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A philosophy for health informatics education in developing countries: Nigeria as a case study.

The use of computers in the health sector has increased significantly during the last few years in Nigeria. This paper addresses the integration of health and informatics education, or health education and informatics education, or informatics education in health care delivery. It gives an introduction to the status of a health informatics programme in the daily practice of computer use. The essence of a health informatics curriculum, the planning and administration of the programme in medical schools, and what informatics education offers the health sector, even in a developing country, are presented. The problems of administering an informatics programme in a conventional medical training curriculum are highlighted. The article describes the philosophy which should underline the framework for the formulation of appropriate national policies and curricula for health informatics education in developing countries, using Nigeria as a case study.

Curriculum↗

Transformation of health care through innovative use of information technology: challenges for health and medical informatics education.

Information storage and processing continues to become increasingly important for health care, and offers enormous potential to be realised in the delivery of health care. Therefore, it is imperative that all health care professionals should learn skills and gain knowledge in the field of health informatics, or medical informatics, respectively. Working Group 1, Health and Medical Informatics Education, of the International Medical Informatics Association (IMIA WG1) seeks to advance the knowledge of how these skills are taught in courses for the various health care professions around the world, and includes physicians, nurses, administrators, and specialists in medical informatics. IMIA WG1 held its 6th International Conference on Health and Medical Education in Newcastle, Australia, in August 1997. The theme of the conference was 'Transformation of Healthcare through Innovative Use of Information Technology'. This special issue of the International Journal of Medical Informatics on Health and Medical Informatics Education contains selected papers presented at the conference. In addition to the central topic, Educating Health Care Professionals in Medical Informatics the topics telematics, distance education and computer based training were also discussed at the conference.

Health Occupations↗

A framework for the biomedical informatics curriculum.

The problem of developing a curriculum for biomedical informatics is highly dependent on how we choose to define and practice the field. Numerous authors have questioned how to position biomedical informatics along the continuum of formal, empirical and engineering disciplines. A concern with current educational programs in biomedical informatics is that students finish without a clear understanding of the relation between theory and practice, or worse, with the impression that the field does not possess any theoretical basis. In this paper, we propose that biomedical informatics curricula explicitly address skills and competencies at three levels: formal, empirical, and applied. We posit that that knowledge of formalization is necessary to build testable empirical models, and that model-driven approaches are necessary for deploying information systems that can be evaluated in a meaningful way. A curricular framework is proposed that identifies a set of methods, techniques and theories that have broad applicability within the domain of biomedicine, and which can span a wide range of application areas: bioinformatics, imaging informatics, clinical informatics and public health informatics. A stronger linkage between theory and practice will result in students who are empowered to create effective and lasting solutions to biomedical problems.

Computational Biology↗

Biomedical informatics training at Stanford in the 21st century.

The Stanford Biomedical Informatics training program began with a focus on clinical informatics, and has now evolved into a general program of biomedical informatics training, including clinical informatics, bioinformatics and imaging informatics. The program offers PhD, MS, distance MS, certificate programs, and is now affiliated with an undergraduate major in biomedical computation. Current dynamics include (1) increased activity in informatics within other training programs in biology and the information sciences (2) increased desire among informatics students to gain laboratory experience, (3) increased demand for computational collaboration among biomedical researchers, and (4) interaction with the newly formed Department of Bioengineering at Stanford University. The core focus on research training-the development and application of novel informatics methods for biomedical research-keeps the program centered in the midst of this period of growth and diversification.

Biomedical Engineering↗

Training residents in medical informatics.

BACKGROUND AND OBJECTIVES: A number of medical educators have called for an increased emphasis on medical informatics training, but few family practice residency programs have provided more than cursory teaching efforts in this area. This paper provides an overview of approaches to medical informatics education that have been implemented with some success by "pioneer" programs. A comprehensive review of the literature reveals many promising teaching applications of informatics tools, such as palmtop computing devices, e-mail, decision support software, and videoconferencing. However, barriers to the advancement of informatics training in residency remain, including low rates of computer ownership and use among residents, a lack of information regarding faculty computer skills, and lack of collaboration among programs teaching informatics. Based on the literature review and tempered by expert recommendations, an eight-step process for developing or refining a family medicine informatics curriculum is proposed: 1) conduct a needs assessment 2) review expert recommendations, 3) enlist faculty and local institutional support, 4) espouse a human-centered approach, 5) integrate informatics training into the larger curriculum, 6) provide easy access to computers, 7) provide practical training, and 8) measure and report educational outcomes.

Computer Literacy↗

[Medical informatics in research, teaching and patient management].

