醫(yī)學(xué)信息學(xué)課件

1、歡迎進(jìn)入Medical Informatics的世界2022/10/51歡迎進(jìn)入Medical Informatics2022/10 了解基本概念 能簡單的完成任務(wù) 對(duì)這個(gè)領(lǐng)域感興趣 教學(xué)目標(biāo) 2022/10/52 了解基本概念教學(xué)目標(biāo) 2022/10/22Medical Informatics：概念與歷史 醫(yī)學(xué)信息學(xué)的定義Medical Informatics的稱謂 醫(yī)療信息學(xué)的歷史 醫(yī)學(xué)信息學(xué)的應(yīng)用 醫(yī)學(xué)信息學(xué)的任務(wù) 醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)醫(yī)療信息學(xué)的信息資源2022/10/53Medical Informatics：概念與歷史 醫(yī)學(xué)信息醫(yī)學(xué)信息學(xué)的定義 人們不斷用科學(xué)和正規(guī)簡潔的術(shù)語

2、來定義這個(gè)領(lǐng)域，做出了許多非同一般的嘗試。下面我們按照時(shí)間順序，列舉出關(guān)于Medical Informatics比較重要的定義 1977年，Allan H. Levy將醫(yī)學(xué)信息學(xué)定義為“處理與信息有關(guān)的問題，醫(yī)療衛(wèi)生服務(wù)過程中信息的獲取、分析、和傳播” 是什么？對(duì)象工具范圍信息：獲取、分析、傳播醫(yī)療衛(wèi)生服務(wù)/history/what.html2022/10/54醫(yī)學(xué)信息學(xué)的定義 人們不斷用科學(xué)和正規(guī)簡潔的醫(yī)學(xué)信息學(xué)的定義 1984年，著名的醫(yī)學(xué)信息學(xué)教科書Handbook of Medical Informatics的作者，荷蘭的Jan van Bemmel將其定義為：醫(yī)學(xué)信息學(xué)由信息處理和通

3、訊的理論和實(shí)踐兩個(gè)方面組成，它以醫(yī)療和衛(wèi)生保健過程中所產(chǎn)生的知識(shí)和經(jīng)驗(yàn)為基礎(chǔ)。是什么？對(duì)象工具范圍信息處理和通訊理論和實(shí)踐知識(shí)和經(jīng)驗(yàn)醫(yī)療和衛(wèi)生保健2022/10/55醫(yī)學(xué)信息學(xué)的定義 1984年，著名的醫(yī)學(xué)信息學(xué)教科根據(jù)Myers的定義，美國醫(yī)學(xué)院協(xié)會(huì)（Association of American Medical College，AAMC）將MI擴(kuò)展定義為：醫(yī)學(xué)信息學(xué)是關(guān)于組織管理醫(yī)學(xué)臨床、教育和科研信息的發(fā)展中的知識(shí)的集合和技術(shù)的集合醫(yī)學(xué)信息學(xué)將醫(yī)學(xué)科學(xué)、信息科學(xué)和計(jì)算機(jī)科學(xué)的相關(guān)技術(shù)和原理結(jié)合起來，為使這些技術(shù)和原理能促進(jìn)醫(yī)學(xué)基礎(chǔ)知識(shí)的應(yīng)用，最終提高醫(yī)療服務(wù)水平提供手段。醫(yī)學(xué)信息學(xué)的定義

4、 1986 年，Jack D. Myers將Medical Informatics定義為：“是一個(gè)發(fā)展中的知識(shí)實(shí)體和技術(shù)集合，它對(duì)支持醫(yī)學(xué)科研、教學(xué)和醫(yī)療的信息進(jìn)行組織和管理?！?是什么對(duì)象工具范圍知識(shí)和技術(shù)信息醫(yī)學(xué)、信息、計(jì)算機(jī)科學(xué)醫(yī)學(xué)：科研、教學(xué)、醫(yī)療2022/10/56根據(jù)Myers的定義，美國醫(yī)學(xué)院協(xié)會(huì)（AssociationJack D. Myers, MACP, a pioneer in medical informatics, a member of the National Academy of Sciences and a former ACP President and R

5、egent, 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 medical students and residents for his thorough teaching style and received ACPs Dis

6、tinguished 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 the Quick Medical Reference. He continued to contribute to the field of medical informa

7、tics 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, Institute of Medicine, elected him to membership in 1976.Jack D. Myers2022/10/57Jack D.

