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Overview of Medical Computing

Overview of Medical Computing. James J. Cimino, M.D. Department of Medical Informatics Columbia University. Medical Informatics. Medical Information Science. We are all Medical Informaticians. Medical education Patient data collection and recording Clinical Information retrieval

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Overview of Medical Computing

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  1. Overview of Medical Computing James J. Cimino, M.D. Department of Medical Informatics Columbia University

  2. Medical Informatics • Medical • Information • Science

  3. We are all Medical Informaticians • Medical education • Patient data collection and recording • Clinical Information retrieval • Medical knowledge retrieval • Medical decision making

  4. Categories of Medical Computing • Financial databases • Clinical information systems • Research databases • Medical knowledge systems • Expert systems • Decision support systems • Computer-assisted instruction • Putting it all together

  5. Financial databases • Initial impetus for clinical information systems • Started with billing • Grew to capture billable clinical information • Expanded capabilities for prospective payment • Next expansion: managed care

  6. Clinical information systems • Ancillary systems • Central repositories added onto financial systems • Comprehensive clinical systems • Clinician applications and workstations • Next expansion: computer-based patient record systems

  7. Research databases • Initially, built from scratch • Now built from clinical information systems • Next expansion: outcomes research

  8. Medical Knowledge Sources • Medline - 1966 • Colleague - full-text - 1984 • Electronic textbooks • Next expansion: Visible Human Project

  9. Computer-Assisted Instruction • Electronic quiz • Hypertextbooks • Simulations • Next expansion: customized learning

  10. Expert Systems • First medical computing application: 1950 • Mycin • Acid-base calculators • Internest-I and QMR • DXplain • “Attending” systems • Pattern-recognition systems • Next expansion: decision support systems

  11. Decision support systems • Decision analysis systems • Help • CPMC alerting system • Next expansion: managed care

  12. Putting It All Together • Multiple applications on line • IAIMS - one-stop information shopping • Integration of • clinical information systems • medical knowledge resources • educational systems • expert systems • decision support systems • Next expansion: Internet and the World Wide Web

  13. Systems • Columbia IAIMS • Life&Death • Medline buttton • DSE • DOP • WWW

  14. Current Challenges • Clinical data representation • Controlled vocabularies • User interface design • Confidentiality • System integration • Implementing critical pathways

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