1 2 what is medical informatics? nancy b. clark, m.ed. director of medical informatics education...
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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
https://www.amia.org/informatics-academic-training-programs
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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 Adopters
Early MajorityLate Majority
Laggard
Stakeholder Attitudes and Perceptions
Rogers, 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
Student and Faculty PDAsEssential Evidence Plus
PEPIDePocrates
Harrison’s PracrticePediatric Care Online
GAYF
Student Wireless Tablet PCsMicrosoft Office Professional
Stedman’s Medical SpellcheckerPhotoshop Elements
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
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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2001-2002
Issued Palm devices to first class
InfoRetriever ePocrates Drug
Reference Avantgo PDxMD Stedman’s Medical
Dictionary
2010-2011
Switched from HP iPAQ to iPod Touch Epocrates Essentials PEPID Essential Evidence Plus Dynamed Harrison’s Practice Pediatric Care Online
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Hands on Experience
Knowledge Managemen
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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
QuestionMark 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
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Point of Care Clinical Tools
EBM Resources Online Point of Care
Resources Drug Resources Patient Education
Resources
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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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Secure 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
SOAPware Electronic Medical Record System Loaded on each student computer Used all 3rd year in Longitudinal weekly clinic Follow 6 patients with chronic disease Build entire medical record Use Flow Sheets, Reminder System
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Field Trip to Doctors Office