Lékařská informatika


Popis situace

Lékařskou informatiku lze považovat za nejperspektivnější technologicky orientovaný studijní obor, protože spojuje dvě nejintenzívněji se rozvíjející odvětví. S postupem doby dochází ke:

Jednotlivé složky nového trendu v lékařské informatice se již vyvíjejí a živelně spějí k jeho úplné realizaci:
  • Technologie Internetu, databází a fultextu jsou již zvládnuty.
  • Technologie znalostních databází a umělé inteligence jsou v prudkém vývoji (v oboru medicíny viz UMLS).
  • Lingvistika je rovněž v prudkém vývoji, postupně spěje ke sjednocení se znalostními databázemi a umělou inteligencí (viz WordNet + SUMO). Právě ona je klíčem k úspěchu, protože umožní neomezenou komunikaci v celém systému.
  • Konkurenční výhoda

    Současná situace v ČR je výjimečně příznivá pro realizaci velkého pokroku v lékařské informatice, protože všechny potřebné realizační složky (lidé i technologie) jsou zde k disposici a to ve špičkové kvalitě:


    Návrh na zavedení studijního oboru

    Zavést studijní obor "Lékařská informatika" koncipovaný ve smyslu výše popsaném, tedy moderněji, než na jiných školách. Očekávané rysy:

    V oboru by byl volně začleněn i přemět "Management ordinace" s kapitolami:

    Definice (nalezeny na Google dotazem "define: medical informatics") Synonyma Odkazy v ČR Odkazy na studium v ČR


    IZIP    Celkově je IZIP hodnocen:    Návrh:

    MedlinePlus® Connect
    http://medlineplus.gov/connect



    Mycin
    http://en.wikipedia.org/wiki/Mycin



    Google Health končí, zájem prý nebyl tak velký - link

    Po třech letech provozu bylo oznámeno, že služba Google Health bude zrušena. Netěšila se prý takovému uživatelskému zájmu, který by si Google představoval. Řadí se tak mezi další služby Googlu, které vzbuzovaly velké očekávání, ale pro malý zájem nakonec byly odstaveny. Google Health poběží do 1. ledna 2012. Další rok si pak odsud budou moci uživatelé ještě stáhnout svá data.

    Připomeňme si, že Google Health měla být služba kde by si uživatelé mohli shromažďovat informace o svém zdravotním stavu různého charakteru: zadávat jakými nemocemi trpí, jaké alergie mají, které léky užívají, jaké rehabilitační procedury absolvují atd. K tomu Google přidal doplňky typu hledání lékařů a zdravotnických zařízení.



    MS HealthVault Developer Center
    http://msdn.microsoft.com/en-us/healthvault/


    IBM: Chytřejší zdravotní péče
    http://www.ibm.com/smarterplanet/cz/cs/healthcare_solutions/ideas/index.html
    http://www.pcpcc.net/content/joint-principles-patient-centered-medical-home?ca=content_body - Patient Centered Medical Home

    http://www.ibm.com/smarterplanet/cz/cs/food_technology/ideas/index.html?re=sph - Chytřejší potraviny



    http://www.reuters.com/article/healthNews/idUSTRE57J21J20090820

    U.S. grants $1.2 billion for electronic health records

    Thu Aug 20, 2009 3:06pm EDT

    By Debra Sherman

    CHICAGO (Reuters) - The U.S. government announced grants of almost $1.2 billion on Thursday to help hospitals and health care providers establish and use electronic health records.

    The grants include $598 million to set up some 70 health information technology centers to help health care institutions acquire electronic health record systems and $564 million to develop a nationwide system of health information networks, Vice President Joe Biden's office said in a statement.

    The funds are aimed at helping physicians and hospitals adopt electronic medical records and at building an exchange to move health information among various healthcare agencies, Health and Human Services Secretary Kathleen Sebelius said on a conference call.

    "This is just the first wave of resources invested in health technology aimed at transforming our paper-driven system to an electronic system over the next several years," said Sebelius, who was in Chicago to unveil the grants with Biden.

    She said that expanding the use of electronic medical records would be "fundamental to reforming" the system and that broad adoption could help reduce medical errors, improve quality and make the entire system more efficient.

