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Medical Technology / Informatics
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One of the pathology fellowship choices is medical infomatics. But, I don't know where it is offered.
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What does someone do in a residency involving medical informatics?
I mean, the doctors dont design the technology or program the computers. They simply use whatever the engineer/technician has set up for them.
So I'm not understanding why programs would specifically list this as part of the residency. Sure, they USE medical informatics, but whats the big deal about that?
I guess I just dont understand the need for residency training in medical informatics. It takes very minimal training to learn how to use these systems with patients. Its just simple computer data entry and manipulation. Why would you need to devote a significant time learning simple tasks like that?
I mean, the doctors dont design the technology or program the computers. They simply use whatever the engineer/technician has set up for them.
So I'm not understanding why programs would specifically list this as part of the residency. Sure, they USE medical informatics, but whats the big deal about that?
I guess I just dont understand the need for residency training in medical informatics. It takes very minimal training to learn how to use these systems with patients. Its just simple computer data entry and manipulation. Why would you need to devote a significant time learning simple tasks like that?
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Actually, the best programs are built by doctors who can program themselves, since the design loop is much shorter, and has stronger results. Instead of having long meetings trying to paint out a design for a better HL7 compliant system to use on their handhelds, they can parallel process all the aspects out in their mind at design time, and can thing both in the program syntax of how it can execute as well as what the program should do to be best used in the clinic. The doctor who can program can assess and design a thousand thread possibilities in a short time for each aspect of the design and come out with a superior product faster.
There is quite a few doctors who can program, a scan of the papers put out by any large organization such as the IMIA or AMIA will give a glimpse as to what is being done.
A small group of post-graduate training programs that combine informatics research on top of the medicine, for a talented bunch of young doctors, would be very popular looking to improve their training in both aspects.
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So you're saying these doctors actually write code and design computer system hardware like bus interfaces, fiber optics, etc?
Dont they require you to have some kind of background in computer science or engineering then?
Its not like you can just walk into a residency never having written code before and all of a sudden learn how to do stuff with Java, C++, etc.
Dont they require you to have some kind of background in computer science or engineering then?
Its not like you can just walk into a residency never having written code before and all of a sudden learn how to do stuff with Java, C++, etc.
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- Resident [Any Field]
As mentioned before, check out the following for insight into medical informatics:
-www.amia.org
-http://www.cdc.gov/epo/dphsi/informat.htm),
--http://dmi-www.mc.duke.edu/dukemi/program/program.html),
-http://www.nlm.nih.gov/resprog.html and
-http://www.nlm.nih.gov/ep/curr_inst_grantees.html.
Hope that this helps!
-www.amia.org
-http://www.cdc.gov/epo/dphsi/informat.htm),
--http://dmi-www.mc.duke.edu/dukemi/program/program.html),
-http://www.nlm.nih.gov/resprog.html and
-http://www.nlm.nih.gov/ep/curr_inst_grantees.html.
Hope that this helps!
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A fine set of links. And just for fun, one more:
The History of BioWare: The Baulder's Gate games (consistently in the top 5 sellers of recent years) are from BioWare, which was started off as just just a pack of young doctors that liked to program.
For learning to program, it does not require a comp sci degree, not the least of which is that an early slice of comp sci degree is usually spent on learning earlier language before moving up to the present. You can sit down and learn Python in a day. C++ is probably the best since the basic syntax is the foundation for so many others, which would be about 2 weeks. 2 weeks, since 80% of the language one won't ever use; one can just learn the things that are basic, then learn the rest as they are needed. Most doctors have a high IQ, and programming languages by their nature are nothing but pure logic--no eponyms here, things that are an integer are called 'int'.
Some physicians branch into hardware/software integration because of a personal need to improve the electronic devices they use.
The History of BioWare: The Baulder's Gate games (consistently in the top 5 sellers of recent years) are from BioWare, which was started off as just just a pack of young doctors that liked to program.
For learning to program, it does not require a comp sci degree, not the least of which is that an early slice of comp sci degree is usually spent on learning earlier language before moving up to the present. You can sit down and learn Python in a day. C++ is probably the best since the basic syntax is the foundation for so many others, which would be about 2 weeks. 2 weeks, since 80% of the language one won't ever use; one can just learn the things that are basic, then learn the rest as they are needed. Most doctors have a high IQ, and programming languages by their nature are nothing but pure logic--no eponyms here, things that are an integer are called 'int'.
