implementation and evaluation of public health surveillance and situation awareness systems and, in some cases, will discuss the key technologies being studied in Center for Biosecurity Informatics Research at University of Texas, Health Science Center at Houston.
Mirhaji, Parsa; Zhang, Jiajie; Smith, Jack W.; Madjid, Mohammad; Casscells, Samuel W.; Lillibridge, Scott R.
...Proposed Collection; Comment Request; Cancer Biomedical Informatics Grid[supreg...data collection projects, the National Cancer Institute (NCI), the National Institutes...approval. Proposed Collection: Title: cancer Biomedical Informatics Grid...
Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ?12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINITAB® 12.21 (USA) statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9) and attachment (78.7%) during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2%) of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7%) had “fair” to “good” infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers’ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs), infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to improve the knowledge and practices of mothers on infant feeding.
Lawan, Umar M.; Amole, Gboluwaga T.; Jahum, Mahmud G.; Sani, Abdullahi
Background & objectives: H1N1 influenza is a recognized cause of febrile respiratory infection worldwide. There are not many studies to show its impact on pregnancy. In the present study we aimed to assess clinical characteristics, obstetric and perinatal outcome of pregnant women with H1N1 infection. Methods: A retrospective observational study was conducted at a tertiary care teaching hospital in New Delhi, India. A total of 24 pregnant women microbiologically positive for H1N1 were included. Maternal characteristics and outcome were recorded. Perinatal outcome which was defined as presence of any of the indicators such as abortion, preterm delivery, intrauterine death and neo natal death was noted. Results: The mean age of the study group was 25.2 ± 3 yr with a mean gestational age of 34.9 ± 4.6 wk. Six patients (25%) had associated co-morbidities. Nine patients (37.5%) presented within 48 h of onset of symptoms and 15 (62.5%) reported after 48 h. In 17 (70.83%) patients treatment was delayed by >48 h. ICU admission was needed in 20.8 per cent patients and mortality rates was 8.3 per cent. There were seven cases of adverse perinatal outcome. Interpretation & conclusions: The presenting symptoms of pregnant women with H1N1 were similar to that of general population. Acquiring infection in late trimester, late initiation of antiviral treatment and presence of co-morbid illness were high risk factors for developing critical illness. Pregnant women with suspected H1N1 influenza should be started on antiviral therapy at the earliest. This is likely to help reduce the ICU admission rates and mortalities in this group of women.
Throughout the world, particularly in colonized countries, the health status of indigenous people and the unequal representation of indigenous people within the health workforce is of concern. In 2002, as part of a national health workforce development strategy, a qualification was developed to provide Maori (Indigenous New Zealander) health professionals with the skills and confidence to teach and supervise students on clinical placements in Maori health environments. This project required close collaboration between two education providers, one a Maori private education provider and the other a traditional government-funded tertiary institution; and for both organizations to work cooperatively with Maori communities and Maori health providers. The Christchurch College of Education (CCE) and Mauri Ora Associates are jointly involved in the administration, design and delivery of the programme, recruitment of guest lecturers, and ongoing curriculum updates. The content for the programme is mainstream, international and interprofessional but the pedagogy is Maori, with Maori customs, values and traditions upheld and practised. A national Maori health workforce development organization contracts independently with both organizations and provides an oversight and quality monitoring role. Together, the three organizations work with other Maori health professional groups and Maori elders to deliver the qualification. This paper describes how this course was designed, how it is delivered within a Maori paradigm, and how the outcomes are achieved. It also describes the cooperation between Maori and Pakeha (white New Zealanders) across health, community and educational organizations that was required to sustain this programme over five years and identifies some themes that may be applied in a global context. In sharing our experiences, we hope to inspire others to consider ways they can meet the needs of indigenous learners within their mainstream programmes. PMID:17095438
Established in mid-2011 by the NCAB, the IWG is charged with providing strategic guidance and direction on NCI informatics investments that support the Institute’s scientific goals. The IWG provides a venue for identifying high-priority biomedical informatics needs, harmonizing ongoing and proposed informatics projects across NCI programs, both intramural and extramural, and reducing redundancies wherever possible.
Aimed at solutions for existing problems in the informatization of domestic and foreign enterprises, this paper proposes an enterprise informatization maturity model and a dynamic equilibrium model from perspectives of the level, quality, capacity, and moderation of enterprise informatization based on low-carbon economy, so as to deal with resources configuration and measurement as well as the choices between optimality and
In this article, changes in "Mathematics for Informatics" at the Faculty of Organisation and Informatics in the University of Zagreb are described, and correlated with students pass rates. Students at the Faculty work in an interdisciplinary field, studying Informatics within a business context. The main reason for introducing the changes in the…
Background/Context: The management, processing, and transformation of information constitute central tasks in education. Education informatics intersects the theories and practices of both informatics and education. In particular, informatics aids in the systematic incorporation of technology as educational stakeholders represent, process, and…
Objective: This study presents the results of an author co-citation analysis of the interdisciplinary field of medical informatics. Methods: An author co-citation analysis was conducted for the years 1994 to 1998, using the fifty most-cited American College of Medical Informatics fellows as an author population. Co-citation data were calculated for every author pair, and multivariate analyses were performed to ultimately show the relationships among all authors. A multidimensional map was created, wherein each author is represented as a point, and the proximity of these points reflects the relationships of authors as perceived by multiple citers. Results and Conclusion: The results from this analysis provide one perspective of the field of medical informatics and are used to suggest future research directions to address issues related to better understanding of communication and social networks in the field to inform better provision of information services.
Social sciences view spirituality and religion separately; medicine views them together. We identified distinctions regarding clinical practice and teaching among clinician educators based on their self-identified spirituality versus religiosity. We emailed a 24-item survey on spiritual/religious (S/R) issues to clinician educators (n = 1,067) at our institution. Three summary scales were created. Responses to statements, 'I consider myself to be spiritual' and 'I consider myself to be religious' generated four comparison groups: 'spiritual only,' 'religious only,' 'both spiritual and religious' and 'neither.' Analyses employed ANOVA and T tests. A total of 633 (59 %) surveys were completed. Four percentage self-identified as 'religious only'; remaining respondents divided evenly, about 30 % into each of the other categories. Groups differed from one another on all summary scales (p < .0001). Using T tests, the 'spiritual only' group differed from the 'religious only' group regarding teaching. The 'spiritual and religious' group had the highest mean ratings for all summary scales. The 'neither' and 'religious only' group had the lowest mean ratings. Clinicians' spiritual versus religious identity is associated with differences in behavior/attitudes regarding S/R toward clinical practice and medical student teaching. These findings elucidate opportunities for faculty development to explore effects of beliefs on behavior and attitudes within this realm. PMID:24609783
The search and design of new materials can be significantly aided by combinatorial experiments. However the key to minimizing the search process in combinatorial experiments is to identify the key combinations that achieve the desired functionality in the class of materials being studied. The concept of virtual combinatorial experiments for materials selection and design strategy is useful to show how one may design combinatorial libraries a priori by integrating data mining techniques with physically robust multivariate data. In this thesis, using crystal chemistry of spinel nitrides as a framework for materials design, the methodology for integrating derived variables using newly proposed mixing rules based on statistical tools such as Partial Least Squares (PLS) and Principal Component Analysis (PCA) is described. Strategically selecting appropriate quantum mechanical and crystallographic data are used to predict and identify new alloy chemistries, modulus properties, and phase stabilities. This approach is unique in materials design because it overcomes problems of length scale by connecting the microscopic phenomena and macroscopic engineering properties. The integration of the physics based predictions with data mining predictions is used to propose new virtual compounds, especially with higher order or multicomponent chemistries. With the predicted target properties (bulk moduli and phase stabilities) by PLS, correlations between all variables in a created library of binary and ternary spinel nitrides is visualized in the dimensionally reduced structure maps created by PCA. Through these activities, materials informatics plays an important role in guiding the choice of the most promising chemistries that exhibit the desired functionality in the virtual combinatorial libraries of hypothetical materials.
