Handbook of medical informatics:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Houten [u.a.]
Bohn, Stafleu, Van Loghum [u.a.]
1997
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| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | 621, XL S. Ill., graph. Darst. |
| ISBN: | 3540633510 9031322946 |
Staff View
MARC
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| 245 | 1 | 0 | |a Handbook of medical informatics |c J. H. van Bemmel ... ed. |
| 264 | 1 | |a Houten [u.a.] |b Bohn, Stafleu, Van Loghum [u.a.] |c 1997 | |
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| adam_text | Preface I
Electronic Support of the Handbook Ill
How to Use the Handbook V
Table of Contents VII
Table of Authors XXVII
What is Medical Informatics? XXXI
1 Panel 1 What s in a Name? XXXII
Panel 2 Definitions of Medical Informatics XXXIII
PART I: Data and Information
Chapter 1: Introduction and Overview 3
1. Introduction 3
2. Diagnostic Therapeutic Cycle 4
2.1 Observation 5
2.2 Diagnosis 6
2.3 Therapy 7
3. Information Processing 7
3.1 Support of Human Thinking 8
3.2 Developments in Health Care 9
3.3 Parallels 9
4. Systematization of Computer Applications 10
5. Concluding Remarks 16
I
Table of Contents __^_
Chapter 2: Information and Communication 19
1. Introduction 19
2. Sender, Channel, and Receiver 19
3. Perception and Transducers t 24
4. Aspects of Information 25
4.1 Syntactic Aspect 26
4.2 Semantic Aspect 26
4.3 Pragmatic Aspect 26
4.4 Mathematical Definition of Information 27
5. Information Entropy 30
6. Data in Computers 31
6.1 Completeness 32
6.2 Accuracy 32
6.3 Precision 33
6.4 Coding 33
6.5 Free Text 33
6.6 Conclusions 34
Panel 1 Information 27
Panel 2 Information Content of DNA 28
Panel 3 Information Content of a Biological Signal 29
PART II: Data in Computers
Chapter 3: Data Processing 37
1. Introduction 37
2. The Information Processing System 37
2.1 The User 38
2.2 Data Entry 39
2.3 User Interface 40
2.4 Data Processing 41
2.5 Data Presentation 43
3. The Hardware .44
3.1 The Central Processing Unit 44
3.2 Computer Memory 46
3.3 Peripherals .46
4. The Software 50
4.1 The Operating System 50
4.2 User Programs 52
Panel I Multi user, Multi processing, Timesharing 45
Panel 2 Object oriented Programming 51
Table of Contents
Chapter 4: Database Management 53
1. Introduction 53
1.1 Data Structure in Paper Based Patient Records 54
1.2 Data Structure in Computers 54
1.3 The DBMS for Data Structuring 54
2. DBMS Functions 55
2.1 Data Modeling 55
2.2 Data Control 57
3. Physical Datastorage 58
3.1 File Cabinet 58
3.2 Computer Storage 59
4. DBMS Modeling 60
4.1 Relational Data Model 60 I
4.2 Hierarchical Data Model 62
4.3 Network Data Model 65
4.4 Index Structures 65
4.5 Future Database Structures 66
Panel 1 Main Tasks of a DBMS 56
Panel 2 SQL 67
Panel 3 Conceptual Schema of a Relational Database 62
Panel 4 Object oriented Database Management Systems 63
Chapter 5: Telecommunication, Networking and Integration 67
1. Introduction 67
2. Communication in Health Care 67
2.1 Fax 68
2.2 E Mail 68
2.3 EDI 70
3. Shared Care Protocols 72
4. Communication Hardware 72
4.1 Public Telephone Network 72
4.2 Digital Networks 73
5. Communication Software 74
5.1 Addressing and Routing 75
5.2 Reliability of Communication 75
5.3 Authentication and Security 75
5.4 Clients and Servers 75
6. Internet 77
Panel 1 Health Care Message Protocol MEDEUR 69
Panel 2 Message Protocol in HL 7 71
Panel 3 LANs and WANs 74
Panel 4 TCP/IP. 74
Panel 5 World Wide Web 76
Table of Contents
PART III: Data from Patients
Chapter 6: Coding and Classification 81
1. Introduction 81
2. Classifications 82
2.1 Ordering Principles 83
