medical informatics - algom medical informatics association () workgroups 7. new educational area?...

Oleg Pianykh [email protected] 1

Medical Informatics

Oleg Pianykh, PhD

[email protected]

Oleg Pianykh [email protected]

Introduction


Medical Informatics?


Performer: Sivu, http://www.youtube.com/watch?v=_964dqQxQwY

Welcome to Medical Informatics!



So, what is MI anyway?

What is MI?

Why the heck are you taking this class???


1. MI = Hospitals + IT projects?

Hospital X:1. Buys new 64-bit, Windows 9 PCs to

replace its old computers

2. Equips surgery rooms with iPads

3. Starts tracking ambulances with GPS and geofencing, real-time

4. Consults outpatients on Skype and Tweeter

5. Buys expensive 3D workstations for brain analysis

6. Embraces cloud storage for its medical records


Retina display


2. Dream job?


Q: Did you have any experience with MI-like projects?

3. Popular buzzword?


We need a much better definition!

Triumph of ambiguity


4. Perfect investment?


5. Science?

Science or “intersection”? MI is often defined as a discipline at the intersection of

information/computer science and healthcare.

“Intersection” definitions offer little help for describing MI applications, and tell nothing about its aims, methods or major research directions.

… or “intersections”? Another approach to defining MI involves breaking it in

pieces: dentistry informatics, surgical informatics, mammoinformatics, …



MI publications

Exponential growth in publications after year 2000:


[DeShazo, 2009]

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

1986 1990 1994 1998 2002 2006

MI papers in Medical Subject Headings

Q: Can MI-related papers help us define MI ?

What are they all writing about?

Schuemie in 2009 analyzed 14,885 articles from 16 MI-related journals, over 15 years (1993-2008).

The articles (titles and abstracts) were classified and clustered based on their keywords.

Consequently, the journals and

research areas were classified as well,

based on their proximity to

MI subject clusters.


Keyword extraction example [Schuemie, 2009]


Clustering MI papers from 1993-2008


3660 articles from 16 medical informatics journals

[Schuemie, 2009]

Three major clusters:1. Data analysis (classification

techniques and statistical modeling, signal and image analysis)

2. Health information systems, their application, evaluation, and organization

3. Medical knowledge representation in the form of clinical guidelines, ontologies, and databases.

MI was described as a distinct discipline (distinct from bioinformatics, for instance)

[Bansard, 2007]

Problems with MI self-definitions

We can cluster MI publications, but do we really know what drives them?


1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

1986 1990 1994 1998 2002 2006

MI papers in MeSH

0.4

0.6

0.8

1

1991 1996 2001 2006

Correlation: MI papers with PC sales

We need a much better definition!!!

Bare technology and papers cannot define MI


6. Societies, Workgroups and Standards?

Biomedical Pattern Recognition

Consumer Health Informatics

Critical Care Informatics

Dental Informatics

Health and Medical Informatics Education

Health Informatics for Development

Health Informatics for Patient Safety

Health Information Systems

Human Factors Engineering for Healthcare Informatics

Informatics in Genomic Medicine (IGM)

Intelligent Data Analysis and Data Mining


Medical Concept Representation

Mental Health Informatics

Open Source Health Informatics

Organizational and Social Issues

Primary Health Care Informatics

Security in Health Information Systems

SIG NI Nursing Informatics

Smart Homes and Ambient Assisted Living

Social Media

Standards in Health Care Informatics

Technology Assessment & Quality Development in Health Informatics

Telehealth (provisional)

Wearable Sensors in Healthcare

International Medical Informatics Association (www.imia.org)Workgroups

7. New educational area?

MI is often diluted by particular audience type, which varies greatly from librarians (understanding MI as knowledge mining tool) to MDs (sometimes viewing MI as computer literacy classes).

As a result, many MI curricula get overloaded with extraneous details – such as computer architecture, finance/management, or anatomy lessons.



Should we even teach MI?

Is MI too advanced?

Is MI curriculum too distractive for medical students?

Is it too remote for engineering/science students?


Typical discussion on MI curriculum

8. Historical phenomenon


Q: Ho old is MI ?


MI Evolution

Do you know about the real Imhotep? First known physician

First known engineer

Medicine and engineering have been connected since the earliest times

Late 19th century – early 20th century Punch cards to process census data (IBM predecessor)

Physicians start using phones

Cars


http://www.vopus.org/en/gnosis/great-characters/imhotep-master-of-sciences.html,Cohen: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307150/pdf/westjmed00160-0042.pdf,© Explosm.net cartoon

Radio doctor 1924



MI Evolution

1950s: First realization that clinical reasoning can be expressed in mathematical terms (logic, probability) Math can make clinical decisions more solid (read good

paper from Ledley, [1959]).