This article describes an extensive online criterion-referenced evaluation system for the assessment of veterinary students' achievement during their final year's Doctor of Veterinary Medicine (or equivalent) clinical education. Data are reported for the 2001 to 2009 University of California at Davis veterinary graduates, for a total of more than 1,100 students. These criterion-referenced evaluations extensively document the level of clinical skills attained and demonstrated during the individual clinical rotations that comprise the fourth-year curriculum. On average, in each of the 17,500 clinical rotations undertaken during this time period, student performance was assessed in at least 11 separate areas of skills, knowledge, and professional attributes. This provided more than 200,000 criterion-referenced judgments of the individual clinical attributes of graduates over nine years. The system is based on a previously detailed and validated definition of the skills, knowledge, and professional attributes that students should have demonstrated before graduation. The extensive database that this system has provided has established that this system, termed VOLES (VMTH [Veterinary Medicine Teaching Hospital] On-Line Evaluation System), is an effective tool to assess the clinical capabilities of veterinary students and their achievement of the "Day One" skills required for entering clinical practice. These expected proficiencies are balanced according to the differing expectations that each area of veterinary clinical practice demands. PMID:22430080
Zeck, Steven; Wall, Judy A; Smith, Bradford P; Wilson, W David; Walsh, Donal A
There are rapid changes occurring in the health care environment. Radiologists face new challenges but also new opportunities. The purpose of this report is to review how new informatics tools and developments can help the radiologist respond to the drive for safety, quality, and efficiency. These tools will be of assistance in conducting research and education. They not only provide greater efficiency in traditional operations but also open new pathways for the delivery of new services and imaging technologies. Our future as a specialty is dependent on integrating these informatics solutions into our daily practice. PMID:24029051
As a multidisciplinary field, medical informatics draws on a range of disciplines, such as computer science, information science, and the social and cognitive sciences. The cognitive sciences can provide important insights into the nature of the processes involved in human– computer interaction and help improve the design of medical information systems by providing insight into the roles that knowledge, memory, and strategies play in a variety of cognitive activities. In this paper, the authors survey literature on aspects of medical cognition and provide a set of claims that they consider to be important in medical informatics.
Patel, Vimla L.; Arocha, Jose F.; Kaufman, David R.
Background 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. Methods 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. Results 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 teaching skills, and that they need to continually adapt to changes in curricula. Conclusions This study offers a long overdue, systematic view of current practices of library/informatics training at Western U.S. medical schools. Medical educators, particularly curricular leaders, will find opportunities in this study's results for more productive collaborations with the librarians responsible for library and informatics training at their medical schools.
This collection of papers examines what it means to teach culture as an integrated part of language from both the language learner's and the language teacher's perspectives. The 11 papers include the following: "Teaching Cultures as an Integrated Part of Language: Implications for the Aims, Approaches and Pedagogies of Language Teaching" (Chantal…
In recent years, both academic and policy making circles in the UK have shown a growing interest in the potential uses of information and communication technologies (ICTs) in the delivery of government services. Much of the academic literature has been centred around the concept of 'informatization', and it has been suggested that the new technologies are transforming public services. Key
caBIG stands for the cancer Biomedical Informatics Grid. It is an open-source, open-access, voluntary information network that will enable cancer researchers to share tools, standards, data, applications, and technologies according to agreed upon common standards and needs.
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.
Objective: The article offers a current perspective on medical informatics and health sciences librarianship. Narrative: 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. Summary: 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 main role of medical and healthcare informatics is the manipulation of medical information and the dissemination of knowledge. The advent of the Web increased the pervasiveness of medical information and attracted the interest of both practitioners and patients. Web 2.0 in its turn brings people together in a more dynamic, interactive space. With new services, applications and devices, it
Abstract Receiver operating characteristic (ROC) curves are frequently used in biomedical,informatics research to evaluate classification and prediction models for decision support, diagnosis, and prognosis. ROC analysis investigates the accuracy of a models ability to separate positive from negative cases (such as predicting the presence or absence of disease), and the results are independent of the prevalence of positive cases in
Thomas A. Lasko; Jui G. Bhagwat; Kelly H. Zou; Lucila Ohno-machado
Describes the development of a standardized curriculum in informatics for adult education institutes in West Germany which features problem solving using computers, structure and function of a computer, social implications of computer use, and computers in business and administration. Reasons for taking courses are classified and tested.…
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
Mass spectrometry has become the pre-eminent analytical method for the study of proteins and proteomes in post-genome science. The high volumes of complex spectra and data generated from such experiments represent new challenges for the field of bioinformatics. The past decade has seen an explosion of informatics tools targeted towards the processing, analysis, storage, and integration of mass spectrometry based proteomic data. In this review, some of the more recent developments in proteome informatics will be discussed. This includes new tools for predicting the properties of proteins and peptides which can be exploited in experimental proteomic design, and tools for the identification of peptides and proteins from their mass spectra. Similarly, informatics approaches are required for the move towards quantitative proteomics which are also briefly discussed. Finally, the growing number of proteomic data repositories and emerging data standards developed for the field are highlighted. These tools and technologies point the way towards the next phase of experimental proteomics and informatics challenges that the proteomics community will face. PMID:19199887
The life and activities of every man in the period of transition from the second into the third millennium have been marked by epochal changes which appear as the consequence of scientific and technological revolution dominated by highly developed information and communication technology. Informatics and information education based on information…
As a multidisciplinary field, medical informatics draws on a range of disciplines, such as computer science, information science, and the social and cognitive sciences. The cognitive sciences can provide important insights into the nature of the processes involved in human– computer interaction and help improve the design of medical information systems by providing insight into the roles that knowledge, memory,
In 1986, the National Library of Medicine (NLM) assembled a large multidisciplinary, multisite team to work on the Unified Medical Language System (UMLS), a collaborative research project aimed at reducing fundamental barriers to the application of computers to medicine. Beyond its tangible products, the UMLS Knowledge Sources, and its influence on the field of informatics, the UMLS project is an
Betsy L Humphreys; Donald A B Lindberg; Harold M Schoolman; G Octo Barnett
The complete genome sequences of more than 60 microbes have been completed in the past decade. Concurrently, a series of new informatic stools, designed to harness this new wealth of information, have been developed. Some of these new tools allow researchers to select regions of microbial genomes that trigger immune responses. These regions, termed epitopes, are ideal components of vaccines.
