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Computers in Medicine

Computers in Medicine. Lecturer and Coordinator Israel Gannot Tel: 6711, E-mail: gannot@eng.tau.ac.il Assistant Shamai Salzberger shamai@eng.tau.ac.il. WEBsite: http://www.eng.tau.ac.il/~gannot/MI/. What does it mean computers in medicine ?.

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Computers in Medicine

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  1. Computers in Medicine Lecturer and Coordinator Israel Gannot Tel: 6711, E-mail: gannot@eng.tau.ac.il Assistant Shamai Salzberger shamai@eng.tau.ac.il WEBsite: http://www.eng.tau.ac.il/~gannot/MI/

  2. What does it mean computers in medicine ?

  3. The Computer Meets Medicine and Biology:Emergence of a Discipline After taking this course, you should know the answers to these questions:

  4. · Why is information management a central issue in biomedical research and clinical practice? · What are integrated information- management environments and how might we expect them to affect the practice of medicine and biomedical research in coming years? · What do we mean by the terms medical computer science, medical computing ,medical informatics, clinical informatics, nursing informatics, bioinformatics, and health informatics?

  5. · Why should health professionals and students of the health professions learn about medical-informatics concepts and informatics applications? · How has the development of mini- computers, microprocessors, and the Internet changed the nature of biomedical computing? · How is medical informatics related to clinical practice, biomedical engineering, molecular biology, decision science, information science, and computer science?

  6. · How does information in clinical medicine and health differ from information in the basic sciences? · How can changes in computer technology and the way medical care is financed influence the integration of medical computing into clinical practice.

  7. Subjects Index: • Medical Decision making: Probabilistic • medical reasoning. • Patient care systems. • Patient monitoring systems. • Computer aided surgery. • Computer based patient record systems. • Clinical decision support systems. • The internet. • Standards in medical informatics. • Imaging modalities. • Image management systems. • Telemedicine. • Bioinformatics.

  8. Inputs to the medical recordsTraditional paper medical records

  9. Outputs of the medical records

  10. Conventional data collection for clinical trial Medical records Data sheets • Clinical trial design • Definition of data elements • Definition of eligibility • Process descriptions • Stopping criteria • Other details of the trial Computer database Analyses Results

  11. Role of EMR in supporting clinical trials Medical records systems Clinical data repository Clinical trial database • Clinical trial design • Definition of data elements • Definition of eligibility • Process descriptions • Stopping criteria • Other details of the trial Analyses Results

  12. Networking the organization Personnel systems Clinical databases Electronic medical records Enterprise network Pharmacy Patient workstation Billing and financial systems Clerical workstation Cost accounting Clinical workstations Microbiology Library resources Research databeses Radiology Material management Clinical laboratory Data warehouse Educational programs Administrative systems (e.g. admissions, discharges and transfers)

  13. Moving beyond the organization The Internet Government health insurance programs 3rd party payers Other hospitals and physicians Patients Pharmaceuticals regulators Healthy individuals Communicable disease agencies Government medical research agencies Providers in offices or clinics Vendors of various types (e.g. pharmaceuticals companies Information resources (Medline..) Health Science Schools

  14. Healthcare institutes are seeking Integrated clinical work stations that will : .

  15. assist with clinical matters by: • reporting results of tests. • allowing direct entry of orders by clinicians. • facilitating access to transcribed reports. • supporting telemedicine applications. • Supporting decision-support functions.

  16. administrative and financial topics • tracking of patients within the hospital. • managing materials and inventory • .supporting personnel functions. • managing the payroll.

  17. research • analyzing the outcomes associated with • treatments and procedures. • performing quality assurance. • supporting clinical trials. • implementing various treatment protocols.

  18. scholarly information • accessing digital libraries. • supporting bibliographic search. • providing access to drug-information • databases. • office automation (providing access to • spreadsheets, word processors, and the like).

  19. The key notion is that at the heart of the evolving clinical workstation lies the medical record in a new incarnation: • electronic, • accessible. • Confidential. • Secure. • acceptable to clinicians and patients. • integrated with other types of • non-patient-specific information.

