Medical Informatics Medical Informatics BasicsBasics

Lection 1

Basic QuestionsBasic QuestionsMedical Informatics DefinitionMedical Informatics DefinitionMedical Informatics as the Scientific AreaMedical Informatics as the Scientific AreaMedical Informatics AreasMedical Informatics AreasAspects of the Aspects of the Medical InformaticsMedical Informatics field fieldssClinical informaticsClinical informaticsBiomedical informaticsBiomedical informaticsBioinformaticsBioinformaticsPublic health informaticsPublic health informaticsNursing informaticsNursing informaticsDental informaticsDental informaticsMedical CyberneticsMedical CyberneticsInformation Systems examplesInformation Systems examples

1. Medical Informatics (A)1. Medical Informatics (A)

Medical information science is the science Medical information science is the science of using system-analytic tools . . . to of using system-analytic tools . . . to develop procedures (algorithms) for develop procedures (algorithms) for management, process control, decision management, process control, decision making and scientific analysis of medical making and scientific analysis of medical knowledge.knowledge.

(E.H. Shortliffe, The science of biomedical computing. (E.H. Shortliffe, The science of biomedical computing. Medical InformaticsMedical Informatics 1984;9:185-93.) 1984;9:185-93.)

1. Medical Informatics (B)1. Medical Informatics (B)

Medical Informatics comprises the Medical Informatics comprises the theoretical and practical aspects of theoretical and practical aspects of information processing and information processing and communication, based on knowledge and communication, based on knowledge and experience derived from processes in experience derived from processes in medicine and health care.medicine and health care.

(J.H. van Bemmel, The structure of medical informatics. (J.H. van Bemmel, The structure of medical informatics. Medical InformaticsMedical Informatics 1984;9:175-80.) 1984;9:175-80.)

1. Medical Informatics (C)1. Medical Informatics (C)

In medical informatics we develop and In medical informatics we develop and assess methods and systems for the assess methods and systems for the acquisition, processing, and interpretation acquisition, processing, and interpretation of patient data with the help of knowledge of patient data with the help of knowledge that is obtained in scientific research.that is obtained in scientific research.

(J.H. van Bemmel and M.A. Musen, (J.H. van Bemmel and M.A. Musen, Handbook of Medical Handbook of Medical InformaticsInformatics, Springer Verlag, 1997.), Springer Verlag, 1997.)

1. Medical Informatics (D)1. Medical Informatics (D)

It iIt is the intersection of s the intersection of information information sciencescience, , computer sciencecomputer science and and health health carecare. It deals with the resources, devices . It deals with the resources, devices and methods required to optimize the and methods required to optimize the acquisition, storage, retrieval and use of acquisition, storage, retrieval and use of information in health and biomedicineinformation in health and biomedicine..

(Wikipedia, 2008.)(Wikipedia, 2008.)

1. The Informatics1. The Informatics Informatics (academic field),Informatics (academic field), a broad a broad academic field encompassing human-computer academic field encompassing human-computer interaction, information science, information interaction, information science, information technology, algorithms, and social science technology, algorithms, and social science – Computer science,Computer science, the study of complex systems, the study of complex systems,

information and computation using applied information and computation using applied mathematics, electrical engineering and software mathematics, electrical engineering and software engineering techniques. engineering techniques.

– Information science,Information science, the study of the processing, the study of the processing, management, and retrieval of information management, and retrieval of information

Information technology,Information technology, the study, design, the study, design, development, implementation, support, or development, implementation, support, or management of computer-based information management of computer-based information systems systems

1. Medical Informatics is 1. Medical Informatics is MultidisciplinaryMultidisciplinary

It is applies methodologies developed in It is applies methodologies developed in multiple areas of scientific endeavor to multiple areas of scientific endeavor to many different tasksmany different tasks

In turn, it often gives rise to new, more In turn, it often gives rise to new, more general methodologies that enrich these general methodologies that enrich these scientific disciplinesscientific disciplines

1. Medical Informatics is 1. Medical Informatics is MultidisciplinaryMultidisciplinary

2. Example of Scientific Areas 2. Example of Scientific Areas Relevant to Medical InformaticsRelevant to Medical Informatics

Medicine/ BiologyMedicine/ Biology

MathematicsMathematics

Information SystemsInformation Systems

Computer ScienceComputer Science

StatisticsStatistics

Decision AnalysisDecision Analysis

Economics/Health Care PolicyEconomics/Health Care Policy

PsychologyPsychology

2. Example of Scientific Areas 2. Example of Scientific Areas Relevant to Medical InformaticsRelevant to Medical Informatics

2. The Diagnostic-Therapeutic 2. The Diagnostic-Therapeutic Cycle, Simplified ViewCycle, Simplified View

PatientPatient

1.Data collection1.Data collection:-History-Physical examinations-Laboratory and other tests

