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Contemporary Issues in Medical Informatics

Contemporary Issues in Medical Informatics. James J. Cimino Department of Medical Informatics Columbia University. Applications. Diagnosis Treatment Training Telepresence Decision support. Technologies. Electronic medical records Bioinformatics Controlled medical terminologies

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Contemporary Issues in Medical Informatics

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  1. Contemporary Issues in Medical Informatics James J. Cimino Department of Medical Informatics Columbia University

  2. Applications • Diagnosis • Treatment • Training • Telepresence • Decision support

  3. Technologies • Electronic medical records • Bioinformatics • Controlled medical terminologies • Knowledge bases • Internet

  4. Applications Î Technologies DX Training Presence Support EMRs Bioinf. CMTs KBs Internet Shared Information Improved Care Case Based Learning Automated Integration Predictive Probability Prediction/ Prognosis Effective Planning Repre- sentation Linkages Bridging Expert Systems Guidelines Collaboration Resources

  5. History Taking • New model for medical record • Granularity of terminology • Teach patients to give histories

  6. Summary of Presentations James J. Cimino Department of Medical Informatics Columbia University

  7. Summary of Presentations • Presentations • Issues • Topics for discussion

  8. Presentations - David Williams • Decay of training • Pharmacology is unknown • Think about requirements MD on Board

  9. Presentations - Sam Pool • Pharmacodynamics and pharmacokinetics have implications for evidence-based medicine • What medications? • What equipment?

  10. Presentations - Jay Sanders • The 80-20 rule • Mars to Main Street • Focus on history-taking

  11. Presentations -Jeff Sutton • Smart systems for Rx and monitoring • Novel sensors • Novel therapeutic modalities • Remote fabrication • Intelligent systems for mentoring/training

  12. Presentations - Terry Clemmer • Complex adaptive systems • Setting the vision is the attractor • Clockware vs. Swarmware • The human on a bike (AI-RHEUM) • Rapid cycle trials - process oriented • Protocol development

  13. Presentations - Dan Masys • How much will we know in the next 25 years? • Human genome project: a parts list • Task of functional genomics is to map the patterns to the clinical picture • Interrupt command and control mechanisms

  14. Presentations - Michael Ackerman • Interactivity is an issue • Things to pack • Lessons from submarines • Risk/benefit analysis

  15. Presentations - Larry Weed • Decouple data collection from heuristics • Stop relying on what’s in doctors’ heads • New tools are needed • A new science of medical practice

  16. Issues • What do we need to learn? • What do we need to build?

  17. Issues - What do we need to learn? • How to do interviews - but what about psychiatric ones? • Study what gets used in subs, space station, islands, Poles - what are the cognitive issues? • Can we apply informatics to backward chain in collecting evidence?

  18. Issues - What do we need to learn? • Heuristics and EBM • Swarmware and chaos theory - it’s ok to kill a few termites • Genomics - functions vs. markers • Pattern matching and gestalt - if we can model human physicians, why not just model human astronauts?

  19. Issues - What do we need to build? • My first aid kit • Lab on a chip - a super dipstick? • Expert systems - which part is the bicycle and which part is the human?

  20. Topics for Discussion • How will we practice evidence-based health care? • What to pack: hardware vs. warmware

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