Medical Informatics Defined

Medical Informatics Definitions

• Medical Information Science uses system-analytic tools to develop algorithms for management, process control, decision making, and scientific analysis of medical knowledge.
• Ted Shortliffe originated the definition for Medical Information Science
• Medical Informatics includes theoretical and practical aspects of information processing and communication.
• Medical Informatics is based on knowledge/experience from medicine and health care processes, according to Jan van Bemmel.
• Medical informatics intersects information science, computer science, and health care.
• It optimizes the acquisition, storage, retrieval, and use of information in health and biomedicine.
• Medical informatics concerns cognitive, information processing, and communication tasks related to medical practice, education, and research.
• It encompases information science and technology and supports medical tasks.
• Medical informatics is a rapidly evolving scientific field.
• It is concerned with optimizing the storage, retrieval, and management of biomedical information for problem-solving and decision-making.
• Edward Shortliffe of Stanford University posed "What is medical informatics?" in 1995.

Health Informatics Components

• Health informatics includes information technology, health care, research, and education.
• Fundamentals of health informatics are communication, knowledge management and decision support.
• It is heavily involved in clinical information management.

Technology Needs for Students

• Laptops
• Microsoft Office Professional
• Stedman's Medical Spellchecker
• Endnotes
• Adobe Photoshop Elements
• Medical References

Personal Digital Assistants (PDAs)

• PDAs contain evidence-based references, disease references, medical calculators, and drug references.
• PDAs contain medical dictionaries and the CDCS system.
• Computer labs can offer student teaching and faculty development.

Improving Educational Strategies

• Medical informatics improves didactic vs. problem-solving educational strategies.
• Competencies include word processing, information retrieval, and information management.
• Data analysis, presentation, communication skills are key competencies.
• E-mail, file transfer, and web skills are critical.

Applications of Informatics in Healthcare

• Informatics is used in telemedicine, teletadiology, patient e-mail and presentations.
• Knowledge management uses journals, consumer health information, and evidence-based medicine.
• Decision support uses reminder systems, diagnostic expert systems, and drug interaction checks.
• Information management benefits from electronic medical records, billing transactions, and ordering systems.

Diagnostic-Therapeutic Cycle

• Computers aid in data collection, including history, physical examinations, and lab tests.
• Analyzing data leads to decision-making, which informs therapeutic planning and diagnoses/assessments.
• This planning is then put into action with the patient and creates new data.

Medical Informatics in Education

• The goal is to avoid frustration from lack of computer knowledge.
• Despite frustration, computers and IT are wanted now.
• Medical informatics has numerous areas like:
• Hospital information systems.
• Clinical decision-support systems.

Hospital Information Systems

• Electronic medical records
• Medical vocabularies
• Laboratory information systems
• Pharmaceutical information systems
• Radiological imaging information systems.
• Patient monitoring systems.

Clinical Decision-Support Systems

• Diagnosis/interpretation
• Therapy/management

Health Informatics Tools

• Tools include computers, clinical guidelines, formal medical terminologies, and information/communication systems.
• These tools apply to nursing, clinical care, dentistry, pharmacy, public health and biomedical research.

Infrastructure to Support Informatics Curriculum

• Hardware/Software
• Support Issues
• Workflow/Mindset Issues
• Training Issues
• Budgeting Issues

Infrastructure for Medical Informatics

• The infrastructure utilizes student and faculty PDAs, including Stedman's Medical Dictionary and InfoRetriever.
• Data collection and evaluation is done using Arcstream System, Avantgo Server, and SQL Server.
• College of Medicine Network Infrastructure includes technology-enhanced classrooms and campus-wide wireless.
• The college network uses video conferencing, file sharing, web servers for video sharing and student research.
• A good infrastructure includes IT section support, such as Database Development, Web design, Video Editing and tech support.
• Student wireless laptops are an important resource.
• Resources may include Microsoft Office Professional, Dorland's Medical Spellchecker, and Adobe Photoshop Elements.
• Virtual Library Resources
• Blackboard Courseware
• All Courses

Computer-Aided Instruction

• Computer-aided instruction means using a variety of computer-based resources.
• It leverages applications for information management, decision support, and communication.
• Medical informatics involves computer applications, knowledge, skills, and the use of biomedical information.

Computers in Medical Education

• Changes in healthcare delivery/learning styles require evaluation of new teaching tools, including computers.
• Computers won't replace patient interaction, but enhance learning through interactive environments.

Teaching with Computers

• The first serious introduction of computers into medical education was two decades ago.
• De Dombal introduced computer-based material to enhance medical trainee understanding of management.
• The training was for trainees in an emergency department that were managing patients with acute abdominal pain.

Adopting Change

• Medical schools have long recognized the need to revise their teaching, but have been slow.

