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Cost-effectiveness of informatics and health IT: impact on finances and quality of care 信息学和卫生信息技术的成本效益:对财务和护理质量的影响
Pub Date : 2012-05-01 DOI: 10.1136/amiajnl-2012-000964
L. Ohno-Machado
This issue of the journal focuses on an important but often underpublished area of biomedical informatics: the cost-effectiveness of informatics interventions in healthcare. The adoption of electronic health records (EHR) across the USA has been accelerated in response to legislation, but there is still much uncertainty regarding costs as well as short and long-term effects, given the many different ways in which systems are implemented and the high diversity of institutions served. A systematic review by O'Reilly ( see page 423 ) covers economic evaluations of medication management systems, and the author also describes the cost-effectiveness of a clinical decision support system (CDSS) for diabetes in another article ( see page 341 ). Frisse ( see page 328 ) reports on the financial impact of EHR in an emergency department, and Subramanian ( see page 439 ) analyzes the financial impact of a CDSS for renal dose adjustments.The financial aspects are not sufficient to assess the full impact of information systems and informatics interventions. Several articles relate to the impact of systems in the quality of care. Connelly ( see page 334 ) describes …
本期杂志关注生物医学信息学的一个重要但经常未被充分发表的领域:医疗保健信息学干预的成本效益。电子健康记录(EHR)的采用在美国已经加速响应立法,但考虑到系统实施的许多不同方式和服务机构的高度多样性,在成本以及短期和长期影响方面仍然存在很多不确定性。O'Reilly的一篇系统综述(见第423页)涵盖了药物管理系统的经济评估,作者还在另一篇文章(见第341页)中描述了糖尿病临床决策支持系统(CDSS)的成本效益。Frisse(见第328页)报告了急诊部门电子病历的财务影响,Subramanian(见第439页)分析了CDSS对肾脏剂量调整的财务影响。财务方面的问题不足以评价信息系统和信息学干预的全部影响。有几篇文章涉及系统对护理质量的影响。康纳利(见第334页)描述了……
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引用次数: 6
President's column: reflections on AMIA's past 3 years 主席专栏:对AMIA过去三年的反思
Pub Date : 2012-03-01 DOI: 10.1136/amiajnl-2012-000861
E. Shortliffe
AMIA has been the home for informatics professionals for 22 years, and has undergone a remarkable evolution during that time. Its autumn meeting continues to be a vibrant setting for the best in informatics science and practice, building on a tradition that started with SCAMC (the Symposium on Computer Applications in Medical Care) in 1977. Its journal, created in the early 1990s, is now arguably the preeminent journal in our discipline, combining cutting-edge science with important insights from the practice community. I have been honored to serve as AMIA's President during the past 3 of those 22 years and would like to take a moment to reflect on our recent accomplishments while acknowledging our ongoing challenges and exciting opportunities for the future. Among our recent accomplishments:
AMIA已经为信息学专业人士提供了22年的服务,并在此期间经历了显著的发展。它的秋季会议在1977年SCAMC(医疗保健中的计算机应用研讨会)开始的传统的基础上,继续成为信息学科学和实践中最好的一个充满活力的环境。它的期刊创建于20世纪90年代初,现在可以说是我们学科中最杰出的期刊,结合了前沿科学和实践界的重要见解。在过去的22年里,我很荣幸担任AMIA的主席,我想花一点时间来回顾我们最近的成就,同时承认我们正在面临的挑战和未来令人兴奋的机遇。我们最近取得的成就包括:
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引用次数: 0
Use of electronic health record systems for decision support 使用电子健康记录系统进行决策支持
Pub Date : 2011-11-01 DOI: 10.1136/amiajnl-2011-000577
L. Ohno-Machado