8、Myers, MACP, a pioneer 1987，美國國立醫(yī)學(xué)圖書館的Donald A.B. Lindberg的定義是：“醫(yī)學(xué)信息學(xué)試圖為將計(jì)算機(jī)和自動(dòng)化信息系統(tǒng)應(yīng)用于生物醫(yī)學(xué)和醫(yī)療保健工作提供理論和科學(xué)基礎(chǔ)醫(yī)學(xué)信息學(xué)研究生物醫(yī)學(xué)情報(bào)、數(shù)據(jù)和知識(shí)，它們的存貯、檢索和在解決問題和決策中的合理使用?！?醫(yī)學(xué)信息學(xué)的定義 是什么對(duì)象工具范圍？情報(bào)、數(shù)據(jù)、知識(shí)的存儲(chǔ)、檢索和使用計(jì)算機(jī)、自動(dòng)化信息系統(tǒng)生物醫(yī)學(xué)、醫(yī)療保健2022/10/58 1987，美國國立醫(yī)學(xué)圖書館的Donald A.B. Donald A. B. Lindberg, M.D., a scientist who has pion

9、eered in applying 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 pos

10、ition as founding 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 Ap

11、plications Project.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 Scienc

12、e and Professor 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

13、of the American 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

14、the Council of the Institute of Medicine of the National Academy of Sciences.2022/10/59Donald A. B. Lindberg, M.D., aDr. 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, sever

15、al book chapters, and more than 200 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 Ph

16、ysicians and Surgeons, Columbia University. 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

17、Public Service, the Walter C. Alvarez 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 H

18、ealth Sciences, Federal Computer Weeks 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, Cou

19、ncil of Biology Editors Meritorious 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

20、Missouri-Columbia.2022/10/510Dr. Lindberg is the author of 1990，M.S. Blois 和Edward H. Shortliffe,在JAMA上發(fā)表的著名文章中，認(rèn)為“醫(yī)學(xué)信息學(xué)是一個(gè)迅速增長的科學(xué)領(lǐng)域，研究如何存貯、檢索和合理使用為解決問題和決策所必需的生物醫(yī)學(xué)信息、數(shù)據(jù)和知識(shí)。 醫(yī)學(xué)信息學(xué)的定義 是什么對(duì)象工具范圍科學(xué)學(xué)科信息、數(shù)據(jù)和知識(shí)現(xiàn)代信息技術(shù)：計(jì)算和通訊生物醫(yī)學(xué)科學(xué)的基礎(chǔ)和應(yīng)用隨后，Shortliffe在自己的教科書 Medical Informatics: Computer Applications in Health

21、 Care中重新定義道：“醫(yī)療信息學(xué)是一個(gè)有關(guān)生物醫(yī)學(xué)信息、數(shù)據(jù)以及用于解決問題和決策的知識(shí)的存儲(chǔ)、檢索、共享和合理利用的科學(xué)學(xué)科，它涉及到生物醫(yī)學(xué)科學(xué)的基礎(chǔ)和應(yīng)用所有的學(xué)科，并且與現(xiàn)代信息技術(shù)密切聯(lián)系在一起，尤其是計(jì)算和通訊領(lǐng)域?！?2022/10/511 1990，M.S. Blois 和Edwa 此外，英國醫(yī)學(xué)信息學(xué)會(huì)則認(rèn)為，MI是“一個(gè)科學(xué)學(xué)科的名稱，它是在過去幾十年里由全球從事將信息和技術(shù)應(yīng)用于醫(yī)療的知識(shí)的提高和教學(xué)工作的人們發(fā)起并推動(dòng)的，它是醫(yī)療衛(wèi)生、信息和計(jì)算機(jī)科學(xué)、心理學(xué)、流行病學(xué)和工程學(xué)交叉的地方?！?醫(yī)學(xué)信息學(xué)的定義 是什么對(duì)象工具范圍科學(xué)學(xué)科醫(yī)療知識(shí)信息和技術(shù)醫(yī)療衛(wèi)生、信

