Understanding Medical Informatics

Medical Informatics Definitions

• Medical Information Science uses system-analytic tools to develop procedures for managing, controlling processes, making decisions, and scientifically analyzing medical knowledge. Ted Shortliffe defined it.
• Medical Informatics includes theoretical and practical aspects of information processing and communication grounded in medical and healthcare knowledge and experience. Jan van Bemmel defined it.

Medical Informatics

• Medical informatics intersects information science, computer science, and health care.
• Medical informatics optimizes the acquisition, storage, retrieval, and use of information in health and biomedicine.
• It concerns itself with the cognitive, information processing, and communication tasks in medical practice, education, and research.

Health Informatics as a Rapidly Developing Science

• Medical informatics is a rapidly developing science that deals with resources, devices, and formalized methods for optimizing storage, retrieval, and management of biomedical information for problem-solving and decision-making.
• Edward Shortliffe defined medical informatics at Stanford University in 1995.

Health Informatics Consists Of

• Information Technology includes health care, research, and education.
• Fundamentals includes communication, knowledge management, and decision support.
• Clinical Information Management is a fundamental component.

Medical Informatics Components

• Aspects of Medical Informatics Include:
• Knowledge Management
• Clinical Information Management
• Communication
• Decision Support

Technology Needs for Students

• Laptops for each student
• Microsoft Office Professional is needed.
• A medical spellchecker
• EndNote software is needed.
• Adobe Photoshop Elements
• Medical References

Personal Digital Assistants (PDAs)

• PDAs are useful for medical students.
• They include Evidence-Based References, Disease References, Medical Calculators, Drug References and Medical Dictionaries.
• They also include access to the CDCS system.
• Computer labs for student and faculty development are helpful.

Medical Informatics Improves Educational Strategies

• It involves practical applications compared to didactic learning.
• Competencies include word processing, information retrieval, information management, data analysis, presentation skills and improved communication skills.
• Improved communication skills include E-mail and file transfer capabilities.

Informatics Use in Healthcare

• Communication: telemedicine, teleradiology, patient e-mail, and presentations.
• Knowledge Management: journals, consumer health information, and evidence-based medical information.
• Decision Support: reminder systems, diagnostic expert systems, and drug interaction information.
• Information Management: electronic medical records, billing transactions, and ordering systems.

Computer Makes The Diagnostic-Therapeutic Cycle

• Data collection involves the history, physical examinations, and laboratory and other tests.
• A patient's care includes data collection, assessment/diagnosis, planning, decision making and new information.

Why Learn Medical Informatics?

• Computers are a key part of the modern world.
• Some knowledge of the underlying mechanisms of computers is needed.

Examples of Medical Informatics Areas

• Hospital information systems: electronic medical records, medical vocabularies, laboratory, pharmaceutical, and radiological information systems, and patient monitoring systems.
• Clinical decision-support systems include diagnosis/interpretation and therapy/management.

Medical informatics tools

• Utilizes not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems.
• Medical informatics tools are applied to nursing, clinical care, dentistry, pharmacy, public health, and (bio)medical research.

Infrastructure to support Informatics Curriculum

• Hardware/Software
• Includes support, workflow/mindset, training, and budgeting issues.

Infrastructure for Medical Informatics

• Student and Faculty PDAs include Stedman's Medical Dictionary, InfoRetriever, ePocrates, PDxMD, and CPOnhand.
• A data Collection and Evaluation System includes Arcstream System, Avantgo Server and SQL Server.
• College of Medicine Network Infrastructure includes Technology Enhanced Classrooms, Campus-Wide Wireless Coverage, and Video Conferencing.
• IT Section Support includes Database Development, Web design, Video Editing and Tech Support.
• Student Wireless Laptops have Microsoft Office Professional, Dorland's Medical Spellchecker, Photoshop Elements, and Endnote.
• Blackboard Courseware hosts All Courses.

Computer-Aided Instruction

• Applying computer-aided instruction involves learning about computers, their applications, and the use of computer-based information resources.
• It also uses computers as a tool and a mechanism for information management, decision support and includes communication.
• Medical informatics is not just computer applications but the skills and attitudes to use biomedical information.

Computer and Medical Informatics

• Changes in healthcare delivery and learning styles in medical education require the use and evaluation of new teaching tools, including computers.
• Computers can reproduce an interactive environment that can mimic medical situations, and unlikely to replace patients during learning.

Attempts of Teaching with Computers

• Medical education introduction was made two decades ago.
• De Dombal used computer-based material to teach emergency department trainees how to manage patients with acute abdominal pain.

Adapting to Change is Slow

• Medical schools have acknowledged the need to revise their teaching methods.
• Change has been slow.

Patient Data as an Information Source

• Medical knowledge is rapidly expanding.
• There are increasing demands for efficient coordination of patient data.
• Pressures for improved practice and application of evidence-based medicine exist.
• Medical informatics will have an increasing influence in the work of clinicians.

Limitations of Traditional Didactic Methods

• Traditionally, instructors and students rely on traditional resources in medical education.
• These traditional resources include teaching with a patient and lectures/tutorials, but this is no longer sufficient.

Medical Education Shifting to Problem-Based Learning

• There has been a philosophical shift in medical education in recent years.
• McMaster and Newcastle medical schools pioneered this shift.
• There has been a move away of traditional, lecture-focused programs.
• Shift to a problem-based approach.

Virtual Reality in Teaching

• Virtual reality in simulated procedures aids medical education.
• It is a new application of computers in medical education.
• Procedures can be standardized, and trainees able to test and practice their skills.

Cybernetics

• Cybernetics includes: Theory of Information, Communications, Coding, Algorithms, Probabilities, and Stochastic Processes.
• It also covers Theory of Control, Operations Research, Optimization, and Systems Analysis.

