# 醫學資訊概論1.The Science and the Pragmatics

[簡報在這裡](https://elearn2.fju.edu.tw/course/234105/learning-activity#/1226892)
::: spoiler 目錄
[TOC]
:::
## 小考題目及解答:
- 選擇題
1. Which area of biomedical informatics aims to(目的、旨在) solve the informatics of "molecular(分子) and cellular(細胞) processes,such as gene sequences and maps"?
- [X] Bioinformatics
- [ ] image informatics
- [ ] clinician informatics
- [ ] public health
2. Which biomedical informatic aims to study the issues of medical image production, storage, identification, analysis, and so on?
- [ ] clinician informatics
- [ ] public health informatics
- [ ] biomedical informatucs
- [X] image informatics
3. Which one of biomedical informatics aims to maintain and promote the health of populations(人口), such as infectious(傳染性) or chronic(慢性) disease surveillance(監測) and prevention(預防)?
- [ ] clinical informatics
- [X] public health informatics
- [ ] biomedical informatics
- [ ] imaging informatics
4. Which biomedical informatic majorly provides(主要提供) the needs of data, information and knowledge for the research and development of COVID-19 vaccine?
- [ ] clinical informatics
- [ ] public health informatics
- [X] biomedical informatics
- [ ] imaging informatics
5. Which biomedical informatic majorly provide(主要提供) the trial, data collection after trial, and knowledge regarding to the vaccine trial(疫苗試驗) of COVID-19 in a medical institution such as the hospital of Fu Jen U. ?
- [X] clinicial informatics
- [ ] public health informatics
- [ ] biomedical informatucs
- [ ] imaging informatics
6. Which contains observation and data by a physician or a healthcare person for recording patient medical and health data?
- [X] Electronic health record
- [ ] Computer medical record
- [ ] Electronic medical record
7. Which technique is used to store medical record to comply with law or regulation?
- [ ] Internet
- [ ] electronic data exchange
- [X] digital signature
- [ ] database
8. 下列哪一種病人紀錄需要達到病人資料隱私、資料安全及數位簽章的要求?
- [ ] automated medical record
- [ ] Computerized medical record
- [X] Electronic medical record
9. Biomedical informatic is an interdisciplinary field(跨學科之領域). Which one is not its interdisciplinary field mentioned in our course handout(課程講義)?
- [ ] computer science
- [X] natural science
- [ ] genetics
- [ ] clinical medicine
10. Internet(互聯網、網際網路)起始是在什麼年代美國國防部資助建立之ARPANET?
- [X] 1970s
- [ ] 1980s
- [ ] 1990s
- [ ] 2000s
11. 醫療機構間醫療及健康資訊的銜接與交換，必須賴下列何種機制的建立方可有效達成?
- [ ] 標準化介面
- [ ] 標準化文件格式
- [ ] 共通網路平台與基礎
- [X] 以上皆是
12. 下列何者非屬近代醫院資訊系統之核心系統?
- [ ] 電子病歷系統
- [ ] 醫療資訊系統
- [ ] 行政管理系統
- [X] 以上皆非
13. 哪一項不屬於生物醫學資訊應用及研究範圍?
- [ ] 理論及實務應用模型的建構
- [ ] 生物醫學資訊的處理(manipulation)
- [ ] 生物醫學資訊應用系統的建立、使用與評估
- [X] 以上皆非(即都屬於)
- 申論題
1. Biomedical Informatics所包含的四個領域其應用與研究。

- Biomedical informatics--->從微觀生物角度進行研究
- Image informatics--->建構醫療資訊模型
- Clinical informatics--->臨床數據分析
- Public health informatics--->預防及監測疾病發生

2. 從紙本病歷進展至完整的電子病歷，需經過四個階段性發展。請分別說明每階段的要件為何?

- (第一階段)電腦化(自動化)的醫療紀錄->將原有的平面紙張紀錄，修正設計為電腦化的紀錄
- (第二階段)數位化的醫療紀錄->病歷資料完全以電子媒體檔案表示
- (第三階段)電子化的醫療紀錄->無紙化作業，提供醫療人員診斷及治療上的建議(==為電子病例實施的基本要求==)
- (第四階段)電子化的病人紀錄->重視個人隱私、資料安全，需醫療人員診療之電子簽章(醫療界稱此為==電子病歷==)
- (第五階段)電子化的健康紀錄->將電子病歷做到個人化的健康紀錄(==為電子病歷實施的終極目標==)
- 可參考本篇[醫學資訊概論1.The Science and the Pragmatics](/EvbVbTXOTwyT2rWBv0y0fQ) "電子病歷的發展進程"

