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Medical Imaging Informatics and Medical Informatics: opportunities and constraints. Findings from the IMIA yearbook of Medical Informatics 2002.

OBJECTIVES: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.yearbook.uni-hd.de). The 2002 Yearbook of Medical Informatics took as its theme the topic of Medical Imaging Informatics. In this paper, we will summarize the contributions of medical informatics researchers to the development of medical imaging informatics, discuss challenges and opportunities of imaging informatics, and present the lessons learned from the IMIA Yearbook 2002. RESULTS AND CONCLUSIONS: Medical informatics researchers have contributed to the development of medical imaging methods and systems since the inception of this field approximately 40 years ago. The Yearbook presents selected papers and reviews on this important topic. In addition, as usual, the Yearbook 2002 also contains a variety of papers and reviews on other subjects relevant to medical informatics, such as Bioinformatics, Computer-supported education, Health and clinical management, Health information systems, Knowledge processing and decision support, Patient records, and Signal processing.

Computer-Assisted Instruction↗

An international summer school on health informatics: a collaborative effort of the Amsterdam Medical Informatics Program and IPhiE--the International Partnership for Health Informatics Education.

PURPOSE: Today, the need for health informatics training for health care professionals is acknowledged and educational opportunities for these professionals are increasing. To contribute to these efforts, a new initiative was undertaken by the Medical Informatics Program of the University of Amsterdam-Academic Medical Center and IPHIE (IPhiE)-the International Partnership for Health Informatics Education. In the year 2004, a summer school on health informatics was organized for advanced medical students from all over the world. METHODS: We elaborate on the goals and the program for this summer school. In developing the course, we followed the international guidelines of the International Medical Informatics Association-IMIA. Students provided feedback for the course through both summative and formative evaluations. As a result of these evaluations, we outline the lessons we have learned and what consequences these results have had in revising the course. RESULTS: Overall the results of both the summative and formative evaluation of the summer school showed that we succeeded in the goals we set at the beginning of the course. Students highly appreciated the course content and indicated that the course fulfilled their educational needs. The decision support and image processing computer practicums however proved too high level. We therefore will redesign these practicums to competence requirements of medical doctors as defined by IMIA. All participants recommended the summer school event to other students. CONCLUSIONS: Our experiences demonstrated a true need for health informatics education among medical students and that even a 2 weeks course can fulfill health informatics educational needs of these future physicians. Further establishment of health informatics courses for other health professions is recommended.

Curriculum↗

Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association.

The Primary Care Informatics Working Group (PCIWG) of the American Medical Informatics Association (AMIA) has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI), to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

Humans↗

Dental informatics: an emerging biomedical informatics discipline.

Biomedical informatics is a maturing discipline. During the last forty years, it has developed into a research discipline of significant scale and scope. One of its subdisciplines, dental informatics, is beginning to emerge as its own entity. While there is a growing cadre of trained dental informaticians, dental faculty and administrators in general are not very familiar with dental informatics as an area of scientific inquiry. Many confuse informatics with information technology (IT), are unaware of its scientific methods and principles, and cannot relate dental informatics to biomedical informatics as a whole. This article delineates informatics from information technology and explains the types of scientific questions that dental and other informaticians typically explore. Scientific investigation in informatics centers primarily on model formulation, system development, system implementation, and the study of effects. Informatics draws its scientific methods mainly from information science, computer science, cognitive science, and telecommunications. Dental informatics shares many types of research questions and methods with its parent discipline, biomedical informatics. However, there are indications that certain research questions in dental informatics require novel solutions that have not yet been developed in other informatics fields.

Dental Research↗

Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics.

In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.

Germany↗

Pathology informatics questions and answers from the University of Pittsburgh pathology residency informatics rotation.