Anne S De Groot; Hakima Sbai; Caitlin Saint Aubin; Julie McMurry; William Martin; AS De Groot
Lipid mediator informatics is an emerging area denoted to the identification of bioactive lipid mediators (LMs) and their biosynthetic profiles and pathways. LM informatics and proteomics applied to inflammation, systems tissues research provides a powerful means of uncovering key biomarkers for novel processes in health and disease. By incorporating them with system biology analysis, we review here our initial steps toward elucidating relationships among a range of bimolecular classes and provide an appreciation of their roles and activities in the pathophysiology of disease. LM informatics employing liquid chromatography-ultraviolet-tandem mass spectrometry (LC-UV-MS/MS), gas chromatography-mass spectrometry (GC-MS), computer-based automated systems equipped with databases and novel searching algorithms, and enzyme-linked immunosorbent assay (ELISA) to evaluate and profile temporal and spatial production of mediators combined with proteomics at defined points during experimental inflammation and its resolution enable us to identify novel mediators in resolution. The automated system including databases and searching algorithms is crucial for prompt and accurate analysis of these lipid mediators biosynthesized from precursor polyunsaturated fatty acids such as eicosanoids, resolvins, and neuroprotectins, which play key roles in human physiology and many prevalent diseases, especially those related to inflammation. This review presents detailed protocols used in our lab for LM informatics and proteomics using LC-UV-MS/MS, GC-MS, ELISA, novel databases and searching algorithms, and 2-dimensional gel electrophoresis and LC-nanospray-MS/MS peptide mapping. PMID:16752008
Lu, Yan; Hong, Song; Gotlinger, Katherine; Serhan, Charles N
Geo-informatics is a field of science that combines geodetic and spatial information processing methods with computing hardware and software technologies. Research being conducted by the authors extends this blend of science and technology by utilising contemporary computational techniques for data analysis and some sensor and telemetry technologies integrated with spatial information processing methods. The geo- spatial technologies of Geographic Information
Subana Shanmuganathan; Philip Sallis; Leopoldo Pavesi; Mary Carmen Jarur Muñoz
The evolution of the name information science is traced, and terminology of 39 definitions of the term is compared to find common concepts and its central topic of investigation. The comparison reveals no consensus as to what information science is. Informatics is suggested as a better term for the field. (62 references) (Author/SJ)
This poster categorizes the various applications to aid the management of Pediatric Bronchial Asthma. An attempt is made at classifying the various informatics approaches in this domain. Later, the approach of the proposed Asthma CAMS (Computer Aided Management System) project, being developed by the Child Health Institute and ClinicalInformatics Research Group www.cirg.washington.edu at the University of Washington, is discussed.
Much research has shown the benefits of additional anatomical learning and dissection beyond the first year of medical school human gross anatomy, all the way through postgraduate medical training. We have developed an interactive method for teaching eye and orbit anatomy to medical students in their ophthalmology rotation at Duke University…
Kivell, Tracy L.; Doyle, Sara K.; Madden, Richard H.; Mitchell, Terry L.; Sims, Ershela L.
The introduction of informatics into the national school curriculum in Japan requires changes to educational policy, curricula, methods, facilities, etc. Although the basic functions of the school--i.e., to transmit the culture and to cultivate competencies that will allow a future society to develop--remain unchanged, new technologies change the…
High-resolution protein electrophoresis of serum, urine, and cerebrospinal fluid (CSF) can aid in the diagnosis of multiple myeloma, amyloidosis, macroglobulinemia, multiple sclerosis, and other diseases. Electrophoresis-Tutor is a personal computer program based on approximately 150 digital images that teaches the clinical interpretation of agarose gel electrophoretic patterns. The program is divided into the following sections: introduction, CSF, serum, urine, review of disease states, program navigator, and final exam. The CSF section describes normal and abnormal CSF findings with emphasis on oligoclonal banding, as seen in the CSF of patients with multiple sclerosis. The serum section emphasizes monoclonal gammopathy patterns but also has detailed descriptions of inflammation, liver disease, protein-losing disorders, genetic deficiencies, and other patterns. Monoclonal gammopathy is described in the context of specific associated clinical conditions (e.g., myeloma, amyloidosis). For each monoclonal gammopathy example, results of standard electrophoresis, densitometry, and immunofixation are presented. The review of disease states uses animation to illustrate the development and remission of a variety of pathological patterns. The program navigator allows the user to jump quickly to any place in the program. The optional exam contains 20 questions, and detailed feedback is given after each question. Electrophoresis-Tutor can be used as a stand-alone teaching tool, a companion to traditional instruction, or a reference source. PMID:7656448
Astion, M L; Rank, J; Wener, M H; Torvik, P; Schneider, J B; Killingsworth, L M
I am going to talk about teaching legislation, a class I have taught several times at Georgetown University Law Center, as well as teaching a federal legislation clinic, which I founded ten years ago at the law school. Bill Eskridge has done a wonderful job laying out the different ways one can teach a course in legislation; you will see
An analysis of Information Technology knowledge of Hungarian and Romanian students was made with the help of a self developed web based Informatics Test. The goal of this research is an analysis of the Computer Science knowledge level of Hungarian and Romanian students attending a Science course or a Mathematics-Informatics course. Analysed was…
The systems PRACTICE and GRAPP being under development at the A. P. Ershov Institute of Informatics Systems in Novosibirsk are considered. They are Web-based systems intended to support computer-science teaching and learning. In the paper the current versions of systems being in use by students of Novosibirsk State University are presented, and our plans are outlined.
