1 / 59

Medical Informatics:

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.

Télécharger la présentation

Medical Informatics:

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.


Presentation Transcript

  1. 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 7, 2002 Richmond, VA

  2. Medical Informatics Outline of Lecture Informatics: Philosophy of Governing Life Component 2 Decision Support and Theory Medical Records Diagnostic Support Pharmaceutical Prescriptions Health System Modeling Data Mining Component 1 Information Technology Computers Communications Internet Overview of the subject and a couple of practical advises

  3. Medical Informatics INTRODUCTION Download content as MS PPT presentation

  4. Phi Beta Kappa- philosophia biou kybernetes Philosophy Governs Life • Philosophy • Mathematics • Natural Philosophy • Physics • Engineering • General Theory of Systems • Cybernetics • Informatics

  5. General Theory of Systems Bertalanffy (Austria-Hungary), Bogdanov (Russia) - 1908 Crash of empires after the Great War The Second World War: FLAK Norbert Wiener (MIT): Cybernetics: Control and Communication in the Animal and the Machine - 1948 The Second World War: Enigma Theory of Information, Finite Mathematics, Probabilities John von Neumann (Princeton) Alan Turing (Bletchley Park) Claud Shannon (MIT) Andrey Kolmogorov (Moscow State)

  6. Cybernetics • Theory of InformationCommunicationsCodingAlgorithmsProbabilities and Stochastic Processes • Theory of ControlOperations ResearchOptimizationManagement Science • Systems Analysis

  7. Applications • Live, bio-systems • Engineering, machines, robots • Organizational systems • Computer Science • Systems AnalysisDecision Support, Artificial Intelligence

  8. Whence Informatics? • Concept of Cybernetics turned 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

  9. 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!

  10. 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

  11. 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

  12. Informatics - What? • Information Technology and TheoryComputers, Communications, Data Processing, Algorithms • Decision Theory and ApplicationsBayesian Approach, Expert Systems, Artificial Intelligence, Knowledge-based Systems, Algorithms

  13. A Good INTRO to Informatics But should we go all the way together?

  14. Medical Informatics INFORMATION TECHNOLOGY COMPUTERS Download content as MS PPT presentation

  15. 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

  16. 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.

  17. Medical Informatics INFORMATION TECHNOLOGY COMMUNICATIONS Download content as MS PPT presentation

  18. Communication Protocols • Communications include - • Noise elimination in the channel • Coding (error detection and correction) • Encryption (security) • Internet • Standards - 7 layers of ISO communication protocols from bits, wires to applications • Internet protocols FTP, Telnet, Email, NNTP, HTTP==WWW

  19. 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

  20. Remote Computing - I Fred at UBC hasreport software... Wilma at CUNY has data, needs report!

  21. Remote Computing - II Fred sends Wilma the username and the password Never by EMAIL !!! Wilma at CUNY has data, needs report!

  22. Remote Computing - III Fred at UBC hasreport software... FTP Wilma uploads her data with FTP

  23. Remote Computing - IV Fred at UBC hasreport software... Telnet Wilma manipulates her data on Fred’s computer with Telnet

  24. Remote Computing - V Fred at UBC hasreport software... FTP Wilma downloads the report with FTP

  25. Remote Computing - VI Fred at UBC hasreport software... Email Wilma prints the report in her office and sends her kisses to Fred by email

  26. Remote Computing -Security

  27. Using Email - 1 Email is very much like Regular Mail:sending mail and receiving are done quite differently! To send mail, you may drop a letter 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

  28. Using Email - 2 You send a letter thru a Mail Drop Box You may use any one you find in the street

  29. 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

  30. 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

  31. Using Email - 5 To receive a letter, you must have a homeor a number in a US Post Office

  32. 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

  33. 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 Mozilla, Eudora, TheBat! support multiple email accounts Webmail allows to use email with your browser --good when you are on the go The poor and street people use Hotmail, Yahoo, etc. --but it is not a true email

  34. Using Email - 8 Basic Rules of Nice Conduct 1. Never consider email as confidential 2. Email should best be a simple message 3. Do not send messages formatted with HTML -- not all email clients can deal with them, it confirms a hit for spammers (impossible not to use in AOL email program ) 4. Avoid sending binary attachments these may come corrupted and can carry viruses How to avoid binary attachments in Email, see “http://www.intmed.vcu.edu/inm/advice.html”

  35. The Most Intimate Secret Like Wine dichotomy in Russia - White wine: Moonshine, Vodka, Brandy - Red wine: all the rest

  36. The Most Intimate Secret Data dichotomy in Internet - Text files: Plain English text: A-Z, a-z, 0-9 - Binary files: all the rest