22、息和計(jì)算機(jī)科學(xué)、心理學(xué)、流行病學(xué)和工程學(xué)2022/10/512 此外，英國醫(yī)學(xué)信息學(xué)會(huì)則認(rèn)為，MI是“一個(gè)綜合上述觀點(diǎn)，我們可以歸納出如下共同點(diǎn)：1. 應(yīng)用范圍明確：涉及到了醫(yī)學(xué)科學(xué)的各個(gè)方面， 包括基礎(chǔ)、臨床和教學(xué)；2. 使用工具清楚：與信息技術(shù)密切結(jié)合，尤其是計(jì) 算機(jī)和通訊；3. 學(xué)科性質(zhì)確定：該學(xué)科是一個(gè)應(yīng)用、交叉學(xué)科。 醫(yī)學(xué)信息學(xué)的定義 2022/10/513綜合上述觀點(diǎn)，我們可以歸納出如下共同點(diǎn)：醫(yī)學(xué)信息學(xué)的定義 2Medical Informatics的稱謂 Medical Informatics，中文直譯為“醫(yī)學(xué)信息學(xué)”。1968年，前蘇聯(lián)的情報(bào)學(xué)家米哈依洛夫情報(bào)學(xué)基礎(chǔ)的書名上使

23、用了“Informatika” 一詞。上個(gè)世紀(jì)70年代，英語中首次出現(xiàn)了“Medical Informatics”一詞，一般認(rèn)為系由Medical Information Science 更名而成。2022/10/514Medical Informatics的稱謂 Medical 作為學(xué)科名稱，Medical Informatics中使用的形容詞部分“medical”本意是想包括生物醫(yī)學(xué)的各個(gè)方面 medical=clinical ?dental informatics, pharmaceutical informaticshealth informatics, HealthBioinform

24、aticsnursing informaticsBiomedical InformaticsMedical Informatics的稱謂 2022/10/515 作為學(xué)科名稱，Medical InforMedical Informatics的稱謂 在中國，由于歷史原因，“醫(yī)學(xué)信息學(xué)”實(shí)際上指的是醫(yī)學(xué)圖書情報(bào)學(xué)，它與Medical Informatics有很多差異：起源不同應(yīng)用范圍不同2022/10/516Medical Informatics的稱謂 如果想要表現(xiàn)這個(gè)學(xué)科的發(fā)展史，可以根據(jù)該學(xué)科所處理的對(duì)象和所使用的工具分析判斷，醫(yī)學(xué)信息學(xué)所處理的三類對(duì)象是：數(shù)據(jù)（Data）：為分析所預(yù)備的單個(gè)

25、條目。信息（Information）：帶有某種解釋或者附加含義的成 組的數(shù)據(jù)。知識(shí)（Knowledge）：一組用于從數(shù)據(jù)和信息中創(chuàng)造信息 的規(guī)則、公式或者探索方法。Medical Informatics的歷史 2022/10/517 如果想要表現(xiàn)這個(gè)學(xué)科的發(fā)展史，可以根據(jù)該 1950s1960s1970s1980s數(shù)據(jù)處理應(yīng)用開展研究基礎(chǔ)模型成熟深入信息處理應(yīng)用提出概念開展研究基礎(chǔ)模型成熟知識(shí)處理應(yīng)用提出概念提出概念開展研究基礎(chǔ)模型 分析計(jì)算機(jī)科學(xué)在醫(yī)學(xué)數(shù)據(jù)、信息和知識(shí)上的應(yīng)用歷史，可以總結(jié)出如下的發(fā)展階段：Medical Informatics的歷史 2022/10/518 1950s196

