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Medical informatics


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Medical informatics

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Medical informatics

  1. 1. MEDICAL INFORMATICS Presenters: Dr. REENA Dr. MIGOM Moderator: Dr. S. CHATURVEDI1
  2. 2. What is Medical Informatics? Medical Informatics is the application of computers, communications and information technology and systems to all fields of medicine- Medical care Medical education Medical research MF Collen (MEDINFO ’80, Tokyo) 2
  3. 3. Medical informatics is a developing body of knowledge and a set of techniques concerning the organisational management of information in support of medical research, education and patient care. Assoc. of American Medical Colleges (AAMC) 1986 3
  4. 4. HISTORY • 1950s- “medical applications of computer science” • Medical computer science • Medical information science • Biomedical computing • Medical informatics • Health or healthcare informatics • Clinical informatics 4
  5. 5. HISTORY • 1949- Gustav Wager • 1950- United States National Bureau of Standards • mid 50’s- MYCIN • 1965- MEDLINE • 1968- Homer Warner founded the department of medical informatics • 1970- IMIA, MUMPS language and OS 5
  7. 7. Standards in Medical Informatics There are four ways in which a standard can be produced: 1. Ad hoc method: Ex.-American College of Radiology-> DICOM 2. De facto method: Ex- Microsoft’s Windows 3. Government-mandate method: Ex-HCFA’s UB92 insurance-claim form 4. Consensus method: Ex- Health Level 7 (HL7) 7
  8. 8. Standards Bodies •ISO •CEN •HL7 •ANSI
  9. 9. Standards in Medical Informatics The ISO/TC215 is the International Organization of Standardization's Technical Committee on Medical Informatics. TC215 works on the standardization of Medical Informatics and ICT, to allow for compatibility and interoperability between independent system. 9
  10. 10. Healthcare functions and Information Technology INFORMATION TECHNOLOGY Patient Care Patient Safety Medical Educatio n Disease Manage ment Evidence Based Care Pharmac y,Laborat ory Medical Records Quality Manage ment 10
  11. 11. Communication Knowledge Management Decision Support Information Management MEDICAL INFORMATICS 11 INFORMATICS USE IN HEALTH CARE
  12. 12. COMMUNICATIONS Telemedicine Telecardiology Teleradiology Telepsychiatry Correctional telehealth Teledentistry Patient e-mail Presentations 12
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  14. 14. Benefits of telemedicine  Care for those living in remote places  Consultation, education and back up for specialists in remote areas  Decreased costs  Better care in remote monitoring for patients  Reduced visits TYPES:  Store and forward telemedicine  Remote monitoring  Interactive telemedicines 14
  15. 15. KNOWLEDGE MANAGEMENT 15 Journals International Journal of Medical Informatics Indian Journal of Medical Informatics Journal of the American Medical Informatics Association The Open Medical Informatics Journal BMC Medical Informatics and Decision Making Journal of Medical Internet Research Consumer health information system refers to information sought by consumers or patients without the need for medication by health professionals E.g. Mayo Clinic Health Community, WebMD, VaxNation etc
  16. 16. Evidence based medical information  Evidence based medicine (EBM) is an approach to medical practice by emphasising the use of evidence from well designed and conducted research  ‘Evidence based’-David M.Eddy  ‘Evidence based medicine’- Gordon Guyatt  E.g.Index medicus (1879-2004)- comprehensive bibliographic index  MEDLARS/MEDLINE, PubMed LIMITATIONS:  Quantitative research, may not be relevant always  RCTs are expensive  Lag between RCT and results  Published studies may not be representative  Research tends to focus on populations but individuals vary 16
  17. 17. Cochrane library Collection of databases in medicine and other healthcare specialities Named after Archie Cochrane Cochrane reviews DARE- The Database of Abstracts of Reviews of Effects CENTRAL- The Cochrane Central Register of Controlled Trials Cochrane Methodology Register Health Technology Assessment Database (HTA) NHS Economic Evaluation Database (NHS EED) 17
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  19. 19. DECISION SUPPORT Reminder systems • SMS, Apps like talksoft, google now Diagnostic expert systems • Internist-I/QMR- internal medicine • Dx, Iliad • EON- guideline based therapy • MYCIN- for infectious diseases • ONCOCIN- support application of oncology protocols Drug interactions-Apps like Medscape Standard Treatment Guidelines Standard of Procedures 19
  20. 20. INFORMATION MANAGEMENT Electronic Medical Records Digital version of a paper chart containing all of a patient’s medical history, mostly used by providers NeHA- nodal authority ‘Electronics Health Record Standards for India’ approved E.g. Health centres in GZP and Dallupura Disease registries NCDIR (ICMR)- cancer, diabetes, CVD, stroke Billing transactions Ordering systems 20