Patient Data

• Patient data is key.
• Coordination of patient data becomes paramount as medical knowledge expands.
• Medical informatics will have increasing influence in our working lives as clinicians.

Traditional Didactic Methods

• Traditional resources have always been available in medical education.
• Teaching traditionally involves learning centered on patients, backed up by lectures and tutorials.
• Information can be obtained from journals.
• These traditional resources are no longer sufficient.

Shifting to Problem-Based Learning

• Medical education has shifted philosophically recent years.
• Schools have shifted from lecturing to a problem-based approach.
• The McMaster and Newcastle medical schools pioneered this shift.

Virtual Reality

• Virtual reality in simulated procedures is a new application of computers in medical education and is yet in its infancy.
• Virtual reality standardizes procedures and lets trainees be able to test and practice their different skills.

Cybernetics Encompasses

• Theory of Information, Communications, Coding and Algorithms
• Probabilities and Stochastic Processes.
• Theory of Control
• Operations Research
• Optimization & Management Science
• Systems Analysis

Library Resources

• Material is now available in electronic formats and on CDs or online.
• These digital resources save storage space and manpower
• Students can use library facilities electronically, often from home.

Faculty's Role

• Faculty must identify information and skills students need.
• Faculty help students access electronic information sources and learn course content.
• Faculty show students how to access information electronically.

Students' Responsibility

• Students need to acquire knowledge about relevant sources of information.
• Students must develop the skills to access electronic information.

Handheld Applications

• ePocrates
• 5 Minute Clinical Consult
• Medical Calculators, and Immunization schedule

Medical Informatics Empowers Students

• A goal is for students to be independent, information seekers, and proficient with computer tech.
• This can be inadequately implemented throughout medical school.

Orientation by Teachers

• The goal of preparing of students to be medical information managers is what Teachers should strive for.
• This is a strong rationale for using medical Informatics.
• It indicates the appropriateness of offerings and outcomes.

Indian Journal of Medical Informatics (IJMI)

• The IJMI is has open access.
• It is peer-reviewed online journal adopting a broad definition of medical informatics
• It focuses on applied aspects of computers to healthcare delivery.

IT Basics of Security

• Ensure workstation is physically safe and secure.
• Don't send passwords by email
• Don't paste passwords beside the workstation
• Install and regularly (weekly) update virus protection
• Avoid sending attachments
• Don't open unsolicited attachments; always check file extensions.

Security

• Never open unexpected files with EXE, COM, DOC, DLL, PIF, LNK, VBS extensions.
• Be careful of links and hover with the mouse look at the status bar where the link leads when clicked
• Firewalls may protect or cheat you

Implementation Barriers

• Stakeholder Attitudes and Perceptions,
• Stakeholder development
• Funding
• Time
• Technical Support
• Availability and Accessibility

Important websites

• medicalstudent.com : A digital library of authoritative medical information for medical students.
• about.com: The greatest collections of information on diseases and conditions on the Net.
• bestdoctors.com : Provides contact on the best doctors and provide the best content on a site that others can access free of charge.
• healthatoz.com : Contains so much information that there's little chance you won't find what you're looking for.
• healthcommunities.com : Offers information designed to give you disease-related information through channels."
• healthfinder.gov : A government portal that delivers quickly and with reliability.
• intelihealth.com : Intelihealth is your gateway to top-notch information.
• nih.gov: Contains the leading collection of health research institutes in the world.
• nlm.nih.gov: Best electronic medical library in the world
• webmd.com : divided for different audiences, ranging from patients and doctors to physician assistants to health teachers.

Standards for Exchange and Management of Medical Information

• Interoperability between systems across different platforms needs to be maintained.
• HL7 (Health Level 7) aims to provide standards for exchange.
• This standard includes management/integration of data for clinical patient care, delivery and evaluation of health care services.
• Digital Imaging and Communications in Medicine (DICOM): uses diagnostic images, waveforms and test reports.

Computers in Medicine

• The computer is here to stay in one form or another.
• Computers are of considerable educational benefit and will serve medical students and practitioners throughout their careers

IT is part of the solution to Medical Education

• Remember that it is not a fix all
• Information technology must not be viewed as a potential cure to the current ailments of medical education. It may be part of the solution and should be treated as such

Educational strategies

• Didactic vs problem solving
  • Word processing
  • Information retrieval
  • Information management
  • Data analysis
  • Presentation
  • Communication skills
  • E-mail, file transfer, web

Approaching Basic Sciences Classes with Medical Informatics

• Anatomy lab video
• Digital web-slide program (BacusLabs)
• Gold Standard Multimedia
• An atlas of Cross Sectional Anatomy
  • LXR Testing Program
    • Question bank
    • Computer-based testing
    • Item analysis/grading
  • United Streaming Videos -Anatomy -Histology
  • Web Path