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PubMed2006

The Western New York regional electronic health record initiative: Healthcare informatics use from the registered nurse perspective.

This paper describes a select population of Western New York (WNY) Registered Nurses' (RN) perspectives on the use of healthcare informatics and the adoption of a regional electronic health record (EHR). A three part class assignment on healthcare informatics used a Strengths, Weaknesses, Opportunities, Threats (SWOT) Analysis, and a Healthcare Informatics Schemata: A paradigm shift over time(c) timeline to determine RN perspectives about healthcare informatics use at their place of employment. Qualitative analysis of 41 RNs who completed the SWOT analysis provided positive and negative themes related to perceptions about healthcare informatics and EHR use at their place of employment. 29 healthcare organizations were aggregated by year on the timeline from 1950 through 2000. Information suggests that, RNs have the capacity to positively drive the adoption of EHRs and healthcare informatics in WNY.

Attitude of Health Personnel↗

PubMed2006

Online informatics education: Challenges and lessons learned.

Current advances in knowledge and technology have resulted in profound implications on the methodology of teaching. Faculty involved with Informatics Nursing curriculum face particular challenges because the foundational concepts of Informatics must often be integrated with the software commonly used in information management systems.This demonstration includes an overview of the informatics curriculum and explores the issues related to providing a nursing informatics curriculum at a distance. An in-depth review of an actual course that combines the foundational concepts of informatics with software technology used in informatics management systems will be provided. The end-of-course assessments and lessons learned from integration of software technology within the curriculum will be discussed.

Education, Nursing↗

PubMed2006

Modeling in biomedical informatics--an exploratory analysis (part 1).

OBJECTIVES: Modeling is a significant part of research, education and practice in biomedical and health informatics. Our objective was to explore, which types of models of processes are used in current biomedical/health informatics research, as reflected in publications of scientific journals in this field. Also the implications for medical informatics curricula were investigated. METHODS: Retrospective, prolective observational study on recent publications of the two official journals of the International Medical Informatics Association (IMIA), the International Journal of Medical Informatics (IJMI) and Methods of Information in Medicine (MIM). RESULTS: 384 publications have been analyzed, 190 of IJMI and 194 of MIM. In regular papers (69 in IJMI, 62 in MIM), analyzed here in part 1, all of these model types could be found. In many publications we observed a mixture of models, being used to solve the 'core' research questions and also to systematically evaluate the research done. Knowledge of (and models for) software engineering and project management are also often needed. IJMI seems to have a closer focus on research concerning health information systems and electronic patient records, with a strong emphasis on evaluation. MIM seems to have a broader range of research approaches, including also statistical modeling and computational intensive approaches. The aim to provide solutions for problems related to data, information and knowledge processing and to study the general principles of processing data, information and knowledge in medicine and health care in order to contribute to improve the quality of health care, and of research and education in medicine and the health sciences was given in all publications. CONCLUSIONS: Modeling continues to be a major task in research, education and practice in biomedical and health informatics. Knowledge and skills concerning a broad range of model types is needed.

Bibliometrics↗

PubMed1999

Medical informatics education in paediatric residency training.

OBJECTIVES: The objective of this study was to determine whether Medical Informatics education among house staff is included in the current residency curriculum, and to present ways in which this type of education may be improved. DESIGN: During autumn 1996 a mailed survey was distributed to chief residents of American paediatric residency programmes. Questions included the resident's use of computers, the influence of Informatics-trained faculty members on programme education and plans for curriculum expansion. SETTING: Division of General Paediatrics, University of Alabama, United States. SUBJECTS: Paediatric chief residents. RESULTS: Eighty programmes (63%) returned a survey. An average of 97% of residents use the computer for looking up patient laboratory results, while 70% use it for Medline searches. Less than half of all residents use the Internet or computer-based learning programmes. Thirty-seven per cent of programmes provided formal lectures on computer topics, and 22% of programmes provided hands-on Internet training. There was no association between the presence if Informatics faculty and current programmes; however, programmes with Informatics faculty were more likely to have future curriculum plans (P=0.04). Some of the programmes' future plans are described. CONCLUSIONS: We felt that an overall description of what is currently being done with computers would be helpful as a baseline for other programmes considering new curricula changes. Residents use the computer often to check patient laboratory results but not as much for self-education. Many programmes are expanding their Informatics curriculum. Faculty without formal Informatics training can take part in basic computer education for residents. A self-study approach by the residents has been received positively.

