Search

Background: The National Library of Medicine's Integrated Academic/Advanced Information Management Systems (IAIMS) initiative played a central role in the evolution of health informatics over the project's lifetime (1983-2009) and continues to do so., Aim: Our objective is to demonstrate how IAIMS and two key IAIMS concepts, integration and outreach, have functioned at very different times during this evolutionary process., Approach: Using a framework drawn from Lorenzi and Stead's 2021 history of IAIMS, we examine the role of integration and outreach in work at the University of Maryland Baltimore (UMB) in the early 1980s and at the University of Texas Arlington (UTA) in 2020., Results: Guided by these concepts, UMB implemented a campus-wide information utility, while UTA established a center to accelerate research and innovation., Conclusions: Outreach and integration have been formative in the evolution of health informatics and will continue to hold their power., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Among the many contributions of Donald A.B. Lindberg was his work on behalf of a variety or professional organizations in the field of biomedical and health informatics. These began during his early days at the University of Missouri and continued throughout his 30 years at the National Library of Medicine. This chapter summarizes that work, which occurred both through his personal efforts and through the impact of the NLM under his leadership. Examples include his role in the development of organizations themselves (e.g., the International Medical Informatics Association, the American College of Medical Informatics, and the American Medical Informatics Association) and also his contributions to the professional scientific meetings that have advanced the field (e.g., the Symposium on Computer Applications in Medical Care, MEDINFO, and the AMIA Annual Symposium).

Objectives: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) in the 2020 time period and to welcome its 2020 Class of Fellows., Method: Report from the members of the Academy's Board., Results: Due to the SARS-CoV-2 pandemic, both Plenary meetings in 2020 had to be organized as virtual meetings. Scientific discussions, focusing on mobilizing computable biomedical knowledge and on data standards and interoperability formed major parts of these meetings. A statement on the use of informatics in pandemic situations was elaborated and sent to the World Health Organization. A panel on data standards and interoperability started its work. 34 Fellows were welcomed in the 2020 Class of Fellows so that the Academy now consists of 179 members., Conclusions: There was a shift from supporting to strategic activities in the Academy's work. After having achieved organizational stability, the Academy can now focus on its strategic work and so on its main objective., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

This study describes the realization of onset and coda clusters in a 4-year old child acquiring American English, and with a higher than usual level of unintelligible speech. It reviews previous studies that have tested cluster realization against markedness and, in particular, the sonority hypothesis. This latter predicts steep rises in sonority at onsets and more gradual falls in sonority at codas of syllables. The data collected for this study cover four different onset cluster types and three different coda cluster types, and are derived from spontaneous speech produced during clinical sessions. An analysis of the patterns of cluster realizations shows that the participant's cluster realizations do not always follow the sonority hypothesis, and various factors are discussed that could be motivating the child's choice of realization.

Consumer demand for personal health records (PHRs) and the capabilities provided by regional health information organizations (RHIOs) will change healthcare, just as automatic teller machines have changed banking. The PHR is predicated on the existence of electronic medical records (EMRs) and electronic health records (EHRs). Patient and consumer principles guiding the development of the PHR reflect issues of access, control, privacy, and security. Working models illustrate the variations of RHIOs and PHRs possible and suggest the benefits that electronic information exchange can accrue for healthcare and healthcare consumers. Today both the private and public sectors are working to define the issues involved in efforts that are now taking place and that will transform healthcare. Consumers are ready for the type of changes that will improve healthcare quality.

A hospital is a type of system, yet healthcare information technology (IT) has largely failed to view it as such. The failure to view the hospital as a system has contributed to the practice of inefficient and ineffective clinical documentation. This paper seeks to address how current clinical documentation practices reflect and reinforce inefficiency and poor patient care. It also addresses how rethinking clinical documentation and IT together may improve the entire healthcare process by promoting a more integrated and patient-centered healthcare information paradigm. Rethinking IT in support of clinical documentation from a system-oriented perspective may help improve patient care and provider communication.

Ongoing government and healthcare industry initiatives clearly indicate that information technology will be the driver for change in healthcare. As systems proliferate, healthcare organizations grapple with issues of whether to choose best-of-breed systems or standardize around one vendor. For many years, HCA Inc. has been a major proponent of standardization to help meet its financial and patient safety objectives. This article examines HCA's experience and explores how standardization has been a major factor in the company's financial and clinical success, enabling faster implementation, greater quality control and significant cost-savings.

