1、欢迎进入Medical Informatics 的世界,2018/11/27,1,了解基本概念能简单的完成任务对这个领域感兴趣,教学目标,2018/11/27,2,Medical Informatics：概念与历史,医学信息学的定义 Medical Informatics的称谓 医疗信息学的历史 医学信息学的应用 医学信息学的任务 医学信息学的从业人员和机构 医疗信息学的信息资源,2018/11/27,3,医学信息学的定义,人们不断用科学和正规简洁的术语来定义这个领域，做出了许多非同一般的尝试。下面我们按照时间顺序，列举出关于Medical Informatics比较重要的定义,1977年，A
2、llan H. Levy将医学信息学定义为“处理与信息有关的问题，医疗卫生服务过程中信息的获取、分析、和传播”,http:/www.amia.org/history/what.html,2018/11/27,4,医学信息学的定义,1984年，著名的医学信息学教科书Handbook of Medical Informatics的作者，荷兰的Jan van Bemmel将其定义为：医学信息学由信息处理和通讯的理论和实践两个方面组成，它以医疗和卫生保健过程中所产生的知识和经验为基础。,2018/11/27,5,根据Myers的定义，美国医学院协会（Association of American Me
3、dical College，AAMC）将MI扩展定义为：医学信息学是关于组织管理医学临床、教育和科研信息的发展中的知识的集合和技术的集合医学信息学将医学科学、信息科学和计算机科学的相关技术和原理结合起来，为使这些技术和原理能促进医学基础知识的应用，最终提高医疗服务水平提供手段。,医学信息学的定义,1986 年，Jack D. Myers将Medical Informatics定义为：“是一个发展中的知识实体和技术集合，它对支持医学科研、教学和医疗的信息进行组织和管理。”,2018/11/27,6,Jack D. Myers, MACP, a pioneer in medical informa
4、tics, a member of the National Academy of Sciences and a former ACP President and Regent, died Jan. 31. 1998. He was 84. After serving overseas in the Army medical reserves, Dr. Myers was chair of the department of medicine at the University of Pittsburgh. Dr. Myers was well known among the schools
5、medical students and residents for his thorough teaching style and received ACPs Distinguished Teaching Award in 1981. During the late 1970s, Dr. Myers began studying the field of artificial intelligence and computer-assisted medical education, and he became involved in building databases such as th
6、e Quick Medical Reference. He continued to contribute to the field of medical informatics almost until his death. Dr. Myers served as an ACP Regent from 1971-75 and President from 1976-77. He also served on advisory councils for the National Institutes of Health. The National Academy of Sciences, In
7、stitute of Medicine, elected him to membership in 1976.,Jack D. Myers,2018/11/27,7,1987，美国国立医学图书馆的Donald A.B. Lindberg的定义是：“医学信息学试图为将计算机和自动化信息系统应用于生物医学和医疗保健工作提供理论和科学基础医学信息学研究生物医学情报、数据和知识，它们的存贮、检索和在解决问题和决策中的合理使用。”,医学信息学的定义,2018/11/27,8,Donald A. B. Lindberg, M.D., a scientist who has pioneered in app
8、lying computer technology to health care beginning in 1960 at the University of Missouri, in 1984 was appointed Director of the National Library of Medicine, the worlds largest biomedical library (annual budget $275 million; 690 career staff). From 1992-1995 he served in a concurrent position as fou
9、nding Director of the National Coordination Office for High Performance Computing and Communications (HPCC) in the Office of Science and Technology Policy, Executive Office of the President. In 1996 he was named by the HHS Secretary to be the U.S. Coordinator for the G-7 Global Health Applications P
10、roject. In addition to an eminent career in pathology, Dr. Lindberg has made notable contributions to information and computer activities in medical diagnosis, artificial intelligence, and educational programs. Before his appointment as NLM Director, he was Professor of Information Science and Profe
