The Contributions of Biomedical Informatics to the Fight Against Bioterrorism

A comprehensive and timely response to current and future bioterrorist attacks requires a data acquisition, threat detection, and response infrastructure with unprecedented scope in time and space. Fortunately, biomedical informaticians have developed and implemented architectures, methodologies, and tools at the local and the regional levels that can be immediately pressed into service for the protection of our populations from these attacks. These unique contributions of the discipline of biomedical informatics are reviewed here.Current outbreaks of anthrax exposure and cases test our health care delivery and public health systems with threats of large spatial scope—the entire nation—that demand a very short temporal latency in our responses. Other potential bioterrorist attacks only increase the dimensions of this unprecedented challenge. The dimensions, however, are not unprecedented; rather, they are quite familiar to many researchers in biomedical informatics over the last 40 years. The task of comprehensive real-time monitoring on the regional and national scale has been the subject of full-fledged design and large-scale implementations led by biomedical informaticians.Nonetheless, we run the risk that the knowledge gained in the decades of informatics research will not, in the appropriate haste to safeguard the population of the United States from the threats of bioterrorism, be reflected in the national public health information infrastructure. And that may result not only in wasteful expenditures but also in ineffective measures to prevent future attacks on the health of the U.S. population. This is, therefore, a timely juncture to review some of the most germane contributions from the biomedical informatics armamentarium to the tasks at hand, particularly data acquisition, threat detection, and response.     

A Longitudinal Social Network Analysis of the Editorial Boards of Medical Informatics and Bioinformatics Journals

ObjectiveThe goal of this research is to learn how the editorial staffs of bioinformatics and medical informatics journals provide support for cross-community exposure. Models such as co-citation and co-author analysis measure the relationships between researchers; but they do not capture how environments that support knowledge transfer across communities are organized.MethodsIn this paper, we propose a social network analysis model to study how editorial boards integrate researchers from disparate communities. We evaluate our model by building relational networks based on the editorial boards of approximately 40 journals that serve as research outlets in medical informatics and bioinformatics. We track the evolution of editorial relationships through a longitudinal investigation over the years 2000 through 2005.ResultsOur findings suggest that there are research journals that support the collocation of editorial board members from the bioinformatics and medical informatics communities. Network centrality metrics indicate that editorial board members are located in the intersection of the communities and that the number of individuals in the intersection is growing with time.ConclusionsSocial network analysis methods provide insight into the relationships between the medical informatics and bioinformatics communities. The number of editorial board members facilitating the publication intersection of the communities has grown, but the intersection remains dependent on a small group of individuals and fragile.     

面向非医学信息学专业的医学信息学教材建设探析

列举国内外医学信息学代表教材,参考国际医学信息学会的建议,针对国内非医学信息学专业医学生医学信息学教材存在的问题,提出整合先进的医学信息学内容,阐明教材编写原则及形式,以期加强非医学信息学专业医学生的医学信息学教育水平。     

医学工程科室文化建设的探讨与实践

医院文化随着现代化医院管理发展而受到重视,作为医院一个重要部门的医学工程部门也应随之建立起自己的科室文化.本文简述了医学工程科科室文化建设中涉及的一些方面.     

谈影像科网络安全

本文主要对如何做好影像科日常网络安全作了介绍,其中有硬件安全保障、网络系统的稳定性、安全性以及医学影像存储.     

医学生社会实践活动模式探讨

医学生社会实践活动是大学生全面发展、健康成才的有效载体,为此西安交通大学医学院努力探索新形势下医学生社会实践活动模式,通过组织开展一系列形式多样的社会实践活动,探索出医学生社会实践活动新思路,逐步形成具有医学特色的社会实践活动新模式,进一步推动了该院教育、科研、服务、实习相结合的运行机制的建立。     

耳鼻咽喉科住院医师规范化培训的实践与探讨

住院医师规范化培训是培养合格住院医师的必要途径。作者所在科室自从2009年开展住院医师规范化培训的实践工作以来,根据我国住院医师培训的要求,结合耳鼻咽喉科医师培养的特殊性及科室自身的特点,取得了一定的经验。作者总结了培训过程中的体会,探讨了耳鼻咽喉科带教教师如何帮助新医师完成住院医师规范化培训过程,使其成长为合格的住院医师。     