  21. 21. Key players in medical informatics • Online searches for health Information • Web portals for storing personal medical information, making appointments, checking lab results, etc • Search choice of physician, hospital or insurance plan • Online chat, blogs, podcasts and support groups • Access to electronic health records • Telemedicine Patient • Online searches with MEDLINE, Google and digital libraries • Patient and Physicians web portals • Clinical decision support, reminders and alert • Electronic health records (EHRs) • Telemedicine and telehomecare • Online continuing medical education (CME) • Electronic (e)-prescribing • Disease management and registries • Picture archiving and communication systems (PACS) • E-research Clinicians 21
  22. 22. Nursing and Support Staff • Patient enrolment • Electronic appointments • Electronic billing process • EHRs • Telehomecare monitoring • Secure patient-office e-mail communication • Electronic medication administration record (e-Mar) • Online educational resources and CME • Disease registries Public Health • Incident reports • Syndromic surveillance as part of bio-terrorism program • Establish link to all public health departments • Geographic information systems to link disease outbreaks with geography • Telemedicine • Remote reporting using mobile technology 22
  23. 23. • Electronic claims transmission • Physician profiling • Information systems for “pay for performance” • Monitor adherence to clinical guidelines and preferred formularies • Promote claims based personal health records and information exchanges • Reduce litigation by improved patient safety through fewer medication errors Insurance Company • Interoperable electronic health records • Electronic billing • Information systems to monitor outcomes, length of stay, disease management, etc • Bar coding and radio frequency identification (RFID) to track patients, medications, assets, etc • Patient and physician portals • E-prescribing • Health Information Organizations (HIOs) • Telemedicine • Picture archiving and communication systems (PACS) Hospitals 23
  24. 24. • Database creation • Online collaborative web sites e.g. CaBIG • Electronic case report forms (eCRFs) • Software for statistical analysis of data e.g. SPSS • Literature searches • Randomization using software programs • Improved subject recruitment using EHRs and e-mail • Online submission of grants Research 24
  25. 25. Barriers Time Expertise AccessResources Support 25
  26. 26. CHALLENGES First: Prepare physicians for the changing behaviours of patients Second: To raise awareness among physician and medical students Third challenge: To motivate medical students and practitioners to use ICT Fourth challenge: How to implement this innovation into teaching and learning 26
  27. 27. FACTORS IN INCREASE OF MEDICAL INFORMATICS  Increase in use of technology  Mobility of population  Specialization  Managed care systems  Rise in healthcare costs  Improved hardware  Improved methods  Reduced computer costs  Increased awareness 27
  28. 28. WHAT MEDICAL INFORMATICS IS NOT Overuse of the term “medical informatics” Do not refer to any activity involving medicine and computers Computers in medicine is not equivalent of “medical informatics” For e.g., nursing informatics is not The nurse who likes computers The nurse who hates computers The nurse who knows computers The nurse who is now a network analyst The programmer who is now a Nurse 28
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  30. 30. Objectives of IAMI 1. Develop computer awareness in people of medical profession 2. Give necessary assistance and guidance 3. Help to identify problems 4. Introduce computer education 5. Improve educational and training methodologies 6. Assist hospitals in planning, procurement and installation 7. Suggest improvements 8. Collaboration with other countries and companies 9. Assist in development and employment of manpower 10. Help India achieve high international standards 11. Periodic professional conferences 30
  31. 31. Courses on medical informatics in India 1. International Institute of Health Management in Research, New Delhi 2. Indira Gandhi National Open University, New Delhi 3. Indian Institute of Public Health, Hyderabad 4. Osania University, Hyderabad 5. Foundation of Healthcare Technologies Society, New Delhi 6. Medavarsity Online, Hyderabad 7. Indrapastha Apollo Hospital, New Delhi 8. Bioinformatics Institute of India, Noida 9. eHCF School of Medical Informatics 10.Manipal University, Karnataka 31
  32. 32. MRD VISIT e-scanning started last month They are entering NAME MLC No. IPD No. DOA/DOD Scanned copy of the record sheet kept Outsourced to some private company 32
  33. 33. THANK YOU 33