26、0s1970s1980s數(shù)據(jù)處理應(yīng)用 在每一個(gè)類別里，首先提出概念，隨后根據(jù)這個(gè)概念發(fā)展出相應(yīng)的技術(shù)，當(dāng)這些技術(shù)不斷發(fā)展到一定程度之后，出現(xiàn)相應(yīng)的研究。 一旦建立了核心假說，研究人員建立基礎(chǔ)模型給出合理的反饋，最后，一旦某些基礎(chǔ)模型成熟了，新的互補(bǔ)性的應(yīng)用開發(fā)就推廣開來了。Medical Informatics的歷史 2022/10/519 在每一個(gè)類別里，首先提出概念，隨后根據(jù)這個(gè)Medical Informatics的歷史 啟蒙階段（50-1968年） 50年代，美國國家科學(xué)院(NAS)和國家衛(wèi)生研究院(NIH)設(shè)立了有關(guān)的資助項(xiàng)目 1964-1966年，布朗大學(xué)、哈佛大學(xué)、猶他大學(xué)、華盛

27、頓大學(xué)等大學(xué)紛紛開設(shè)了“生命科學(xué)計(jì)算機(jī)資源”課程。 1966年，Blum和Duncan分析了紐約羅切斯特地區(qū)的3家醫(yī)院，大約25%的費(fèi)用來源于信息處理。他們認(rèn)為需要計(jì)算機(jī)來幫助管理信息處理，但是還不清楚計(jì)算機(jī)如何能幫助。還有一些有關(guān)醫(yī)學(xué)信息的問題需要澄清，如應(yīng)該收集什么樣的醫(yī)學(xué)數(shù)據(jù)，醫(yī)學(xué)數(shù)據(jù)應(yīng)該如何組織，誰應(yīng)該為此負(fù)擔(dān)費(fèi)用等等。 2022/10/520Medical Informatics的歷史 啟蒙階段（50系統(tǒng)開發(fā)階段（1968-1977年） Medical Informatics的歷史 PROMIS (Problem-Oriented Medical Information System

28、) ，1969 ，Vermont大學(xué)醫(yī)學(xué)中心醫(yī)院 RMRS（Regenstrief Medical-Record System） 1972年，印第安納大學(xué) COSTAR （Computer-Stored Ambulatory Records ）1968-1978，麻省波士頓的哈佛大學(xué)醫(yī)學(xué)院 TMR(The Medical Record) 1970年，北卡羅來納州的杜克大學(xué)Durham醫(yī)學(xué)中心 HELP (Health Evaluation through Logical Processing)1975年，猶他州鹽湖城LDS醫(yī)院 2022/10/521系統(tǒng)開發(fā)階段（1968-1977年） Med

29、ical Inf深入研究階段（1977-） Medical Informatics的歷史 1984年，高級(jí)信息管理集成系統(tǒng)計(jì)劃(Integrated Advanced Information Management System, IAIMS) 1986年，一體化醫(yī)學(xué)語言系統(tǒng)（Unified Medical Language System, UMLS） 2022/10/522深入研究階段（1977-） Medical Informat2022/10/523醫(yī)學(xué)信息學(xué)的學(xué)科性質(zhì)可以概括為三點(diǎn)： 方法意義 基礎(chǔ)地位 綜合應(yīng)用 2022/10/223醫(yī)學(xué)信息學(xué)的學(xué)科性質(zhì)可以概括為三點(diǎn)：醫(yī)學(xué)信息學(xué)的內(nèi)容