This issue of JAMIA completes my first year as the Editor-in-Chief. The extended scope, improved workflow, and increase in editorial staff have allowed us to reduce the median review time to <30 days, even with a nearly 70% increase in original submissions. It is exciting to see an increasing number of authors with diverse backgrounds submitting from many different institutions in numerous countries, reinforcing our intent to reflect the best work of informatics without borders .This issue focuses on electronic health records (EHRs, including medical and personal health records (PHRs)) and Clinical Decision Support Systems (CDSS). The debate on what really constitutes meaningful use of information technology (IT) in healthcare has never been so intense, with informatics professionals playing a central role in designing, implementing, and evaluating relevant information systems. EHRs and CDSS are critical components of meaningful use.An editorial by …
本期《JAMIA》结束了我担任主编的第一年。扩展的范围、改进的工作流程和编辑人员的增加使我们能够将中位审查时间减少到<30天,即使原始提交增加了近70%。令人兴奋的是,越来越多来自许多国家的不同机构的不同背景的作者提交了报告,这加强了我们反映无国界信息学最佳工作的意图。这一期重点关注电子健康记录(EHRs,包括医疗和个人健康记录(PHRs))和临床决策支持系统(CDSS)。在医疗保健中,关于信息技术(IT)的真正意义的使用的争论从未如此激烈,信息学专业人员在设计、实施和评估相关信息系统方面发挥着核心作用。电子病历和CDSS是有意义使用的关键组成部分。……的社论。
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引用次数: 1
AMIA president's column: AMIA's corporate relations activities AMIA会长专栏:AMIA的企业关系活动
Pub Date : 2011-09-01 DOI: 10.1136/AMIAJNL-2011-000469
E. Shortliffe
As I discussed in a recent president's column,1 the roots of AMIA's founding and early identity were largely academic, with an emphasis on informatics and computer science research, both basic and applied. Yet, with the passage of time, yesterday's research has evolved into standard approaches and tools. Today's clinical computing products often reflect research that was carried out in academia or other investigational settings 10, 20, or 30 years ago. Similarly, today's research and development work will be reflected in products a decade or so in the future. This observation emphasizes the ongoing importance of basic and applied research, to fill the pipeline with the ideas and methods that will define the systems of tomorrow.With the evolution of the field, AMIA has necessarily evolved as well, and now embraces a much more diverse membership and, accordingly, different member expectations.2 There is a greater emphasis on applied research and practice, health information technology policy, broad workforce development, and the increasingly successful and mature world of commercial health information technology. In this column I would like to focus on AMIA's increasing interactions with the corporate world and our major efforts to identify and nurture synergies at that interface.AMIA, its members, and the biomedical informatics community have much to contribute to industry and much to gain from healthy relationships with the companies that work in diverse …
正如我在最近的一篇校长专栏中所讨论的那样,AMIA的成立和早期身份主要是学术的,重点是信息学和计算机科学研究,包括基础研究和应用研究。然而,随着时间的推移,昨天的研究已经演变成标准的方法和工具。今天的临床计算产品通常反映了10年、20年或30年前在学术界或其他研究环境中进行的研究。同样,今天的研发工作将在未来十年左右的时间里体现在产品上。这一观察结果强调了基础研究和应用研究的持续重要性,以填补将定义未来系统的思想和方法的管道。随着该领域的发展,AMIA也必须发展,现在拥有更多样化的成员,因此,不同的成员期望更强调应用研究和实践、卫生信息技术政策、广泛的劳动力发展以及日益成功和成熟的商业卫生信息技术世界。在本专栏中,我想重点介绍AMIA与企业界日益增加的互动,以及我们在这一界面上识别和培养协同效应的主要努力。AMIA及其成员和生物医学信息学社区可以为行业做出很大贡献,并从与在不同领域工作的公司的健康关系中获益良多。
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引用次数: 1
American College of Medical Informatics In Memoriam, 2009-2010 美国医学信息学纪念学院,2009-2010
Pub Date : 2011-07-01 DOI: 10.1136/amiajnl-2011-000278
M. Bloom