  37. The Most Intimate Secret Symbols -- Bytes -- Octets Secret == 53 65 63 72 65 74 Bits 1010011 1100101 1100011 1110010 1100101 1110100 Sept “bits” fassent un “octet”! This is the ASCII Standard. This has been implemented in communication networks hardware. Yet -- Éç == C9 E7 == 11001001 11100111 Now you see that the French have a reason to call the “byte” not “septet” but “octet”! If you strip the 8th bit then corruption occurs: É -> 49 == I and ç -> 67 == g

  38. The Most Intimate Secret The Revelation Only text files may be sent through Internet Binary files will come corrupted To send a binary, it must be converted to a text file (encoded) and on the receiving end the encoded file must be decoded. In FTP protocol, the type must be told explicitly In Email, binary files go as attachments. There are different encode/decode procedures which may lead to confusion and errors

  39. Security: Cryptography Fred reads my message I send message to Fred Dear Fred, bla-bla... ]hk@s#2kdMs0fHquja... Dear Fred, bla-bla... Fred’s public key Fred’s private key Fred answers my message I read Fred’s answer My public key My private key Dear Vlad, bla-bla... Msios$[\iqN7dkoZnu... Dear Vlad, bla-bla...

  40. Communications. Security 80% trash, 5% pearls

  41. Internet Protocols Usenet, News, Forums -- NNTP Protocol A small ISP carries ~45,000 groups. Different ISPs give different groups, have different scopes Medical and Health Related Groups listed: www.mipt.vcu.edu/ng.html

  42. Internet Protocols World Wide Web == HTTP protocol User client -- browser Opera, Mozilla, Netscape, Internet Explorer WWW is only a small part of Internet !!! AOL and MSN are not Internet at all !!! Internet AOL MSN gateway gateway archive.salon.com/tech/feature/2001/06/26/locking_up_the_web/index3.html Internet Services Providers give you full Internet

  43. Internet Protocols Web Browsers web standards are important for compatibility longevity of websites, and future development Opera and Mozilla are W3C compliantInternet Explorer violates the standards (version 6 may comply)has many security holes Netscape 4 is incapable to view modern websitesNetscape 7 is a commercialized version of Mozilla 1.0 Replace Netscape 4 with Opera or Mozilla! MSN

  44. Internet Connectivity A decent ISP must give a client: o SMTP address to send email o POP3 address to access the mailbox o NNTP address to get Newsgroups Additionally: o Space to host website at ISP’s IP address o FTP access to update website Optionally: o Fixed IP address for hosting own website

  45. Web Design What is a good website? -- presentable for all users: WIN, Mac, Unix, etc. -- acceptable for all browsers: Opera, Netscape, MSIE, etc. -- loads fast: byte size < 50 kB -- does not use Cutting Edge technologies Learn the culture of Web Design at webpagesthatsuck.com review the Daily Sucker site daily!

  46. Information TechnologyBasics of Security • make sure workstation is physically safe and secure • never send passwords by email • never paste passwords beside the workstation • install and regularly (weekly) update virus protection • avoid sending attachments • never open unsolicited attachments, always check and double-check the attachment’s file extension • never open unexpected file with extensions EXE COM DOC DLL PIF LNK VBS (Windows does not show LNK and PIF extensions, you will be taken for a ride by MS ) • firewall may protect both yourself and the world but may also cheat you)

  47. Medical Informatics DECISION SUPPORT AND THEORY Download content as MS PPT presentation

  48. The Fundamental Principle of Decision Theory THE BAYES THOREM [New Knowledge] = [Experimentation] x [Old Knowledge] Application: Making Diagnosis [Old Knowledge] - we know disease D prevalence, p(D) [New Knowledge] - we need to know if the patient has disease D if he has symptom S, p(D|S) [Experimentation] - Bayes Theorem builds the Likelihood Function: L(D|S) = p(S|D) / {p(S|D) p(D) + p(S|’D) p(‘D)} Now this Likelihood Function modifies the Old Knowledge: p(D|S) = L(D|S) p(D)

  49. Medical Decision Support to mention a few Clinical Systems Financial Medical Records Comprehensive Diagnostic Systems QMR, Iliad, DXPlain, etc. Pharmaceutical Prescriptions Health System Modeling Research Data Mining

  50. Medical Decision SupportClinical Systems Computerized Medical Record systems are discussed in class: TMR -- CMR from Duke Medical Center MedicaLogica Pharmaceutical System for Multiple Drug Therapy in ICU, Pharm-X is discussed in class Comprehensive system for VCU HealthSystem (by CERNER) is discussed in class.

More Related