Some physicians branch into hardware/software integration because of a personal need to improve the electronic devices they use.
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roo,
The company you profiled was developed by doctors who had lots of previous experience in computer hardware, software and programming.
But lets face it, not many doctors are very adept at these fields. Only a very small percentage majored in computer science/engineering and I seriously doubt that a very high portion of non tech grads just decided during med school "oh why dont i try to learn C++/Java/Fortran/Basic while i'm here"
While it is true that you can learn the basics of C++ in 2 weeks, you CAN NOT implement a full fledged GUI database with that amount of knowledge and training. There is no way you could program a medical informatics database and distribution system with such minimal exposure. It would take you a good year or more to develop the kind of software programming skills you need to build a medical informatics system from scratch, and thats only for the most techno savvy of people.
I looked at some of the website links, and the way they describe it, these programs are for everybody who has technical interests, not just physicians. You dont need an MD to do medical informatics, and in fact if medical informatics is what you want to do then you are wasting your time with an MD.
All medical informatics is just creating and maintaining data access systems. You dont need the training that comes with an MD to do that. It helps, but its WAY overkill for what you actually need to know medical-wise for implementing these systems.
This topic goes back to my earlier post about doctor's use of technology. Everyday I hear of some doctor that is supposedly "revolutionizing" the field of medicine with technology, when in reality all he/she did was use a device or machine on a patient that was designed/built/tested by non MD personnel.
The company you profiled was developed by doctors who had lots of previous experience in computer hardware, software and programming.
But lets face it, not many doctors are very adept at these fields. Only a very small percentage majored in computer science/engineering and I seriously doubt that a very high portion of non tech grads just decided during med school "oh why dont i try to learn C++/Java/Fortran/Basic while i'm here"
While it is true that you can learn the basics of C++ in 2 weeks, you CAN NOT implement a full fledged GUI database with that amount of knowledge and training. There is no way you could program a medical informatics database and distribution system with such minimal exposure. It would take you a good year or more to develop the kind of software programming skills you need to build a medical informatics system from scratch, and thats only for the most techno savvy of people.
I looked at some of the website links, and the way they describe it, these programs are for everybody who has technical interests, not just physicians. You dont need an MD to do medical informatics, and in fact if medical informatics is what you want to do then you are wasting your time with an MD.
All medical informatics is just creating and maintaining data access systems. You dont need the training that comes with an MD to do that. It helps, but its WAY overkill for what you actually need to know medical-wise for implementing these systems.
This topic goes back to my earlier post about doctor's use of technology. Everyday I hear of some doctor that is supposedly "revolutionizing" the field of medicine with technology, when in reality all he/she did was use a device or machine on a patient that was designed/built/tested by non MD personnel.
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•
But lets face it, not many doctors are very adept at these fields.•
I agree that there is certainly not enough. Which is a very good reason to implement more training in practical medical informatics.
•Only a very small percentage majored in computer science/engineering and I seriously doubt that a very high portion of non tech grads just decided during med school "oh why dont i try to learn C++/Java/Fortran/Basic while i'm here"•
I know of zero that learned Fortran because it is dead in a modern-day scenario. There are 5 in my class of 180 that can code in either C or Java, 4 of which learned while they were here.
•While it is true that you can learn the basics of C++ in 2 weeks, you CAN NOT implement a full fledged GUI database with that amount of knowledge and training.•
Actually one of the best items to learn on is a GUI frontend, since it is rapid and people can see their results quickly. However it is 2001 now, making a GUI database is secondary to wiring it up online instead, at which the student can get an easier ride without the headache of pointers. Macromedia/Allaire Coldfusion is popular (though more pricey than a PHP/ASP), but you can learn enough to wire up an online database in two afternoons (I personally can verify this because I've seen the results at the end of a workshop for the medical professors, who haven't touched the stuff before, but its a simple scripting language, logical syntax, and the things that are actually used are written in a few lines, with all the hard stuff abstracted away). The online database programming course always fills up. Some know some stuff before hand, others come in pretty much cold, with just the basic syntax of HTML. About 3 days should be set aside to learn ANSI SQL though, since that won't ever change: again nothing heavy, just SELECT,FROM,WHERE and a few others: again 80% you will never use, and the extra propreitary stuff just makes it difficult to migrate databases anyways. SQL is actually taught in our first year informatics course so they have that covered already.