2.2 Nomenclatures and Thesauri 84
2.3 Codes 84
2.4 Taxonomy 86
2.5 Nosology 86
3. History of Classification 87
4. Classification and Coding Problems 88
4.1 Classification Problems 88
4.2 Coding Problems 88
5. Classification Systems 89
5.1 ICD International Classification of Diseases 89
5.2 ICPC International Classification of Primary Care 90
5.3 DSM Diagnostic and Statistical Manual for Mental Disorders 91
5.4 SNOMED Systematized Nomenclature of Human and Veterinary Medicine 91
5.5 ICD O International Classification of Diseases for Oncology 92
5.6 CPT Current Procedural Terminology 93
5.7 ICPM International Classification of Procedures in Medicine 93
5.8 RCC Read Clinical Classification 93
5.9 ATC Anatomic Therapeutic Chemical Code 94
5.10 MeSH Medical Subject Headings 95
5.11 DRC Diagnosis Related Groups 95
6. Current Developments 96
7. Conclusion 98
Panel I Reasons (or Storing Medical Data in a Computer. 82
Panel 2 Requirements for a Classification 83
Panel J Unified Medical Language System (UMLS) %
Chapter 7: The Patient Record 99
1. Introduction 99
2. History of the Patient Record 99
3. The Present Day Medical Record 102
4. The Computer based Patient Record 104
4.1 Primary Care 106
4.2 Specialty Care 106
5. Data Entry 107
5.1 Natural Language Processing 107
5.2 Structured Data Entry 109
5.3 Forms for Data Entry 109
5.4 Dynamic SDE 109
5.5 Interfaces for SDE 110
Table of Contents
5.6 User Adaptive SDE 112
6. Coding and Standardization 112
6.1 Exchangeability of Patient Data and Coded Data 112
6.2 Nontextual Data 112
7. Representation of Time 113
8. Clinical Use of the CPR 114
8.1 Other Uses of the CPR 115
8.2 Multimedia Patient Records 115
Panel 1 Hippocrates Describes a Disease 100
Panel.2 Time Oriented Medical Record 101
Panel 3 Source Oriented Medical Record 102
Panel 4 Problem oriented Medical Record 103
Panel 5 Speech Recognition for Reporting of Medical Findings 110 V
Chapter 8: Biosignal Analysis 117
1. Introduction 117
2. Characteristics of Biosignals 118
3. Types of Signals 119
3.1 Deterministic Waveforms 119
3.2 Stochastic Waveforms 120
4. Analog to Digital Conversion 120
4.1 How often? 122
4.2 How accurate? 123
5. Application Areas of Biosignal Analysis 124
Panel 1 Sampling of Signals: How Often? 121
Panel 2 Sampling of Signals: How Accurate? 122
Chapter 9: Medical Imaging 127
1. Introduction 127
2. Ultrasound 128
2.1 A mode 128
2.2 M mode and B mode 128
2.3 C scan 130
2.4 Sector Scan 130
2.5 Doppler Effect 130
2.6 Advantages of Ultrasound 131
3. Radiology 131
3.1 Imaging by Means of X rays 131
3.2 Principles of DSA 132
3.3 Computed Tomography 133
3.4 Principles of MRI 137
4. Nuclear Medicine 140
4.1 The Gamma Camera 142
4.2 Histogram Mode 143
4.3 List Mode 143
4.4 Synchronized Recordings 144
Table of Contents
4.5 Processing of Scintigrams 145
4.6 Three Dimensional Reconstructions (SPECT and PET) 145
4.7 Functional MRI 145
Panel 1 Principle of Echo Scanners 129
Panel 2 Principle of Computed Tomography 135
Panel 3 Principle of Magnetic Resonance Imaging 140
Chapter 10: Image Processing and Analysis 147
1. Introduction 147
2. Goals of Image Processing 148
2.1 Visualization 148
2.2 Automation 148
C 2.3 Quantification 149
3. Issues in Image Processing and Image Analysis 149
3.1 Image Acquisition and Sampling 149
3.2 Grey Level Quantization 150
3.3 Image Restoration 151
3.4 Image Enhancement 151
3.5 Edge or Contour Detection 151
3.6 Image Segmentation 152
3.7 Measurements in Images 152
3.8 Image Compression 153
3.9 Image Registration 153
3.10 Visualization 153
3.11 Picture Archiving 154
4. Image Transformations 154
4.1 Global Transformations 154