Purpose Next-generation sequencing (NGS) has transformed genetic research and is poised to revolutionize clinical diagnosis. However, the vast amount of data and inevitable discovery of incidental findings require novel analytic approaches. We therefore implemented for the first time a strategy that utilizes an a priori structured framework and a conservative threshold for selecting clinically relevant incidental findings. Methods We categorized 2016 genes linked with Mendelian diseases into “bins” based on clinical utility and validity, and used a computational algorithm to analyze 80 whole genome sequences in order to explore the use of such an approach in a simulated real-world setting. Results The algorithm effectively reduced the number of variants requiring human review and identified incidental variants with likely clinical relevance. Incorporation of the Human Gene Mutation Database (HGMD) improved the yield for missense mutations, but also revealed that a substantial proportion of purported disease-causing mutations were misleading. Conclusions This approach is adaptable to any clinically relevant bin structure, scalable to the demands of a clinical laboratory workflow, and flexible with respect to advances in genomics. We anticipate that application of this strategy will facilitate pre-test informed consent, laboratory analysis, and post-test return of results in a clinical context.
Berg, Jonathan S.; Adams, Michael; Nassar, Nassib; Bizon, Chris; Lee, Kristy; Schmitt, Charles P.; Wilhelmsen, Kirk C.; Evans, James P.
A research consortium including Windber Research Institute (WRI), the US Army Space and Missile Defense Command (USASMDC), the Joyce Murtha Breast Cancer Care Center (JMBCC), and the Clinical Breast Care Project (CBCP) Walter Reed Army Medical Center (WRA...
The Collaboratory for Multi-scale Chemical Science (CMCS) is developing a powerful informatics-based approach to synthesizing multi-scale information to support a systems-based research approach and is applying it in support of combustion research. An open source multi-scale informatics toolkit is being developed that addresses a number of issues core to the emerging concept of knowledge grids including provenance tracking and lightweight federation of data and application resources into cross-scale information flows. The CMCS portal is currently in use by a number of high-profile pilot groups and is playing a significant role in enabling their efforts to improve and extend community maintained chemical reference information.
Myers, James D.; Allison, Thomas C.; Bittner, Sandra J.; Didier, Brett T.; Frenklach, Michael; Green, William H.; Ho, Yen-Ling; Hewson, John; Koegler, Wendy S.; Lansing, Carina S.; Leahy, David; Lee, Michael; McCoy, Renata; Minkoff, Michael; Nijsure, Sandeep; von Laszewski, Gregor; Montoya, David; Oluwole, Luwi; Pancerella, Carmen M.; Pinzon, Reinhardt; Pitz, William; Rahn, Larry A.; Ruscic, Branko; Schuchardt, Karen L.; Stephan, Eric G.; Wagner, Al; Windus, Theresa L.; Yang, Christine
The Collaboratory for Multi-scale Chemical Science (CMCS) is developing a powerful informatics-based approach to synthesizing multi-scale information to support a systems-based research approach and is applying it in support of combustion research. An open source multi-scale informatics toolkit is being developed that addresses a number of issues core to the emerging concept of knowledge grids including provenance tracking and lightweight federation of data and application resources into cross-scale information flows. The CMCS portal is currently in use by a number of high-profile pilot groups and is playing a significant role in enabling their efforts to improve and extend community maintained chemical reference information.
Myers, J D; Allison, T C; Bittner, S; Didier, B; Frenklach, M; Green, Jr., W H; Ho, Y; Hewson, J; Koegler, W; Lansing, C; Leahy, D; Lee, M; McCoy, R; Minkoff, M; Nijsure, S; von Laszewski, G; Montoya, D; Pancerella, C; Pinzon, R; Pitz, W J; Rahn, L A; Ruscis, B; Schuchardt, K; Stephan, E; Wagner, A; Windus, T; Yang, 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 which enhances (and does not impede) their interactions.
Snyder, Claire F.; Wu, Albert W.; Miller, Robert S.; Jensen, Roxanne E.; Bantug, Elissa T.; Wolff, Antonio C.
Over the last decades Nanotechnology has promised to advance science and technology in many areas. Within medicine, Nanomedicine promises to deliver new methods for diagnosis, prognosis and therapy. As the amount of available information is rapidly growing, new Biomedical Informatics approaches have to be developed to satisfy the increasing demand on data and knowledge management. In 2007, a new sub-discipline, already named "Nanoinformatics", was created with support from the US National Science Foundation. In Europe, a project named ACTION-Grid was launched in 2008 with support from the European Commission to analyze the challenges and agenda for developing Nanoinformatics as a discipline related to Nanotechnology, Biomedicine and Informatics. For MIE 2009, members of this consortium proposed a workshop to discuss the scientific and strategic issues associated with this topic. Nanoinformatics aims to create a bridge between Nanomedicine and Information Technology applying computational methods to manage the information created in the nanomedical domain. PMID:19745461
De La Iglesia, Diana; Chiesa, Stefano; Kern, Josipa; Maojo, Victor; Martin-Sanchez, Fernando; Potamias, George; Moustakis, Vassilis; Mitchell, Joyce A
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. PMID:24429021
The Collaboratory for Multi-scale Chemical Science (CMCS) is developing a powerful informatics-based approach to synthesizing multi-scale information to support a systems-based research approach and is applying it in support of combustion research. An open source multi-scale informatics toolkit is being developed that addresses a number of issues core to the emerging concept of knowledge grids including provenance tracking and lightweight federation of data and application resources into cross-scale information flows. The CMCS portal is currently in use by a number of high-profile pilot groups and is playing a significant role in enabling their efforts to improve and extend community maintained chemical reference information.
Myers, James D.; Allison, Thomas C.; Bittner, Sandra; Didier, Brett T.; Frenklach, Michael; Green, William H.; Ho, Yen-Ling; Hewson, John; Koegler, Wendy S.; Lansing, Carina S.; Leahy, David; Lee, Michael; McCoy, Renata; Minkoff, Michael; Nijsure, Sandeep; von Laszewski, Gregor; Montoya, David W.; Pancerella, Carmen M.; Pinzon, Reinhardt; Pitz, William; Rahn, Larry; Ruscic, Branko; Schuchardt, Karen L.; Stephan, Eric G.; Wagner, Albert F.; Windus, Theresa L.; Yang, Christine
Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.
Cushing, J. B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J. L.; Schweik, C.; Sonntag, W.
In recent years, the deluge of complicated molecular and cellular microscopic images creates compelling challenges for the image computing community. There has been an increasing focus on developing novel image processing, data mining, database and visualization techniques to extract, compare, search and manage the biological knowledge in these data-intensive problems. This emerging new area of bioinformatics can be called ‘bioimage informatics’. This article reviews the advances of this field from several aspects, including applications, key techniques, available tools and resources. Application examples such as high-throughput/high-content phenotyping and atlas building for model organisms demonstrate the importance of bioimage informatics. The essential techniques to the success of these applications, such as bioimage feature identification, segmentation and tracking, registration, annotation, mining, image data management and visualization, are further summarized, along with a brief overview of the available bioimage databases, analysis tools and other resources. Contact: email@example.com Supplementary information: Supplementary data are available at Bioinformatics online.