Objectives: To heighten awareness about the critical issues currently affecting patient care and to propose solutions based on leveraging information technologies to enhance patient care and influence a culture of patient safety., Methods: Presentation and discussion of the issues affecting health care today, such as medical and medication-related errors and analysis of their root causes; proliferation of medical knowledge and medical technologies; initiatives to improve patient safety; steps necessary to develop a culture of safety; introduction of relevant enabling technologies; and evidence of results., Results and Conclusion: Medical errors affect not only mortality and morbidity, but they also create secondary costs leading to dissatisfaction by both provider and patient. Health care has been slow to acknowledge the benefits of enabling technologies to affect the quality of care. Evaluation of recent applications, such as the computerized patient record, physician order entry, and computerized alerting systems show tremendous potential to enhance patient care and influence the development of a culture focused on safety. They will also bring about changes in other areas, such as workflow and the creation of new partnerships among providers, patients, and payers.

The growing understanding of medical errors as systemic in nature underscores the importance of analyzing and redesigning systems. Best practices in medication safety that promise rapid payback include computerized physician order entry, ongoing tracking and benchmarking, and the creation by leadership of nonpunitive environments where this new culture of safety can thrive.

Today, the clinical trial process remains slow and paper-based. The creation of a Cancer Informatics Infrastructure (CII) can provide the architectural base across the continuum of cancer research and cancer care. Recommendations of a Long Range Planning Committee identified near-term activities for the Office of Informatics at the National Cancer Institute (NCI). These include participating in national standards development; fostering oncology-related terminology and standards, e.g., Common Data Elements (CDEs); and leveraging mainstream informatics and Internet technologies, using the successful Internet model that focuses on facilitating stakeholder participation, sponsoring the CII rather than subsidizing it, and providing a test bed as well as an infrastructure. Diffusion tactics include extending the CII concept beyond its "early adopters" to the wider community through recommendations for the near-term and development of a major document defining next-phase activities.

As healthcare changes, HIM professionals must act as individuals to keep pace with the transformation. Educational changes in HIM curricula are evolving, but HIM professionals must take responsibility for their education to take advantage of opportunities presented by new information technologies.

Information systems are a necessity in tomorrow's healthcare environment--but who will be trained to use them and use them well? A whole generation of practitioners is backing away from the challenge--how are they to become educated?

Health informatics continues to gain recognition as a discipline in the United States and abroad, and professional societies are encouraging medical educators to include informatics in their curricula. Other health professions are also developing courses and requirements in informatics. The University of Maryland is establishing a database of informatics programs in the United States and abroad, and readers are invited to contribute information to this database.

With support from the National Library of Medicine, the University of Maryland at Baltimore is creating an Integrated Academic Information Management System (IAIMS) that will serve as a prototype for academic health centers. A campus-wide undertaking, the IAIMS initiative at Maryland is characterized by its functional comprehensiveness and its planning model. The resulting strategic plan is serving as a guide in the ongoing model development within an interdisciplinary Hypertension Center.

Informatics, the applied use of information science, is undergoing definition and development in the health professions with the encouragement of the National Library of Medicine and other professional organizations. Medical informatics and disciplinary subsets such as nursing and dental informatics look to optimize a growing range of applications ranging from video-disks to expert systems. Recommendations call for the integration of informatics into the education of health care professionals. Academic health sciences centers are developing informatics programs; the University of Maryland Campus for the Professions has convened a task force and a national advisory board on informatics.

A survey of vendors reveals the growing range of applications that are offered by second-generation hospital information systems.

The University of Maryland Campus for the Professions is now realizing the first benefits of integrated academic information management systems (IAIMS). With the support of the National Library of Medicine, the information Resources Management Division has joined with the Health Sciences Library to plan and to implement change. Within the information utility concept, networked data communications and end-user computing function as the means to integration. Plans call for new 370-based software to extend system capabilities. Mechanisms for outreach ensure that the potential of integration is realized. These mechanisms include technology assisted learning centers, informatics program development, special programs (geriatrics, hypertension pilot), and new applications (conferencing system, voice mail, videodisc development, interinstitutional resource sharing).