4.2 Local Image Transformations 154
5. Modern Trends in Image Processing 155
PART IV: Patient Centered Information Systems
Chapter 11: Primary Care 159
1. Introduction 159
2. Primary Care and Shared Care 159
3. History of Primary Care Information Systems 161
3.1 Gatekeepers in Primary Care 162
3.2 Introducing Systems in Primary Care Information: the Dutch Experience 162
3.3 Introduction of Information Systems in Primary care 163
4. Functionality of Primary Care Information Systems 165
4.1 Basic Module 165
4.2 Medical Module 165
4.3 Pharmacy Module 167
4.4 Scheduling Module 167
Table of Contents
4.5 Financial Module 167
4.6 Communication Module 167
4.7 Research Module 168
5. Developments 170
Panel 1 Diabetes Mellitus 160
Panel 2 Shared Care for Patients with Benign Prostatic Hyperplasia 169
Chapter 12: Clinical Departmental Systems 171
1. Introduction 171
2. Internal Medicine 172
2.1 Oncology 172
2.2 Nephrology 173
2.3 Endocrinology diabetes 174
2.4 Hematology hemophilia 174
2.5 Intestinal Endoscopy 175
2.6 Organ Transplants 176
3. Cardiology 176
3.1 Electrocardiography 177
3.2 Coronary Angiography 177
3.3 Cardiac Scintigraphy 177
3.4 Echocardiography 178
3.5 CPRs in Cardiology 178
4. Neurology 178
5. Pediatrics 179
6. Obstetrics 179
7. Surgery 179
8. Psychiatry 182
9. Critical Care 184
9.1 Data from Organ Systems 184
9.2 Patient Data Management Systems 187
9.3 Reasons for Computer Assisted Patient Monitoring 188
10. Radiotherapy 189
10.1 Development of Radiotherapy Planning 189
10.2 Treatment Planning 189
10.3 Conformal Radiotherapy 192
10.4 Brachytherapy 193
11. Retrospective Review of Departmental Information Systems 193
Panel 1 Virtual Reality in Health Care 180
Panel 2 Variability in Diagnosing Dementia 183
Panel 3 Example of Critical Care Monitoring 186
Panel 4 Principles of Radiotherapy 190
Chapter 13: Clinical Support Systems 195
1. Introduction 195
2. Radiology Information Systems 195
3. Function Laboratories 197
Table of Contents
3.1 Electrocardiography 198
3.2 Modular ECG Processing 200
3.3 Spirography 201
3.4 Electroencephalography 201
4. The Pathology Laboratory 202
4.1 Diagnosis in the Pathology Laboratory 202
4.2 The Diagnostic Process 203
4.3 Potential Sources of Diagnostic Errors 204
4.4 The Role of Computers in Pathology 204
5. Clinical Chemistry and Hematology 207
5.1 Request Processing 208
5.2 Sample Preprocessing 208
( 5.3 The Preanalytical Phase 209
5.4 The Analytical Process 209
5.5 Reporting 210
5.6 Management Information 211
5.7 Electronic Reporting of Clinical Laboratory Test Results 211
6. Hospital Pharmacy 212
6.1 Processes in Hospital Pharmacy 212
6.2 Computer Applications in Hospital Pharmacy 213
6.3 Basic Functionality 214
6.4 Prescription Support 215
6.5 Current Trends 215
6.6 Medication Distribution Devices 215
6.7 Use of Point of Care Information Systems 216
6.8 Open Communication 217
Chapter 14: Nursing Information Systems 219
1. Introduction 219
2. Nursing Informatics 219
3. Formalizing Nursing Knowledge 220
4. Multidisciplinary Collaboration 221
5. Content of the Clinical Nursing Record 222
6. Problems with Paper Based Records in Nursing 223
7. Levels of Use of Nursing Data 224
7.1 Nursing Minimum Data Set 224
7.2 Nursing Data 227
7.3 Nursing Terminology 228
7.4 Nurses Clinical Reasoning and Judgment 228
8. Nursing Information Systems 228
8.1 What Support is Needed? 228
8.2 Systems in Use 229
Panel / Decision Support Systems in Nursing 226
Table of Contents
PART V: Medical Knowledge and Decision Support
Chapter 15: Methods for Decision Support 233
1. Introduction 233
2. The Forms of Medical Knowledge 234