11、ssor of Pathology at the University of Missouri-Columbia. He has current academic appointments as Clinical Professor of Pathology at the University of Virginia and Adjunct Professor of Pathology at the University of Maryland School of Medicine. Dr. Lindberg was elected the first President of the Ame
12、rican Medical Informatics Association (AMIA). As the countrys senior statesman for medicine and computers, he has been called upon to serve on many boards including the Computer Science and Engineering Board of the National Academy of Sciences, the National Board of Medical Examiners, and the Counci
13、l of the Institute of Medicine of the National Academy of Sciences.,2018/11/27,9,Dr. Lindberg is the author of three books: The Computer and Medical Care; Computers in Life Science Research; and The Growth of Medical Information Systems in the United States, several book chapters, and more than 200
14、articles and reports. He has served as editor and editorial board member of nine publications including the Journal of the American Medical Association. Dr. Lindberg graduated Magna cum Laude from Amherst College and received his M.D. degree from the College of Physicians and Surgeons, Columbia Univ
15、ersity. Among the honors he has received are Phi Beta Kappa, Simpson Fellow of Amherst College, Markle Scholar in Academic Medicine, Surgeon Generals Medallion, recipient of the First AMA Nathan Davis Award for outstanding Member of the Executive Branch in Career Public Service, the Walter C. Alvare
16、z Memorial Award of the American Medical Writers Association, the Presidential Senior Executive Rank Award, Founding Fellow of the American Institute of Medical and Biological Engineering, the Outstanding Service Medal of the Uniformed Services University of the Health Sciences, Federal Computer Wee
17、ks Federal 100 Award, Computers in Healthcare Pioneer Award, Association of Minority Health Professions Schools Commendation, RCI High Performance Computing Industry Recognition Award, U.S. National Commission on Libraries and Information Science Silver Award, Council of Biology Editors Meritorious
18、Award, HHS Meritorious Service Award, Medical Library Association Presidents Award, Fellow of the American Association for the Advancement of Science, and honorary doctorates from Amherst College, the State University of New York at Syracuse and the University of Missouri-Columbia.,2018/11/27,10,199
19、0，M.S. Blois 和Edward H. Shortliffe,在JAMA上发表的著名文章中，认为“医学信息学是一个迅速增长的科学领域，研究如何存贮、检索和合理使用为解决问题和决策所必需的生物医学信息、数据和知识。,医学信息学的定义,随后，Shortliffe在自己的教科书 Medical Informatics: Computer Applications in Health Care中重新定义道：“医疗信息学是一个有关生物医学信息、数据以及用于解决问题和决策的知识的存储、检索、共享和合理利用的科学学科，它涉及到生物医学科学的基础和应用所有的学科，并且与现代信息技术密切联系在一起，尤其
20、是计算和通讯领域。”,2018/11/27,11,此外，英国医学信息学会则认为，MI是“一个科学学科的名称，它是在过去几十年里由全球从事将信息和技术应用于医疗的知识的提高和教学工作的人们发起并推动的，它是医疗卫生、信息和计算机科学、心理学、流行病学和工程学交叉的地方。”,医学信息学的定义,2018/11/27,12,综合上述观点，我们可以归纳出如下共同点： 1. 应用范围明确：涉及到了医学科学的各个方面， 包括基础、临床和教学； 2. 使用工具清楚：与信息技术密切结合，尤其是计算机和通讯； 3. 学科性质确定：该学科是一个应用、交叉学科。,医学信息学的定义,2018/11/27,13,Medi