Computer-Assisted Instruction↗

PubMedDate not supplied

Consumer informatics supporting patients as co-producers of quality.

The track entitled "Consumer Informatics Supporting Patients as Co-Producers of Quality" at the AMIA Spring 2000 Congress was devoted to examining the new field of consumer health informatics. This area is developing rapidly, as worldwide changes are occurring in the organization and delivery of health care and in the traditional roles of patient and provider. This paper describes the key themes of the track; implications of the growing area of consumer health informatics; and recommendations for informatics research, design, and policy. Key themes that emerged from the panels and discussions involved changes in roles of consumers and providers; supporting a patient-provider-information technology partnership; virtual, not physical, structure for health care and health care information delivery; and health care as an integrated part of one's life. Panelists and participants at the Congress developed recommendations for informatics research, design, and policy, with an overarching focus on how to support the patient-provider-information technology partnership to provide more patient-centered health care. They recommended that AMIA take an active leadership role in consumer health informatics. Specific recommendations were made concerning research, new patient record systems, provider support, information access and evaluation, and policy and regulation.

Community Participation↗

PubMed2005

[Informatics system at the Croatian Institute of Health Insurance today and plans for future].

Basic information is provided on the informatics system at the Croatian Institute of Health Insurance (CIHI). The focus is on the newwork infrastructure, which connects 130 locations 24 hours on line and installed hardware and software equipment at CIHI. A modern network infrastructure makes technical basis of modern informatics system. Technical data on the safe and reliable communication system with FR telecommunication capacity are presented. UNIX servers at the headquaters and branch offices, INFORMIX database and the own application ZOROH provide a basis for core business. Active Directory, web pages www.hzzo-net.hr, Intranet and CIHI IT portal are the main parts of the modern CIHI office info subsystem. Basic information is given about the system for production and.distribution of health insurance cards--plastic cards with magnetic strip for basic and additional health insurance. Informatics Department of CIHI has issued more than 13,000,000 basic health insurance cards and over 1,500,000 additional health insurance cards. Data storage and reporting system as part of the CIHI informatics system is essential for analyzing and planning health insurance business. CIHI IT has created a modern reporting system with: (a) superior performance and power of analytical and reporting possibilities; (b) scalable and flexible platform; (c) proactive reporting (Web, SMS, WAP, e-mail, fax, voice); (d) web interface for users. The presentation is concluded with basic information on the current projects such as introduction of digital signature in CIHI and plans for the introduction of smart cards instead of plastic cards with magnetic strip. Today, CIHI IT plays the major role in the process of health system computerization in Croatia. CIHI is technically and personnel equipped for computerization of the entire health system. The informatics system of CIHI can serve as a backbone for the informatics health system in the future.

Academies and Institutes↗

PubMed1990

Medical informatics. An emerging academic discipline and institutional priority.

Information management constitutes a major activity of the health care professional. Currently, a number of forces are focusing attention on this function. After many years of development of information systems to support the infrastructure of medicine, greater focus on the needs of physicians and other health care managers and professionals is occurring--to support education, decision making, communication, and many other aspects of professional activity. Medical informatics is the field that concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research, including the information science and the technology to support these tasks. An intrinsically interdisciplinary field, medical informatics has a highly applied focus, but also addresses a number of fundamental research problems as well as planning and policy issues. Medical informatics is now emerging as a distinct academic entity. Health care institutions are considering, and a few are making, large-scale commitments to information systems and services that will affect every aspect of their organizations' function. While academic units of medical informatics are presently established at only a few medical institutions in the United States, increasing numbers of schools are considering this activity and many traditional departments are seeking and attracting individuals with medical informatics skills.

Career Choice↗

PubMed1993

Developments in health informatics within the standards associations of Australia and New Zealand.