Background: The need for informatics training as part of pathology training has never been so critical, but pathology informatics is a wide and complex field and very few programs currently have the resources to provide comprehensive educational pathology informatics experiences to their residents. In this article, we present the “pathology informatics curriculum wiki”, an open, on-line wiki that indexes the pathology informatics content in a larger public wiki, Wikipedia, (and other online content) and organizes it into educational modules based on the 2003 standard curriculum approved by the Association for Pathology Informatics (API). Methods and Results: In addition to implementing the curriculum wiki at http://pathinformatics.wikispaces.com, we have evaluated pathology informatics content in Wikipedia. Of the 199 non-duplicate terms in the API curriculum, 90% have at least one associated Wikipedia article. Furthermore, evaluation of articles on a five-point Likert scale showed high scores for comprehensiveness (4.05), quality (4.08), currency (4.18), and utility for the beginner (3.85) and advanced (3.93) learners. These results are compelling and support the thesis that Wikipedia articles can be used as the foundation for a basic curriculum in pathology informatics. Conclusions: The pathology informatics community now has the infrastructure needed to collaboratively and openly create, maintain and distribute the pathology informatics content worldwide (Wikipedia) and also the environment (the curriculum wiki) to draw upon its own resources to index and organize this content as a sustainable basic pathology informatics educational resource. The remaining challenges are numerous, but largest by far will be to convince the pathologists to take the time and effort required to build pathology informatics content in Wikipedia and to index and organize this content for education in the curriculum wiki.
Kim, Ji Yeon; Gudewicz, Thomas M.; Dighe, Anand S.; Gilbertson, John R.
The context for nursing informatics research has changed significantly since the National Institute of Nursing Research-funded Nursing Informatics Re- search Agenda was published in 1993 and the Delphi study of nursing informatics research priorities re- ported a decade ago. The authors focus on 3 specific aspects of context—genomic health care, shifting research paradigms, and social (Web 2.0) technolo- gies—that must
Suzanne Bakken; Patricia W. Stone; Elaine L. Larson
Duke University first offered World Wide Web (WWW) based courses in Nursing Informatics in January of 1997. The first class enrolled 18 nurses who were completing either a Post-Master's Certificate Program or were near completion of their Master's degree. Courses were designed around principles of advanced nursing practice, performance support, mastery learning, and virtual learning communities. Extensive learning assessment included traditional papers, real-world application projects, and a variety of pre and post-test measurements.
This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor. PMID:24310397
Geissbuhler, A; Hammond, W E; Hasman, A; Hussein, R; Koppel, R; Kulikowski, C A; Maojo, V; Martin-Sanchez, F; Moorman, P W; Moura, L A; de Quirós, F G B; Schuemie, M J; Smith, B; Talmon, J
ObjectiveGiven the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area.DesignThe authors performed a needs assessment, content and technology planning, implementation, and student evaluation.MeasurementsThe needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions.ResultsThe needs assessment indicated much interest in
William R Hersh; Katherine Junium; Mark Mailhot; Patricia Tidmarsh
GEMINI (Geo-Engineering Modeling through Internet Informatics) is a public-domain web application focused on analysis and modeling of petroleum reservoirs and plays (http:\\/\\/www.kgs.ukans.edu\\/Gemini\\/index.html). GEMINI creates a virtual project by ''on-the-fly'' assembly and analysis of on-line data either from the Kansas Geological Survey or uploaded from the user. GEMINI's suite of geological and engineering web applications for reservoir analysis include: (1) petrofacies-based
Purpose: The aim of the study was to evaluate the diagnostic accuracy of an informatics-based, noninvasive, prenatal paternity test using array-based single-nucleotide polymorphism measurements of cell-free DNA isolated from maternal plasma. Methods: Blood samples were taken from 21 adult pregnant women (with gestational ages between 6 and 21 weeks), and a genetic sample was taken from the corresponding biological fathers. Paternity was confirmed by genetic testing of the infant, products of conception, control of fertilization, and/or preimplantation genetic diagnosis during in vitro fertilization. Parental DNA samples and maternal plasma cell-free DNA were amplified and analyzed using a HumanCytoSNP-12 array. An informatics-based method measured single-nucleotide polymorphism data, confirming or rejecting paternity. Each plasma sample with a sufficient fetal cell-free DNA fraction was independently tested against the confirmed father and 1,820 random, unrelated males. Results: One of the 21 samples had insufficient fetal cell-free DNA. The test correctly confirmed paternity for the remaining 20 samples (100%) when tested against the biological father, with P values of <10?4. For the 36,400 tests using an unrelated male as the alleged father, 99.95% (36,382) correctly excluded paternity and 0.05% (18) were indeterminate. There were no miscalls. Conclusion: A noninvasive paternity test using informatics-based analysis of single-nucleotide polymorphism array measurements accurately determined paternity early in pregnancy.
Ryan, Allison; Baner, Johan; Demko, Zachary; Hill, Matthew; Sigurjonsson, Styrmir; Baird, Michael L.; Rabinowitz, Matthew
The availability of health information on the Internet has equalized opportunities for knowledge between patients and their health care providers, creating a new phenomenon called the e-patient. E-patients use technology to actively participate in their health care and assume higher levels of responsibility for their own health and wellness. This phenomenon has implications for nursing informatics research related to e-patients and potential collaboration with practitioners in developing a collective wisdom. Nursing informatics can use the data, information, knowledge, and wisdom (DIKW) framework to understand how e-patients and clinicians may achieve this collective wisdom. Nurse informaticists can use constructivism and Gadamerian hermeneutics to bridge each stage of this framework to illustrate the fundamentals of patient and clinician interactions and commonality of language to achieve a collective wisdom. Examining the e-patient phenomenon will help nurse informaticists evaluate, design, develop, and determine the effectiveness of information systems used by e-patients. The Internet can facilitate a partnership between the patient and clinician and cultivate a collective wisdom, enhanced by collaboration between nurse informatics and e-patients. PMID:22221955
Gee, Perry M; Greenwood, Deborah A; Kim, Katherine K; Perez, Susan L; Staggers, Nancy; DeVon, Holli A
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. PMID:15319061
The use of technology in social work practice has risen dramatically over the past 10 years. Clinical interventions such as psychotherapy using telephones, interactive video, and the Internet are gaining in popularity. For a discipline traditionally tied to face-to-face interaction, many concerns about moving to technology-based practices have…
Issues in the conflict between clinical practice and basic research in pharmacy are reviewed: professional associations' role, curriculum needs and traditions, internal strains and diversity in the profession, computer use, scholarly work of faculty, using the medical profession as a model, and misperceptions of what clinical and basic sciences…
...Submission for OMB Review; Comment Request; Cancer Biomedical Informatics Grid[supreg...Paperwork Reduction Act of 1995, the National Cancer Institute (NCI), the National Institutes...number. Proposed Collection: Title: cancer Biomedical Informatics Grid...