2.Decision2.Decisionmakingmaking

3.Planning3.Planning

Information

Diagnosis/assessmentTherapy plan

Data

2. Levels of Automated Support2. Levels of Automated Support

3. Examples of Medical Informatics Areas3. Examples of Medical Informatics Areas

Hospital information systemsHospital information systems– Electronic medical records & medical vocabulariesElectronic medical records & medical vocabularies– Laboratory information systemsLaboratory information systems– Pharmaceutical information systemsPharmaceutical information systems– Radiological (imaging) information systemsRadiological (imaging) information systems– Patient monitoring systemsPatient monitoring systems

Clinical decision-support systemsClinical decision-support systems– Diagnosis/interpretationDiagnosis/interpretation– Therapy/managementTherapy/management

BioinformaticsBioinformatics: Closely related tasks/methods: Closely related tasks/methods

3. Examples of Medical Informatics Areas3. Examples of Medical Informatics Areas

4. 4. Aspects of the Aspects of the Medical InformaticsMedical Informatics field fieldss

AArchitectures for rchitectures for electronic medical recordselectronic medical records and and other health information systems other health information systems

Decision support systemsDecision support systems in healthcare, including in healthcare, including clinical decision support systemsclinical decision support systems

SStandards (e.g. tandards (e.g. DICOMDICOM, , HL7HL7) and ) and integrationintegration profiles to facilitate the exchange of information profiles to facilitate the exchange of information between between healthcare information systemshealthcare information systems

ControlledControlled medical vocabularies ( medical vocabularies (CMVCMVs) such as s) such as the the Systematized Nomenclature of Medicine, Systematized Nomenclature of Medicine, Clinical Terms (Clinical Terms (SNOMED CTSNOMED CT)),, used to allow a used to allow a standard, accurate standard, accurate exchangeexchange of data content of data content between systems between systems

4. 4. Aspects of the Aspects of the Medical InformaticsMedical Informatics field fieldss

5. 5. Clinical informaticsClinical informatics

It It is a sub-field of is a sub-field of medical informaticsmedical informatics..

It It is a combination of is a combination of information information sciencescience, , computer sciencecomputer science, and , and clinical clinical sciencescience designed to assist in the designed to assist in the management and processing of data, management and processing of data, information and knowledge to support the information and knowledge to support the practice and delivery of clinical carepractice and delivery of clinical care..

((Shortliffe and Perreault, Medical Informatics: Computing Shortliffe and Perreault, Medical Informatics: Computing applications in health care and biomedicineapplications in health care and biomedicine))

6. 6. Biomedical informaticsBiomedical informatics

ItIt is concerned with the study and is concerned with the study and application of application of information technologyinformation technology and and computer sciencecomputer science as well as as well as decision making, human problem solving, decision making, human problem solving, cognitive science, standards, policies, and cognitive science, standards, policies, and human factors in the practice of human factors in the practice of biomedical sciencebiomedical science, , medicinemedicine and and healthcarehealthcare and is most commonly used in and is most commonly used in this way in the USAthis way in the USA..

7. 7. BioinformaticsBioinformatics

BioinformaticsBioinformatics and and computational computational biologybiology involve the use of techniques involve the use of techniques including including applied mathematicsapplied mathematics, , informaticsinformatics, , statisticsstatistics, , computer sciencecomputer science, , artificial intelligenceartificial intelligence, , chemistrychemistry, and , and biochemistrybiochemistry to solve to solve biologicalbiological problems problems usually on the usually on the molecularmolecular level level..

8. 8. Public Health InformaticsPublic Health Informatics

Public Health InformaticsPublic Health Informatics has been has been defined as the systematic application of defined as the systematic application of information and information and computer sciencecomputer science and and technology to technology to public healthpublic health practice, practice, research, and learningresearch, and learning..

Major tasks:Major tasks:Collection of public health dataCollection of public health data..

Storage of public health dataStorage of public health data..

Analysis of public health dataAnalysis of public health data..

9. 9. Nursing informatics (A)Nursing informatics (A)

It is It is a specialty of a specialty of Health care Health care informaticsinformatics which deals with the support which deals with the support of of nursingnursing by by information systemsinformation systems in in delivery, documentation, administration delivery, documentation, administration and evaluation of patient care and and evaluation of patient care and prevention of diseases.prevention of diseases.

(Wikipedia, 2008)(Wikipedia, 2008)

9. 9. Nursing informatics (B)Nursing informatics (B)

It It is a specialty that integrates is a specialty that integrates nursing nursing science, computer sciencescience, computer science, and , and information scienceinformation science to manage and to manage and communicate data, information, and communicate data, information, and knowledge in nursing practice.knowledge in nursing practice.

((American Nurses Association's Scope and Standards American Nurses Association's Scope and Standards for Nursing Informatics Practicefor Nursing Informatics Practice,, 2006 2006))

10. 10. Dental informaticsDental informatics Dental informaticsDental informatics is the application of computer is the application of computer

and information science to improve dental and information science to improve dental practice, research, education and management.practice, research, education and management.