2.1 Two Types of Knowledge 234
2.2 Brains versus Computers 235
3. Learning by Humans and Machines 236
3.1 Features 236
3.2 Supervised Learning 238
3.3 Unsupervised Learning 238
4. Decision Support Models 239
4.1 Quantitative Decision Support Methods 240
4.1.1 One Feature: Single Decision Threshold 240
4.1.2 Receiver Operating Characteristics 242
4.1.3 Performance of Decision Models 243
4.1.4 Cost and Risks 244
4.1.5 Bayes Rule 244
4.1.6 Multiple Features 246
4.1.7 Multiple Diseases 246
4.2 Qualitative Decision Support Methods 247
4.2.1 Decision Tables 248
4.2.2 Flowcharts 249
4.2.3 Rule Based Reasoning 251
4.2.4 Other Elements of Symbolic Reasoning 254
4.2.5 Knowledge Structuring 254
4.2.6 Knowledge Based Systems 254
4.2.7 Explanation Support 254
5. Acceptance of Decision Support Systems 255
5.1 Legal and Ethical Aspects of Computer Assisted Decision Support System 258
Panel 1 Computers, Grandmasters and Clinicians 235
Panel 2 Bayes Rule 245
Panel 3 Flowchart of a Diagnostic Process 252
Panel 4 Validation of Decision Support Systems 256
Chapter 16: Clinical Decision Support Systems 261
1. Introduction 261
1.1 History of Systems 261
1.2 Types of Systems 261
2. Definition of Clinical Decision Support Systems 262
3. Influence of Decision Support Systems 263
3.1 Abdominal Pain 263
3.2 Patient Outcome 263
4. Categories of Systems 264
4.1 Solicited Advice 264
Table of Contents
4.1.1 Characteristics 264
4.1.2 Example: QMR 264
4.2 Unsolicited Advice 271
4.2.1 Characteristics 272
4.2.2 Example: Arden Syntax 273
4.3 Autonomous Systems 273
5. Current Trends 275
Panel 1 Diagnosing Diseases in QMR 270
Panel 2 Rules in the Arden Syntax 274
Chapter 17: Strategies for Medical Knowledge Acquisition 277
1. Introduction 277
ll 1.1 Sources of Medical Knowledge 277
1.2 Distribution of Medical Knowledge 278
2. Information Needs and Problem Solving 278
2.1 Decision Support Systems as Greek Oracles 279
2.2 Shortcomings of Decision Support Systems 279
3. Categories of Decision Support Systems and Medical Knowledge Bases 280
3.1 Types of Decision Support Systems 280
3.2 Quality of Data Underlying Knowledge Bases 281
3.2.1 Patient Data Repositories 281
3.2.2 Statistics for Bayesian Systems 281
3.2.3 Training Artificial Neural Networks 281
3.2.4 Maintenance of Knowledge Bases 282
4. Medical Knowledge Bases and Medical Knowledge Acquisition 282
4.1 Practice Guidelines 282
4.2 Meta Analysis 282
4.3 Quality of Knowledge Sources 283
4.4 Two Knowledge Sources 283
4.5 Tools for Knowledge Acquisition 283
5. Trends in Knowledge Acquisition 284
5.1 Reproducibility 285
5.2 Textual Sources 285
5.3 Electronic journals 286
5.4 Free Text Analysis 286
5.5 Prestored Bibliographic Search Logic 287
5.6 Knowledge Base Maintenance 288
6. Delivery of Medical Knowledge Bases for Clinical Use 289
7. Evaluation of Medical Knowledge Bases 291
8. Conclusion 291
Panel 1 TEIRESIAS 285
Panel 2 OPAL 286
Panel 3 PROTECE 1 287
Panel 4 INTERNIST I/QMR 288
Panel 5 Interauthor Agreement on KB Construction 290
Table of Contents
Chapter 18: Predictive Tools for Clinical Decision Support 293
1. Introduction 293
2. Development of Predictive Tools 293
3. Decision Support with Simple Predictive Tools 295
3.1 Prediction Rules Based on Statistical Analysis 295
3.1.1 Selection of Variables 296
3.1.2 Estimation of Regression Coefficients 296
3.1.3 Evaluation of Model Performance 296
3.1.4 Presentation of Results Model 296
3.2 Tools Based on Decision Analysis 304
4. Evaluation and Conclusions 304
Panel 1 Prediction of Histology as a Predictor in the Decision to Resect in Testicular Cancer 297
Panel 2 Prediction of Spontaneous Pregnancy Chances in Fertility Medicine 300