CONTEXT: Effective pathology practice increasingly requires familiarity with concepts in medical informatics that may cover a broad range of topics, for example, traditional clinical information systems, desktop and Internet computer applications, and effective protocols for computer security. To address this need, the University of Pittsburgh (Pittsburgh, Pa) includes a full-time, 3-week rotation in pathology informatics as a required component of pathology residency training. OBJECTIVE: To teach pathology residents general informatics concepts important in pathology practice. DESIGN: We assess the efficacy of the rotation in communicating these concepts using a short-answer examination administered at the end of the rotation. Because the increasing use of computers and the Internet in education and general communications prior to residency training has the potential to communicate key concepts that might not need additional coverage in the rotation, we have also evaluated incoming residents' informatics knowledge using a similar pretest. DATA SOURCES: This article lists 128 questions that cover a range of topics in pathology informatics at a level appropriate for residency training. These questions were used for pretests and posttests in the pathology informatics rotation in the Pathology Residency Program at the University of Pittsburgh for the years 2000 through 2002. With slight modification, the questions are organized here into 15 topic categories within pathology informatics. The answers provided are brief and are meant to orient the reader to the question and suggest the level of detail appropriate in an answer from a pathology resident. RESULTS: A previously published evaluation of the test results revealed that pretest scores did not increase during the 3-year evaluation period, and self-assessed computer skill level correlated with pretest scores, but all pretest scores were low. Posttest scores increased substantially, and posttest scores did not correlate with the self-assessed computer skill level recorded at pretest time. CONCLUSIONS: Even residents who rated themselves high in computer skills lacked many concepts important in pathology informatics, and posttest scores showed that residents with both high and low self-assessed skill levels learned pathology informatics concepts effectively.

Internship and Residency↗

Hyperlinked Lexicon in Nursing Informatics--a tool for navigating through Nursing Informatics Terminology.

The Evolution of Information Technology is rapid. Electronic circuits substitute mental activities and new Technology invades to all aspects of life. Nursing, which is like all the other Health related professions information-intensive, could use the new Technology to be facilitated. The implementation of Informatics to Nursing was supported by the growing information that Nursing has to manage. The definition of Nursing Informatics was put on 1980 and since then a lot attempts to define Nursing Informatics have followed. The applications of Nursing Informatics are focused on four fields of Nursing: Administration of Nursing, Clinical Practice, Education, and Research. The first applications of Nursing Informatics made visible the need for the development of a Unified Language System. The efforts, today, are focused on two fields: to establish a standard definition of the terms of or related to Nursing Informatics, to establish standard definitions and Classification Schemes for the Nursing Phenomena and Practice so that they can be processed by Nursing Informatics. In solving these problems important role plays the study of Linguistics. Another important factor that should be taken into account is the Development of International Standards of general acceptance that enhances communication aspects. Apart from the International Standardisation Organisations, other non-profit organisations have constituted Special Groups that are dealing with the promotion of Nursing Informatics. Final Nursing Informatics should follow the previous attempts of Nursing to establish a Unified Language System. All the steps of the development of the application are described. In particular subjects that are covered are: the scope of the application, the collection of the material, the designing and building up of the Database, the development of a User Interface and the characteristics of the Application.

Databases as Topic↗

Medical informatics and the quality of health: new approaches to support patient care - findings from the IMIA Yearbook of Medical Informatics 2003.

OBJECTIVES: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (http://www. yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003. RESULTS AND CONCLUSIONS: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

Delivery of Health Care↗

Reviews in radiology informatics: establishing a core informatics curriculum.

The advent of digital imaging and information management within the radiology department has prompted the growth of a new radiology subspecialty: Radiology Informatics. With appropriate training, radiologists can become leaders in Medical Informatics and guide the growth of this technology throughout the medical enterprise. Radiology Informatics fellowships, as well as radiology residency programs, provide inconsistent exposure to all the elements of this subspecialty, in part because of the lack of a common curriculum. The Society for Computer Applications in Radiology (SCAR) has developed a curriculum intended to guide training in Radiology Informatics. This article is the first in a series presented by SCAR and the Journal of Digital Imaging, titled "Reviews in Radiology Informatics." The series is designed to sample from each of the major components in the Radiology Informatics Curriculum, to spark further interest in the field and provide content for informatics education.

Curriculum↗

Effect of an informatics for evidence-based practice curriculum on nursing informatics competencies.

Effective and appropriate use of information and communication technologies is an essential competency for all health care professionals. The purpose of this paper is to describe the effect of an evolving informatics for evidence-based practice (IEBP) curriculum on nursing informatics competencies in three student cohorts in the combined BS/MS program for non-nurses at the Columbia University School of Nursing. A repeated-measures, non-equivalent comparison group design was used to determine differences in self-rated informatics competencies pre- and post-IEBP and between cohorts at the end of the BS year of the combined BS/MS program. The types of Computer Skill competencies on which the students rated themselves as competent (> or =3) on admission were generic in nature and reflective of basic computer literacy. Informatics competencies increased significantly from admission to BS graduation in all areas for the class of 2002 and in all, but three areas, for the class of 2003. None of the three cohorts achieved competence in Computer Skills: Education despite curricular revisions. There were no significant differences between classes at the end of the BS year. Innovative educational approaches, such as the one described in this paper demonstrate promise as a method to achieve informatics competence. It is essential to integrate routine measurement of informatics competency into the curriculum so that approaches can be refined as needed to ensure informatics competent graduates.