It can be considered a subset of It can be considered a subset of medical medical informaticsinformatics and and biomedical informaticsbiomedical informatics..

It improves patient care by improving efficiency It improves patient care by improving efficiency and effectiveness in different areas of a common and effectiveness in different areas of a common dental practice:dental practice:administration;administration;clinical care;clinical care;charting records;charting records;patient education. patient education.

11. 11. Medical CyberneticsMedical CyberneticsCyberneticsCybernetics is the interdisciplinary study of the is the interdisciplinary study of the

structure of structure of complex systemscomplex systems, especially , especially communication processescommunication processes, , control mechanismscontrol mechanisms and and feedback principlesfeedback principles. Cybernetics is closely . Cybernetics is closely related to related to control theorycontrol theory and and systems theorysystems theory..

Concepts studied by cyberneticists include, but are not Concepts studied by cyberneticists include, but are not limited to: limited to: learning, cognition, adaption, social learning, cognition, adaption, social control, emergence, communication, efficiency, control, emergence, communication, efficiency, efficacyefficacy and and interconnectivityinterconnectivity. These concepts . These concepts are studied by other subjects such as engineering are studied by other subjects such as engineering and biology, but in cybernetics these are removed and biology, but in cybernetics these are removed from the context of the individual organism or from the context of the individual organism or device.device.

11. 11. Medical CyberneticsMedical CyberneticsPure cyberneticsPure cybernetics studies systems of control as a concept, studies systems of control as a concept,

attempting to discover the basic principles underlying attempting to discover the basic principles underlying such things as:such things as:Artificial intelligence Artificial intelligence Robotics Robotics Computer Vision Computer Vision Control systems Control systems Emergence Emergence Learning organizationLearning organization

Computer scienceComputer science directly applies the concepts of directly applies the concepts of cybernetics to the control of devices and the analysis of cybernetics to the control of devices and the analysis of information.information.Decision support system Decision support system Cellular automaton Cellular automaton Simulation Simulation

11. 11. Medical CyberneticsMedical CyberneticsCybernetics in biology is the study of cybernetic Cybernetics in biology is the study of cybernetic

systems present in biological organisms, systems present in biological organisms, primarily focusing on how animals adapt to their primarily focusing on how animals adapt to their environment, and how information in the form of environment, and how information in the form of genes is passed from generation to generation:genes is passed from generation to generation:

Bioengineering Bioengineering

Biocybernetics Biocybernetics

Bionics Bionics

Homeostasis Homeostasis

Medical cybernetics Medical cybernetics

Synthetic Biology Synthetic Biology

11. 11. Medical CyberneticsMedical CyberneticsMedical CyberneticsMedical Cybernetics is a field of applied cybernetics which is a field of applied cybernetics which

utilizes the concepts of cybernetics to medical research utilizes the concepts of cybernetics to medical research and practice. It covers an emerging working program for and practice. It covers an emerging working program for the application of systems- and communications-theory, the application of systems- and communications-theory, connectionism and decision theory on biomedical connectionism and decision theory on biomedical research and health related questions.research and health related questions. TopicsTopics::Systems TheorySystems Theory in medical sciencesin medical sciences (searching for (searching for and modelling of physiological dynamics).and modelling of physiological dynamics).Medical information and Communication TheoryMedical information and Communication Theory (mathematically describe signalling processes and (mathematically describe signalling processes and information storage in different physiological layers)information storage in different physiological layers) ConnectionismConnectionism ((describe information processing in describe information processing in neural networksneural networks))Medical Decision TheoryMedical Decision Theory (gather evidence based (gather evidence based foundations for decision making in the clinical settingfoundations for decision making in the clinical setting ))

12. Information systems – example12. Information systems – example

Electronic health record (EHR) with image and document links.Electronic health record (EHR) with image and document links.

12. Information systems – example12. Information systems – example

Sample patient record view from an image-based electronic health record (VistA).Sample patient record view from an image-based electronic health record (VistA).

12. Information systems – example12. Information systems – example

12. Information systems – example12. Information systems – example

A PACS allows to store volumic exams and to reconstruct 3D images A PACS allows to store volumic exams and to reconstruct 3D images

ConclusionConclusion

Medical Informatics DefinitionMedical Informatics DefinitionMedical Informatics as the Scientific AreaMedical Informatics as the Scientific AreaMedical Informatics AreasMedical Informatics AreasAspects of the Aspects of the Medical InformaticsMedical Informatics field fieldssClinical informaticsClinical informaticsBiomedical informaticsBiomedical informaticsBioinformaticsBioinformaticsPublic health informaticsPublic health informaticsNursing informaticsNursing informaticsDental informaticsDental informaticsMedical CyberneticsMedical CyberneticsInformation Systems examplesInformation Systems examples