Panel 3 Prediction of Survival Time in the Decision to Replace a Risky Heart Valve 302
PART VI: Institutional Information Systems
Chapter 19: Modeling of Health Care for Information Systems Development ....309
1. Introduction 309
2. Public Health and Health Care 309
2.1 Public Health 309
2.2 Conceptual Model of Public Health 310
2.3 HealthCare 312
3. Models for Information System Development 316
3.1 Nolan s Growth Model 316
3.2 Cascade Model for System Development 318
3.3 Business Modeling 318
3.4 Modeling Clinical Practice 319
3.5 Modeling Public Health Surveillance 320
3.6 Reference Models in Health Care 320
3.6.1 Common Basic Specification 321
3.6.2 Orders and Acts 322
3.6.3 Hospital Information Model 322
3.7 Development of Reference Models !24
3.8 Application of Reference Models 326
4. Information Requirements Determination !26
4.1 Essential Issues in IRD 526
4.2 IRD in Health Care 327
Panel I Health Status M
Panel 2 Determinants, Health Policy, Health Care, and Autonomous Developments 314
Panel 3 Example of Activities, Information Needs and Relations in the HIM 323
Table of Contents
Chapter 20: Hospital Information Systems: Clinical Use 331
1. Introduction 331
2. The Historic Development of Hospital Information Systems 331
2.1 Admission and Discharge 332
2.2 Order Entry 332
2.3 Results Review 332
2.4 Stand Alone Applications 333
2.5 Storage Facilities 333
3. Advanced Clinical Information Systems 333
3.1 Policy and Technology Change 334
3.2 Today s Hospital Systems Environment 335
3.3 Technical Aspects of Current Hospital Information Systems 338
Iv 4. The Future of Hospital Information Systems 341
Chapter 21: Hospital Information Systems: Technical Choices 343
1. Introduction 343
2. The HIS Concept 346
3. Architectures of an HIS 348
3.1 Isolated Applications 349
3.2. Monolithic Systems 349
3.3 Evolutionary Systems Type 1 349
3.4 Evolutionary Systems Type II 349
3.5 Composable Systems 350
4. Integration between HIS applications 351
4.1 Standards for Message Exchange 351
4.2 Integration and the Multivendor Aspect 352
5. Operational HISs 352
5.1 HiscomHIS 352
5.2 DiogeneHIS 353
6. Accessibility and Data Protection 354
7. Management Control 355
8. Trends 355
8.1 Support of Patient Care 356
8.2 Workstations and Bedside Terminals 356
Panel 21.1 The Role of an HIS in Clinical Epidemiological Research 344
Chapter 22: Health Information Resources 357
1. Introduction 357
2. HIR Characteristics and Features 358
2.1 System Characteristics 358
2.2 Data Acquisition 358
2.3 Data Storage 359
2.4 Geographical Information Systems 360
2.5 Data Warehouses 362
2.6 Data Analysis and Retrieval 363
3. Health Information Resource Domains 363
Table of Contents
3.1 Health Information Networks 363
3.2 Public Health Information Resources 365
3.3 Administrative Systems 365
3.4 Registries 368
3.5 Health Surveillance and Vigilance 370
3.6 Organ, Tissue, and Blood Banks 371
4. Summary and Trends 371
Panel 22.1 Standards Applicable to Health Information Resources 359
Panel 22.2 Examples of Projects using a CIS 367
Panel 22.3 Data Mining and Knowledge Discovery in Databases 362
Panel 22.4 Media and Electronic Publishing Formats 364
Panel 22.5 Electronically Available Information Resources 366
Panel 22.6 The Chemical Abstracts Service Registry 367 1
Panel 22.7 Home Care Systems Using Handheld Computers 368
PART VII: Methodology for Information Processing
Chapter 23: Logical Operations 375
1. Introduction 375
2. Logical Operations and Truth Tables 375
2.1 The Venn diagram 376
2.2 Logical Operators 376
2.3 Logical expressions 377
3. Boolean Algebra and Karnaugh Diagrams 380