In this special section, initiated by Past President Joyce Mitchell in the expectation that it will become an ACMI tradition, we memorialize the lives of the fellows who died during her presidency. There were seven. Six were born a generation before the term informatics was coined and more than 50 years before the founding of AMIA. Six lived through World War II, four through the Great Depression. Two of the deceased— Helmuth Orthner and William Yamamoto —were founding fellows of ACMI in 1984, while three— Allan Pryor , Harold Schoolman , and William Schwartz —were elected the following year. Joachim Dudeck and Mario Stefanelli became fellows in 2001. Most of us are aware of the accomplishments of these men (for details, visit the ACMI wiki), but few are familiar with the lives they lived. Here, aided by the reminiscences of families, friends, and colleagues, we celebrate those lives. (An article about Marco Ramoni , who was elected to ACMI posthumously, appears on page 369 of this issue.)Joachim Dudeck, a physician, recognized the medical potential of informatics early in his career and greatly enjoyed the intellectual camaraderie of others of like mind. In fact, he reveled in it. Joachim treasured his colleagues. He loved visiting them, hosting them, opera-going with them, dining with them, wining with them, discoursing with them, and seeing to their comfort. Joachim was a devotee of fine living and a consummately social being. ![Graphic][1] “When I visited for his 65th birthday conference, I was constantly accompanied by someone from his staff to make sure I got from the airport to the hotel, from the hotel to the airport, and everywhere in between. I was a guest at his home for dinner, as well. And he didn't know me from Adam,” recalls Jim Cimino of the National Institutes … [1]: /embed/inline-graphic-1.gif
在这个由前任主席乔伊斯·米切尔发起的特别章节中,我们纪念在她担任主席期间去世的研究员的生命,希望它能成为ACMI的传统。有七个。其中六人在信息学这个术语被创造出来之前的一代人出生,在AMIA成立之前的50多年。6人经历了二战,4人经历了大萧条。两位已故院士——赫尔姆斯·奥斯特纳和威廉·山本——是1984年ACMI的创始成员,而三位——艾伦·普赖尔、哈罗德·斯库曼和威廉·施瓦茨——则是在次年当选的。Joachim Dudeck和Mario Stefanelli在2001年成为研究员。我们大多数人都知道这些人的成就(详情请访问ACMI wiki),但很少有人熟悉他们的生活。在这里,借助对家人、朋友和同事的回忆,我们庆祝这些生命。(一篇关于马可·拉莫尼(Marco Ramoni)的文章出现在本期杂志的第369页,他在死后被选为ACMI成员。)内科医生约阿希姆·杜德克(Joachim Dudeck)在职业生涯的早期就认识到了信息学的医学潜力,并非常喜欢与志同道合的人建立知识分子友谊。事实上,他乐在其中。约阿希姆珍视他的同事。他喜欢拜访他们,招待他们,和他们一起看歌剧,和他们一起吃饭,一起喝酒,一起聊天,照顾他们的舒适。约阿希姆是一个追求美好生活的人,也是一个极爱社交的人。“当我去参加他65岁生日的会议时,他的工作人员一直陪着我,以确保我从机场到酒店,从酒店到机场,以及在这之间的任何地方。我也是他家里的客人。而且他对我一无所知,”美国国家研究院的吉姆·西米诺回忆道
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引用次数: 0
In Memoriam: Darlene P Vian 纪念达琳·P·维安
Pub Date : 2011-07-01 DOI: 10.1136/amiajnl-2011-000352
B. P. McCune, E. Shortliffe
Darlene LeMay Pearson Vian, 78, of Palo Alto, California passed away on February 9, 2011. Ms Vian worked at the Stanford University Medical School for over 37 years. She was Secretary of the Faculty Senate for nearly 10 years. She was … Correspondence to Brian P McCune, Cyladian Technology Consulting, 825 Oak Grove Avenue, Suite D101, Menlo Park, CA 94025-4427, USA; mccune{at}cyladian.com
达琳·勒梅·皮尔森·维安于2011年2月9日去世,享年78岁,住在加州帕洛阿尔托。维安女士在斯坦福大学医学院工作了37年多。她担任教务委员会秘书近10年。Brian P McCune, Cyladian Technology Consulting, 825 Oak Grove Avenue, Suite D101, Menlo Park, CA 94025-4427, USA;mccune在}{cyladian.com
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引用次数: 0
Electronic health records and computer-based clinical decision support: are we there yet? 电子健康记录和基于计算机的临床决策支持:我们做到了吗?