  20. References: Course textbook: 1. HANDBOOK of MEDICAL INFORMATICS Editors: J.H. van Bemmel, Erasmus University, Rotterdam M.A. Musen, Stanford University Stanford, Springer, 1997. Additional books: 2. The computer based patient records: An essential Technology for Healthcare, Institute of Medicine National Academy Press, 1997. 3. Strategies and Technologies for healthcare information: Theory and practice, Marion J. Ball, Judith V. Douglas and David E. Garrets, editors, Springer, 1999. 4. Clinical decision support systems: Theory and practice. Eta S. Berner, Springer, 1998. 5. Telemedicine-Practicing in the information age, Stevan F. Viegas, Kim Dunn, Editors, Lippincott-Raven, 1998.

  21. WEBsites: • National Institutes of Health • http://www.nih.gov • National Library of Medicine (Medline)- • http://igm.nlm.nih.gov/ • American Medical Informatics Association- • http://www.amia.org/ • The international Society for computer aided surgery. • http://igs.slu.edu/ • The helath level 7 committee: • http://www.hl7.org • The European Committee for Standardization • Technical Committee for Health Informatics • http://www.centc251.org/ • BioInformatics resources on the WEB • http://www.niehs.nih.gov/science/bioinfo.htm • Tools for DNA gene and protein sequencing. • http://www.ncbi.nlm.nih.gov/Tools/index.html

  22. Journals: • CRITICAL REVIEWS IN MEDICAL INFORMATICS. • HEALTH COMMUNICATIONS AND INFORMATICS • HEALTHCARE INFORMATICS • INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS • JOURNAL OF THE AMERICAN MEDICAL INFORMATICS • ASSOCIATION • MEDICAL INFORMATICS • MEDICAL INFORMATICS AND THE INTERNET IN • MEDICINE • STUDIES IN HEALTH TECHNOLOGY AND INFORMATICS • BIOINFORMATICS • COMPUTERS AND BIOMEDICAL RESEARCH • COMPUTERS IN BIOLOGY AND MEDICINE • COMPUTERS IN HEALTHCARE • COMPUTERS IN HOSPITALS • COMPUTERS IN NURSING

  23. Journals: • http://www.interscience.wiley.com:83/cas/

  24. Bioinformatics: Bioinformatics is the study of how information is represented and transmitted in biological systems, starting at the molecular level. Whereas clinical informatics deals with the management of information related to the delivery of health care, bioinformatics focuses on the management of information related to the underlying basic biological sciences. DNA, protein gene sequencing.

  25. NIH group maintains a database of macromolecular 3D structures, as well as tools for their visualization and comparative analysis. MMDB, the Molecular Modeling Database, contains experimentally determined biopolymer structures obtained from the Protein Data Bank.

  26. National library of medicine. Medline

  27. Standards in Medical Informatics • Medical Information Bus - IEEE 1073 • HL-7 Health Level 7 • DICOM - Digital Imaging and Communications in • Medicine.

  28. HL7 Mission Statement • To provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services.

  29. A domain-specific, common protocol for the exchange of health care information. Function Communication What does “HL7” stand for? HL7 7 Application 6 Presentation 5 Session 4 Transport 3 Network 2 Data Link 1 Physical ISO-OSI Communication Architecture Model

  30. LiteBox MAGN ETOM DICOM Application Domain Storage, Query/Retrieve, Study Component Print Management Query/Retrieve Results Management Media Exchange Query/Retrieve, Patient & Study Management Information Management System

  31. Medical Information BusIEEE 1073, Standard for Medical Device Communications. This standard for medical device communication defines a family of standards for providing interconnection and interoperability of medical devices and computerized healthcare information systems. Medical devices include a broad range of clinical monitoring, diagnostic and therapeutic equipment. Computerized healthcare information systems similarly include broad range of clinical data management systems, patient care systems and hospital information systems.

  32. Applications of Medical Informaticsby NASA to provide: • Telemonitoring • people • environment • systems • Tele-education • Telecare • Telescience

  33. Virtual Reality • Biocomputation • improved skills • pre-surgery planning • new techniques testing • immersive robotic surgery

  34. 1995 • ARC telemed demo with Trident & Mt. Sinai Medical Center • Spacebridge to Russia • 1997 • NASA Commercial Space Center theMedical Informatics and TechnologyApplications Consortium (MITAC) • 1998 • Andes/Ecuador surgery consult • Everest Extreme Expedition I • 1999 • Virtual Hospital demonstration with ARC • Everest Extreme Expedition II

  35. Schedule

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