4. Binary Numbers and Logic 384
Panel 1 Basic Boolean Operations 379
Panel 2 Example of De Morgan s Law 381
Panel 3 Example of a Karnaugh Diagram 382
Panel 4 Transformations from Decimal to Binary and Vice Versa 383
Panel 5 Binary Addition and Subtraction 384
Chapter 24: Biostatistical Methods 387
1. Introduction 387
2. Data Description 387
2.1 Qualitative Data 388
2.2 Continuous Data 388
3. Estimation of Parameters and Hypothesis Testing 390
3.1 Hypothesis Testing 391
3.2 Parameter Estimation 392
4. Multivariate Analysis 393
5. Biostatistical Aspects Design of Experiments and Observational Studies 396
5.1 Controlled Clinical Trials 396
5.2 Non randomized Approaches 396
Table of Contents
Chapter 25: Biosignal Processing Methods 399
1. Signal Amplitude Properties 399
1.1 First Order Amplitude Density Distributions 399
1.2 Second Order Amplitude Density Distributions 400
1.2.1 Deterministic Signals: Sines and Cosines 400
1.2.2 Deterministic Signals: ECGs 402
1.2.3 Stochastic Signals and Point Processes 403
1.3 Correlation .404
2. Frequency Spectra and Filtering 404
2.1 Fourier Transform 404
2.2 Filtering .407
3. Signal to Noise Ratio .408
3.1 Coherent Averaging .409
4. Signal Detection 409
4.1 Detection of QRS Complexes in an ECG 410
4.2 Impulse Series plus Disturbance 411
4.3 Conclusions Regarding Detection 411
Panel 1 One Dimensional Distributions, Means and Variances 401
Panel 2 Two Dimensional Distributions and Correlation 403
Panel 3 Wavelet Analysis 406
Panel 4 Coherent Averaging 408
Chapter 26: Advances in Image Processing 413
1. Introduction .413
2. Two Dimensional Medical Image Processing: Preprocessing 416
2.1 Computer Vision Versus Human Vision 416
2.2 Feature Extraction .416
2.3 Boundary Detection 416
2.4 Image Filtering .417
2.5 Image Processing Strategies 417
2.6 Vision Based Methods 418
2.7 Image Compression 418
2.8 Interpretation of Compressed Images 418
3. Three Dimensional Medical Image Processing 419
3.1 Three Dimensional Reconstruction 419
3.2 Image Transformations 419
3.3 Validation of Image Processing 420
3.3 General versus Special Solutions 420
3.4 Incorporating Domain Knowledge 420
4. Medical Image Processing and Informatics Implications 421
4.1 Image Databases 421
4.2 Visible Humans Project 421
Panel I The Visible Humans Project 415
Table of Contents
Chapter 27: Pattern Recognition 423
1. Introduction 423
2. Syntactic Pattern Recognition 424
3. Statistical Pattern Recognition 424
3.1 Supervised Pattern Recognition 425
3.2 Unsupervised Methods .427
4. Design of a Pattern Recognition Application 429
5. Modern Developments 429
Chapter 28: Modeling for Decision Support 431
1. Introduction .431
2. A Broad View of Decision Support 432
3. Rule Based Systems .432
4. Abstraction Beyond the Rules .434
5. The Knowledge Level Hypothesis 436
6. KADS .438
7. Reusable Problem Solving Methods 439
8. Reusable Ontologies 442
9. Modern Architectures for Decision Support 444
10. Summary .447
Chapter 29: Structuring the Computer based Patient Record 449
1. Introduction .449
2. Four Levels 449
3. Generic Structure of CPRs 450
3.1 Structuring CPR Data 450
3.1.1 Events .451
3.1.2 Relationships 451
3.1.3 Views .452
3.1.4 Reliability 453
3.2 Temporal Aspects of CPRs 453
3.3 Models for CPR Data Representation 454
3.4 Data Entry 455
3.4.1 Natural Language Processing 455
3.4.2 Structured Data Entry 455
3.4.3 Patient driven Data Entry 456
4. Realization of CPR Systems 45f)
4.1 CPR systems in Primary Care 456
4.2 CPR Systems in Hospitals 458
4.2.1 Platforms for CPRs 458
4.2.2 Structure of Clinical CPRs 458
5. Use of CPR Data 459
5.1 Decision Support 4^9
