scholarly journals People and Ideas in Medical Informatics - A Half Century Review

2011 ◽  
Vol 20 (01) ◽  
pp. 175-182
Author(s):  
J. H. van Bemmel
Keyword(s):  
Health Care ◽  
Human Factors ◽  
Medical Informatics ◽  
Interdisciplinary Approach ◽  
Medical Decision ◽  
The Public ◽  
Medical Decision Support ◽  
Care Processes ◽  
Medical Decision Support Systems ◽  
The Impact

SummaryReviewing the onset and the rapid changes to make realistic predictions on the future of medical informatics.Pointing to the contributions of the early pioneers, who had their roots in other disciplines and by illustrating that from the onset an interdisciplinary approach was characteristic for our field.Some of the reasons for the changes in medical informatics are that nobody was able to predict the advent of the personal computer in the 1970s, the world-wide web in 1991, and the public start of the Internet in 1992, but foremost that nobody expected that it was not primarily the hardware or the software, but human factors that would be crucial for successful applications of computers in health care. In the past sometimes unrealistic expectations were held, such as on the impact of medical decision-support systems, or on the overly optimistic contributions of electronic health records. Although the technology is widely available, some applications appear to be far more complex than expected. Health care processes can seldom be fully standardized. Humans enter at least in two very different roles in the loop of information processing: as subjects conducting care - the clinicians - and as subjects that are the objects of care - the patients.Medical informatics lacks a specific methodology; methods are borrowed from adjacent disciplines such as physics, mathematics and, of course, computer science. Human factors play a major role in applying computers in health care. Everyone pursuing a career in biomedical informatics needs to be very aware of this. It is to be expected that the quality of health care will increasingly be assessed by computer systems to fulfill the requirements of medical evidence.

Medical decision support systems on the basis of artificial intelligence — strategy for the development of personalized medicine of the next stage

2020 ◽  
pp. 48-53
Author(s):  
P. Kuznetsov ◽  
P. Kakorina ◽  
A. Almazov
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Human Capital ◽  
Decision Support ◽  
Personalized Medicine ◽  
Decision Support Systems ◽  
Support Systems ◽  
Medical Decision ◽  
Medical Decision Support ◽  
Medical Decision Support Systems

Prospects of creating decision support systems (DSS) in health care are substantiated in the article, the feasibility of mass implementation of DSS and the principle of their work on the basis of a medical and digital system for managing human capital are analyzed, examples of clinical DSS in Russia and abroad on the basis of 4P medicine are provided.

Medical Decision Support Systems: Old Dilemmas and new Paradigms?

2003 ◽  
Vol 42 (03) ◽  
pp. 190-198 ◽  
Author(s):  
J.-C. Dufour ◽  
P. Staccini ◽  
J. Gouvernet ◽  
O. Bouhaddou ◽  
M. Fieschi
Keyword(s):  
Health Care ◽  
Decision Support ◽  
Decision Support Systems ◽  
Practice Guidelines ◽  
Support Systems ◽  
Medical Decision ◽  
Care Process ◽  
Medical Terminology ◽  
Medical Decision Support ◽  
Medical Decision Support Systems

Summary Objectives: The purpose of this paper is to examine past and present medical decision support systems and the environment in which they operate and to propose specific research tracks that improve integration and adoption of these systems in today’s health care systems. Methods: In preamble, we examine the objectives, decision models, and performances of past decision support systems. Results: Medical decision support tools were essentially formulated from a technical capability perspective and this view has met limited adoption and slowed down new development as well as integration of these important systems into patient management work flows and clinical information systems. The science base of these systems needs to include evidence-based medicine and clinical practice guidelines and the paradigms need to be extended to include a collaborative provider model, the users and the organization perspectives. The availability of patient record and medical terminology standards is essential to the dissemination of decision support systems and so is their integration into the care process. Conclusion: To build new decision support systems based on practice guidelines and taking into account users preferences, we do not so much advocate new technological solutions but rather suggest that technology is not enough to ensure successful adoption by the users, the integration into practice workflow, and consequently, the realisation of improved health care outcomes.

The Roots of Global Health Inequity

2017 ◽  
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Primary Health Care ◽  
Economic Policies ◽  
World War ◽  
The Public ◽  
The World Bank ◽  
Primary Health ◽  
The Cold War ◽  
The Impact

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.