国际全科期刊的主题分析

背景　专业学会的学术期刊所刊载的文章,反映出该学科领域的发展程度和方向。不同于通常的科研文章的“海选”式的系统评估,从学科期刊的角度评价,可以对学科、期刊和行业发展提出更有针对性的信息。目的　通过对国际上全科医学学科同行期刊的分析,了解全科医学科研的发展现状与趋势,为中国全科医学学术研究和学术期刊管理提供有意义的借鉴。方法　有目的地选择和检索国际有代表性的全科医学/家庭医学专业组织的学术期刊,并提取其中2019年9月-2020年9月的期刊文章、研究主题、研究对象及研究方法等关键信息。结果　（1）以新型冠状病毒肺炎为例,发表101篇文章,其中9篇为研究类文章,反映出全科学术期刊具有一定的响应性。（2）近一年10本期刊共发表文章1 524篇,发文量排在前4位的分别为《英国全科医学杂志》（BJGP）、《加拿大家庭医师》（CFP）、《澳大利亚全科医学杂志》（AJGP）、美国《家庭医学年报》（AFM）。（3）科研文章的发文量为463篇,占总发文量的30.4%。科研文章发文量以BJGP和AFM居多,其次是《斯堪的纳维亚初级卫生保健杂志》（SJPHC）、AJGP、新西兰《初级卫生保健杂志》（JPHC）、CFP。（4）10本期刊科研文章的第一作者来自25个国家/地区,排在前列的为英国、美国、加拿大、澳大利亚、新西兰、日本、瑞典、挪威、马来西亚、荷兰、丹麦、芬兰。（5）106篇科研文章有明确的人口社会学特征服务对象,排序分别为老年人、儿童和青少年、妇女、弱势群体和族群。有107篇研究关注全科医学服务现在和未来的人力资源及所做工作,涉及全科医生/基本医疗服务提供者、全科团队成员、其他工作者、医学生和全科学员。有156篇文章的研究对象是具体疾病和问题人群,按照基层医疗国际分类第2版（ICPC-2）,第1类为心血管系统疾病或问题,第2类为内分泌/代谢和营养疾病或问题,第3类为心理和精神疾病或问题,第4类为呼吸系统疾病或问题。（6）科研文章的研究问题多样化,涉及广泛。（7）科研文章涉及的干预或措施包括全科临床诊治、服务系统管理、评判思维、全科教育和领导、药物合理使用、多科学整合服务、电子化服务、质量与安全等。（8）科研文章最常用的研究方法是定量方法,占全部科研文章的61.3%（284/463）。在定量研究中,试验性研究有47篇,包括随机对照试验23篇、非随机对照试验24篇;余237篇（83.5%）定量研究为观察性研究,且161篇为未设立对照组的描述性研究。108篇（23.3%）科研文章采用质性研究方法,知情人个别深入访谈是采用最多的质性研究方法（72篇）,其次为焦点小组访谈方法（11篇）。多种研究方法混合使用的科研文章为24篇（5.2%）。结论　全科医学学会期刊对社区需要具有一定的响应性,研究对象与社区健康需要相一致,并关注全科人力资源发展,研究问题和干预措施多样化。研究方法以定量观察研究为主,且质性研究文章超过文章总数的1/5。建议通过对国际学科文献的评价,进一步提高国内学科期刊的学科水平。     

中医药信息学的内涵及原理研究

中医药信息学是由中医学和信息科学交叉产生,对其内涵与原理的研究将丰富学科理论,促进中医药信息学的学科发展。通过对中医药信息学学科产生的理论基础与学科特点进行了论述,并从中医药信息的形成、获取、识别、转化、反馈控制、经验性知识激活与传播等方面探讨了学科原理和任务。     

高校医务社会工作专业实践教学体系建设

在长期从事专业教学的基础上，对当前医务社会工作专业实践教学的现状及其原因进行了分析。同时，结合本校实践教学的开展状况，提出了一个包含课堂情境模拟、实验室操作、实践教学基地和社区机构服务在内的多层次的医务社会工作实践教学体系。     

生物医学工程专业《仪器分析》双语教学探索与实践

仪器分析作为生物医学工程专业的专业基础课之一,其双语教学对于提高教学质量具有重要意义。结合仪器分析课程双语教学的实践经验,阐述了双语教学的重要意义,并在教材的选择、课堂的组织和目前存在的问题等方面进行了探讨,为仪器分析课程双语教学改革提供参考。     

Blackboard网络平台下的检体诊断学双语教学实践

五年制临床医学专业检体诊断学是高等医院校重要的专业基础课。随着高等医学教育技术的发展,课程教学对大量有关疾病症状体征及检体诊断手法的专业英语词汇、互联网以及国内外最新医学资源的需求也日益增多。如何更好的提高教学质量、激发学生学习的兴趣,是检体诊断学课程急需解决的问题。本文通过五年制临床医学专业的检体诊断学教学实践,对利用Blackboard网络教学平台进行双语教学进行了初步探讨。     

神经内科临床实习中存在的问题分析及对策

神经病学是高等医学院校非常重要的一门临床医学课程,神经内科临床实习阶段是医学生整个实习过程中的重要环节。由于神经系统疾病诊疗的特殊性和复杂性,使得神经内科很难掌握。通过临床教学实践工作,作者分析了神经内科临床实习中存在的问题,同时就诊疗特点以及如何提高临床实习质量等方面做以探讨。     

Evaluation of a Physician Informatics Tool to Improve Patient Handoffs

Objective

To facilitate patient handoffs between physicians, the computerized patient handoff tool (PHT) extracts information from the electronic health record to populate a form that is printed and given to the cross-cover physician. Objectives were to: (1) evaluate the rate at which data elements of interest were extracted from the electronic health record into the PHT, (2) assess the frequency for needing information beyond that contained in the PHT and where obtained, (3) assess physician's perceptions of the PHT, (4) identify opportunities for improvement.

Design

Observational study.

Measurements

This multi-method study included content coding of PHT forms, end of shift surveys of cross-cover resident physicians, and semi-structured interviews to identify opportunities for improvement. Thirty-five of 42 internal medicine resident physicians participated. Measures included: 1264 PHT forms coded for type of information, 63 end-of-shift surveys of cross-cover residents (residents could participate 2 times), and 18 semi-structured interviews.

Results

For objective 1, patient identifiers and medications were reliably extracted (>98%). Other types of information—allergies and code status—were more variable (<50%). For objective 2, nearly a quarter of respondents required information from physician notes not available in the PHT. For objective 3, respondents found that the PHT supported handoffs but indicated that it often excluded the assessment and plan. For objective 4, residents suggested including treatment plans.

Conclusions

The PHT reliably extracts information from the electronic health record. Respondents found the PHT to be suitable, although opportunities for improvement were identified.     

Perioperative and ICU Healthcare Analytics within a Veterans Integrated System Network: a Qualitative Gap Analysis

Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create “one-stop shopping” for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.