5.2 Quality Assessment 459
5.3 Clinicians Responsibilities 460
6. Final Remarks 461
Table of Contents
Chapter 30: Evaluation of Clinical Information Systems 463
1. Introduction .463
1.1 Why Evaluate? 463
1.2 Subjectivist and Objectivist Approaches to Evaluation 463
1.3 The Range of Evaluation Techniques 464
1.4 General Framework for an Objectivistic Evaluation Study 464
2. Planning and Executing an Objectivistic Evaluation Study 464
2.1 Defining and Prioritizing Study Questions 464
2.2 Defining the System to be Studied 465
2.3 Selecting or Developing Reliable, Valid Measurement Methods 466
2.4 Designing the Demonstration Study 466
2.4.1 Descriptive, Correlational, and Comparative Studies 466
TC 2.4.2 Eliminating Potential Bias 468
2.4.3 Ensuring that Study Findings can be Generalized 468
2.5 Carrying out the Study 468
2.6 Analyzing and Reporting Study Results 469
3. Conclusions .469
PART VIII: Methodology for Information Systems
Chapter 31: Human Computer Interaction in Health Care 473
1. Introduction .473
2. Cognitive Aspects of Human Computer Interfacing 474
2.1 Why Consider Psychology? 474
2.2 Cognitive Frameworks for HCI 475
2.3 Resources in Human Information Processing 476
2.4 Expertise, Skilled Performance, and Learning 476
2.5 Perception and Attention 477
2.6 Recent Approaches to Cognition and HCI 477
2.7 Usability .478
3. Technological Aspects of Human Computer Interfacing 478
3.1 Interaction Style .479
3.1.1 Command Languages and Character Based Interfaces 479
3.1.2 Graphical Manipulation 480
3.2 Principles for the Display of Information 481
3.3 Data Entry 483
4. Emerging Technologies in Medical Computer User Interfaces 484
4.1 Visualization of Medical Data 484
4.2 Multimedia .484
4.3 Hypertext and Hypermedia 485
4.4 Advances in Pen Based Input 486
4.5 Advances in Speech Recognition 486
4.6 User Interfaces to the Internet 486
4.7 Cooperative Work Environments 487
Table of Contents
4.8 Customizable and Adaptive User Interfaces 487
5. Methods for the Design and Evaluation of User Interfaces 488
5.1 Stages in the Development of User Interfaces 488
5.2 Advances in User Interface Evaluation 490
6. Principles for the Design of Health Care User Interfaces 492
7. Conclusions 493
Chapter 32: Costs and Benefits of Information Systems 495
1. Introduction .495
2. Costs of information systems 495
2.1 Hardware Costs 496
2.2 Costs of Consumables 496
2.3 Software Costs 496
2.4 Personnel Costs 496
2.5 Costs for Housing 497
2.6 Overhead Costs 497
3. Benefits of Information Systems . 497
3.1 Nonquantifiable Benefits 497
3.2 Quantifiable, Nonmonetary Benefits 498
3.3 Quantifiable, Monetary Benefits 498
4. Evaluation of Information Systems 499
5. Example 500
Chapter 33: Security in Medical Information Systems 503
1. Introduction 503
2. The Scenario for Data Protection 504
3. Policy with respect to Data Security 504
3.1 Rules for Data Security 505
3.2 Confidentiality 50S
3.3 Privacy Regulation
4. Threats ^)(l
4.1 Threats to Confidentiality 5Of
4.2 Threats to Data Integrity and Availability ^
5. Measures ^()f)
6. Choice of Measures to be Taken : () )
6.1 Identify the Threats w
6.2 Estimating the Chances of an Incident )(, )
6.3 Estimating the Expected Damage ,() J
6.4 Probability of Occurrence and Expected Damage a10
6.5 List the Considered Measures ¦,1°
6.6 Estimate the Costs of Each Measure 31°
6.7 Croup the Measures 6.8 Relationships between Threats and Measures 51 °
6.9 Select Measures 51°
7. Introduction of the Measures 8. Responsibility for Data Security
Table of Contents 9. Legislation and Regulation 512
Panel 1 Protection of Information Systems 507
Panel 2 Seismed Guidelines 57?