21、cal Informatics的称谓,Medical Informatics，中文直译为“医学信息学”。 1968年，前苏联的情报学家米哈依洛夫情报学基础的书名上使用了“Informatika” 一词。 上个世纪70年代，英语中首次出现了“Medical Informatics”一词，一般认为系由Medical Information Science 更名而成。,2018/11/27,14,作为学科名称，Medical Informatics中使用的形容词部分“medical”本意是想包括生物医学的各个方面medical=clinical ? dental informatics, pharm
22、aceutical informatics health informatics, Health Bioinformatics nursing informatics Biomedical Informatics,Medical Informatics的称谓,2018/11/27,15,Medical Informatics的称谓,在中国，由于历史原因，“医学信息学”实际上指的是医学图书情报学，它与Medical Informatics有很多差异： 起源不同 应用范围不同,2018/11/27,16,如果想要表现这个学科的发展史，可以根据该学科所处理的对象和所使用的工具分析判断，医学信息学所处
23、理的三类对象是：数据（Data）：为分析所预备的单个条目。 信息（Information）：带有某种解释或者附加含义的成组的数据。 知识（Knowledge）：一组用于从数据和信息中创造信息的规则、公式或者探索方法。,Medical Informatics的历史,2018/11/27,17,分析计算机科学在医学数据、信息和知识上的应用历史，可以总结出如下的发展阶段：,Medical Informatics的历史,2018/11/27,18,在每一个类别里，首先提出概念，随后根据这个概念发展出相应的技术，当这些技术不断发展到一定程度之后，出现相应的研究。一旦建立了核心假说，研究人员建立基础模型给
24、出合理的反馈，最后，一旦某些基础模型成熟了，新的互补性的应用开发就推广开来了。,Medical Informatics的历史,2018/11/27,19,Medical Informatics的历史,启蒙阶段（50-1968年） 50年代，美国国家科学院(NAS)和国家卫生研究院(NIH)设立了有关的资助项目 1964-1966年，布朗大学、哈佛大学、犹他大学、华盛顿大学等大学纷纷开设了“生命科学计算机资源”课程。 1966年，Blum和Duncan分析了纽约罗切斯特地区的3家医院，大约25%的费用来源于信息处理。他们认为需要计算机来帮助管理信息处理，但是还不清楚计算机如何能帮助。还有一些有关
25、医学信息的问题需要澄清，如应该收集什么样的医学数据，医学数据应该如何组织，谁应该为此负担费用等等。,2018/11/27,20,系统开发阶段（1968-1977年）,Medical Informatics的历史,PROMIS (Problem-Oriented Medical Information System) ，1969 ，Vermont大学医学中心医院,RMRS（Regenstrief Medical-Record System） 1972年，印第安纳大学,COSTAR （Computer-Stored Ambulatory Records ） 1968-1978，麻省波士顿的哈佛大学
26、医学院,TMR(The Medical Record) 1970年，北卡罗来纳州的杜克大学Durham医学中心,HELP (Health Evaluation through Logical Processing) 1975年，犹他州盐湖城LDS医院,2018/11/27,21,深入研究阶段（1977-）,Medical Informatics的历史,1984年，高级信息管理集成系统计划 (Integrated Advanced Information Management System, IAIMS),1986年，一体化医学语言系统 （Unified Medical Language Sys
27、tem, UMLS）,2018/11/27,22,2018/11/27,23,医学信息学的学科性质,可以概括为三点：方法意义基础地位综合应用,医学信息学的内容,三个方面学科分支 1.生物信息学 2.生物成像学 3.临床信息学 4.公共卫生信息学,2018/11/27,24,理论研究,1.知识管理2.科学决策3.医学概念的体系分类4.系统链接,2018/11/27,25,具体应用,1. 电子病历2. 决策支持系统3. 信息（知识）检索系统4. 图像与远程医疗系统5. 支持医学教育6. 病人与公共卫生信息系统,临床数据、信息和知识的搜集 传递 利用 存储 组织表现 检索,2018/11/27,26
28、,以电子病历为例： 临床术语的标准化：词表的使用和编制 医学数据隐私和安全：艾滋病、流产等等。 数据录入的困难：录入的类型有手工输入自动输入 病历与其它信息资源的集成：与文献检索系统的集成，与实验室、药局信息系统的集成等等。 用户的教育与培训：如何使用电子病历系统等等,医学信息学的任务,2018/11/27,27,1. 学术研究机构 如大学，美国的著名大学都有Department of Medical Informatics，开设有关的医疗信息学研究生课程。美国国立医学图书馆(NLM)资助12个学校的医疗信息学教育，此外还有6-8个其他学校也开设医疗信息学课程。 中国医科大学，有信息学系和图书
29、馆，医学计算机中心、医院的计算机中心（室）、病历室、电教中心等等。,医学信息学的从业人员和机构,2018/11/27,28,So Some people might find his/her interests quickly, some people may take longer time, even some people will use his/her whole life to identify what he/she really want to do. But it doesnt matter. Dont stopping exploring because what you
30、are doing now is not what you really want to do later. Once you know what this area is about, you will be easy to catch what that area is about.,Clear idea that what you are interested in. This issue is related to a persons life value, professional plan, and career development. What kind of person y
31、ou want to be? What kind of work you want to do? What do you really want to delve into in your life?,2018/11/27,29,In my case, I am not really clear what I want to learn and what I want to do when I came to America. I think that is because I know so little about this area-medical informatics or info
