Medical Informatics: Computers, Decisions, and Communications Vlad Olchanski, PhD o Moscow Institute of Physics and Technology o Institute of Control Sciences o International Institute for Applied Systems Analysis o World Health Organization o Medical College of Virginia Download content as MS PPT presentation MCV Course for 4th year medical students Dr. Olchanski Home Page November 14, 2001
Medical Informatics Outline of Course Philosophy of Governing Life Informatics Component 2 Decision Support and Theory Medical Records Diagnostic Support Pharmaceutical Prescriptions Health System Modeling Data Mining Component 1 Information Technology Computers Communications Internet
Medical Informatics INTRODUCTION Download content as MS PPT presentation
Why Learn Medical Informatics? Cutting Edge Technologies: 1930s 1990s Radio communications Computers, Internet
Why Learn Medical Informatics? • In the 1920-1930s the Radio was very cool. • In those days, the Radio was not a black box with buttons you have in your car. • To get a good reception, you had to know a little bit about electronics and things...
Why Learn Medical Informatics? • Computers are cool today. • If you don’t know a little bit about what "coils” are inside - • you will get frustrated and will bother other people. • And yet we want computers and IT now!
Why Learn Medical Informatics? 21st Century the Age of Informatics Major Tool of Informatics -- INTERNET • IT is not as simple today as is Radio. • Internet will turn into a black box with buttons. • But not today. • And not tomorrow.
Why Learn Medical Informatics? • Therefore, to behave as a conscious Medical Professional, a Physician of today has to know the basics of Information Technologyas well as the basics of Physiology and Pharmacology. • Yet the Information Technology alone cannot help you without the intellectual component of Medical Informatics: the Decision Theory.
Phi Beta Kappa- philosophia biou kybernetes Philosophy Governs Life • Philosophy • Mathematics • Natural Philosophy • Physics • Engineering • General Theory of Systems • Cybernetics • Informatics KybernetesGoverns Cybernetics
General Theory of Systems Bertalanffy (Austria-Hungary), Bogdanov (Russia) - 1908 Crash of empires after the Great War The Second World War: FLAK, Enigma Norbert Wiener (MIT): Cybernetics: Control and Communication in the Animal and the Machine - 1948 Theory of Information, Finite Mathematics, Probabilities John von Neumann (Princeton) Alan Turing (Bletchley Park) Claud Shannon (MIT) Andrey Kolmogorov (Moscow State)
First Computers This weaponry could not protect England:
Cybernetics • Theory of InformationCommunicationsCodingAlgorithmsProbabilities and Stochastic Processes • Theory of ControlOperations ResearchOptimizationManagement Science • Systems Analysis
Applications • Live, bio-systems • Engineering, machines, robots • Organizational systems • Computer Science • Systems AnalysisDecision Support, Artificial Intelligence
Whence Informatics? • Concept of Cybernetics too broad • Word Cybernetics tarnished, devalued by Sci-Fi and Pop culture • Pragmatic reduction to Computer Sciencein USA • CS translated into INFORMATIQUE in France • Backward translation of CS as INFORMATICS expanding the scope
Handbook of Medical Informatics • http://www.mieur.nl/mihandbook • http://www.mihandbook.stanford.edu/ This excellent book unfortunately has very little coverage of the Internet applications. Otherwise, this is the #1 Resource!
Medical InformaticsDefinitions • Medical Information Science is the science of using system-analytic tools . . . to develop procedures (algorithms) for management, process control, decision making and scientific analysis of medical knowledge - Ted Shortliffe • Medical Informatics comprises the theoretical and practical aspects of information processing and communication, based on knowledge and experience derived from processes in medicine and health care - Jan van Bemmel
Whence Informatics? • Computer Science and Informatics are practically synonyms: the difference in emphasizing the application aspect • Informatics is frequently understood as broadly as Cybernetics --Information Processing including Decision Making and Systems Analysis
Names used for Medical Informatics • medical computer science • medical information science • computer application(s) in medicine • health informatics, and more specialized terms such as • nursing informatics • dental informatics • and so on.
Informatics - What? • Information Technology and TheoryComputers, Communications, Data Processing, Algorithms • Decision Theory and ApplicationsBayesian Approach, Expert Systems, Artificial Intelligence, Knowledge-based Systems, Algorithms
A Good INTRO to Informatics But should we go all the way together?