Computers can help in doing math.

First programming languages (FORTRAN, Cobol)

The Professional Group in Bio-Medical Electronics (later IEEE)

Oleg Pianykh [email protected][Ledley, 1959]

MI Evolution

Growth and expansion in 1960s Rapid growth of MI publications

First MI departments

Naming game: medical computing, medical data processing, medical information processing, health care information systems, medical computer science, etc. The French, then the German and Russian scientists, start using the word informatique [Collen, 1986].

Mainframe computers; PC and network prototypes



MI Evolution

The first academic department in the United States for teaching computing in medicine was established in 1960 at Tulane University School of Medicine (New Orleans), and J.W. Sweeney was designated as its first Professor of Computer Medicine.

When asked about his title, he would jokingly counter, “Does this mean that I treat sick computers?”


MI Evolution

1970s First CT (computed tomography) scanners: 100%

computer-made medical images

The term “Medical Informatics” is born: "medical informatics as the application of computer technology to all fields of medicine.” MI journals follow.

First MI classes

Oleg Pianykh [email protected][Sittig, 2006]

The first clinical CT scan on a patient took place on October 1st, 1971 at Atkinson Morley's Hospital, in

London, England. First slice was 80x80 pixels; took 5 min to make (0.3 sec for modern 1024x1024 CT).


MI Evolution

Rapid growth since late 1980s, correlated with mass digitization of medical practices

50 member societies with 50,000 members to date

Result: a new discipline, conceived from several non-intersecting directions (medicine, engineering, computer science, math) Consequences: major identity problem, when MI is viewed as “anything clinical with computers”

Harrison, 1984: “There is no term in the English language to encompass this conglomerate of knowledge.”


We need a much better definition!!

OK, what is MI anyway???

Q: Define Medical Informatics: …

…

…



So, how do we define MI?

Medical Informatics (MI) = intelligent processing of clinical information in order to improve healthcare quality.

Medical data → logical structure → better technology

Applied science: practical success is everything


HealthcareHigh-qualityHealthcare

MI

+ =

What’s wrong with these pictures?



And what’s wrong with these projects?

Hospital X:1. Buys new 64-bit, Windows 8.1 PCs to

replace its old computers

2. Equips surgery rooms with iPads

3. Starts tracking ambulances with GPS and geofencing, real-time

4. Consults outpatients on Skype and Tweeter

5. Buys expensive 3D workstations for brain analysis

6. Embraces cloud storage for its medical records


Retina display

Principal reasons for MI progress

Need for complex data analysis (better healthcare)

Digital formats for medical data

Increasing data volume – well beyond human processing capabilities

Need for faster and error-free workflow (30% to 60% spent on paperwork)



Questions

What would you like to learn in this class? …

…

…

Why do you want to learn this?


References

R.S.Ledley, L.B.Lusted, "Reasoning Foundations of Medical Diagnosis”, Science, July 3 1959.

R.S.Ledley, "Digital Electronic Computers in Biomedical Science", Science, November 6 1959.

M.F. Collen, “Origins of medical informatics”, West. J. Med. 145 (1986) 778–785.

D.F. Sittig, J.S. Ash, R.S.Ledley, “The Story Behind the Development of the First Whole-body Computerized Tomography Scanner as Told by Robert S. Ledley”, Journal of the American Medical Informatics Association Volume 13 Number 5 Sep / Oct 2006.

M.J. Schuemie, J.L. Talmon, P.W. Moorman, J.A. Kors, Mapping the domain of medical informatics, Methods Inf. Med. 48 (2009) 76–83.

R. Haux, Medical informatics: Past, present, future, international journal of medical informatics 79 (2010) 599–610.

J.P. DeShazo, D.L. LaVallie, F.M.Wolf, Publication trends in the medical informatics literature: 20 years of "Medical Informatics" in MeSH, BioMedCentral, Januaru 21, 2009.

Bansard JY, Rebholz-Schuhmann D, Cameron G, Clark D, van Mulligen E, Beltrame E, Barbolla E, Martin-Sanchez Fdel H, Milanesi L, Tollis I, van der Lei J, Coatrieux JL, Medical informatics and bioinformatics: a bibliometric study, IEEE Trans Inf Technol Biomed. 2007 May;11(3):237-43. Review.


medical informatics - algom medical informatics association () workgroups 7. new educational area?...

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