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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 l.jpg
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/


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What does it mean

computers

in medicine ?


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The Computer Meets Medicine and Biology:Emergence of a Discipline

After taking this course, you should

know the answers to these questions:


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· 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?


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· 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?


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· 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.


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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.


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Inputs to the medical recordsTraditional paper medical records



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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


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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


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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)


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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



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assist with clinical matters by: stations that will :

  • reporting results of tests.

  • allowing direct entry of orders by clinicians.

  • facilitating access to transcribed reports.

  • supporting telemedicine applications.

  • Supporting decision-support functions.


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administrative and financial topics stations that will :

  • tracking of patients within the hospital.

  • managing materials and inventory

  • .supporting personnel functions.

  • managing the payroll.


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research stations that will :

  • analyzing the outcomes associated with

  • treatments and procedures.

  • performing quality assurance.

  • supporting clinical trials.

  • implementing various treatment protocols.


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scholarly information stations that will :

  • accessing digital libraries.

  • supporting bibliographic search.

  • providing access to drug-information

  • databases.

  • office automation (providing access to

  • spreadsheets, word processors, and the like).


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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.


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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.


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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


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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


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Journals:

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


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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.


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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.


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National library of medicine. 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.Medline


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Standards in Medical Informatics 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.

  • Medical Information Bus - IEEE 1073

  • HL-7 Health Level 7

  • DICOM - Digital Imaging and Communications in

  • Medicine.


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HL7 Mission Statement 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.

  • 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.


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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


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LiteBox health care information.

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


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Medical Information Bus health care information.IEEE 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.


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Applications of health care information.Medical Informaticsby NASA

to provide:

  • Telemonitoring

    • people

    • environment

    • systems

  • Tele-education

  • Telecare

  • Telescience


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Virtual Reality health care information.

  • Biocomputation

    • improved skills

    • pre-surgery planning

    • new techniques testing

    • immersive robotic surgery


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  • 1995 health care information.

    • 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


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Schedule health care information.


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