Medical Informatics. Institute for Genomics and Bioinformatics

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1 Medical Informatics Zlatko Trajanoski Institute for Genomics and Bioinformatics Graz University of Technology Institute for Genomics and Bioinformatics 1

2 Institute s Activities Dry lab Software engineering (tools and databases) High-performance computing Methods for biomedical data analysis Wet lab Cell culture Mouse models (diabetes, obesity) Molecular biology and biochemistry Microarrays Medical Informatics, Bioinformatics, Computational Medicine Medizinische Informatik (Medizinische Informatik 1) Einführung in die Bioinformatik (Bioinformatik) Computational Medicine (Medizinische Informatik 2) 2

3 Medical Informatics, Bioinformatics, Computational Medicine Adjective problem of the field: Medical Informatics Bioinformatics Biomedical Informatics Biomedical Computing Biocomputing Health Care Informatics Public Health Informatics Clinical Informatics ehealth Telemedicine. Medical Informatics, Bioinformatics, Computational Medicine Wikipedia ( Medical Informatics: Health informatics or medical informatics is the intersection of information science, computer science and health care. It deals with the resources, devices and methods required to optimize the acquisition, storage, retrieval and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. 3

4 Medical Informatics, Bioinformatics, Computational Medicine Wikipedia ( Medical Informatics: Subdomains of (bio)medical or health care informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, bioinformatics, veterinary informatics, and pharmacy informatics Medical Informatics, Bioinformatics, Computational Medicine Wikipedia Bioinformatics: Bioinformatics and computational biology involve the use of techniques including applied mathematics, informatics, statistics, computer science, artificial intelligence, chemistry, and biochemistry to solve biological problems usually on the molecular level. 4

5 Medical Informatics, Bioinformatics, Computational Medicine Johns Hopkins University ( Computational medicine: To understand the mechanisms and to improve the diagnosis, prediction and treatment of human disease through applications of mathematics and computational science Medical Informatics, Bioinformatics, Computational Medicine Wikipedia ( Medical Informatics: Health informatics or medical informatics is the intersection of information science, computer science and health care. It deals with the resources, devices and methods required to optimize the acquisition, storage, retrieval and use of information in health and biomedicine. 5

6 Medical Informatics The term biomedical computing...is non-descriptive and neutral, implying only that computers are employed for some purpose in biology or medicine... We define medical informatics as the scientific field that deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making. Shortliffe, E.H., Perreault, L.E., Wiederhold, G., and Fagan, L.M. (eds.) (1990). Medical Informatics: Computer Applications in Health Care and Biomedicine, Menlo Park: Addison-Wesley. medical informatics is a field of study concerned with the broad issues in the management and use of biomedical information, including medical computing and the study of the nature of medical information. Shortliffe, E.H., Perreault, L.E., Wiederhold, G., and Fagan, L.M. (eds.) (2001). Medical Informatics: Computer Applications in Health Care and Biomedicine, 2nd Edition. New York: Springer-Verlag Medical Informatics storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving, decision making, and research 6

7 Classification Medical Informatics Communication Databases Clinical Support Systems Biosignal Analysis Biomedical Imaging Visible Human Project Stakeholders 7

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9 Functions of computers in medicine Data acquisition and presentation Record keeping and access Communication and integration of information Surveillance Information storage and retrieval Data analysis Decision support Education 9

10 Types of doctors Primary care provider Internist, family practitioner, pediatrician Specialist Medical Surgical Hospital based provider Anesthesiologist Pathologist Radiologist Types of health interaction Healthy visit Chronic visit Diagnostic visit Acute care 10

11 Office Hospital Home Locations of health care and documentation Chronic care Other hospitals Abroad Etc. Types of information Textual Trend Lab data 2/3D images Administrative Billing 11

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14 Images 14

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16 2 and 3-d data sets Echocardiography Data storage Current approaches Computerized approaches Visualization of data 16

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20 History John Snow ( ) a legendary figure in the history of public health, epidemiology and anesthesiology. The year was 1854; the scene was the Soho District of west London. During the stifling beat of August, there had been a handful of deaths from the dreaded disease cholera. Not unusual, in itself. But on August 31, the situation exploded: In a single evening, within a radius of only blocks, doctors reported 56 new cholera cases. By the next evening there were 143, and the death toll had reached 70 and was climbing. Residents started fleeing the district in panic. Medical authorities debated around the clock but couldn't settle on a plan of action. 20

21 Napoleon's Invasion of Russia, 1812 Chart by Minard Issues Nature of medical information Technical challenges Uses of medical information medicine research Status of development in field Ethical concerns (Professional Career Trajectories) 21

22 Uses of Medical Records Medical decision making-individual cases Contractual (insurance ) Legal Process improvement Clinical trials, evaluation of therapy Basic human research Information Types Textual chief complaint, symptoms, history of present illness, history, family history, physical exam, insurance information Graphical ECG, ultrasound, X-ray, hand-drawn figures longitudinal data (blood pressure graph) Digital/Image(X-rays, ) 22

23 Text Information Structured Data Entry (forms) Natural Language Processing essential for interpretation parsing algorithms Thesauri thrombophlebitis=phlebothrombosis, DVT, blood clot in the leg, milk leg, phlegmasia caerulea dolens, dropsy generalized idiopathic lymphandenopathy (1980) => AIDS!!!» Change over time Ideal Terminology Text Standards Complete, Formal, Universal, Translatable Candidate languages SNOMED, UMLS, ICD, Read Codes, DSM Digital Entry, storage, retrieval, usage? 23

24 Graphs/Images Archivable Sharable Searchable Transmittable Multiple input/output formats X-rays, ultrasounds, cameras Medical Uses of Enhanced Records Enhance clinical decision making UKHMO: what are your current meds? Rapid, rational query of records Potential for increased use of knowledge systems (eg. Drug interactions) ACE inhibitor sensitivity, ER doc Enhanced delivery of care Monitoring clinical success all patient records become clinical trials 24

25 Research Uses Epidemiology Infectious disease Life history, risk factor... Tissue Banks Pedigrees/Populations DATAMINING Medical Genetics Basic disease work Pharmacogenomics 25

Medical Informatics I

Medical Informatics I Zlatko Trajanoski Alexander Sturn Institute for Genomics and Bioinformatics Graz University of Technology http://genome.tugraz.at zlatko.trajanoski@tugraz.at Medical Informatics I