Activities to support the development and adoption of Standards in health informatics are now well started. The Standards Association of Australia formed a committee (IT/14) on Medical Informatics which met for the first time in February 1991: early in 1992 it changed its name to reflect a broader concern with "Health Informatics" rather than the rather narrower interpretation that many had chosen to place on the term "Medical Informatics". The Standards Association of New Zealand held the inaugural meeting of persons interested in constituting committee SC606 on Health Informatics in August of this year. A growing program of active collaboration between Australia and New Zealand was formalised in July of this year, whereby standards will for the most part be jointly developed and adopted regionally, and whereby the separate committees will be merged wherever practicable to form a single head Joint Technical Committee (JTC) for each domain of involvement. The focus in Australia and New Zealand is at present very much on the need for standards to implement national health information networks. The progressive definition of network standards is prompting increased interest in the standards implemented within the systems and installations that must connect to the networks. The initial implementation of a national health information system in New Zealand is scheduled for 1st July 1993: detailed plans for an Australian health communications network are well advanced although no date for its implementation has been proposed. This paper outlines the general structure of the standards committees in the Antipodes, and of their various sub-committees. It will also outline broad terms of reference of these groups, and the major areas of current interests, activity and developments.

Australia↗

PubMed2002

Medical informatics: searching for underlying components.

OBJECTIVE: To discuss unifying principles that can provide a theory for the diverse aspects of work in medical informatics. If medical informatics is to have academic credibility, it must articulate a clear theory that is distinct from that of computer science or of other related areas of study. RESULTS: The notions of reusable domain antologies and problem-solving methods provide the foundation for current work on second-generation knowledge-based systems. These abstractions are also 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 basis for our field.

Information Science↗

PubMed2001

Health informatics.

Health informatics is the development and assessment of methods and systems for the acquisition, processing and interpretation of patient data with the help of knowledge from scientific research. This definition implies that health informatics is not tied to the application of computers but more generally to the entire management of information in healthcare. The focus is the patient and the process of care. The apparent information overload and the imperfection of medical decision making motivate the use of information systems for medical decision support. Health informatics provides tools to control processes in healthcare, acquire medical knowledge and communicate information between all people and organisations involved with healthcare. Although the development of medical information systems may often lag behind the available possibilities, the technological state of the current medical information systems is better than it is generally held to be. Health informatics should help healthcare professionals to provide better and more cost-effective care and enable healthcare systems to be more efficient and to adapt better to our patients' needs. Health informatics may reshape the way we deliver care to meet the demands of the future.

Artificial Intelligence↗

PubMed2004

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Curriculum↗

PubMed2005

osni.info-Using free/libre/open source software to build a virtual international community for open source nursing informatics.

Many health informatics organizations seem to be slow to take up the advantages of dynamic, web-based technologies for providing services to, and interaction with, their members; these are often the very technologies they promote for use within healthcare environments. This paper aims to introduce some of the many free/libre/open source (FLOSS) applications that are now available to develop interactive websites and dynamic online communities as part of the structure of health informatics organizations, and to show how the Open Source Nursing Informatics Working Group (OSNI) of the special interest group in nursing informatics of the International Medical Informatics Association (IMIA-NI) is using some of these tools to develop an online community of nurse informaticians through their website, at . Some background introduction to FLOSS applications is used for the benefit of those less familiar with such tools, and examples of some of the FLOSS content management systems (CMS) being used by OSNI are described. The experiences of the OSNI will facilitate a knowledgeable nursing contribution to the wider discussions on the applications of FLOSS within health and healthcare, and provides a model that many other groups could adopt.

Database Management Systems↗

PubMed2002

Master of science program in health information management at Heidelberg/Heilbronn: a health care oriented approach to medical informatics.