Clinical Competence↗

Skill needs for nurses in their role as health informatics professionals: a survey in the context of global health informatics education.

In the process of developing global health informatics education, a common understanding of educational outcomes is required. Therefore, an educational framework for health informatics professionals is desirable to support student mobility, trans-national and borderless education. Nurses form a significant part of the health workforce and need to be properly educated for their roles in health informatics. To ascertain their perceptions of needs and priorities, we developed a web-based questionnaire and surveyed Australian nurses on the preferred knowledge/skills set for health informatics professionals. Among others, the questionnaire is based on the International Medical Informatics Association's (IMIA) set of recommendations on education and IMIA's scientific map. Benner's five levels of competencies were applied to measure the degree of competency required for each skill/knowledge. Altogether, 82 Australian nurses completed the questionnaire. The nurses' perceived degree of competency required for a total of 74 specific skills and knowledge in five skill categories is presented in this paper as well as the overall results for each of the five categories. Further, significant differences between the nurses' primary roles and primary interest in health informatics are discussed. The development of a comprehensive health informatics education framework needs to take into account nurses as well as other health professionals. Repeating the survey in other countries and for various professions is essential to develop an international educational framework.

Adult↗

Medical informatics specialists: what are their job profiles? Results of a study on the first 1024 medical informatics graduates of the Universities of Heidelberg and Heilbronn.

OBJECTIVES: Since 1972, the University of Heidelberg and the University of Applied Sciences Heilbronn have jointly been running a medical informatics program. To continuously provide high quality education, the curriculum is regularly evaluated among its graduates. The objectives of this study were to assess the job situation of the graduates and to evaluate the curriculum from their viewpoint. METHOD: Anonymous inquiry of all medical informatics graduates, having finished their studies before March 31, 2001 (n=1024) using a structured questionnaire. RESULTS: The questionnaire was answered by 446 (compliance: 45.5%) graduates. About one third (146 of 444 valid cases) are working in software/hardware companies. 179 (43.0% of 416 valid cases) graduates are working within medical informatics, 214 (51.4%) are working outside of medical informatics, but within other informatics. 23 (5.5%) graduates are working neither in medical nor in other informatics. 15 percent of the responding graduates have received a doctor's degree. Software engineering, database and information systems are regarded as most important parts of the education. The majority of the graduates are satisfied with their education as well as with their personal career. CONCLUSIONS: The variety of jobs, the job profiles, and the high level of our graduates' satisfaction with their education indicate the relevance of specialized medical informatics programs with a curricular profile like the one in Heidelberg/Heilbronn. Investigations like this can help to adjust the contents of the curriculum to professional needs.

Career Mobility↗

Recommendations of the International Medical Informatics Association (IMIA) on education in health and medical informatics.

The International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics / medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware. The IMIA recommendations centre on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in health care (physicians, nurses, HMI professionals, ...), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, ...). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree). To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http://www.imia.org/wg1).

Education, Continuing↗

Are medical informatics and nursing informatics distinct disciplines? The 1999 ACMI debate.

The 1999 debate of the American College of Medical Informatics focused on the proposition that medical informatics and nursing informatics are distinctive disciplines that require their own core curricula, training programs, and professional identities. Proponents of this position emphasized that informatics training, technology applications, and professional identities are closely tied to the activities of the health professionals they serve and that, as nursing and medicine differ, so do the corresponding efforts in information science and technology. Opponents of the proposition asserted that informatics is built on a re-usable and widely applicable set of methods that are common to all health science disciplines, and that "medical informatics" continues to be a useful name for a composite core discipline that should be studied by all students, regardless of their health profession orientation.

Medical Informatics↗

Contribution of EFMI to development of medical informatics. European Federation for Medical Informatics.

