From scientific informatics to semantic informatics

The evolution of research into the scientific information phenomenon and the patterns of scientific and information activity are outlined. The necessity of extending the subject of the investigation of scientific informatics and transforming it into a science about semantic information is shown. The scientific and organizational results of the half century of the development of scientific informatics are summed up and the premises for setting semantic informatics are noted.     

The European Community: standardization in medical informatics and imaging.

The use of informatics and telecommunications in health care and medicine has reached a stage where the application of standards is an absolute requirement. The AIM Programme of the CEC DGXIII stimulated the study of the subject, and has supported the set up of an official European platform for standardization in this field, the CEN TC251. The needs for standardization in one of the subareas, medical imaging, are described in detail. The future solutions of the problems concerned are regarded prerequisites for the general and practical use of PACS and IMACS.     

Training in medical informatics

A course is described for the training of medical students in medical informatics (other terms: computational medicine, medical computing). The philosophy behind the course is that there are several modes or levels of human interaction in working with computers, running from registrative functions to assistance at diagnosis and therapy. The course, which consists of five full days, contains lessons in the areas of medical data bases, hospital information systems, medical records, biological signal analysis, computer-assisted diagnosis making, and patient simulation by CAI. Each group of two students has a terminal available, connected to a mini- and/or a microcomputer. The microprocessor takes care of signal analysis and the minicomputer is available for data base construction and interactive operations. The article describes the purposes and contents of all different lessons of this course.     

Considering something 'ELSE': ethical, legal and socio-economic factors in medical imaging and medical informatics

The focus on the use of existing and new technologies to facilitate advances in medical imaging and medical informatics (MIMI) is often directed to the technical capabilities and possibilities that these technologies bring. The technologies, though, in acting as a mediating agent alter the dynamics and context of information delivery in subtle ways. While these changes bring benefits in more efficient information transfer and offer the potential of better healthcare, they also disrupt traditional processes and practices which have been formulated for a different setting. The governance processes that underpin core ethical principles, such as patient confidentiality and informed consent, may no longer be appropriate in a new technological context. Therefore, in addition to discussing new methodologies, techniques and applications, there is need for a discussion of ethical, legal and socio-economic (ELSE) issues surrounding the use and application of technologies in MIMI. Consideration of these issues is especially important for the area of medical informatics which after all exists to support patients, healthcare practitioners and inform science. This paper brings to light some important ethical, legal and socio-economic issues related to MIMI with the aim of furthering an interdisciplinary approach to the increasing use of Information and Communication Technologies (ICT) in healthcare.     

A vocabulary for medical informatics

The terminology in medical informatics is evolving rapidly. The organizers of MEDINFO and SCAMC have used different sets of keywords to index their documents. Recognizing the limitations of this approach, members of those organizations joined with the National Library of Medicine in the creation of a better terminology for medical informatics. A hierarchical structure was placed on the terms to produce a thesaurus typical of the sort often used in the indexing and retrieving of documents. The building of this thesaurus began with an automatic merging of the thesaurus used by the Association of Computing Machinery and the Information Sciences component of the "Medical Subject Headings." This product was pruned by eliminating terms not related to those in the MEDINFO keyword list or not in the medical informatics literature. Further refinement of the thesaurus resulted from extensive discussions among the authors of this paper. The first major application of this terminology has been to the indexing of the articles in "MEDINFO-86 Proceedings." Major components of this medical informatics thesaurus also have been incorporated into the "Medical Subject Headings." This paper describes the process of preparing the thesaurus and presents an evaluation of its coverage of the "MEDINFO-86 Proceedings."     

Ten years of medical informatics. Introduction

The discussions of the Tenth Anniversary of the Symposium on Computer Applications in Medical Care (SCAMC) are summarized. Eight different subject areas are addressed: Medical informatics and medical education; Decision making, medical artificial intelligence, modelling and simulations; Image processing, 3-D graphics, and computer networks; Reimbursement policy, legal and regulatory issues; Encoding and representation of medical meaning; Ambulatory medical records systems; Hospital information systems; and Software environments for developing medical information systems. The activities of the 10th SCAMC consisted of Tutorials, Panel Discussions, a Plenary Session, Scientific Demonstrations, and an International Student Paper Competition in Medical Informatics.     

Evolution of medical informatics societies in the United States

Medical informatics, the application of computers to medicine, was supported by engineering groups in the 1950s, by biomedical engineering societies in the 1960s, and by medical informatics organizations in the 1970s and 1980s. Because of the highly specialized and technical nature of medical informatics, the dissemination of early articles on the subject was largely dependent on publication of the proceedings and transactions of meetings of professional organizations. The American Medical Informatics Association (AMIA) was recently formed from the merger of three professional organizations, each dedicated to medical informatics: the American Association for Medical systems and Informatics (AAMSI), the American College for Medical Informatics (ACMI), and the Symposium on Computer Applications in Medical Care (SCAMC). An increase in professional interest and activity in medical informatics is anticipated in the 1990s.     

Telehealth and the global health network in the 21st century. From homecare to public health informatics

The Information Era we live in has created new challenges and opportunities. This age of information highways has an economic price, which has not been properly evaluated. Detailed studies are needed to prove the cost and medical effectiveness of these technologies as well as its effects in the quality of life. Our society's future may depend on it. People are living longer, discoveries in genetics and in information technology are not only helping produce newer drugs faster but also providing the opportunity to exploit new areas such as disease prevention. These technologies provide a variety of opportunities to address public health challenges such as universal access for the uneducated, counter-bioterrorism, telemedicine, distance education, and home care. These opportunities present new challenges such as: surveillance, privacy/confidentiality/security of personal information which will affect all of our lives. No strategy has been presented publicly (yet) addressing (neither) the benefits (n)or the pitfalls of such technologies. From an economic point of view it is an imperative necessity to understand the importance of the Information Technology Infrastructure (ITI) and what it is. The investments in creating and maintaining this ITI will not come from a single application area such as healthcare, but rather from a combination of sources such as electronic commerce, banking, financial, manufacturing, entertainment, travelling, weather forecasting, pharmaceuticals, education, defence and many other 'industries' or application areas.     

Simulators for medical training: application to vascular ultrasound imaging

Whilst computers are more and more used in the medical and surgical domains, medical education is still very conservative. However, new information technology could bring a lot to this area. In particular, simulators are of paramount interest: they would allow one both to experiment with surgical or imaging techniques for a wide range of pathologies without the need for patients and to quantitatively evaluate the trainees' performances. Ultrasound imaging is a typical area where virtual reality may change educational uses. This paper describes an ultrasound imaging simulator dedicated to the training of physicians for the detection of deep venous thromboses of the lower limbs. Like this one, a lot of other pathologies of soft tissue are diagnosed using ultrasound imaging. Because this examination is difficult and operator‐dependent, developing a simulator is very useful to give common databases of pathological samples on which physicians can both experiment with image acquisition and evaluate their understanding of clinical cases. Real‐time simulation is mandatory. An ultrasound imaging simulator has been developed and is being tested. This paper presents the hardware and software components of the simulator and describes the status of this project. Copyright © 2000 John Wiley & Sons, Ltd.