Chapter 34: Standards in Health Care Informatics and Telematics in Europe 513
1. Introduction 513
2. Telematics Requirements in Health Care 513
3. Definitions 515
3.1 Standardization 515
3.2 Telematics and Electronic Data Interchange 516
4. Benefits and Role of CEN 516
4.1 Benefits 516
TC 4.2 CEN 517
5. Description of Present European Standards 518
5.1 The Medical Informatics Vocabulary 518
5.2 The Health Care Information Framework 518
5.3 The Electronic Health Care Record Architecture 518
5.4 The Standard Architecture for Health Care Information Systems 519
5.5 Classification and Coding 519
5.5.1 Nomenclature, Classification, and Coding for Clinical Laboratories 519
5.5.2 Classification and Coding of Surgical Procedures 519
5.5.3 Structure of Concept Systems, Vocabulary 519
5.5.4 Coding Systems for Drugs 520
5.5.5 Coding Systems for Medical Devices 520
5.6 Standards 520
5.6.1 Standards for Quantities in Clinical Sciences 520
5.6.2 Time Standards 520
5.7 Data Interchange 520
5.7.1 Syntaxes for Data Interchange 520
5.7.2 Registration of Coding Schemes 521
5.7.3 Exchange of Laboratory Information 521
5.7.4 Registration of the Data Sets used in EDI 521
5.7.5 Messages for Diagnostic Services 521
5.7.6 Messages for Exchange of Health Care Administrative Data 522
5.7.7 Messages for Patient Referral and Discharge 522
5.7.8 Methodology for the Development of Health Care Messages 522
5.8 Images 523
5.8.1 Imaging and Related Data Interchange Formats 523
5.8.2 Medical Image Management Standard 523
5.8.3 HIS, RIS, and PACS 523
5.8.4 Media Interchange of Medical Images 523
5.9 Biosignals 523
5.9.1 Computerized ECG Interchange 523
5.9.2 Vital Signs Information Representation 524
5.10 Security 524
5.10.1 User Identification, Authentication, Security 524
Table of Contents
5.10.2 Security for Health Care Information Systems 524
5.10.3 Digital Signature Services 524
5.10.4 Intermittently Connected Devices 525
Chapter 35: Project Management 527
1. Introduction 527
2. Information Systems and Projects 527
3. Functions in an EDP Project 528
4. Cooperation between EDP Professionals and Users 529
5. Development of an Information System 529
6. Problems during an EDP project 531
6.1 Problems with the Design 532
6.2 Problems in the Field of Elapsed Time 532
6.3 Problems in the Field of Costs 533
7. Final Remarks 534
PART IX: Medical Informatics as a Profession
Chapter 36: Education and Training in Medical Informatics 537
1. Introduction 537
2. Medical Informatics Courses and Programs 537
2.1 Medical Informatics as Part of Educational Programs 538
2.1.1 Medical Informatics in the Medical and Health Sciences Curricula 538
2.1.2 Medical Informatics in Computer Science Educational Programs 538
2.1.3 Medical Informatics in Other Educational Programs 539
2.2 Dedicated Programs in Medical Informatics 539
2.3 Continuing Education and Fellowship Training 542
2.3.1 Continuing Education 542
2.3.2 Fellowship Training 542
3. Working Croup on Health and Medical Informatics Education 542
4. The European Situation in Medical Informatics Education 543
4.1 Europe 543
4.2 United States 544
4.3 General Observations 544
5. Recommendations for Medical Informatics Education 545
6. Conclusions 547
Panel I Why Teaching Health and Medical Informatics? 539
Panel 2 Recommendations on Health and Medical Informatics Education 546
Chapter 37: International Developments in Medical Informatics 549
1. Introduction 549
2. International Medical Informatics Association 549
2.1 IMIA Membership 549
2.2 IMIA Coals 549
Table of Contents
2.3 IMIA Activities 550
3. Yearbooks of Medical Informatics 551
4. Other International Activities 552
5. Other Organizations 553
Glossary 557
Keyword Index 607
List of Authors XXXV
TC
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| id | DE-604.BV011535356 |
| illustrated | Illustrated |
| indexdate | 2025-02-20T06:37:55Z |
| institution | BVB |
| isbn | 3540633510 9031322946 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-007764192 |
| oclc_num | 260034498 |
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| physical | 621, XL S. Ill., graph. Darst. |
| publishDate | 1997 |
| publishDateSearch | 1997 |
| publishDateSort | 1997 |
| publisher | Bohn, Stafleu, Van Loghum [u.a.] |
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| spellingShingle | Handbook of medical informatics Informatics cabt Medizinische Informatik (DE-588)4038261-8 gnd |
| subject_GND | (DE-588)4038261-8 |
| title | Handbook of medical informatics |
| title_auth | Handbook of medical informatics |
| title_exact_search | Handbook of medical informatics |
| title_full | Handbook of medical informatics J. H. van Bemmel ... ed. |
| title_fullStr | Handbook of medical informatics J. H. van Bemmel ... ed. |
| title_full_unstemmed | Handbook of medical informatics J. H. van Bemmel ... ed. |
| title_short | Handbook of medical informatics |
| title_sort | handbook of medical informatics |
| topic | Informatics cabt Medizinische Informatik (DE-588)4038261-8 gnd |
| topic_facet | Informatics Medizinische Informatik |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007764192&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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Indexes
THWS Schweinfurt Zentralbibliothek Lesesaal
| Call Number: |
2000 ST 640 B455 |
|---|---|
| Copy 1 | ausleihbar Available Place a Hold |