In the year 2000 the University of Heidelberg and the University of Applied Sciences Heilbronn established a second educational program in medical informatics, leading to a Master of Science (MSc) degree. In addition to their 4.5 year medical informatics program as an informatics-based approach to medical informatics, a postgraduate program in 'health information management' (Informationsmanagement in der Medizin) was set up as a complementary health care oriented approach to this field. The aim of the MSc program is to qualify physicians and other health care professionals to work as medical informaticians, particularly in the area of health information management. We admit 15 new students into the program each year. The intended program length is 15 months, comprising two study semesters (14 weeks per semester) and three months for the Master's thesis. The graduates are awarded the title 'Master of Science' by the Medical Faculty of the University of Heidelberg. The program is part of the International Partnership in Health Informatics Education of the Universities of Amsterdam, Heidelberg/Heilbronn, Minnesota and Utah. We report on this new program and on our experience with our very first students. The curriculum is compared with the related MSc programs.

Curriculum↗

PubMed1997

Challenges for medical informatics in the 21st century.

This paper introduces the topic of this special issue: challenges for medical informatics in the 21st century. This paper discusses the nature of medical informatics. Some descriptions and definitions of medical informatics are reviewed. Then the research aspects of medical informatics are discussed. It is argued that the more mundane aspects of medical informatics like system development and implementation are important and need further consideration, especially concerning social aspects and correctness.

Computer Literacy↗

PubMed1997

Aims and tasks of medical 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; (4) early-recognition and prevention; (5) compensating physical handicaps; (6) health consulting ('the informed patient'); (7) health reporting; (8) health care information systems; (9) medical documentation and (10) comprehensive documentation of medical knowledge and knowledge-based decision support. Work is, in part, already in progress. To all these aims and tasks medical informatics can and may be should make substantial contributions. Prior to outlining the above aims and tasks, an account is given of the meaning of medical informatics, of the objective it pursues in general and of its achievements so far. The present paper intends to contribute to a broad public discussion of the aims and tasks for research in the field of medical informatics.

Artificial Intelligence↗

PubMed1998

Health and medical informatics education for nurses and health service managers.

Health and Medical informatics is a discipline encompassing and combining aspects of all health, medical and informatics disciplines. Consequently, the topics to be covered in any educational program can vary considerably both in depth and breadth. Given that such programs need to meet the needs of a very diverse health professional workforce, educators need to develop curricula to suit specific target groups although common topic areas need to be included. This paper presents the state of play regarding nursing informatics education. It discusses informatics education for health service managers primarily in Australia through the use of a case study and compares these with some other similar programs. It then explores some of the issues encountered which are seen as impediments to the progression of health and medical informatics education, the most significant of which is traditional University organisational structures which do not readily facilitate multidisciplinary educational programs.

Accreditation↗

PubMed1998

Education and training of medical informatics in the medical curriculum.

The teaching of medical informatics is of importance for students in medicine and health care, realizing that they will be the health professionals of the future. Training in medical informatics is also of value for practicing clinicians who are overwhelmed by the avalanche of systems that are available on the market. Some examples of operational systems are presented here to indicate that health care has changed dramatically over the last decades. This paper intends to contribute to the drafting of IMIA guidelines for teaching medical informatics by (1) reporting on the experience at the Faculty of Medicine and Health Sciences of the Erasmus University Rotterdam as part of the curriculum, (2) reporting on the implementation of guidelines for teaching medical informatics in The Netherlands since these guidelines were drafted in 1986, and (3) by introducing the teaching material contained in the new Handbook of Medical Informatics and on its Web site.

Curriculum↗

PubMed1998

Education and training in health informatics: the IT-EDUCTRA project.

In this contribution both the EDUCTRA project of the European Advanced Informatics in Medicine Programme and the IT-EDUCTRA project of the Telematics Applications Programme (Health Sector) are described. EDUCTRA had as aim to investigate which gaps in knowledge health professionals have with respect to health informatics and to suggest ways to remedy this. It was assumed that health professionals had a basic understanding of health informatics and that additional educational material only had to cover the knowledge necessary for appreciating the new products coming from the AIM programme. A state-of-the-art survey revealed that the knowledge of health professionals with respect to health informatics was deplorable. Guidelines for curricula were therefore proposed to enable potential teachers to design courses. IT-EDUCTRA is a continuation of the EDUCTRA project. It has as aim to create learning materials covering a broad area of health informatics.

Curriculum↗