Health Informatics Assignment Week 1 to 2

Week 0 (warm up) Assignment

AMIA was started in 1967?

The earliest use of computers in health informatics was in dental projects during late 50s in the US

There were over 40 members at the first HMSS convention in the 1960s.

The use of clinical guidelines and standardized protocols of care increased significantly during the 1970s

Modern statistics and datasets used to compare symptoms, diagnoses, and treatments
Information is easily available in a digital format for healthcare professionals, the patient and possibly by family members as well (with proper authentication and credentials)
Protection and security of data and information is not only dependent on the systems and devices, but also on the professional’s actions.
Electronic systems decrease the time required for scheduling, storing data, and sending information

Contribute to the selection and utilization of appropriate information technologies to meet business requirements.
Contribute to ongoing evaluation of the functionality of systems so that they can evolve to support best practice in clinical care.
Demonstrate knowledge of analysis, design, development and implementation of health information systems and applications
Demonstrate an understanding of architectural relationships between key health information technology components.

Questions for Discussion

How do you interpret the phrase “logical behaviour”? Do computers behave logically? Do people behave logically? Explain your answers.
What do you think it means to say that a computer program is “effective”? Make a list of a dozen computer applications with which you are familiar. List the applications in decreasing order of effectiveness, as you have explained this concept. Then, for each application, indicate your estimate of how well human beings perform the same tasks (this will require that you determine what it means for a human being to be effective). Do you discern any pattern? If so, how do you interpret it?
Discuss three society-wide factors that will determine the extent to which computers are assimilated into medical practice.
Reread the future vision presented in Section 1.1. Describe the characteristics of an integrated environment for managing medical information. Discuss two ways in which such a system could change medical practice.

A satisfactory health care delivery scheme should have two chief areas:

(1) enabling all citizens to access health care amenities, and

(2) enabling the amenities to be cost-effective and encounter convinced superiority morals.
Do you believe that improving the technical quality of health care entails the risk of dehumanization? If so, is it worth the risk? Explain your reasoning

You check your pulse and discover that your heart rate is 100 beats per minute. Is this rate normal or abnormal? What additional information would you use in making this judgment? How does the context in which data are collected influence the interpretation of those data?

Given the imprecision of many medical terms, why do you think that serious instances of miscommunication among health care professionals are not more common? Why is greater standardization of terminology necessary if computers rather than humans are to manipulate patient data?

Based on the discussion of coding schemes for representing medical information, discuss three challenges you foresee in attempting to construct a standardized medical terminology to be used in hospitals, physicians’ offices, and research institutions throughout the United States.

How would medical practice change if nonphysicians were to collect all medical data?

Consider what you know about the typical daily schedule of a busy clinician. What are the advantages of wireless devices, connected to the Internet, as tools for such clinicians? Can you think of disadvantages as well? Be sure to consider the safety and protection of information as well as workflow and clinical needs.

To decide whether a patient has a significant urinary tract infection, physicians commonly use a calculation of the number of bacterial organisms in a millilitre of the patient’s urine. Physicians generally assume that a patient has a urinary tract infection if there are at least 10,000 bacteria per millilitre. Although laboratories can provide such quantification with reasonable accuracy, it is obviously unrealistic for the physician explicitly to count large numbers of bacteria by examining a millilitre of urine under the microscope. As a result, one recent article offers the following guideline to physicians: “When interpreting . . . microscopy of . . . stained centrifuged urine, a threshold of one organism per field yields a 95 percent sensitivity and five organisms per field a 95 percent specificity for bacteriuria [bacteria in the urine] at a level of at least 10,000 organisms per ml.” (Senior Medical Review, 1987, p. 4)

Describe an experiment that would have allowed the researchers to determine the sensitivity and specificity of the microscopy.
How would you expect specificity to change as the number of bacteria per microscopic field increases from one to five.
How would you expect sensitivity to change as the number of bacteria per microscopic field increases from one to five.
Why does it take more organisms per microscopic field to obtain a specificity of 95 percent than it does to achieve a sensitivity of 95 percent.