Medical Informatics I

Transcription

1 Medical Informatics I Zlatko Trajanoski Alexander Sturn Institute for Genomics and Bioinformatics Graz University of Technology zlatko.trajanoski@tugraz.at Medical Informatics I Introduction Data and Data Management Databases and DBMS LIMS Standards Data Integration Electronic Patient Record 1

2 Medical Informatics II Introduction Mathematical Foundations Biostatistics Probability theory Computational Methods Classification Methods Clustering Methods Hidden Markov Models Introduction Adjective problem of the field: Medical Informatics Bioinformatics Biomedical Informatics Biomedical Computing Health Care Informatics Public Health Informatics Clinical Informatics ehealth Telemedicine. 2

3 Introduction 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 3

4 Introduction storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving, decision making, and research 4

5 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 5

6 Types of doctors Primary care provider Internist, family practitioner, pediatrician Specialist Medical Surgical Hospital based provider Anesthesiologist Pathologist Radiologist 6

7 Types of health interaction Healthy visit Chronic visit Diagnostic visit Acute care Locations of health care and documentation Office Hospital Home Chronic care Other hospitals Abroad Etc. 7

8 Types of information Textual Trend Lab data 2/3D images Administrative Billing 8

9 9

10 10

11 11

12 2 and 3-d data sets Echocardiography Data storage Current approaches Computerized approaches Visualization of data 12

13 13

14 14

15 15

16 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. 16

17 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) 17

18 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, ) 18

19 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? 19

20 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 20

21 Research Uses Epidemiology Infectious disease Life history, risk factor... Tissue Banks Pedigrees/Populations DATAMINING Medical Genetics Basic disease work Pharmacogenomics 21