    National Coordinator for Health IT David Blumenthal said these funds will likely be granted in three cycles over the course of 2010. Blumenthal, who was also on the call taking questions, said he did not know what hospitals or physician groups would seek government funds, but expects those that have been at the forefront of using technology to apply.

    The grants will be funded by the American Recovery and Reinvestment Act of 2009 and be made available in 2010, the statement said.

    The Obama administration has made the overhaul of the $2.5 trillion U.S. healthcare system a centerpiece of its domestic agenda.

    Providers of electronic medical record software and solutions include Cerner Corp, McKesson Corp, athenahealth Inc, Eclipsys Corp, Quality Systems Inc and Allscripts Misys Healthcare Solutions Inc.

    Michael Cherny, an analyst with Deutsche Bank Securities, said all providers stand to benefit from this far-reaching effort expand the electronic health system. In afternoon trading, their stocks were mostly a little higher, with Quality Systems showing the biggest gain, about 1.8 percent.

    Andrew Rocklin, a principal at Booz & Co, said shares in these companies are unlikely to rise much until hospitals and physician groups start to see some success and savings tied to the transition.

    "That will take time," Rocklin said.

    (Reporting by Debra Sherman, editing by Gerald E. McCormick)

    http://www.reuters.com/news/globalcoverage/healthcarereform


    Why we must invest in electronic medical records - odkaz

    OPEN FORUM
    William H. Frist
    Sunday, July 24, 2005

    At a Department of Veterans Affairs Medical Center just a few miles from my office in the United States Capitol, visitors can see the future of American medicine. Sitting at an ordinary desktop computer, Dr. Ned Evans hits a few keys on the keyboard and clicks his mouse a few times. Sample patient data spill out: X-ray images, lab notes and blood-pressure numbers. "Everything I might want, everything I need, I can see right here," he says. "It's a seamless part of life. It lets me do just about everything better."

    And when the New England Journal of Medicine used 11 measures to compare VA patients treated in the VA's own hospitals with Medicare patients treated in a mixture of private and public hospitals, the VA's patients were in better health and received more of the treatments professionals believe they should. According to the VA's own medical professionals, a computer system called Vista is the key to their success. "I'm proud of what we do here, but it isn't that we have more resources," explains Stanford Garfunkle, the director of the Washington VA Medical Center. "The difference is information."

    While the VA has invested a lot in its computer system, most hospitals, clinics and doctors haven't invested enough. Among America's important economic sectors, health care spends the smallest percentage of its revenue on information technology -- only about 3 percent. Industries such as banking spend 10 percent or more.

    Our underinvestment in health-information technology has dire consequences for all Americans. Researchers at Dartmouth University found that America wastes as much as a third of the $1.8 trillion it spends on medical care -- much of the waste comes from disorganization and lack of information. This, in turn, results in orders for unneeded tests, ineffective procedures and simple human error.

    Sometimes our failure to use technology has deadly consequences. Doctors write about 2 billion prescriptions each year but, because of unclear handwriting, some get filled incorrectly; about 7,000 people die each year as a result. Even worse, enormous disparities exist in the quality of health-care patients receive. Members of some ethnic minorities, residents of rural areas and people with low incomes are more likely to have complex health problems than members of other groups yet are less likely to receive appropriate, high- quality care. At least some of the difference is attributable to the lack of good medical records.

    Quite simply, the entire country should have the highest quality care we can afford, along with electronic medical records such as those used by the VA. That's why Sens. Hillary Clinton, D-N.Y., Mike Enzi, R-Wyo., Edward Kennedy, D-Mass., and I are working together to make sure that we do. We've proposed bipartisan legislation that would begin the process of setting up a system that allows data sharing, available everywhere, and protects privacy while rewarding quality.

    To begin with, Americans should be able to access their records wherever they go. This ranks as a high priority, because existing systems like the VA's are useless outside of the organizations that build them. If two travelers get into a car accident a thousand miles from home, the emergency room they arrive at should be able to access a system that can bring up their full medical history, their allergies and information about the medications they take. Right now, in fact, outdated government regulations stop many hospitals from setting up systems that would do this.