30、三個(gè)方面 學(xué)科分支1.生物信息學(xué)2.生物成像學(xué)3.臨床信息學(xué)4.公共衛(wèi)生信息學(xué)2022/10/524醫(yī)學(xué)信息學(xué)的內(nèi)容三個(gè)方面2022/10/224理論研究 1.知識(shí)管理 2.科學(xué)決策 3.醫(yī)學(xué)概念的體系分類 4.系統(tǒng)鏈接2022/10/525理論研究 1.知識(shí)管理2022/10/225具體應(yīng)用 1. 電子病歷 2. 決策支持系統(tǒng) 3. 信息（知識(shí)）檢索系統(tǒng) 4. 圖像與遠(yuǎn)程醫(yī)療系統(tǒng) 5. 支持醫(yī)學(xué)教育 6. 病人與公共衛(wèi)生信息系統(tǒng)臨床數(shù)據(jù)、信息和知識(shí)的 搜集 傳遞 利用 存儲(chǔ) 組織 表現(xiàn) 檢索2022/10/526具體應(yīng)用 1. 電子病歷臨床數(shù)據(jù)、信息和知識(shí)的202以電子病歷為例：臨床術(shù)語的標(biāo)

31、準(zhǔn)化：詞表的使用和編制醫(yī)學(xué)數(shù)據(jù)隱私和安全：艾滋病、流產(chǎn)等等。數(shù)據(jù)錄入的困難：錄入的類型有 手工輸入 自動(dòng)輸入病歷與其它信息資源的集成：與文獻(xiàn)檢索系統(tǒng)的集成，與實(shí)驗(yàn)室、藥局信息系統(tǒng)的集成等等。用戶的教育與培訓(xùn)：如何使用電子病歷系統(tǒng)等等醫(yī)學(xué)信息學(xué)的任務(wù)2022/10/527以電子病歷為例：醫(yī)學(xué)信息學(xué)的任務(wù)2022/10/2271. 學(xué)術(shù)研究機(jī)構(gòu)如大學(xué)，美國的著名大學(xué)都有Department of Medical Informatics，開設(shè)有關(guān)的醫(yī)療信息學(xué)研究生課程。美國國立醫(yī)學(xué)圖書館(NLM)資助12個(gè)學(xué)校的醫(yī)療信息學(xué)教育，此外還有6-8個(gè)其他學(xué)校也開設(shè)醫(yī)療信息學(xué)課程。中國醫(yī)科大學(xué)，有信息學(xué)系和

32、圖書館，醫(yī)學(xué)計(jì)算機(jī)中心、醫(yī)院的計(jì)算機(jī)中心（室）、病歷室、電教中心等等。醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)2022/10/5281. 學(xué)術(shù)研究機(jī)構(gòu)醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)202So 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 explo

33、ring because what you 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.

34、 What kind of person you want to be? What kind of work you want to do? What do you really want to delve into in your life? 2022/10/529So Some people mightIn 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 abou

35、t this area-medical informatics or information 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 broad

36、er world in the field of medical informatics. 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.

37、 After taking some classes and reading 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. 2022/10/530In my case, I am not really cl2. 醫(yī)學(xué)信息工業(yè)(公司)：從事電子病歷系統(tǒng)開發(fā)

38、的公司從事信息檢索系統(tǒng)開發(fā)的公司醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)2022/10/5312. 醫(yī)學(xué)信息工業(yè)(公司)：醫(yī)學(xué)信息學(xué)的從業(yè)人員和3. 國家機(jī)構(gòu)IMIA: International Medical Informatics Association； AMIA: American Medical Informatics Association; CMIA: China Medical Informatics Association; MLA: Medical Library Association: NLM: National Library of Medicine; HIMSS: Health

39、 Information and Management Systems Society; 醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)2022/10/5323. 國家機(jī)構(gòu)醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)2022/醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)4. 醫(yī)療護(hù)理專業(yè)學(xué)會(huì)AMA: American Medical Association; ACP: American College of Physicians; 5. 教育機(jī)構(gòu)AAMC: Association of American Medical Colleges; 6. 醫(yī)院中的CIO(Chief Internet Officer)：2022/10/533醫(yī)學(xué)信息學(xué)的從業(yè)人員和機(jī)構(gòu)4. 醫(yī)療護(hù)理專業(yè)學(xué)會(huì)2 About career market, medical informatics is a hot area in the world. You can find job in university, library, research center, information center