Library Resources go Electronic

• Modern libraries are converting to electronic formats.
• An increasing amount of electronic journals are available on CD-ROM or the Internet, saving storage space and manpower.
• Students can now review studies using library facilities electronically.

Faculty should Provide Electronic Information

• Faculty must point out the information and skills students need, as well as the information they need to "how to access" that data electronically,

Students Should Show Interest in Electronic Information

• Students must change their attitudes about learning.
• Students must be information seekers and managers.
• They also need knowledge and skills to access electronic information.

Handheld Applications

• Hand held applications include ePocrates, 5 Minute Clinical Consult, Medical Calculators and Immunization schedule.

Medical Informatics Empowers Students

• Students become independent learners, information seekers, and proficient users of computer technology.
• These goals were often inadequately implemented throughout the medical school curriculum.

Teachers and Primary Goals

• Orienting students prepare to be medical information managers is a primary goal.
• There is a solid reason/rationale for adding medical informatics curricula.
• There is a standard to see whether offerings are appropriate, and outcomes can be judged.

Indian Journal of Medical Informatics (IJMI)

• Indian Journal of Medical Informatics(IJMI) is an open-access, peer-reviewed online journal.
• The journal covers the applied aspects of computers to healthcare delivery.

IT Security Basics

• Workstations have to be physically safe and passwords must not be sent by email or pasted to the workstation.
• Virus protection must be updated weekly and attachments should be avoided.
• An attachment's file extension should checked and no unsolicited attachments should be opened.

Information Technology and Security

• Files with EXE COM DOC DLL PIF LNK VBS(Windows does not show LNK and PIFextensions) should not be opened.
• Users need to hover the link with a mouse and looking at the status bar before clicking it.
• Firewalls may protect the user, but are not always secure.

Barriers to Implementation

• Stakeholder Attitudes and Perceptions internal obstacles.
• Funding barriers exist externally.
• There needs to be enough time.
• Technical Support
• There needs to be Availability and Accessibility.

Knowledge is Exploding and Patients are Demanding

• The amount of current medical knowledge requires more effective integration and use.
• Better information sharing with patients is required.

Improving Professional Standards with Medical Informatics

• Goals include improving healthcare through information technology.
• Goals include promoting traditional values in the medical profession and the renewal of the same.

Medical informatics in Curriculum

• Medical informatics should be incorporated into medical school curricula in developing countries.
• This allows physicians to access, analyze, and manage information for patient care decisions.
• Technology helps information sharing with colleagues, public and patient education, and for professional development

Electronic Media

• Computer technology now provides immediate access to information and a mechanism for rapid dissemination of knowledge.
• Computer technology has become an important component of education.
• Computer-assisted instruction (CAI) is integrated into continuing medical education.

Continued Efforts by Faculty

• Continued efforts should be made to teach the skills necessary so medical students can benefit from technology.
• Students should be introduced to computer-based testing early to improve their comfort.

Educational Strategies

• Medical Informatics should increase didactic vs problem solving skills.
• This includes competence in: word processing, information retrieval, information management
• Competence in: data analysis, presentation and communication skills, email and web use.

Approaching basic sciences classes with medical informatics

• Anatomy lab video should be enabled
• Integration of BacusLabs digital web slide program, Gold Standard Multimedia* and Cross Sectional Anatomy.
• Utilization of LXR Testing Program - Question bank, Computer-based testing and Item analysis/grading.
• Utilization of United Streaming Videos for Anatomy and Histology and the Web Path.

Medical Informatics Makes Better Health Managers

• Preparation of students should include medical information management.
• There should be a strong reasoning behind inclusion into the curriculum.

MedicalStudent.com

• A digital library of authoritative medical information for the medical student and all students of medicine.

About.com/www.about.com

• Contains collections of information on diseases and conditions.
• It spans the globe and provides interactive chats and forums for experts and patients to come together.

Bestdoctors.com

• This website is dedicated to empowering patients via providing the best doctor information.
• Find content on a site accessibly

Healthatoz.com

• The site contains so much information users are sure to find what they’re looking for.
• The amount of interactive tools make information searches more enjoyable.
• Intensify a search for extra sources of information.

Healthcommunities.com

• Designed to provide disease-related information using channels.
• It is an interactive medical portal, offering chats, discussion forums, and clinical trials.
• Gain access to medicine in seconds.

Healthfinder.gov

• It delivers quick, reliable government portal for a world of medicine.
• It relies on access tools like libraries, online journals, medical dictionaries and hot topics.
• A big benefit of this site is providing content in Spanish.

Intelihealth.com

• Whether it's drug information, a medical dictionary, or a list of diseases and conditions, Intelihealth is the go-to for help.
• This is your gateway to top-notch information.
• Ties into Harvard consumer information

NIH.gov

• Provides the leading collection of health research institutes in the world and is a gateway to health information.
• The latest in research and well-written fact sheets and brochures inform all.

NLM.NIH.gov

• It is the best electronic medical information library across the globe.
• Access research and important links.

WebMD.com

• A heavily marketed portal nicely divided by the audience.
• There is a robust television service.

Standards For Exchange and Management of Medical Information:

• Interoperability should be maintained between systems across different platforms.
• HL7 (Health Level 7) provides standards for data exchange, management, and integration to support clinical care services.
• DICOM (Digital Imaging and Communications in Medicine) provides diagnostic images, waveforms and test reports.

Computer Are Staying

• The computer is likely here to stay.
• Appropriately used computers can be beneficial for students and practitioners.

IT is Not A Remedy

• IT is not a remedy for all ills in medicine
• It can be part of the remedy and should be treated as such.