Pub Date : 2011-03-01 DOI: 10.1136/amiajnl-2011-000141
L. Ohno-Machado
Electronic health record systems are in different phases of implementation in the US and abroad. From the perspective of enhancing the quality of healthcare, one of the most attractive features of electronic health record systems is the ability to implement computer-based clinical decision support. However, utilization of two main subsets of electronic health record systems, electronic medical records systems (EMRs) and personal health records systems (PHRs), is still very heterogeneous across institutions and individuals. EMRs are not always perceived as advantageous from the standpoint of individual clinicians, with paper records still being the main form of documentation in several institutions. PHRs are still not well integrated into EMRs and their adoption by patients is not widespread.In this issue, we include articles that focus on how electronic health records are being used and how clinical decision support is making …
在美国和国外,电子健康记录系统正处于不同的实施阶段。从提高医疗保健质量的角度来看,电子病历系统最吸引人的特点之一是能够实现基于计算机的临床决策支持。然而,电子健康记录系统的两个主要子集,电子医疗记录系统(EMRs)和个人健康记录系统(PHRs)的使用,在机构和个人之间仍然是非常不同的。从个体临床医生的角度来看,电子病历并不总是被认为是有利的,在一些机构中,纸质记录仍然是主要的文件形式。phrr仍未很好地整合到电子病历中,患者采用phrr的情况也不普遍。在本期中,我们收录了一些文章,重点介绍了电子健康记录是如何使用的,以及临床决策支持是如何制定的……
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引用次数: 3
American College of Medical Informatics Fellows, 2009 美国医学信息学院研究员,2009年
Pub Date : 2010-05-01 DOI: 10.1136/jamia.2009.002741
D. Masys
In 2009, 11 new fellows were elected to the American College of Medical Informatics, and were inducted into the College at a ceremony held in conjunction with the American Medical Informatics Association conference in San Francisco on November 15, 2009. A brief synopsis of the background and accomplishments of each of the new fellows is provided here, in alphabetical order.Riccardo Bellazzi, PhD![Formula][1] Dr Bellazzi graduated laurea cum laude with a degree in Electronics Engineering from the University of Pavia in Italy, with a concentration in planning and temporal reasoning in medical expert systems. He earned his PhD in Bioengineering at the Milan Politecnico and the University of Pavia, with emphasis on causal models and machine learning applied to clinical monitoring. Dr Bellazzi is currently Associate Professor of Medical Informatics in the Department of Computer Science and Systems (Dipartimento di Informatica e Sistemistica), Universita di Pavia, Pavia, Italy.At the time of his election to the College, Professor Bellazzi was a lecturer in Medical Informatics, Machine Learning, Probabilistic Modeling and Bioinformatics applied to genomics and proteomics. He organized the National School of Bioengineering in 2007 with an educational program focused on Computational Genomics and Proteomics.Dr Bellazzi's research interests range across clinical and molecular domains, including data mining, web-based telemedicine for the management of chronic disease, mathematical modeling of biological systems, and the development of novel bioinformatics methods, particularly in the temporal analysis of gene expression patterns, proteomics and analysis of tissue microarray data. He has authored more than 200 publications, and has been an active contributor to both AMIA and IMIA conferences. He was an AMIA Student Paper award winner for work associated with his PhD thesis in 1992.Dr Riccardo Bellazzi is one of the renaissance figures of our field, whose work is having international impact in the … [1]: /embed/graphic-1.gif