The European Federation for Medical Informatics has been established in 1976. At the MIE 96 it has celebrated the 20th anniversary of its existence. During these 20 years the number of number of national societies who became a member has been increased from 10 to 26 and nowadays is 29 not mentioning 2-3 applicants. The objectives of EFMI are: a) to advance international co-operation and dissemination of information, b) to promote research and development, c) to promote high standards in the application, d) to encourage high standards in education in this field. The achieve these goals EFMI organizes yearly European Congresses the MIE-s. Through its working groups contributes very well to the scientific development of medical informatics. The Working Group Chairmen regularly organizes tutorials workshops and many of them participate in teaching medical informatics in their homeland as well as on international courses. EFMI publishes scientific papers from its congresses in the Medical Informatics and in the International Journal of Medical Informatics. The most important meeting, however is the regular Council Meeting--twice a year--where council members can exchange opinions, have opportunity to discuss problems of medical informatics and last but not lease recently medical Inform-ETHICS. This Council is operating as a HUMAN-NET counterbalancing the dysinformations coming from the Internet.

Europe↗

Building health informatics skills for health professionals: results from the Australian Health Informatics Skill Needs Survey.

OBJECTIVE: To ascertain health professionals' perceptions of health informatics skills required in their roles. DESIGN: A paper-based survey with a stratified random sample of Australian health professionals and a web-based survey open to all Australian health professionals were conducted. MEASUREMENT: A questionnaire on the health professionals' perceived degree of competency required for a total of 69 specific skills in five skill categories based on the International Medical Informatics Association's (IMIA) set of recommendations on education and IMIA's scientific map. RESULTS: 462 health professionals responded to the paper-based questionnaire, and 167 respondents to the Internet questionnaire. Internet respondents reported higher required degrees of competency for specific health informatics and information technology skills than paper respondents, while paper respondents valued clinical skills higher than the Internet respondents. CONCLUSION: Health professionals increasingly use information technology (IT), and some also deploy, research or develop health care IT. Consequently, they need to be adequately educated for their specific roles in health informatics. Our results inform developers of educational programs while acknowledging the diversity of roles in health informatics and the diversity of pathways towards a professional health informatics qualification.

Adult↗

Medical informatics Heidelberg/Heilbronn: graduates' experiences and job situation. An inquiry among graduates having completed the curriculum of medical informatics at the University of Heidelberg/School of Technology Heilbronn.

On the occasion of the 20th anniversary of the curriculum of medical informatics at the University of Heidelberg/School of Technology Heilbronn, a written and anonymous inquiry was carried out in March 1992 among the entirety of graduates from the curriculum. The aim of the inquiry was to obtain from the graduates of the curriculum information about their current places of employment, their fields of work, the state of continuing education as well as about their professional position. It was, in addition, intended to obtain from the graduates' point of view an assessment of the education received during their studies as well as an assessment of the job situation. A questionnaire was sent to all persons having completed their studies by that time (n = 567, as of 1.1.1992). 62.2% of the forms were returned duly filled in; 92.2% of the graduates are employed. 44.5% out of them are working within the field of medical informatics, 53.0% are working outside medical informatics but within the sector of informatics and 2.2% in other fields; 0.3% were without indication. As far as places of employment are concerned, enterprises concentrating on hardware and software development rank first, followed by hospitals and medical institutions affiliated to universities. As far as fields of work are concerned, information systems within the health care sector (especially hospital information systems) as well as medical documentation predominate in the group of those employed within medical informatics, whereas among those not working within medical informatics software engineering as well as database systems and information systems prevail.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗

Education review: applied medical informatics--informatics in medical education.

The importance of informatics training within a health sciences program is well recognized and is being implemented on an increasing scale. At Chicago Medical School (CMS), the Informatics program incorporates information technology at every stage of medical education. First-year students are offered an elective in computer topics that concentrate on basic computer literacy. Second-year students learn information management such as entry and information retrieval skills. For example, during the Introduction to Clinical Medicine course, the student is exposed to the Intelligent Medical Record-Entry (IMR-E), allowing the student to enter and organize information gathered from patient encounters. In the third year, students in the Internal Medicine rotation at Norwalk Hospital use Macintosh power books to enter and manage their patients. Patient data gathered by the student are stored in a local server in Norwalk Hospital. In the final year, we teach students the role of informatics in clinical decision making. The present senior class at CMS has been exposed to the power of medical informatics tools for several years. The use of these informatics tools at the point of care is stressed.

Attitude to Computers↗