The field of medical informatics in its current understanding is defined and criteria distinguishing this field from similar areas are provided. Special consideration is given to its position at a School of Medicine - in particular to the University of Vienna Medical School with the Vienna General Hospital as its teaching hospital. Demands for medical informatics and electronic data processing (EDP) in this extended field of activity come from four different sources: (1) research in medical informatics, (2) teaching of medical informatics as well as EDP training, (3) EDP service for research and teaching, and (4) EDP hospital operations to assist patient care. (Purely administrative EDP demands are not considered here.) It is shown that the different demands can be fulfilled by the usually available institutions involved in medical informatics and EDP at a School of Medicine. At many places these institutions are as follows: (1) a department or division of medical informatics with a possibly attached computer center dedicated to provide assistance in the area of research and teaching, (2) the computer center of the respective university the School of Medicine belongs to, (3) the computer center of the hospital-owned institution responsible for all EDP activities connected to patient care, and (4) external software companies and EDP training centers. To succeed in the development of an exhaustive, school-wide system of medical informatics and EDP that considers the different demands in research, teaching, and EDP hospital operations equally, close and well-suited coordination between the institutions involved is necessary.

Artificial Intelligence↗

Two years of German summer school of nursing informatics: Did we reach the goals?

This paper describes a continuous effort to improve the knowledge of nursing informatics among German nurses. The authors have co-operated in the nursing informatics working group of the German Medical Informatics Association GMDS. Besides, one of the authors has been active in the European summer school of nursing informatics (Essoni) for several years. The authors have now established a national counterpart to the Essoni program, the German summer school of nursing informatics. This event in German language is centred around nursing informatics topics. Students may opt for one of the several study tracks to gain insight in topics such as nursing classifications and nursing terminologies, clinical information systems and their implementation or teaching requirements in nursing informatics. They go through a 5-day curriculum consisting of plenary sessions, lectures and opportunities for self learning and self teaching. At the end they demonstrate to the fellow students from the other tracks what they have achieved in their own field of study. The German Summer School is open to interested nurses, nurse executives and nurse teachers. In this paper, we will describe the curriculum, talk about the participants and show results of the questionnaire-based evaluation for the first two events in 1998 and 1999.

Curriculum↗

Health informatics in the Asia Pacific region.

Although health informatics has been an established science in some Asia Pacific countries since the 1970s, its current degree of awareness among countries in this region can largely be attributed to the efforts of the Asia Pacific Association for Medical Informatics. These efforts have included the spawning of national health informatics associations in some countries, creating opportunities for cross-country scientific interactions at national health informatics meetings and promoting regional health informatics activities and expertise through the APAMI web site. This presentation gives a review of the current status of health informatics activities among APAMI member countries as well as a cross-section of some of their health informatics projects.

Australia↗

Accuracy of references in five biomedical informatics journals.

OBJECTIVE: To determine the rate and type of errors in biomedical informatics journal article references. METHODS: References in articles from the first 2004 issues of five biomedical informatics journals, Journal of the American Medical Informatics Association, Journal of Biomedical Informatics, International Journal of Medical Informatics, Methods of Information in Medicine, and Artificial Intelligence in Medicine were compared with MEDLINE for journal, authors, title, year, volume, and page number accuracy. If discrepancies were identified, the reference was compared with the original publication. Two reviewers independently evaluated each reference. RESULTS: The five journal issues contained 37 articles. Among the 656 eligible references, 225 (34.3%) included at least one error. Among the 225 references, 311 errors were identified. One or more errors were found in the bibliography of 31 (84%) of the 37 articles. The reference error rates by journal ranged from 22.1% to 40.7%. Most errors (39.0%) occurred in the author element, followed by the journal (31.2%), title (17.7%), page (7.4%), year (3.5%), and volume (1.3%) information. CONCLUSION: The study identified a considerable error rate in the references of five biomedical informatics journals. Authors are responsible for the accuracy of references and should more carefully check them, possibly using informatics-based assistance.

Bibliographies as Topic↗

Contemporary issues in medicine--medical informatics and population health: report II of the Medical School Objectives Project.

