Are medical informatics and nursing informatics distinct disciplines? The 1999 ACMI debate

Dental Informatics: An Emerging Biomedical Informatics Discipline

Biomedical informatics is a maturing discipline. During the last forty years, it has developed into a research discipline of significant scale and scope. One of its subdisciplines, dental informatics, is beginning to emerge as its own entity. While there is a growing cadre of trained dental informaticians, dental faculty and administrators in general are not very familiar with dental informatics as an area of scientific inquiry. Many confuse informatics with information technology (IT), are unaware of its scientific methods and principles, and cannot relate dental informatics to biomedical informatics as a whole. This article delineates informatics from information technology and explains the types of scientific questions that dental and other informaticians typically explore. Scientific investigation in informatics centers primarily on model formulation, system development, system implementation, and the study of effects. Informatics draws its scientific methods mainly from information science, computer science, cognitive science, and telecommunications. Dental informatics shares many types of research questions and methods with its parent discipline, biomedical informatics. However, there are indications that certain research questions in dental informatics require novel solutions that have not yet been developed in other informatics fields.

Biomedical and Health Informatics Education - the IMIA Years

OBJECTIVE

This paper presents the development of medical informatics education during the years from the establishment of the International Medical Informatics Association (IMIA) until today.

METHOD

A search in the literature was performed using search engines and appropriate keywords as well as a manual selection of papers. The search covered English language papers and was limited to search on papers title and abstract only.

RESULTS

The aggregated papers were analyzed on the basis of the subject area, origin, time span, and curriculum development, and conclusions were drawn.

CONCLUSIONS

From the results, it is evident that IMIA has played a major role in comparing and integrating the Biomedical and Health Informatics educational efforts across the different levels of education and the regional distribution of educators and institutions. A large selection of references is presented facilitating future work on the field of education in biomedical and health informatics.

Nursing domain of CI governance: recommendations for health IT adoption and optimization

CONTEXT

There is a lack of recommended models for clinical informatics (CI) governance that can facilitate successful health information technology implementation.

OBJECTIVES

To understand existing CI governance structures and provide a model with recommended roles, partnerships, and councils based on perspectives of nursing informatics leaders.

DESIGN, SETTING, PARTICIPANTS

We conducted a cross-sectional study through administering a survey via telephone to facilitate semistructured interviews from June 2012 through November 2012. We interviewed 12 nursing informatics leaders, across the United States, currently serving in executive- or director-level CI roles at integrated health care systems that have pioneered electronic health records implementation projects.

RESULTS

We found the following 4 themes emerge: (1) Interprofessional partnerships are essential. (2) Critical role-based levels of practice and competencies need to be defined. (3) Integration into existing clinical infrastructure facilitates success. (4) CI governance is an evolving process. We described specific lessons learned and a model of CI governance with recommended roles, partnerships, and councils from the perspective of nursing informatics leaders.

CONCLUSION

Applied CI work is highly interprofessional with patient safety implications that heighten the need for best practice models for governance structures, adequate resource allocation, and role-based competencies. Overall, there is a notable lack of a centralized CI group comprised of formally trained informaticians to provide expertise and promote adherence to informatics principles within EHR implementation governance structures. Our model of the nursing domain of CI governance with recommended roles, partnerships, and councils provides a starting point that should be further explored and validated. Not only can the model be used to understand, shape, and standardize roles, competencies, and structures within CI practice for nursing, it can be used within other clinical domains and by other informaticians.

Cancer informatics for the clinician: an interaction database for chemotherapy regimens and antiepileptic drugs

BACKGROUND

Cancer patients are at high risks of manifesting drug-drug interactions (DDIs) which can potentiate serious negative outcomes. It is important for clinicians to make accurate, timely, safe and effective decisions with regards to drug use in the patient.

OBJECTIVE

To provide clinicians with an oncology-specific drug interaction database that is relevant to their daily practice. This database focuses on DDIs with anticancer drugs (ACDs), single- and multiple-agent chemotherapy regimens.

METHODS

Drug-related and interaction-related information between anticancer and antiepileptic drugs were compiled from drug information handbooks and databases, package inserts, and published literature from PubMed. Web documents were served from a modified web server with a database engine and programming interface constructed using Adobe software and various programming scripts.

RESULTS

OncoRx is an oncology-specific database whose structure is designed around chemotherapy regimens and generic drug names used in anticancer treatment. OncoRx currently comprises of 117 ACDs and 256 single-agent and combination chemotherapy regimens. It covers all the major classes of ACDs and their frequently prescribed chemotherapy regimens, and can detect up to over 2000 interactions with 24 antiepileptic drugs. Data provided to clinicians include pharmacokinetic parameters of the drugs, information regarding the chemotherapy regimens and the detected DDIs.

CONCLUSION

OncoRx is able to identify DDIs between ACDs and adjuvant drug therapy. This is the first database of its kind to be able to detect interactions for combination chemotherapy regimens. This tool will assist clinicians in improving clinical response and reducing adverse effects based on the therapeutic and toxicity profiles of the drugs.

Basic concepts in medical informatics

This glossary defines terms used in the comparatively young science of medical informatics. It is hoped that it will be of interest to both novices and professionals in the field.

The evolution of definitions for nursing informatics: a critical analysis and revised definition

Despite the fact that nursing informatics is entering its third decade as a specialty within nursing, many definitions still exist to describe the field. This paper offers a rationale for a definition for nursing informatics and a critical analysis of past definitions. An organizing framework of technology-oriented, conceptual, and role-oriented definitions is used to critique these definitions. Subsequently, a revised definition is proposed. This evolutionary definition integrates critical concepts from past work and adds components that are currently missing--patients, information communication, information structures, and decision making. A separate role specification for informatics nurse specialists is provided.

Training synergies between medical informatics and health services research: successes and challenges

Stanford's two decades of success in linking medical informatics and health services research in both training and investigational activities reflects advantageous geography and history as well as natural synergies in the two areas. Health services research and medical informatics at Stanford have long shared a quantitative, analytic orientation, along with linked administration, curriculum, and clinical activities. Both the medical informatics and the health services research curricula draw on diverse course offerings throughout the university, and both the training and research overlap in such areas as outcomes research, large database analysis, and decision analysis/decision support. The Stanford experience suggests that successful integration of programs in medical informatics and health services research requires areas of overlapping or synergistic interest and activity among the involved faculty and, hence, in time, among the students. This is enhanced by a mixture of casual and structured contact among students from both disciplines, including social interactions. The challenges to integration are how to overcome any geographic separation that may exist in a given institution; the proper management of relationships with those sub-areas of medical informatics that have less overlap with health services research; and the need to determine how best to exploit opportunities for collaboration that naturally occur.

Dental informatics

BACKGROUND

Dental informatics is a relatively new field that has significant potential for supporting clinical care. Most dentists are unaware of what dental informatics is, what its goals are, what it has achieved and how they can get involved in it.

METHODS

The authors conducted a literature review and several round-table discussions with dental informatics experts to discuss the preceding issues surrounding dental informatics.

RESULTS

Dental informatics is the application of computer and information sciences to improve dental practice, research, education and management. Numerous applications that support clinical care, education and research have been developed. Dental informatics is beginning to exhibit the characteristics of a discipline: core literature, trained specialists and educational programs.

CONCLUSIONS

Dental informatics presents possible solutions to many long-standing problems in dentistry, but it also faces significant obstacles and challenges. Its maturation will depend as much on the efforts of people as on the collective efforts of the profession.

PRACTICE IMPLICATIONS

Dental informatics will produce an increasing number of applications and tools for clinical practice. Dentists must keep up with these developments to make informed choices.