32、rmation science. The education philosophy in China is to teach students concrete techniques instead of a thought, an idea. For sure techniques are important. But if a person only knows some concrete techniques, he/she actually limits his/her views to know broader world in the field of medical inform
33、atics. So, learning a thought and an idea is very important. Especially, know how to apply those thoughts and ideas into practice. I think your class is a good trial to give students the thought and the idea instead of only techniques. Go back to my experience. After taking some classes and reading
34、relevant literatures (it is very important and helpful), I am kind of clear with what I am interested in. Originally, I just have some vague impression in my mind, now I can speak it out clearly.,2018/11/27,30,2. 医学信息工业(公司)： 从事电子病历系统开发的公司 从事信息检索系统开发的公司,医学信息学的从业人员和机构,2018/11/27,31,3. 国家机构 IMIA: Inter
35、national Medical Informatics Association； www.imia.org AMIA: American Medical Informatics Association; www.amia.org CMIA: China Medical Informatics Association; MLA: Medical Library Association: www.mlanet.org NLM: National Library of Medicine; www.nlm.nih.gov HIMSS: Health Information and Manageme
36、nt Systems Society; www.himmss.org,医学信息学的从业人员和机构,2018/11/27,32,医学信息学的从业人员和机构,4. 医疗护理专业学会 AMA: American Medical Association; www.ama-assn.org ACP: American College of Physicians; www.acponline.org 5. 教育机构 AAMC: Association of American Medical Colleges; www.aamc.org 6. 医院中的CIO(Chief Internet Officer)：
37、,2018/11/27,33,About career market, medical informatics is a hot area in the world. You can find job in university, library, research center, information center, Software Company or other IT industry, hospital, consultant company, etc. It will depend on your focuses. If you are interested in IT indu
38、stry in medical area, you may need to learn more programming and other IT technologies. Otherwise, you may not be able to compete with those computer science students. If you are more focused on “soft area”, you may need to get whole picture about this area and the area you are really interested in.
39、 Making good preparation for your future career from now is a good strategy. For sure the prerequisite is that you kind of know what you want to do later.,Tao Donghua, graduated from our department in 1996.,2018/11/27,34,1. 教科书 （1） Shortliffe et al, Medical Informatics: Computer Applications in Heal
40、th Care (2nd edition) Springer-Verlag 2000 （2） van Bemmel and Musen, Handbook of Medical Informatics, Springer-Verlag 1998 （3） Hersh, Information Retrieval: A Health Care Perspective, Springer-Verlag 1996.,医疗信息学的信息资源,2018/11/27,35,专业期刊 Medical informatics:Journal of the American Informatics Association (JAMIA)Journal of Biomedical Informatics (JBI) Methods of Information in Medicine (MIM) Computers in Nursing British Medical Journal (BMJ) Medscape General Medicine BiomedCentral Medical Informatics.,医疗信息学的信息资源,2018/11/27,36,How far?,2018/11/27,37,多远 ？,你,2018/11/27,38,
