Computers%20in%20Medicine

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Computers in Medicine

• Lecturer and Coordinator
• Israel Gannot
• Tel 6711, E-mail gannot_at_eng.tau.ac.il
• Assistant
• Shamai Salzberger
• shamai_at_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
BiologyEmergence 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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Outputs of the 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 com
panies
Information resources (Medline..)
Health Science Schools
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Healthcare institutes are seeking Integrated
clinical work stations that will
.
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assist with clinical matters by

• 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

• tracking of patients within the hospital.
• managing materials and inventory
• .supporting personnel functions.
• managing the payroll.

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research

• analyzing the outcomes associated with
• treatments and procedures.
• performing quality assurance.
• supporting clinical trials.
• implementing various treatment protocols.

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scholarly information

• 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.com83/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. Medline
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Standards in Medical Informatics

• Medical Information Bus - IEEE 1073
• HL-7 Health Level 7
• DICOM - Digital Imaging and Communications in
• Medicine.

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HL7 Mission Statement

• 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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What does HL7 stand for?

• A domain-specific, common protocol for the
  exchange of health care information.

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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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 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 Medical Informaticsby NASA

• to provide
• Telemonitoring
• people
• environment
• systems
• Tele-education
• Telecare
• Telescience

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Virtual Reality

• Biocomputation
• improved skills
• pre-surgery planning
• new techniques testing
• immersive robotic surgery

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1995 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