    Making such a system available everywhere, however, will take a lot more than computers, satellites and fiber-optic cable. It will also require the government to work with hospitals and doctors to create common terminology for medical records and a common data format for sharing them. Because the federal government pays more medical bills than anyone else, its own health-insurance programs -- Medicare, Medicaid, the Indian Health Service and the State Children's Health Insurance Program -- should help take the lead in promoting the use of electronic health records for beneficiaries.

    In addition, my colleagues and I also believe that the system should include legal and technological safeguards to ensure that, except in life-or- death emergency situations, nobody can access a patient's medical records without permission from that patient.

    Finally, we should use the improved data we collect to reward quality care. Doctors and hospitals who do a good job should receive extra pay from both public and private insurers and those who experience problems should get help to improve. This should begin to erase many of our nation's disgraceful health-care disparities by raising the quality of care for everyone.

    For far too long, America has invested too little in health information technology. It's time for a change. Patients around the country need to become full partners in their own health care and drive the system along. Electronic medical records will help do that. If we create privacy-protected electronic medical records for every citizen who wants them, we will save money and, most important, we will save lives.



    http://medheadlines.com/2008/02/21/google-and-cleveland-clinic-team-up/

    Google and Cleveland Clinic Team Up
    By MedHeadlines • Feb 21st, 2008 • Category: Lifestyle, MedTech

    Google and the Cleveland Clinic are beginning a pilot project to link the health information for some of clinic’s patients with Google personal health records. The pilot project will last six to eight weeks, and involve less than 10,000 patients.

    The Cleveland Clinic has more than 100,000 patients and many of those are retirees who spend some of the year elsewhere such as Arizona and Florida. And when they go, their medical records don’t follow says Dr. C. Martin Harris, the clinic’s chief information officer.

    The Google personal health record Harris says is a solution to that problem, among others. A person can approve the transfer of information on medical conditions, allergies, medications and laboratory results from the clinic’s computers to a Google personal health record.

    Google’s personal health record is still in development, and it will be introduced publicly and made widely available, after the pilot project is concluded. However, other facilities are ready to jump on board. “This is truly a patient-controlled health record, and that’s a very significant step in the drive toward a more consumer-oriented system of health care,” says Dr. John D. Halamka, chief information officer of the Harvard Medical School.



    http://www.nytimes.com/2008/05/20/technology/20google.html?ref=health

    Google Offers Personal Health Records on the Web
    By STEVE LOHR, Published: May 20, 2008

    After a year and half of development, Google began offering online personal health records to the public on Monday.

    Google Inc.The Internet search giant’s service, Google Health, at www.google.com/health, is the latest entrant in the growing field of companies offering personal health records on the Web. Their ranks range from longtime online health services like WebMD to the software powerhouse Microsoft to start-ups like Revolution Health.

    The companies all hope to capitalize eventually on the trend of increasingly seeking health information online, and the potential of Internet tools to help consumers manage their own health care and medical spending.

    Google enters the field of personal health records with a leading online brand, deep pockets and a wealth of technical skills. In a two-month trial this year, the Cleveland Clinic found that its patients were eager to use the Google health records.

    The pilot project, limited to 1,600 patients, was quickly oversubscribed, said C. Martin Harris, the Cleveland Clinic’s chief information officer. Dr. Harris also said that when the clinic’s online health records, introduced in 2004, were linked to the Google record the clinic’s records were used more frequently by patients. “It positioned our personal health record more into an activity that they use every day,” Dr. Harris said.

    The Google record, he said, allows the user to send personal information, at the individual’s discretion, into the clinic record or to pull information from the clinic records into the Google personal file.

    The ability of patients to send information, in particular, can be helpful to clinic doctors, Dr. Harris said. For example, if a person sees specialists outside the clinic and receives a drug prescription from an outside doctor, it raises the risk of harmful drug interactions. “Until now, if a patient doesn’t remember to tell me,” he said, “I don’t know about drugs prescribed outside the Cleveland Clinic system.”

    In the Cleveland trial, patients apparently did not shun the Google health records because of qualms that their personal health information might not be secure if held by a large technology company.

    In Google Health, as in the pilot project, the company is not selling advertisements. And what information is shared with doctors, clinics or pharmacies is controlled by the individual, said Marissa Mayer, Google’s vice president of search products.