This study explored the barriers to a meaningful translation of didactic classroom instruction to clinical practice, using the shortened dental arch (SDA) concept as a case study. A combination of survey and individual and group interviews (a mixed-methods approach) was used to collect data related to the SDA. The cohort consisted of senior dental students and their clinical teachers at the University of the Western Cape, South Africa. The response rates were 100 percent for the students (n=73) and 78 percent for the clinical teachers (n=16). Triangulation was employed to eliminate bias and strengthen the reliability of the research. In the quantitative analysis, most students (81 percent) reported having heard about the SDA concept at the university, but their responses revealed an absence of clinical implementation. The students agreed that patients can function adequately with an SDA and agreed with presenting it as a treatment option to patients. In the qualitative analysis, a "change in the clinical requirements," "being empowered by exposing them to SDA literature," and "change in health policies" were recommended measures to increase implementation of the SDA approach clinically. The students were positive about the SDA as a treatment option, but the lack of adequate knowledge and encouragement in clinical implementation was a hindrance to its use. PMID:24882776
Objective To compare the attitudes of preclinical and clinical dental students toward their own oral health using the Hiroshima University-Dental Behavioral Inventory (HU-DBI). Methods The English-language version of the 20-item HU-DBI was distributed to all preclinical and clinical students at the College of Dentistry, University of Dammam, Kingdom of Saudi Arabia. Dichotomized (agree/disagree) responses to 12 HU-DBI items were used in this study, with a maximum possible score of 12. Responses to the remaining eight statements reflected general oral health attitudes and were excluded from the analysis. Data were analyzed statistically. Results The overall response rate was 72.2% (preclinical, 72.5%; clinical, 72%). The mean HU-DBI score was significantly higher among clinical than among preclinical dental students (7 vs. 5.8; P < 0.05). Higher proportions of preclinical than clinical students did not worry about visiting the dentist but postponed dental visits until they experienced toothache. Furthermore, more preclinical than clinical students reported that their gums bled upon brushing, used a child-sized toothbrush, had observed white, sticky deposits on their teeth, and used strong strokes for toothbrushing. More clinical than preclinical students reported that they did not feel that the condition of their teeth was worsening despite brushing, worried about the color of their teeth, brushed each of their teeth carefully, and checked their teeth in the mirror after brushing. Conclusions Dental health awareness programs should be implemented and information about positive oral health attitudes should be provided to the students at an initial stage of dental training.
Among 15,174 non-duplicated Enterobacteriaceae isolates, the prevalence of carbapenem-nonsusceptible Enterobacteriaceae (CNSE) was about 2.5% at a teaching hospital in Taiwan during 2010. Among 117 available isolates of CNSE, 8.6% carried genes encoding carbapenemases. Tigecycline and colistin were the most active agents against carbapenemase-producing and non-producing isolates. Patients infected with CNSE had an all-cause in-hospital mortality of 37.3%, and mortality was similar for infections from carbapenemase producers and non-producers (14-day mortality rates: 22.2% and 21.5%; 30-day mortality rates: 22.2% and 32.3%, respectively). Continuous surveillance of CNSE is recommended in Taiwan. PMID:24016614
This article describes the inclusion and advantage of dissection in clinical rotations during medical school. Specifically, this study demonstrates the benefits of eye dissection in an ophthalmology rotation in post graduate medical training.
The problem of quantum-like representation in economy cognitive science, and genetics / L. Accardi, A. Khrennikov and M. Ohya -- Chaotic behavior observed in linea dynamics / M. Asano, T. Yamamoto and Y. Togawa -- Complete m-level quantum teleportation based on Kossakowski-Ohya scheme / M. Asano, M. Ohya and Y. Tanaka -- Towards quantum cybernetics: optimal feedback control in quantum bio informatics / V. P. Belavkin -- Quantum entanglement and circulant states / D. Chru?ci?ski -- The compound Fock space and its application in brain models / K. -H. Fichtner and W. Freudenberg -- Characterisation of beam splitters / L. Fichtner and M. Gäbler -- Application of entropic chaos degree to a combined quantum baker's map / K. Inoue, M. Ohya and I. V. Volovich -- On quantum algorithm for multiple alignment of amino acid sequences / S. Iriyama and M. Ohya --Quantum-like models for decision making in psychology and cognitive science / A. Khrennikov -- On completely positive non-Markovian evolution of a d-level system / A. Kossakowski and R. Rebolledo -- Measures of entanglement - a Hilbert space approach / W. A. Majewski -- Some characterizations of PPT states and their relation / T. Matsuoka -- On the dynamics of entanglement and characterization ofentangling properties of quantum evolutions / M. Michalski -- Perspective from micro-macro duality - towards non-perturbative renormalization scheme / I. Ojima -- A simple symmetric algorithm using a likeness with Introns behavior in RNA sequences / M. Regoli -- Some aspects of quadratic generalized white noise functionals / Si Si and T. Hida -- Analysis of several social mobility data using measure of departure from symmetry / K. Tahata ... [et al.] -- Time in physics and life science / I. V. Volovich -- Note on entropies in quantum processes / N. Watanabe -- Basics of molecular simulation and its application to biomolecules / T. Ando and I. Yamato -- Theory of proton-induced superionic conduction in hydrogen-bonded systems / H. Kamimura -- Massive collection of full-length complementary DNA clones and microarray analyses: keys to rice transcriptome analysis / S. Kikuchi -- Changes of influenza A(H5) viruses by means of entropic chaos degree / K. Sato and M. Ohya -- Basics of genome sequence analysis in bioinformatics - its fundamental ideas and problems / T. Suzuki and S. Miyazaki -- A basic introduction to gene expression studies using microarray expression data analysis / D. Wanke and J. Kilian -- Integrating biological perspectives: a quantum leap for microarray expression analysis / D. Wanke ... [et al.].
A decision support system can be approached from two major disciplinary perspectives, those of information systems science (ISS) and artificial intelligence (AI). We present in this chapter an extended ontology for a decision support system in health informatics. The extended ontology is founded on related research in ISS and AI, and on performed case studies in health informatics. The ontology
The public sectors of developing countries require strengthened capacity in health informatics. In Peru, where formal university graduate degrees in biomedical and health informatics were lacking until recently, the AMAUTA Global Informatics Research and Training Program has provided research and training for health professionals in the region since 1999. The Fogarty International Center supports the program as a collaborative partnership between Universidad Peruana Cayetano Heredia in Peru and the University of Washington in the United States of America. The program aims to train core professionals in health informatics and to strengthen the health information resource capabilities and accessibility in Peru. The program has achieved considerable success in the development and institutionalization of informatics research and training programs in Peru. Projects supported by this program are leading to the development of sustainable training opportunities for informatics and eight of ten Peruvian fellows trained at the University of Washington are now developing informatics programs and an information infrastructure in Peru. In 2007, Universidad Peruana Cayetano Heredia started offering the first graduate diploma program in biomedical informatics in Peru.
