Oleg Pianykh [email protected] 1
Medical Informatics
Oleg Pianykh, PhD
Oleg Pianykh [email protected]
Introduction
Oleg Pianykh [email protected] 2
Medical Informatics?
Oleg Pianykh [email protected]
Performer: Sivu, http://www.youtube.com/watch?v=_964dqQxQwY
Welcome to Medical Informatics!
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 3
So, what is MI anyway?
What is MI?
Why the heck are you taking this class???
Oleg Pianykh [email protected]
1. MI = Hospitals + IT projects?
Hospital X:1. Buys new 64-bit, Windows 9 PCs to
replace its old computers
2. Equips surgery rooms with iPads
3. Starts tracking ambulances with GPS and geofencing, real-time
4. Consults outpatients on Skype and Tweeter
5. Buys expensive 3D workstations for brain analysis
6. Embraces cloud storage for its medical records
Oleg Pianykh [email protected]
Retina display
Oleg Pianykh [email protected] 4
2. Dream job?
Oleg Pianykh [email protected]
Q: Did you have any experience with MI-like projects?
3. Popular buzzword?
Oleg Pianykh [email protected]
We need a much better definition!
Triumph of ambiguity
Oleg Pianykh [email protected] 5
4. Perfect investment?
Oleg Pianykh [email protected]
5. Science?
Science or “intersection”? MI is often defined as a discipline at the intersection of
information/computer science and healthcare.
“Intersection” definitions offer little help for describing MI applications, and tell nothing about its aims, methods or major research directions.
… or “intersections”? Another approach to defining MI involves breaking it in
pieces: dentistry informatics, surgical informatics, mammoinformatics, …
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 6
MI publications
Exponential growth in publications after year 2000:
Oleg Pianykh [email protected]
[DeShazo, 2009]
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
1986 1990 1994 1998 2002 2006
MI papers in Medical Subject Headings
Q: Can MI-related papers help us define MI ?
What are they all writing about?
Schuemie in 2009 analyzed 14,885 articles from 16 MI-related journals, over 15 years (1993-2008).
The articles (titles and abstracts) were classified and clustered based on their keywords.
Consequently, the journals and
research areas were classified as well,
based on their proximity to
MI subject clusters.
Oleg Pianykh [email protected]
Keyword extraction example [Schuemie, 2009]
Oleg Pianykh [email protected] 7
Clustering MI papers from 1993-2008
Oleg Pianykh [email protected]
3660 articles from 16 medical informatics journals
[Schuemie, 2009]
Three major clusters:1. Data analysis (classification
techniques and statistical modeling, signal and image analysis)
2. Health information systems, their application, evaluation, and organization
3. Medical knowledge representation in the form of clinical guidelines, ontologies, and databases.
MI was described as a distinct discipline (distinct from bioinformatics, for instance)
[Bansard, 2007]
Problems with MI self-definitions
We can cluster MI publications, but do we really know what drives them?
Oleg Pianykh [email protected]
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
1986 1990 1994 1998 2002 2006
MI papers in MeSH
0.4
0.6
0.8
1
1991 1996 2001 2006
Correlation: MI papers with PC sales
We need a much better definition!!!
Bare technology and papers cannot define MI
Oleg Pianykh [email protected] 8
6. Societies, Workgroups and Standards?
Biomedical Pattern Recognition
Consumer Health Informatics
Critical Care Informatics
Dental Informatics
Health and Medical Informatics Education
Health Informatics for Development
Health Informatics for Patient Safety
Health Information Systems
Human Factors Engineering for Healthcare Informatics
Informatics in Genomic Medicine (IGM)
Intelligent Data Analysis and Data Mining
Oleg Pianykh [email protected]
Medical Concept Representation
Mental Health Informatics
Open Source Health Informatics
Organizational and Social Issues
Primary Health Care Informatics
Security in Health Information Systems
SIG NI Nursing Informatics
Smart Homes and Ambient Assisted Living
Social Media
Standards in Health Care Informatics
Technology Assessment & Quality Development in Health Informatics
Telehealth (provisional)
Wearable Sensors in Healthcare
International Medical Informatics Association (www.imia.org)Workgroups
7. New educational area?
MI is often diluted by particular audience type, which varies greatly from librarians (understanding MI as knowledge mining tool) to MDs (sometimes viewing MI as computer literacy classes).
As a result, many MI curricula get overloaded with extraneous details – such as computer architecture, finance/management, or anatomy lessons.
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 9
Should we even teach MI?
Is MI too advanced?
Is MI curriculum too distractive for medical students?
Is it too remote for engineering/science students?
Oleg Pianykh [email protected]
Typical discussion on MI curriculum
8. Historical phenomenon
Oleg Pianykh [email protected]
Q: Ho old is MI ?
