---
# System prepended metadata

title: 醫學資訊概論1.The Science and the Pragmatics
tags: ['2021', '110', Biomedical Informatics]

---

# 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?
   ![Imgur](https://i.imgur.com/stICI4X.png)
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
![Imgur](https://i.imgur.com/MXclURP.png)

### 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
![Imgur](https://i.imgur.com/DfUxN8Q.png)


## 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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