Kimball, Ann Marie; Curioso, Walter H; Arima, Yuzo; Fuller, Sherrilynne; Garcia, Patricia J; Segovia-Juarez, Jose; Castagnetto, Jesus M; Leon-Velarde, Fabiola; Holmes, King K
Subcellular experimental datasets and detailed cell models are required before modeling of whole organs. Cell modeling requires repeated interaction between simulation and experimental data. This review describes a coupled system of informatics and instrument control suitable for extracting information at the subcellular level. The BioSig informatics framework annotates time-series images with experimental variables and computed representation such as physiological responses,
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising
Alla Keselman; Robert Logan; Catherine Arnott-Smith; Gondy Leroy; Qing Zeng-Treitler
The study of special applications in the field of road transport informatics (RTI) leads to suitable multiplexing algorithms for the corresponding traffic load. Therefore the authors compare several different strategies for statistical multiplexers by means of simulation in real-time environment. According to special applications in the new field of road transport informatics (RTI) in short range mobile radio networks (SR-MRNs),
This study examined the informatics competencies of doctor of nursing practice (DNP) students and whether these competencies differed between DNP students in the post-baccalaureate (BS) and post-master's (MS) tracks. Self-reported informatics competencies were collected from 132 DNP students (68 post-BS and 64 post-MS students) in their first year in the program (2007 to 2010). Students were assessed in 18 areas of 3 competency categories: computer skills, informatics knowledge, and informatics skills. Post-BS students were competent in 4 areas (computer skills in communication, systems, documentation, and informatics knowledge about impact of information management), whereas post-MS students were competent in only 1 area (computer skills in communication). Students in both tracks reported computer skills in decision support as their least competent area. Overall, post-BS students reported slightly higher than or similar competency scores as post-MS students, but scores were statistically significant in only 3 of 18 areas. The assessment indicated that knowledge and skills on informatics competencies need to be improved, especially in computer skills for data access and use of decision support systems. Strategies are suggested to integrate competencies into existing informatics course and DNP curricula. Further studies are recommended using an objective measure of informatics competencies. PMID:24267932
Social Informatics is the body of research that examines the design, uses, and consequences of information and communication technologies in ways that take into account their interaction with institutional and cultural contexts. This article serves as a brief introduction to social informatics. Examples such as computer networks, scientific communication via electronic journals, and public access to the Internet are used
Community informatics can be defined as a strategy or discipline that focuses on the use of information and communication technologies by territorial communities. This paper analyzes the emerging community informatics evaluation literature to develop an understanding of the indicators used to gauge project impacts in community networks and community technology centers. This study finds that community networks and community technology
While interest and activity in health informatics continues to increase worldwide, concerns about the most appropriate educational preparation for practice also arise. Health informatics is an interdisciplinary field that pursues effective use of data, information and knowledge to support effective decision making; in the health field, those…
Spinal manipulation for low back complaints is an intervention supported by randomized clinical trials and its use recommended by clinical practice guidelines. Physical therapists in this country and internationally have used thrust spinal manipulation at much lower-than-expected rates, despite evidence supporting its efficacy for the treatment of acute low back pain (LBP). The purpose of this clinical commentary is to describe a physical therapist professional degree curriculum in thrust spinal manipulation and outline a method of monitoring ongoing student performance during the clinical education experience. Increased emphasis on evidence-based decision making and on the psychomotor skills of thrust spinal manipulation was introduced into a physical therapist professional degree curriculum. As part of ongoing student performance monitoring, physical therapy students on their first full-time (8-week) clinical education experience, collected practice pattern and outcome data on individuals with low back complaints. Eight of 18 first-year students were in outpatient musculoskeletal clinical settings and managed 61 individuals with low back complaints. Patients were seen for an average (+/-SD) of 6.2 +/- 4.0 visits. Upon initial visit the student therapists employed spinal manipulation at a rate of 36.2% and spinal mobilization at 58.6%. At the final visit, utilization of manipulation and mobilization decreased (13% and 37.8%, respectively), while the utilization of exercise interventions increased, with 75% of patients receiving some form of lumbar stabilization training. Physical therapist students used thrust spinal manipulation at rates that are more consistent with clinical practice guidelines and substantially higher then previously reported by practicing physical therapists. Education within an evidence-based framework is thought to contribute to practice behaviors and outcomes that are more consistent with best practice guidelines. PMID:16915979
Flynn, Timothy W; Wainner, Robert S; Fritz, Julie M
Introduction Health informatics systems are a proven tool for tobacco control interventions. To address the needs of low-income groups, the Tobacco Control Initiative was established in partnership with the Louisiana State University Health Care Services Division to provide cost-effective tobacco use cessation services through the health informatics system in the state public hospital system. Methods In this study we used a Web-based, result-reporting application to monitor and assess the effect of the 2009 federal cigarette tax increase. We assessed readiness to quit tobacco use before and after a cigarette tax increase among low-income tobacco users who were outpatients in a public hospital system. Results Overall, there was an increase in readiness to quit, from 22% during the first week of February to 33% during the first week of April, when the tax went into effect. Smokers who were female, 31 or older, African American, and assessed at a clinic visit in April were more likely to report readiness to quit than were men, those aged 30 or younger, those who were white, and those who were assessed at a clinic visit in February. Conclusion A health informatics system that efficiently tracks trends in readiness to quit can be used in combination with other strategies and thus optimize efforts to control tobacco use. Our data suggest that a cigarette tax increase affects smokers’ readiness to quit and provides an opportunity to intervene at the most beneficial time.
Moody-Thomas, Sarah; Horswell, Ronald; Yi, Yong; Celestin, Michael D.; Jones, Krysten D.
The reading comprehension performance of 30 third-graders with hearing impairments from the United Arab Emirates was examined under three teaching conditions, the key word strategy, modified reciprocal teaching, and the basic reading approach. Key word strategy and modified reciprocal teaching significantly enhanced performance in reading…
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The previous literature provides evidence that the characteristics of a successful computer system and the informatics competencies of individuals play a critical role in the adoption of information technology. However, while the combined effects of the two may provide a comprehensive view in understanding nursing informatics research, they have rarely been studied simultaneously. Therefore, this study aimed to examine the influences of computer system success and informatics competencies on nursing organizational impact. We surveyed 454 nurses who worked at international patient centers in Taiwan. The results show that both nurses' informatics competencies and nursing computer system success do have influence on nursing organizational impact. Moreover, nurses' informatics competencies have a greater effect than the superior characteristics of a nursing computer system on nursing organizational performance. Finally, implications for practitioners complete this study. PMID:24132084
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group. PMID:18436895
The promise of health information technology (HIT) has led to calls for a larger and better trained work-force in medical informatics. University programs in applied health and biomedical informatics have been evolving in an effort to address the need for health-care professionals to be trained in informatics. One such evolution is the American Medical Informatics Association’s (AMIA) 10x10 program. To assess current delivery and content models, participant satisfaction, and how graduates have benefited from the program in career or education advancement, all students who completed the Oregon Health & Science University (OHSU) offering of the AMIA 10x10 course through the end of 2006 were surveyed. We found that the 10x10 program is approaching AMIA’s goals, and that there are potential areas for content and delivery modifications. Further research in defining the optimal competencies of the medical informatics workforce and its optimal education is needed.