The Association of American Medical Colleges established the Medical School Objectives Project (MSOP) to set forth program-level learning objectives that medical school deans and faculties can use as guides in reviewing their medical student education programs (initial phase), and to suggest strategies that they might employ in implementing agreed-upon changes in those programs (implementation phase). The publication of MSOP Report I in 1998 concluded the initial phase of the project by presenting 30 program-level learning objectives that represent a consensus within the medical education community on the knowledge, skills, and attitudes that students should possess before graduation from medical school. Report II, published here, is the work of two expert panels that focus on the two interrelated topics of medical informatics and population health for which Report I developed learning objectives. The Medical Informatics Panel identified five roles played by physicians--lifelong learner, clinician, educator-communicator, researcher, and manager--in which medical informatics plays a vital part, and defined one or more informatics learning objectives important for each role (e.g., the successful medical school graduate, in his or her role as a clinician, should be able to retrieve patient-specific information from a clinical information system). The panel then identified ways that schools might implement educational programs to address the various informatics learning objectives and to eventually embed informatics experiences throughout the curriculum rather than relying on an informatics course to achieve some or all of the objectives. The Population Health Perspective Panel developed a consensus definition of "population health perspective" (PHP); chose four types of populations to discuss (e.g., the geographic community); reviewed pressures for and against the implementation of a PHP in the curriculum (e.g., the cross-disciplinary nature of the topic is a barrier); named the fields that encompass training in a PHP (e.g., public health); listed several educational objectives, three principles to govern the design of educational activities, and a number of recommendations; and closed with a list of the knowledge, skills, and attitudes that should be instilled by a successful PHP curriculum.

Education, Medical, Undergraduate↗

Health care in the information society: what should be the role of medical informatics?

OBJECTIVE: To discuss the consequences for medical informatics in encouraging and advancing the development of information processing methodology (IPM) and information and communication technology (ICT) to contribute to high-quality and efficient health care. METHODS: Characterization of the current state of ICT, commenting on literature. RESULTS AND CONCLUSIONS: Medical informatics is the discipline, concerned with the systematic processing of data, information, and knowledge in medicine and health care. Our societies are continuously being influenced by modern IPM and ICT. It can be expected that these developments, leading us into an "information society", will continue. Three factors may significantly influence health care in the near future: the development of the population towards an aging society, progress in medicine, and progress in informatics. The major aims that will have to be achieved are the (1) patient-centered use of medical data, (2) process-integrated decision support, using high-quality medical knowledge, and (3) comprehensive use of patient data for clinical research and health reporting. Medical informatics research is needed on the electronic patient record, modern architectures for health information systems, and medical knowledge bases. In order to adequately pursue the goal of "transforming health care through innovative use of ICT for the 21st century", health care professionals are needed, who are well-trained in medical informatics, respectively health informatics. Medical informatics must offer such educational programs and assure a sufficiently high quality of education.

Delivery of Health Care↗

Towards clinical bioinformatics: advancing genomic medicine with informatics methods and tools.

OBJECTIVES: To summarize the challenges facing clinical applications in the light of growing research results in genomic medicine and bioinformatics. METHODS: Analysis of the contents of the Yearbook of Medical Informatics 2004 of the International Medical Informatics Association (IMIA). RESULTS: The Yearbook of Medical Informatics 2004 includes 32 articles selected from 22 peer-reviewed scientific journals. A special section on clinical bioinformatics highlights recent developments in this field. Several guest editors review the promises and limitations of available methods and resources from biomedical informatics that are relevant to clinical medicine. Integrated data and knowledge resources are generally regarded to be central and key issues for clinical bioinformatics. Further review papers deal with public health implications of bioinformatics, knowledge management and trends in health care education. The Yearbook includes for the first time a section on the history of medical informatics, where the significant impact of the Reisensburg protocol 1973 on international health and medical informatics education is examined. CONCLUSIONS: Close collaboration between bioinformatics and medical informatics researchers can contribute to new insights in genomic medicine and contribute towards the more efficient and effective use of genomic data to advance clinical care.

Computational Biology↗

The challenge of ubiquitous computing in health care: technology, concepts and solutions. Findings from the IMIA Yearbook of Medical Informatics 2005.

OBJECTIVES: To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics. METHODS: Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA). RESULTS: The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare. CONCLUSIONS: Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality.

Biomedical Technology↗

The School of Health Information Science at the University of Victoria: towards an intergrative model for health informatics education and research.