3. 請用一可被理解的圖示，簡要說明何謂"A learning health care system"的內涵及功效?
Order-Entry Systems(醫囑錄入系統)
Decision-Support Systems(決策輔助系統)

## Learning Objective

:::spoiler In Biomedical and Clinical
- Why is information and knowledge management importent
- How we expect the integrated of information management environments
- meaning of terms
- How has the development of computing technologies and the Internet changed the nature of it
- Why should health professionals and students learn about it
:::

## Information Revolution

### Revolution
- 1940s, the first computer
- 1950s, dramatic effects on clinical practice
- presently, mobile devices with wireless connectivity
- computers (...and more) are planning for the new health care environments

### Integrated Access to Clinical Information
- The heart of the evolving integrated environments lies on an **E**lectronic **H**ealth **R**ecord
- computational tools assist
- patient-care matters
- direct entry of medical orders
- healthcare-related decision-support functions
- administrative and financial
- tracking of patients
- supporting personnel functions
- managing the payroll, research and procedures, performing quality assurance
- providing access to drug information databases
- document-management, knowledge management software

### 電子病歷的實施進程
- 電腦化/自動化的醫療紀錄(**C**omputerized /Automated **M**edical **R**ecord)
- 由紙張轉為電腦
- 數位化醫療紀錄(**D**igitalized **M**edical **R**ecord)
- 以==電腦媒體==檔案呈現，不將實體病例傳遞
- 電子化醫療紀錄(**E**lectronic **M**edical **R**ecord)
- 提供診斷及治療上建議
- 電子化病人紀錄(**E**lectronic **P**atient **R**ecord)
- 重視個人隱私及資料安全，需==電子簽章==
- 電子化健康紀錄(**E**lectronic **H**ealth **R**ecord)
- 個人化的健康紀錄

### Adventages of EHR or EMR
- For management and quality control
- For sharing information
- For reducing the cost to maintain medical records and regular operations
- For study and research
- To ensure compliance with a research protocol(rules and conventions)

## Communications Technology and Health Data Integration

### Growth of the Internet
- 1968-1969, 資金贊助 by the **A**dvanced **R**esearch **P**rojects **A**gency of美國國防部==ARPANET==
- 1980s, **N**ational **S**cience **F**oundation took over the ARPATNET of ==backbone network==
- 1990, World Wide Web(WWW)
- Today has over 1 billion users

### influence
- Internet become a major part of medicine and health
- Enhancing patients to gain their health care providers and clinical data
- Disease Surveillance
- HIN(Health Information Network)
- Data from EHRs are pooled in regional and national surveillance databases(CDC)
- A Current and Future Vision of Surveillance Databases

### The critical and practical to pool and deliver data over the internet
- identification and authentication of individuals
- privacy
- data protection
- **H**ealth **I**nsurance **P**ortability and **A**ccountability **A**ct
- Standards for data transmission and sharing and definition
- HL7
- XML
- SNOMED
- LOINC
- Quality control and error checking
- Establishment of clinical database
- summary information can flow back to providers to enhance their decision making at the **p**oint **o**f **c**are
- support the creation of evidence based guidelines or clinical research protocols

### Learning health care system

## Government steps in
- USA
- 2004 ,President Bush of the USA called for universal implementation of electronic health records (EHR) within 10 years
- **H**ealth and **H**uman **S**ervices(如我國之衛福部)was similarly supportive and in the National Coordinator for Health Information Technology (shortened simply to ONC)
- The topic of EHRs subsequently became a hot talk in ONC
- TW
- 民國93年10月開始規劃 「國民健康資訊建設計畫（**N**ational **H**ealth **I**nformatics **P**roject)
- 民國96年8月14日核定通過
- 民國98年Established Taiwan’s EMR exchange center 以利醫療機構間互通與分享
- 民國99年在衛生福利部轄下成立臨時性專案推動辦公室

## Defining Biomedical Informatics
- name
- 1960s, uncertain
- 1970s,
- medical computer science
- biomedical computing
- biocomputation
- 1980s, French term of "informatique", English began to use “medical informatics”
- late 1980s, medical informatics widely use
- today ==**B**io**m**edical **I**nformatics (BMI)==
:::info

- Four applied domain of Biomedical Informatics
- **Bioinformatics**
- molecular and cellular processes
- such as gene sequences and maps
- **Imaging informatics**
- tissues and organs
- such as radiology imaging system
- **Clinical informatics**
- clinicans and patients
- including applications of nursing, dentistry, and other clinical specialties
- **Publichealth informatics**
- populations
- such as disease surveillance
:::
> 其實這整篇只要看上面這塊就好...[name=BluePumpkin]

###### tags: `Biomedical Informatics` `110` `2021`

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