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group.
The National Agenda for Public Health Informatics calls for standards in data and knowledge representation within public health, which requires a multi-level framework that links all aspects of public health. METHOD: The literature of public health informatics and public health informatics application were reviewed. A UML-based systems analysis was performed. Face validity of results was evaluated in analyzing the public health domain of lead poisoning. RESULTS: The core class of the UML-based system of public health is the Public Health Domain, which is associated with multiple Problems, for which Actors provide Perspectives. Actors take Actions that define, generate, utilize and/or evaluate Data Sources. The life cycle of the domain is a sequence of activities attributed to its problems that spirals through multiple iterations and realizations within a domain. CONCLUSION: The proposed Public Health Informatics Meta-Framework broadens efforts in applying informatics principles to the field of public health
Biodiversity informatics plays a central enabling role in the research community's efforts to address scientific conservation and sustainability issues. Great strides have been made in the past decade establishing a framework for sharing data, where taxonomy and systematics has been perceived as the most prominent discipline involved. To some extent this is inevitable, given the use of species names as the pivot around which information is organised. To address the urgent questions around conservation, land-use, environmental change, sustainability, food security and ecosystem services that are facing Governments worldwide, we need to understand how the ecosystem works. So, we need a systems approach to understanding biodiversity that moves significantly beyond taxonomy and species observations. Such an approach needs to look at the whole system to address species interactions, both with their environment and with other species. It is clear that some barriers to progress are sociological, basically persuading people to use the technological solutions that are already available. This is best addressed by developing more effective systems that deliver immediate benefit to the user, hiding the majority of the technology behind simple user interfaces. An infrastructure should be a space in which activities take place and, as such, should be effectively invisible. This community consultation paper positions the role of biodiversity informatics, for the next decade, presenting the actions needed to link the various biodiversity infrastructures invisibly and to facilitate understanding that can support both business and policy-makers. The community considers the goal in biodiversity informatics to be full integration of the biodiversity research community, including citizens’ science, through a commonly-shared, sustainable e-infrastructure across all sub-disciplines that reliably serves science and society alike.
Aims. To quantify the presence of SCCmec types and virulence genes among Staphylococcus aureus colonizing and infecting patients from a teaching hospital. Methods. We analyzed 225 and 84 S. aureus isolates recovered from surveillance and clinical cultures, respectively. Strains were studied for the presence and type of SCCmec, as well as for several virulence genes. Univariate and multivariable analysis were performed in order to identify predictors of invasiveness (defined as isolation from clinical cultures). Results. The presence of SCCmec types III (OR, 2.19, 95% CI, 1.08–4.45) and IV (OR, 5.28 95% CI, 1.35–20.63) and of genes coding for exfoliative toxin B (etb, OR, 6.38, 95% CI, 1.48–27.46) and Panton-Valentine leukocidin (pvl, OR, 2.38, 95% CI, 1.16–4.86) was independently associated with invasiveness. Conclusions. SCCmec types III and IV and virulence genes are associated with greater invasiveness of S. aureus. Patients colonized with methicillin-resistant S. aureus, as well as with strains harboring etb or pvl, may be prone to develop invasive disease. Infection-preventing strategies should be more intensively applied to this group.
Rodrigues, Marcus Vinicius Pimenta; Branco Fortaleza, Carlos Magno Castelo; Martins Souza, Camila Sena; Teixeira, Natalia Bibiana; Ribeiro de Souza da Cunha, Maria de Lourdes
Computer scientists, biologists, and natural resource managers recently met to examine the prospects for advancing computer science and information technology research by focusing on the complex and often-unique challenges found in the biodiversity and ecosystem domain. The workshop and its final report reveal that the biodiversity and ecosystem sciences are fundamentally information sciences and often address problems having distinctive attributes of scale and socio-technical complexity. The paper provides an overview of the emerging field of biodiversity and ecosystem informatics and demonstrates how the demands of biodiversity and ecosystem research can advance our understanding and use of information technologies.
Schnase, J. L.; Cushing, J.; Frame, M.; Frondorf, A.; Landis, E.; Maier, D.; Silberschatz, A.
The purpose of this paper is to describe the emerging role of the nurse as Information Systems Specialist and to delineate a prototype educational curriculum in Nursing Informatics that is designed to prepare nurses for this role. The major duties, knowledge required, and resulting interactions related to the role are discussed. Program objectives, admission requirements, and a description of the major areas of coursework are also outlined. The impact of this model program in strengthening the organization and management of nursing services in the health care system is also emphasized.
A Delphi study was accomplished on the topic "what is needed to implement the information society within healthcare? and which research topics should be given higher priority than other topics to achieve the desired evolution?", involving 29 international experts. The study comprised of four phases, (I) a brainstorming phase based on a open question; (II) an evaluation phase for mutual commenting; (III) a feedback phase allowing corrections/extensions; and (IV) a phase collecting the ratings of individual issues within a questionnaire synthesised from the previous phases. A total of 110 research items and 58 supplementary barriers were raised, divided into 14 topics grouped according to homogeneity. The emphasised research topics are business process re-engineering, the electronic patient record and connected inter-operating systems, (support for) evidence-based medicine and clinical guidelines, and education. Issues inherent to the healthcare domain often are the kernel of the research recommended. Similarly, methods and 'people'-issues are strongly emphasised among the research issues in general and among those for which the experts' joint opinion was rated as statistically significant. In contrast, only a minority of the research issues emphasised was related to technical issues. PMID:10978926
A clinical trials training approach to supervision is a promising and empirically supported method for preparing addiction counselors to implement evidence-based behavioral treatments in community treatment programs. This supervision approach has three main components: (1) direct observation of treatment sessions; (2) structured performance…
Martino, Steve; Gallon, Steve; Ball, Samuel A.; Carroll, Kathleen M.
BACKGROUND: Earlier studies have successfully demonstrated that medical students can achieve success in core clinical rotations with long term attachments in small groups to rural general \\/ family practices. METHODS: In this study, three students from a class of 226 volunteered for this 1-year pilot program, conducted by the University of Queensland in 2004, for medical students in the 3rd
Stephen A Margolis; Llewellyn M Davies; Valmae Ypinazar