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What is Medical Informatics?

Nancy B. Clark, M.Ed.Director of Medical Informatics Education

Florida State University

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Health (Medical) Informatics

Simplistic definition: Medical informatics is the application of

computers, communications and information technology and systems to all fields of medicine - medical care, medical education and medical research. MF Collen, MEDINFO '80, Tokyo

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Health (Medical) Informatics

Medical informatics is the rapidly developing scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem solving and decision making.Edward Shortliffe, M.D., Ph.D. What is medical informatics? Stanford University, 1995.

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Health (Medical) Informatics

Medical Informatics is the branch of science concerned with the use of computers and communication technology to acquire, store, analyze, communicate, and display medical information and knowledge to facilitate understanding and improve the accuracy, timeliness, and reliability of decision-making. Warner, Sorenson and Bouhaddou, Knowledge Engineering in Health Informatics, 1997

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Health Informatics Defined

Information Technology Health care Research Education

Fundamentals Communication Knowledge Management Decision support Clinical Information Management

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Medical Informatics

Knowledge Management

Clinical InformationManagement

Communication Decision Support

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Informatics Use in Health Care

Communication Telemedicine Tele-radiology Patient e-mail Presentations

Knowledge management Journals Consumer Health information Evidence-based medical

information

Decision Support Reminder systems Diagnostic Expert Systems Drug Interaction

Information Management Electronic Medical Records Billing transactions Ordering Systems

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Medical Informatics Changing Medicine

Knowledge Management

InformationManagement

Communication Decision Support

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Institute of Medicine

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Vision of Quality Chasm Report

Standardized information infrastructure Support care teams - Enhances patient-

centered care Supports care coordination Measure outcomes - Improve outcomes Enhance safety - Reduces errors Enables quality measurement/monitoring -

Reward quality

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The Case of Betsy A. Lehman

“How long, Oh Lord, must this continue? …That’s 21 years ago…Isn’t it time that

basic computerization be part of the expected, and required, care at medical

facilities?”

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Reducing Errors

Order entry systems Reduce medication errors Detect potential drug interactions

Clinical decision support systems Improve drug dosing Improve preventive care Not diagnosis

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Informatics Programs

Degree

Fellowships

Certificates

Short courses

Medical schools Information Studies Nursing schools Public health schools Dental schools Health care organizations

http://www.amia.org/resource/acad&training/f1.html

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Innovative Continuing Education/Schools in Informatics

NYU Medical Center Educational Services Department

U of Utah School of Nursing U of Sheffield, UK Stanford Medical School Stanford Center for Advanced Technology in

Surgery

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Informatics Education Research

Comparisons traditional to electronic Retention Satisfaction

Medical Education Cost effective

CME Informatics skills Not evidence based practice skills

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Barriers to Implementation of TechnologyRogers, P. L. (2000). Barriers to adopting emerging technologies in education. Journal ofEducational Computing Research, 22(4), 455-472.

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Educational Barriers to Achieving Vision

Lack of resources

Relationship/behavioral changes required

Variability and lack of receptivity

Discipline specific issues

Continuing education restrictions

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Regulatory/Policy Barriers to Achieving Vision

Concerns over privacy

Unsupportive laws

Lack of financial resources

Lack of/bad experiences

Lack of standards

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Internal Barriers

3%14%

35%34%

14%InnovatorsEarly AdoptersEarly MajorityLate MajorityLaggard

Stakeholder Attitudes and PerceptionsRogers, E. M. & Shoemaker, F. F. (1971). Communication of Innovation. New York: The Free Press. 

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External Barriers in Medicine

Universally agreed-on medical vocabulary Principled and standard formats for laboratory

data, medical images, medical record… Standardization of medical literature formats--

structured abstracts Health care standards -- treatment guidelines Standards for health data exchange

Lack of:

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Educational Strategies

Didactic vs problem solving Competencies

Word processing Information retrieval Information management Data analysis Presentation Communication skills

E-mail, file transfer, web

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AAMC MSOP

Medical School Objectives Project Informatics competencies for medical

students http://www.aamc.org/meded/msop/msop2.pdf

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Informatics Curriculum

Computer Literacy Word processing Graphics

Life-long learning Medical Reference Clinical Information

management

Research Data analysis

Communication skills E-mail, web,

presentation Evidence Based

Medicine

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Infrastructure to Support Informatics Curriculu.

Hardware/Software Support Issues Workflow/Mindset Issues Training Issues Budgeting Issues

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Infrastructure

Data Collection andEvaluation System

Arcstream SystemAvantgo Server

SQL Server

Studentand Faculty PDAs

Stedman’s Medical DictionaryInfoRetriever

ePocratesPDxMD

CPOnhand

StudentWireless Laptops

Microsoft Office ProfessionalDorland’s Medical Spellchecker

Photoshop ElementsInfoRetriever

Endnote

Virtual LibraryResources

BlackboardCourseware

All Courses

IT Section SupportDatabase Development

Web designVideo EditingTech Support

College of MedicineNetwork Infrastructure

Technology Enhanced ClassroomsCampus Wide Wireless Coverage

Video ConferencingFile, Exchange, Web Servers

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Technology

Wireless Laptops for each student Microsoft Office

Professional Stedman’s Medical

Spellchecker Endnotes Adobe Photoshop

Elements Medical References

InfoRetriever

PDAs for each student Evidence Based Ref. Disease Reference Medical Calculator Drug Reference Medical Dictionary The CDCS system

Computer Lab Student teaching Faculty development

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2003-2004

Switch from Palm OS to PocketPC Dell Axim

InfoRetriever ePocrates Drug

Reference Avantgo PDxMD Stedman’s Medical

Dictionary

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Hands on Experience

Knowledge Managemen

t

Clinical InformationManagementOrder entry, EMR, Billing

Communications

Decision Support

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Medical Education

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Basic Sciences Classes

Anatomy lab video enabled

BacusLabs digital web-slide program

Gold Standard Multimedia*

Cross Sectional Anatomy

LXR Testing Program Question bank Computer-based testing Item analysis/grading

United Streaming Videos Anatomy Histology

WebPath

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Knowledge Management

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Knowledge Management

20th Century Medical Library Bricks and morter Print journals, books, quick reference manuals Interlibrary loans Microfiche, Microfilm, dimes

21st Century Medical Library

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Books, Journals and Manuals

StatRef Pubmed PDxMD MDConsult Dynamed

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Consumer Health Information

Health Finder Familydoctor.org More consumer health websites

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Evidence Anyway You Want It

Cochrane Collaboration InfoRetriever

Web Desktop PDA

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Decision Support

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Handheld Applications

ePocrates 5 Minute Clinical

Consult Medical Calculators Immunization schedule

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Communications

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E-mail

Private, secure e-mail between Doctor and Patient

http://www.medocs.net

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Clinical Information Systems

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Clinical Information Systems

Practice Partner Electronic Medical Record System Drug Interaction Allergy checks Internal e-mail Integrated with billing and appointments Links to knowledge base Patient Education handouts

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Field Trip to Doctors Office