Medical Informatics INFORMATION TECHNOLOGY COMPUTERS Download content as MS PPT presentation
Computers: Evolution Von Neuman and the first MAINFRAME at IAS (1948) Vacuum tubes, punch cards or tape Batch mode of operation Low reliability - maintenance team of electronics engineers Transistors- Bill Shockley, 1956 NP MICROCOMPUTERS Interactive mode of operation Reduced size and enhanced reliability due to Integrated Circuits MINICOMPUTERS Interactive mode of operation Higher reliability due to Transistors SUPERMINIS WORKSTATIONS PERSONAL COMPUTERS Renamed from minicomputers to show due respect SUPERCOMPUTERS
Computers: Operating Systems Mainframe OS -- oriented to batch processing Minicomputers -- more interactive, usually designed by hardware manufacturer, like RSX, VMS for late DEC machines Unix - an attempt to standardize Personal computers -- CP/M, MS DOS, IBM OS/2, Mac OS, Windows, Unix Internet developed mainly on Unix machines
Computers: Operating Systems Windows should not be used for critical applications
Programming Mainframe A punch card and the editing tool H Page 104 of a program listing
Programming Mainframe Booting your computer -- giving it a kick?
Programming Mainframe Booting your computer -- giving it a kick? No! It is short from bootstrapping. “Bootstrap” was the name of a short length of the punched tape that was fed to a computer to initiate loading of the Operating System.
Computer Architecture CPU, RAM, Bus, etc. are discussed in class
Computers: Objects Files:Windows Commander: “http://www.ghisler.com” Name long name, DOS name avoid spaces in names! Type extension, internal header, MIME type Size actual / on disk Time creation / modification / access Attrib hidden / system Owner sysadmin/owner / group / world/other Directories (folders): c:\ root ..\ parent
Computers: Startup Files config.sys autoexec.bat system.ini win.ini in Unix: .cshrc Registry System.dat User.dat SAM Text editors: Notepad.exe UltraEdit.exe
Computers: Commands dir cd delete copy mkdir rmdir attrib xcopy diskcopy format tree date, time path set sort more /p - by page help /? -? /h -h
Computer Architecture Data storage on disks File Allocation Table Security issues are discussed in class after Information Coding presentation
Some Utilities • Calculator (scientific mode) • Character Map (Symbols to Computer Code) • Notepad (Text editor)
Medical Informatics INFORMATION TECHNOLOGY COMMUNICATIONS Download content as MS PPT presentation
Communication Protocol Layers ISO Open System Interface Internet the application level is what we use: Email, FTP, Telnet, HTTP, etc. the physical layer is a stream of bits
Internet Protocols • FTP (file transfer protocol) serves to exchange data with a remote computer • Telnet allows to run programs on a remote computer Terms: Upload - send TO a remote recipient Download - receive FROM a remote sender
Remote Computing - I Fred at UBC hasreport software... Wilma at CUNY has data, needs report!
Remote Computing - II Fred sends Wilma the username and the password Never by EMAIL !!! Wilma at CUNY has data, needs report!
Remote Computing - III Fred at UBC hasreport software... FTP Wilma uploads her data with FTP
Remote Computing - IV Fred at UBC hasreport software... Telnet Wilma manipulates her data on Fred’s computer with Telnet
Remote Computing - V Fred at UBC hasreport software... FTP Wilma downloads the report with FTP
Remote Computing - VI Fred at UBC hasreport software... Email Wilma prints the report in her office and sends her kisses to Fred by email
Using Email - 1 Email is very much like Regular Mail:sending mail and receiving are done quite differently! To send mail, you may to drop it in any mail drop box in the street. To send email, you may connect and use any SMTP serverin the world. It is for public convenience. SMTP server sends email
Using Email - 2 You send a letter thru a Mail Drop Box You may use any one you find in the street
Using Email - 3 You send an email thru a SMTP server access controlled access controlled access controlled access controlled access controlled access controlled open for all You may use any one you find in the Internet
Using Email - 4 Email is very much like Regular Mail:sending mail and receiving are done quite differently! To receive mail, you must have either your own mailbox or rent a box at any Post Office. To receive email, you must have an account with any POP3 server. It will be your private possession. You may have as many as you may wish. POP3 server receives email
Using Email - 5 To receive a letter, you must have a homeor a number in a US Post Office
Using Email - 6 To receive an email, you must have an accountat a POP or IMAP mail server you may have as many of these as you like
Using Email - 7 POP server delivers all messages to your computer --good when you are on a fast connection IMAP server delivers only message headers and messages on demand -- good when you are on a dial-upYet you will not have all messages on your computer T’bird, Eudora, TheBat! support multiple email accounts Webmail allows to use email with your browser --good when you are on the go Hotmail, Yahoo, etc. may be used for simple purposes --but it is not a true email