OBJECTIVES: There is an increasing need for well qualified health informatics practitioners and for educational programs that produce them. Since 1981, the School of Health Information Science at the University of Victoria has delivered a range of educational programs in health informatics. The School's objective has been to produce graduates who can assume a range of roles in health informatics, including managers, developers, researchers and evaluators of health care systems. METHODS: The approach taken by the School has been to provide an integrated 'holistic' approach to health informatics education that balances both theory and practice. The curriculum has emphasized interdisciplinary skills and has been based on a process of consultation with key stakeholders in both industry and academia. In addition, several new distance collaborative models for health informatics education (including a distributed MSc degree program) have been recently initiated through the University of Victoria with collaborating Canadian universities. RESULTS: To date, graduates of the programs offered have become highly sought after, with the demand for graduates of the programs continually exceeding the number of graduates. The core undergraduate curriculum has recently been undergone refinement to include training in new emerging areas of health informatics. In addition, a distributed MSc program has been successfully initiated by the School, currently with 23 students participating from dispersed geographical locations across Canada. CONCLUSIONS: The School of Health Information Science at the University of Victoria has been involved in providing unique interdisciplinary education in health informatics for over twenty years. The School continues to maintain its emphasis on integrated education, refining its curriculum and moving into new areas such as distance education and cross-Canadian collaborations.

Curriculum↗

Professional qualification of German physicians in medical informatics.

In addition to the medical education in the Federal Republic of Germany which includes a compulsory Medical Informatics course there exists a formal program for professional qualification of physicians in Medical Informatics. After two years of clinical practice and 1.5 years of professional training at an authorized institution, a physician may receive in addition to the medical degree a "supplement Medical Informatics". The qualification requirements are described in detail. Physicians with the additional Medical Informatics qualification perform responsible tasks in their medical domain and serve as partners for fully specialized Medical Informatics experts in the solution of practical Medical Informatics problems. The formal qualification is available for more than 10 years, has become increasingly attractive, and is expected to grow with respect to future Medical Informatics developments.

Education, Medical, Continuing↗

Theory, abstraction and design in medical informatics.

OBJECTIVE: To analyze the scientific and engineering components of Medical Informatics. A clear characterization of these components should be undertaken to categorize different areas of Medical Informatics and create a research agenda for the future. METHODS: We have adapted a classical ACM and IEEE report on computing to analyze Medical Informatics from three different viewpoints: Theory, Abstraction, and Design. RESULTS: We suggest that Medical Informatics can be considered from these three perspectives: (1) Theory, from which medical informaticians formally characterize the properties of the objects of study, creating new theories or using and adapting existing theories (e.g., from mathematics), (2) Abstraction, from which medical informaticians deal with all aspects of medical information and create new abstractions, methods, and technology-independent models, which can be experimentally verified, and (3) Design, from which medical informaticians develop systems or act as information brokers or advisors between medical and technology professionals, to improve the quality of computer applications in medicine. CONCLUSION: Based on this framework, we suggest that Medical Informatics has an independent scientific character, different from other applied informatics areas. Finally, we analyze these three perspectives using data mining in medicine.

Medical Informatics↗

[Nursing Informatics: state of the art and future of a subspecialty in nursing].

Nursing Informatics is defined as a specialty that combines nursing science, computer science and informatics to capture, process, store and communicate data, information and knowledge from the nursing domain. Therefore, Nursing Informatics is understood as a subspecialty within nursing. In Germany, Switzerland and Austria, Nursing Informatics looks back to more than 10 years of experience in the field. A Nursing Informatics Framework is proposed to represent the scientific and practical work. It goes beyond a mere definition and forms an action space for showing present achievements and the need for future activities. An analysis of the state of the science reveals that applications in patient care, management and education and training are nearly equally covered by Nursing Informatics. However, a deficit in basic research is apparent mainly in formalising and representing nursing knowledge. There is also a lack of system descriptions following the phases of the software-engineering process. In the requirements specification phase for nursing information systems meaningful reporting applications for use in quality assurance, evidence based nursing and management will have to be identified. Systematic software-engineering including scientific evaluations is needed in particular of systems in emerging areas such as case management. However, the activities proposed require a thorough education and training in Nursing Informatics on all levels.

Austria↗

Nursing informatics as a support function for oncology nursing research.

PURPOSE/OBJECTIVES: To provide an overview of nursing informatics and examples of informatics research highlighting the potential for intersecting such research with oncology nursing research. DATA SOURCES: Literature and online sources. DATA SYNTHESIS: Nursing informatics may be discussed from technical, theoretical, or clinical perspectives. The interface between nursing practice and nursing informatics provides an opportunity to create new science and research to expand the boundaries of nursing knowledge. CONCLUSIONS: It is time to evaluate the potential for intersecting informatics research with oncology nursing research. In an era of continuous healthcare change, nursing informatics has the potential to provide a unique contribution to oncology clinical practice and nursing research. IMPLICATIONS FOR NURSING PRACTICE: By creatively applying nursing informatics, oncology nurse researchers may better capture the phenomena relevant to oncology nursing practice and further the discipline.

Clinical Nursing Research↗