Oleg Pianykh [email protected] 10
MI Evolution
Do you know about the real Imhotep? First known physician
First known engineer
Medicine and engineering have been connected since the earliest times
Late 19th century – early 20th century Punch cards to process census data (IBM predecessor)
Physicians start using phones
Cars
Oleg Pianykh [email protected]
http://www.vopus.org/en/gnosis/great-characters/imhotep-master-of-sciences.html,Cohen: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307150/pdf/westjmed00160-0042.pdf,© Explosm.net cartoon
Radio doctor 1924
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 11
MI Evolution
1950s: First realization that clinical reasoning can be expressed in mathematical terms (logic, probability) Math can make clinical decisions more solid (read good
paper from Ledley, [1959]).
Computers can help in doing math.
First programming languages (FORTRAN, Cobol)
The Professional Group in Bio-Medical Electronics (later IEEE)
Oleg Pianykh [email protected][Ledley, 1959]
MI Evolution
Growth and expansion in 1960s Rapid growth of MI publications
First MI departments
Naming game: medical computing, medical data processing, medical information processing, health care information systems, medical computer science, etc. The French, then the German and Russian scientists, start using the word informatique [Collen, 1986].
Mainframe computers; PC and network prototypes
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 12
MI Evolution
The first academic department in the United States for teaching computing in medicine was established in 1960 at Tulane University School of Medicine (New Orleans), and J.W. Sweeney was designated as its first Professor of Computer Medicine.
When asked about his title, he would jokingly counter, “Does this mean that I treat sick computers?”
Oleg Pianykh [email protected]
MI Evolution
1970s First CT (computed tomography) scanners: 100%
computer-made medical images
The term “Medical Informatics” is born: "medical informatics as the application of computer technology to all fields of medicine.” MI journals follow.
First MI classes
Oleg Pianykh [email protected][Sittig, 2006]
The first clinical CT scan on a patient took place on October 1st, 1971 at Atkinson Morley's Hospital, in
London, England. First slice was 80x80 pixels; took 5 min to make (0.3 sec for modern 1024x1024 CT).
Oleg Pianykh [email protected] 13
MI Evolution
Rapid growth since late 1980s, correlated with mass digitization of medical practices
50 member societies with 50,000 members to date
Result: a new discipline, conceived from several non-intersecting directions (medicine, engineering, computer science, math) Consequences: major identity problem, when MI is viewed as “anything clinical with computers”
Harrison, 1984: “There is no term in the English language to encompass this conglomerate of knowledge.”
Oleg Pianykh [email protected]
We need a much better definition!!
OK, what is MI anyway???
Q: Define Medical Informatics: …
…
…
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 14
So, how do we define MI?
Medical Informatics (MI) = intelligent processing of clinical information in order to improve healthcare quality.
Medical data → logical structure → better technology
Applied science: practical success is everything
Oleg Pianykh [email protected]
HealthcareHigh-qualityHealthcare
MI
+ =
What’s wrong with these pictures?
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 15
And what’s wrong with these projects?
Hospital X:1. Buys new 64-bit, Windows 8.1 PCs to
replace its old computers
2. Equips surgery rooms with iPads
3. Starts tracking ambulances with GPS and geofencing, real-time
4. Consults outpatients on Skype and Tweeter
5. Buys expensive 3D workstations for brain analysis
6. Embraces cloud storage for its medical records
Oleg Pianykh [email protected]
Retina display
Principal reasons for MI progress
Need for complex data analysis (better healthcare)
Digital formats for medical data
Increasing data volume – well beyond human processing capabilities
Need for faster and error-free workflow (30% to 60% spent on paperwork)
Oleg Pianykh [email protected]
Oleg Pianykh [email protected] 16
Questions
What would you like to learn in this class? …
…
…
Why do you want to learn this?
Oleg Pianykh [email protected]
References
R.S.Ledley, L.B.Lusted, "Reasoning Foundations of Medical Diagnosis”, Science, July 3 1959.
R.S.Ledley, "Digital Electronic Computers in Biomedical Science", Science, November 6 1959.
M.F. Collen, “Origins of medical informatics”, West. J. Med. 145 (1986) 778–785.
D.F. Sittig, J.S. Ash, R.S.Ledley, “The Story Behind the Development of the First Whole-body Computerized Tomography Scanner as Told by Robert S. Ledley”, Journal of the American Medical Informatics Association Volume 13 Number 5 Sep / Oct 2006.
M.J. Schuemie, J.L. Talmon, P.W. Moorman, J.A. Kors, Mapping the domain of medical informatics, Methods Inf. Med. 48 (2009) 76–83.
R. Haux, Medical informatics: Past, present, future, international journal of medical informatics 79 (2010) 599–610.
J.P. DeShazo, D.L. LaVallie, F.M.Wolf, Publication trends in the medical informatics literature: 20 years of "Medical Informatics" in MeSH, BioMedCentral, Januaru 21, 2009.
Bansard JY, Rebholz-Schuhmann D, Cameron G, Clark D, van Mulligen E, Beltrame E, Barbolla E, Martin-Sanchez Fdel H, Milanesi L, Tollis I, van der Lei J, Coatrieux JL, Medical informatics and bioinformatics: a bibliometric study, IEEE Trans Inf Technol Biomed. 2007 May;11(3):237-43. Review.
Oleg Pianykh [email protected]