    More than two dozen companies and institutions announced that they are partners with Google Health, including Walgreens, CVS, the American Heart Association, Quest Diagnostics, Beth Israel Deaconess Medical Center and the Cleveland Clinic. The partnerships are not exclusive arrangements.

    Cleveland Clinic, for example, is also talking to Microsoft. “As these online services become available, we expect to connect to them all,” Dr. Harris said.

    Google Health, Ms. Mayer said, represents a “large ongoing initiative” by the company, which she said she hoped would eventually include “thousands of partners and millions of users.”


    Google health
    http://zpravy.e15.cz/nazory/komentare/david-klimes-realne-potize-virtualniho-zdravotnictvi-711400
    David Klimeš: Reálné potíže virtuálního zdravotnictví
    Komentář

    Publikováno 25.10.2011 7:39

    V listopadu se správní rada Všeobecné zdravotní pojišťovny (VZP) dozví více o majitelích podezřelé firmy IZIP, audity odhalí o nějaké ty stamiliony více promrhaných prostředků, možná vyplují na povrch i nějaké nevypověditelné smlouvy. Pak nastoupí kupecké počty, zda je levnější celý podnik koupit, nebo se od něj zcela odstřihnout (případně koupit, a pak se od něj odstřihnout).
    ilustrační foto

    Jako by se ale kvůli jedné šikovné machinaci dvou europoslanců stále zapomínalo na dekádu nezodpovězenou otázku: Jak by vlastně mělo vypadat v Česku elektronické zdravotnictví? Kauza IZIP je dvojnásobným smrtelným hříchem politiků.

    Ti totiž zkombinovali v celé Evropě viditelné neúspěchy s různými zdravotnickými elektronickými kartami. K tomu však ještě přidali bytostně českou hloupost, když nechali tajemného soukromníka s akciemi na doručitele zařídit si výkonný vysavač eráru. IZIP si na svých stránkách stěžuje na „nepříliš vstřícný postoj exekutivy“ a „neodůvodněnou politizaci“.

    Čtěte také: Šnajdr ustál pokus o odvolání, rada VZP rozhodne o IZIP za tři týdny

    Bez házení klacků pod nohy by prý už dávno projekt přinášel úspory VZP. Pravda je však prozaičtější. IZIP dosud nedokázal nabídnout lékařům, pojišťovnám, ani pacientům smysluplný produkt. Ani nesmyslné finanční pobídky bílé pláště k elektronickým knížkám nepřivedly. V Česku tak vidíme podobný příběh jako například v sousedním Německu.

    Související články

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          Péči o naše pojištěnce zajistíme, uklidňuje šéf VZP
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          VZP nestačí rezervy ani na dva dny, hrozí zpožďování plateb
          Ředitel VZP chce převzít celý projekt IZIP

    Místo IZIP tam mají Gematik. Náklady na tamní zkrachovalou elektronickou kartu se vyšplhaly na 1,7 miliardy eur. Minulý rok raději ministr zdravotnictví projekt pozastavil. A problémy se nevyhnuly ani rakouské obdobě e-card či francouzské Carte Vitale. K tomu ale přičtěme český vynález vše svěřit soukromníkovi, byť zjevně jde o pionýrský projekt, v němž stát potřebuje plnou kontrolu. V zahraničí může ministr či vláda systém zastavit, v Česku však po stamilionech pro soukromníka řešíme případné arbitráže a práva k duševnímu vlastnictví.

    Celosvětové opojení z takzvaného eHealth byznysu zjevně opadá. Vedle států si na něm vylámali zuby i mnozí soukromníci. V červnu tak třeba zkrachoval projekt Google Health, který kromě medicínských záznamů lákal třeba i na plánování životosprávy. Prostě nesehnal dost klientů, ani spolupracujících amerických pojišťoven.

    Krach elektronických zdravotnických knížek v Česku tak stát postavil před rozhodnutí, kudy vlastně dál. Nechat doktory dál papírovat a posílat pacienty s žádankou ke specialistovi? Nebo vybudovat zcela státní systém elektronických knížek přístupný pro všechny pojišťovny? Nebo vše nechat na chystané zostřené soutěži o pacienta mezi pojišťovnami?

    Odpověď na tyto zásadní otázky je za víc, než za ony dvě miliardy promrhané v IZIP.