Showing papers in "Yearb Med Inform in 2000"

Managing Clinical Knowledge for Health Care Improvement

Abstract: Quality health care rests fundamentally on the achievements of biomedical research. All health outcomes are improved by sound science: health status can be turned around by transplantation when someone's life is in jeopardy due to a diseased organ; social functioning can be improved by shock wave lithotripsy that -leads to faster recovery; and satisfaction can beenhanced when children with moderate or severe asthma receive appropriate anti-inflammatory treatment. To improve the quality of health care that patients actually receive, both biomedical research production and especially its introduction into clinical practice need to be examined.

Patient-Computer Dialogue: A Review.

Abstract: Since the first study of communication between patient and computer was performed at the University of Wisconsin in 1965, programs for patient-computer dialogue have been developed, implemented, and studied in numerous settings in the United States and abroad, and the results have been encouraging. This review presents a brief history of patient-computer dialogue together with suggested guidelines for programs in the future.

Patient-centered Information Systems.

Abstract: Patient-centered information systems augment traditional approaches to health information management with specific functions designed to support patient participation in health care decision making and treatment activities. In addition to computer-based record systems and business management applications, patient-centered information systems must include functionality that support communication between clinician and patient, and that provide information and peer support in a timely fashion to the patient. Current progress in information systems demonstrates the existence and feasibility of consumer health informatics, patient access to computerized clinical records, and technical and organizational solutions to integrating computerized patient information systems. We are now proposing a model of patient-centered system that incorporates all those components, and provides a vision of the future.

Twenty Five Years of Medical Informatics Education at Heidelberg/Heilbronn: Discussion of a Specialized Curriculum for Medical Informatics.

Abstract: The specialized university curriculum for medical informatics (MI) at the University of Heidelberg/School of Technology Heilbronn is one of the oldest educational approaches in the field of medical informatics, and has been successful for 25 years with about 1,000 graduates (Diplom-lnformatikerin der Medizin or Diplomlnformatiker der Medizin). It belongs to the category of dedicated master's programs for medical informatics and is based on the concept of medical informatics as a medical discipline in its own right. The curriculum is oriented towards the total spectrum of medical informatics ranging from health care economics, biosignal and medical image processing, medical documentation, to information and knowledge processing in medicine. It is a 4.5-year program with strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. Thirty-five students are admitted each semester, and in total about 440 students are enrolled. The faculty consists of 17 full-time members and about 25 parttime lecturers.We report on characteristics, structure and contents of the new 5th version of the curriculum and discuss the features of a specialized curriculum for medical informatics with respect to the challenges for medical informatics in the 21st century.

Medical Informatics Research and Training at the Lister Hill National Center for Biomedical Communications.

Abstract: The Lister Hill National Center for Biomedical Communications was established by a joint resolution of the United States Congress in 1968 as a research and development division of the National Library of Medicine (NLM). Lister Hill Center research is carried out through several major programs, all sharing the purpose of improving health-care information dissemination and use. We conduct our research by drawing on a diverse set of scientific fields and methods (see [125] for a sample of our recent publications.) Our researchers have backgrounds in medicine, computer science, library and information science, linguistics, engineering, and educaJtion. We conduct both basic and ap!lilied informatics research and are engaged in a number of broad research areas. Knowledge processing research tincludes language and information })rocessing and expert systems reJearch. Information systems research Includes consumer health informatics, tabase systems, digital library rech, and medical education sys. Image processing research in• des image segmentation, compres' and transmission methods and orithms. We are also the focal point · NLM' s high performance computactivities, including research sup-

Biomdecial and Health Informatics Research and Education at the University of Washington.

Abstract: Although an extensive medical informatics research program as well as courses and training experiences in biomedical informatics have existed at the University of Washington (UW) for many years, a formal home did not exist until 1997 when the Division of Biomedical Informatics was created in the Department of Medical Education, School of Medicine. Since that time the expansion of the research, service and teaching programs has been rapid with a key milestone being a university commitment to provide funding, space and faculty to support the development of a new graduate program in Biomedical and Health Informatics. Hallmarks of the biomedical and health informatics program at the University of Washington include: - Strong shared belief that informatics research can contribute to the improvement of healthcare and health; - Large, multidisciplinary faculty including faculty from computer science, library and information science as well as the health sciences schools (dentistry, medicine, nursing, pharmacy, and public health and community medicine); - Comprehensive research and development partnership with the University of Washington Medical Centers information systems group and the UW Primary Care Network to move research from the laboratory to operational clinical systems; - Extensive and diverse regional setting in which to study information needs and develop informatics solutions in primary care settings; - Lack of barriers to interdisciplinary research and teaching.

Research at the Department of Medical Informatics, Statistics and Documentation of the University of Graz.

Abstract: The Department of Medical Informatics, Statistics and Documentation of the University of Graz has a double responsibility: research in medical informatics, and implementation and operation of information systems in the hospital. Research is therefore application oriented with emphasis on departmental information systems, image management, and information integration. Other topics include analysis of the preconditions for the acceptance and successful use of information systems in medicine, and the ethics and professional responsibility of medical informatics.

Changing the paradigm for Computer-based Patient Records.

Abstract: Reading the four papers that are included in this year's Computer-based Patient Record (CPR) section of the Yearbook, it becomes apparent that there are two diametrical perspectives on the current status of CPRs. Three of the papers (Stair [1], Archbold et al. [2], and Tange et al.[3]) make the underlying assumption that current models of CPRs are appropriate and accurately reflect the needs of practitioners involved in patient care. These papers seek to further the cause of CPRs by providing evidence that such systems can after clinical benefits. Conversely, the paper by Berg [4] rejects the assumption that current CPR models are adequate, citing the fact that there are few, if any, fully integrated CPRs in routine use. Berg argues that the problem with current implementations of CPRs lies in the incorrect model of medical work that is inscribed in them. His study, based on participatory observation, describes medical work from a sociological perspective and examines the consequences of this perspective on current and future CPRs.

Integrated Information Systems.

Abstract: This section of the Yearbook contains a diverse collection of nine papers under the heading Integrated Information Systems. The problems and systems they describe are quite different, but they have in common the fact that each addresses one or more issues involved in integrating or bringing together health information and the people who use it, including consumers, patients, clinicians, epidemiologists, researchers, and policy makers. Two of the papers discuss use of internet by consumers seeking health information and advice, two are concerned with improving prescribing practices, two address two sides of the identification coin: assuring accurate identification of patients to link data in separate repositories, and assuring effective concealment of patient identity when aggregated data is handed over for research; finally, three papers describe systems for using· internet technology to enable sharing of information for -disease surveillance or clinical research.