2009年,11位新院士入选美国医学信息学学院,并于2009年11月15日在旧金山举行的美国医学信息学协会会议上正式入会。这里按字母顺序提供了每位新研究员的背景和成就的简要介绍。里卡多·贝拉齐博士!【公式】【1】Bellazzi博士以优异成绩毕业于意大利帕维亚大学(University of Pavia)电子工程专业,专攻医学专家系统的规划和时间推理。他在米兰理工大学(Milan Politecnico)和帕维亚大学(University of Pavia)获得生物工程博士学位,重点研究因果模型和应用于临床监测的机器学习。Bellazzi博士现任意大利帕维亚大学计算机科学与系统系(Dipartimento di Informatica e Sistemistica)医学信息学副教授。在他入选学院时,Bellazzi教授是医学信息学,机器学习,概率建模和生物信息学应用于基因组学和蛋白质组学的讲师。2007年,他组织了国家生物工程学院,并开展了一个专注于计算基因组学和蛋白质组学的教育项目。Bellazzi博士的研究兴趣涵盖临床和分子领域,包括数据挖掘,慢性病管理的基于网络的远程医疗,生物系统的数学建模,以及新型生物信息学方法的开发,特别是基因表达模式的时间分析,蛋白质组学和组织微阵列数据分析。他撰写了200多篇出版物,并一直是AMIA和IMIA会议的积极贡献者。1992年,他的博士论文获得了AMIA学生论文奖。里卡多·贝拉齐(Riccardo Bellazzi)博士是我们这个领域的复兴人物之一,他的工作在国际上产生了影响。[1]:/embed/graphic-1.gif
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引用次数: 0
Special Feature: Presentation of Morris F. Collen Award to Dr. Marion J. Ball 特辑:颁发Morris F. Collen奖给Marion J. Ball博士
Pub Date : 2003-05-01 DOI: 10.1197/jamia.M1327
C. Safran
The Morris F. Collen Award is given each year, when appropriate, to pioneers in the field of medical informatics who best exemplify the teaching and practice of Morrie Collen. This year's recipient, Dr. Marion Ball, has devoted her career to building bridges, trying to bridge the gaps that divided countries and regions, professions and disciplines, colleagues and co-workers, public sector and private entities.Marion Jokl was born in Johannesburg, South Africa in 1940, where her parents had settled in 1933 after leaving Nazi Germany. Her father, Ernst Jokl, was an international leader in sports medicine, and her mother was a sports teacher and corrective therapist. Both of her parents were on the 1928 German Olympic team and her mother was a gold medalist in track and field. In 1951, when the oppressive apartheid policy was proclaimed in South Africa, the family quickly left and returned to Germany. In 1952 they immigrated to the United States. In 1953, at the urging of famed University of Kentucky basketball coach Adolph Rupp, Dr. Jokl joined the medical faculty at the University in Lexington to develop a sports medicine program. Both Marion and her younger brother, Peter, graduated from high school in Lexington. Marion, who had attended eight schools on three continents, completed one year at Northwestern University in Evanston, Illinois, before returning to …
Morris F. Collen奖每年在适当的时候颁发给医学信息学领域的先驱,他们最好地体现了Morrie Collen的教学和实践。今年的获奖者玛丽昂·鲍尔博士致力于建立桥梁,试图弥合国家和地区、专业和学科、同事和同事、公共部门和私营实体之间的差距。玛丽昂·约克尔1940年出生在南非约翰内斯堡,她的父母在1933年离开纳粹德国后定居在那里。她的父亲恩斯特·约克尔(Ernst Jokl)是运动医学领域的国际领袖,母亲是一名体育老师和矫正治疗师。她的父母都是1928年德国奥运会代表队的成员,她的母亲是田径金牌得主。1951年,当南非宣布实行压迫性的种族隔离政策时,这家人很快离开了南非,回到了德国。1952年他们移民到美国。1953年,在著名的肯塔基大学篮球教练阿道夫·鲁普的敦促下,Jokl博士加入了列克星敦大学的医学院,开发了一个运动医学项目。马里昂和她的弟弟彼得都是从列克星敦的高中毕业的。马里昂曾在三大洲上过八所学校,在伊利诺伊州埃文斯顿的西北大学完成了一年的学业,然后回到……
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引用次数: 0
Poster Abstract: Impact of Basic Computerized Prescribing on Outpatient Medication Errors and Adverse Drug Events 摘要:基本计算机处方对门诊用药错误和不良事件的影响
Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1225
T. Gandhi, S. Weingart, A. Seger, D. Seger, J. Borus, E. Burdick, L. Leape, D. Bates
Few data exist about the impact of computerized prescribing systems on outpa- tient medication errors (MEs) and adverse drug events (ADEs). We compared the rates of MEs and ADEs in handwritten sites versus sites with basic computerized prescribing. These systems reduced ME rates but did not significantly reduce ADE rates. Failure to monitor accounted for a large per- centage of preventable ADEs. More advanced computerized prescribing systems with decision sup- port and monitoring functions may be necessary to reduce outpatient ADE rates.
关于计算机化处方系统对门诊用药错误(MEs)和药物不良事件(ADEs)影响的数据很少。我们比较了手写站点与基本计算机化处方站点的MEs和ADEs的发生率。这些系统降低了ME率,但没有显著降低ADE率。在可预防的不良事件中,未能监测占很大比例。更先进的具有决策支持和监测功能的计算机化处方系统可能是降低门诊ADE率所必需的。
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引用次数: 6
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J. Am. Medical Informatics Assoc.
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