The Good, the Bad and the Ugly in App Diagnosis: Outcomes and Implications by Example

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 38-38
Author(s):  
Sorana D. Bolboacă ◽  
◽  
Adriana Elena Bulboacă ◽  
◽  
◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision ◽  
Medical Decision ◽  
Normal Body Mass Index ◽  
Disk Herniation ◽  
Scientific Evaluation ◽  
Medical Decision Support ◽  
Lower Back ◽  
Clinical Scenarios ◽  
Medical Decision Support Systems

"The Clinical Decision Support (CDS), a form of artificial intelligence (AI), consider physician expertise and cognitive function along with patient’s data as the input and case-specific medical decision as an output. The improvements in physician’s performances when using a CDS ranges from 13% to 68%. The AI applications are of large interest nowadays, and a lot of effort is also put in the development of IT applications in healthcare. Medical decision support systems for non-medical staff users (MDSS-NMSF) as phone applications are nowadays available on the market. A MDSS-NMSF app is generally not accompanied by a scientific evaluation of the performances, even if they are freely available or not. Two clinical scenarios were created, and Doctor31 retrieved the diagnosis decisions. First scenario: man, 29 years old, and three symptoms: dysphagia, weight loss (normal body mass index), and tiredness. Second scenario: women, 47 years old with L5-S1 disk herniation, abnormal anti-TPO antibodies, lower back pain (burning sensations), constipation, and tiredness. The outcome possible effects and implications, as well as vulnerabilities induced on the used, are highlighted and discussed. "

IMPACT OF JOINT COMMISSION INTERNATIONALACCREDITATION (JCIA) ON HEALTH CARE PROCESSES AND THE CHALLENGES FACED BY PHYSICIANS AND NURSES.

2021 ◽  
pp. 34-35
Author(s):  
Binu Thomas ◽  
Ankur Joshi
Keyword(s):  
Health Care ◽  
Employee Engagement ◽  
Interdisciplinary Collaboration ◽  
Joint Commission ◽  
Health Centers ◽  
Cross Sectional ◽  
Care Processes ◽  
Before And After ◽  
Collaboration And Communication ◽  
The Impact

Purpose: To evaluate the impact of joint commission international accreditation on health care processes as well as to assess the challenges faced by the physicians and nurses . Method: Conducted a cross sectional study in 11 health centers belong to Dubai health authority. Prepared a checklist and questionnaire to assess the changes in the processes brought by accreditation as well as the challenges faced by employees respectively. Studied perceived challenges by recruiting physician (n=106) and nurses (n=194) using convenience sampling technique. Done content validity of the tools with clinical quality experts. Conducted pilot study for the questionnaire and checked the reliability using Cronbach alpha (0.924). After obtaining ethical clearance and consent from subjects, the researcher visited health centers and administered questionnaire to the participants. To evaluate the process improvements, the researcher audited documents for the availability of processes before and after accreditation using the validated checklist, which consisted of 25 processes reecting various domains of quality, employee engagement, interdisciplinary collaboration and communication. Results: Observed tremendous improvements in the availability of processes. The proportion of processes before and after the accreditation was statistically signicantly different (p <.001) for quality of health care. However for employee engagement (p=.250) and interdisciplinary collaboration and communication (p=1.000) no statistical signicance were noted even though there were signicant improvements. Majority (57.5%) of doctors and nurses perceived that the accreditation processes were challenging. Discussion: Observed processes improvements ensuring quality, employee engagement, interdisciplinary collaboration and communication after accreditation.However,majority ofthe employees perceived that, the accreditationwas challenging in terms ofworkload, communication and documentation.

scholarly journals Can the Health-Care System Meet the Challenge of Pandemic Flu? Planning, Ethical, and Workforce Considerations

2007 ◽  
Vol 122 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Peter J. Levin ◽  
Eric N. Gebbie ◽  
Kristine Qureshi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Ethical Issues ◽  
Care Delivery ◽  
Care Staff ◽  
Health Care Staff ◽  
Accurate Information ◽  
The Public ◽  
Health Care Delivery Systems ◽  
The Impact

The federal pandemic influenza plan predicts that 30% of the population could be infected. The impact of this pandemic would quickly overwhelm the public health and health-care delivery systems in the U.S. and throughout the world. Surge capacity for staffing, availability of drugs and supplies, and alternate means to provide care must be included in detailed plans that are tested and drilled ahead of time. Accurate information on the disease must be made available to health-care staff and the public to reduce fear. Spokespersons must provide clear, consistent messages about the disease, including actions to be taken to contain its spread and treat the afflicted. Home care will be especially important, as hospitals will be quickly overwhelmed. Staff must be prepared ahead of time to assure their ability and willingness to report to work, and public health must plan ahead to adequately confront ethical issues that will arise concerning the availability of treatment resources. The entire community must work together to meet the challenges posed by an epidemic. Identification and resolution of these challenges and issues are essential to achieve adequate public health preparedness.

scholarly journals Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group

2018 ◽  
Vol 27 (01) ◽  
pp. 156-162 ◽  
Author(s):  
Harshana Liyanage ◽  
Siaw-Teng Liaw ◽  
Emmanouela Konstantara ◽  
Freda Mold ◽  
Richard Schreiber ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Medical Records ◽  
Panel Discussion ◽  
Care Quality ◽  
Care Providers ◽  
Consensus Statements ◽  
Online Access ◽  
The Impact

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.

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