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Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate Editor

Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

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Page 1: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Chapter 1 & 2

Biomedical InformaticsComputer Applicationsin Health Care andBiomedicineThird EditionEdward H. ShortliffeEditorJames J. CiminoAssociate Editor

Page 2: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Grading and assessment:

2 MidExams each 15 = 30

FinalExam Theory = 30

5 Quizzes 5 each, the lowest 2 will be dropped = 15

5 Assignments 5 each, the lowest 2 will be dropped = 15 Semester project 10

Course website: mcst-is-cs.wikispaces.com

Page 3: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

How important are computers in the medical field

Lets take a lookbanks cannot practice modern banking without financial softwareAirlines cannot manage modern travel planning without shared databanks of flight schedules and reservationsLife scientists are generating data at a rate that defies traditional paper-and pencil methods for information management and data analysis.Health professionals also recognize that a large percentage of their activities relates to information management

Page 4: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

for example, obtaining and recording information about patients, consulting colleagues, reading the scientific literature, planning diagnostic procedures, devising strategies for patient care, interpreting results of laboratory and radiologic studies, or conducting case-based and population- based research.

Page 5: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Information Management in Biomedicine

Although the application of computers to biomedicine is recent, the clinical and research influence of biomedical-computing systems is already remarkably broad.

Example: Clinical information systems, which provide communication and

information-management functions, are now installed in essentially all healthcare institutions.

Physicians can search entire drug indexes in a few seconds To anticipate harmful side effects or drug interactions

Electrocardiograms (ECGs) are typically analyzed initially by computer programs

interpretation of pulmonary-function tests and a variety of laboratory and radiologic abnormalities.

Page 6: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Devices with embedded microprocessors routinely monitor patients and provide warnings in critical-care settings, such as the intensive-care unit (ICU) or the operating room.

Both biomedical researchers and clinicians regularly use computer programs to search the medical literature, and modern clinical research would be severely hampered without computer based data-storage techniques and statistical analysis systems

Advanced decision-support tools also are emerging from research laboratories, are being integrated with patient-care systems, and are beginning to have a profound effect on the way medicine is practiced.

Page 7: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

The Study of Computers in Biomedicine

The actual and potential uses of computers in health care and biomedicine form a remarkably broad and complex topic. However, just as you do not need to understand how a telephone or an ATM machine works to make good use of it and to tell when it is functioning poorly, we believe that technical biomedical-computing skills are not needed by health workers and life scientists who simply wish to become effective computer users. On the other hand, such technical skills are of course necessary for individuals with a career commitment to developing computer systems for biomedical environments.

Page 8: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

The Need for Specialists in Biomedical Informatics

The increasing introduction of computing techniques into biomedical environments will require that well-trained individuals be available not only to teach students, but also to design, develop, select, and manage the biomedical-computing systems of tomorrow

Page 9: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Transition to an EHR

Inadequacy of Paper record Intro to Computer record Electronic Medical Record Electronic Health Record

Page 10: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Biomedical Science

Definition:

The scientific field that deals with biomedical information, data, and knowledge—the storage, retrieval, and optimal use for problem solving and decision making

Page 11: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

What is medical Data?

Medical datum: A single observation of medical fact; the value of a specific parameter (e.g., red blood cell count) for a particular object (e.g., patient) at a given point in time.

Types of Medical Data: numerical measurements (e.g., blood pressure), recorded signalse(e.g., heart beat), drawings, and photographs)

Page 12: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Who Collects the Data?

Healthcare team: A coordinated group of health professionals including physicians, nurses, case managers, dieticians, pharmacists, therapists, and other practitioners who collaborate in caring for a patient.

Page 13: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Who uses the medical data?

Direct patient care Administrative purposes Financial purposes Statistical purposes

Page 14: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Roles of Medical Record

1. A communication mechanism among health professionals who work together to plan patient care.

2. Continuity of care3. Anticipate Future Health

Problems/Preventative Measures4. Legal record5. Clinical Research

Page 15: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Weaknesses of the Medical Record System

Can I find the data I need when I need them?Can I find the medical record in which they are

recordedCan I find the data within the record?Can I find what I need quickly?Can I read and interpret the data once I find

them?Can I update the data reliably with new

observations?

Page 16: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Electronic Health Records: Anticipating the Future

single-entry points into a medical world digital libraries, supporting

bibliographic search

Page 17: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Definitions in Ch. 2

Nomenclature: A system of terms used in a scientific discipline to denot classifications and relationships among objects and processes.

Knowledge: Relationships, facts, assumptions, heuristics, and models derived through the formal or informal analysis (or interpretation) of data

Page 18: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Definitions cont.

Information: Organized data or knowledge that provides a basis for decision making.

Heuristic: A mental “trick or rule of thumb; a cognitive process used in learning or problem solving.

Database: A collection of stored data—typically organized into fields, records, and files—and an associated description.

Knowledgebase: A collection of facts, heuristics, and models that can be used for problem solving and analysis of data.

Page 19: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Hypothetico-deductive approach

In clinical medicine, an interative approach to diagnosis in which physicians perform sequential, staged data collection, data interpretation and hypothesis generation to determin and refine a differential diagnosis?

Page 20: Chapter 1 & 2 Biomedical Informatics Computer Applications in Health Care and Biomedicine Third Edition Edward H. Shortliffe Editor James J. Cimino Associate

Question for Discussion

Given the imprecision of many medical terms, why do you think that serious instances of miscommunication among health care professionals are not more common?

Why is greater standardization of terminology necessary if computers rather than humans are to manipulate the data?