Speaking of GUI apps though, first-timers also like Delphi/Kylix for making Windows and Linux apps: a nice gui-based 'hello world' in five minutes. Just drag the components on the form, a line or two of an event handler to set a properties and press a build button. Done. Delphi also ships with integrated database, so just dropping in the wired dropdowns there..a week or so to learn what is needed. Delphi has the drawback of Pascal though, but the object-oriented things are the same regardless.
•There is no way you could program a medical informatics database and distribution system with such minimal exposure. It would take you a good year or more to develop the kind of software programming skills you need to build a medical informatics system from scratch, and thats only for the most techno savvy of people.•
An industry exists in rapid-prototyping software and high level languages now, specifically to shorten the learning curve. Sometimes the software will be non-free, but then again, a doctor's worth per hour is also high, so there is more often a gravitation to high level languages, that don't need a year to learn. Things don't need to be written in assembler any more, computer hardware is at the level that interpreted programs can be run without much noticied difference to a optimized compiled version.
However, 1 year (or better yet spread out over 3 years--in a residency program) could certainly be well-spent improving one's skills, and learning from a mentor in techniques and deployment. Hence the forthcoming of the informatics/medical residency. Most students aren't going to be coming in cold anyways; they will have tried out some programming on their own, found that they like it, and want to train more in that field. This is the same as the other residency options, that the student got an introduction to the field and want to follow that career, and the way that it should be.
•You dont need an MD to do medical informatics, and in fact if medical informatics is what you want to do then you are wasting your time with an MD.•
This misses the critical factor that the physician has an insight into the problem at hand that others with only a technical background don't have. This is why so many of the health service oriented dot-coms failed: there were very skilled technical people creating the software, but it didn't fit the need of what was actually needed in the field.
•All medical informatics is just creating and maintaining data access systems.•
That seems to be a somewhat narrow generalization of medical informatics. Data systems are certainly one important component of the field, but I don't think that covers all the aspects.
•This topic goes back to my earlier post about doctor's use of technology. Everyday I hear of some doctor that is supposedly "revolutionizing" the field of medicine with technology, when in reality all he/she did was use a device or machine on a patient that was designed/built/tested by non MD personnel.•
That seems to be a bit of a generalization also. There are some cases where the physician designs, some cases where the physician is the end user only, and cases some in-between. In all product implementations (not just medical software and hardware) the best people will start to address the problem useing some libraries or components, so that they don't need to spend resources reinventing the wheel, and also to keep the cost of the end product down, since health care costs are so high. There is no reason for me to write a tiff library for a radiology telemedicine app, its been done, just drop it in. Ditto for the digital device, the end cost will be lower if a PC device is used insteed of custom bit of hardware built from scratch for the product. There is little sense in building a new scripting language for the application (though in some cases the physician does anyways), just use a language that exists. Write the software that you want to solve the problem, and enjoy the results.
Best wishes, roo
But lets face it, not many doctors are very adept at these fields.•
I agree that there is certainly not enough. Which is a very good reason to implement more training in practical medical informatics.
•Only a very small percentage majored in computer science/engineering and I seriously doubt that a very high portion of non tech grads just decided during med school "oh why dont i try to learn C++/Java/Fortran/Basic while i'm here"•
I know of zero that learned Fortran because it is dead in a modern-day scenario. There are 5 in my class of 180 that can code in either C or Java, 4 of which learned while they were here.
•While it is true that you can learn the basics of C++ in 2 weeks, you CAN NOT implement a full fledged GUI database with that amount of knowledge and training.•
Actually one of the best items to learn on is a GUI frontend, since it is rapid and people can see their results quickly. However it is 2001 now, making a GUI database is secondary to wiring it up online instead, at which the student can get an easier ride without the headache of pointers. Macromedia/Allaire Coldfusion is popular (though more pricey than a PHP/ASP), but you can learn enough to wire up an online database in two afternoons (I personally can verify this because I've seen the results at the end of a workshop for the medical professors, who haven't touched the stuff before, but its a simple scripting language, logical syntax, and the things that are actually used are written in a few lines, with all the hard stuff abstracted away). The online database programming course always fills up. Some know some stuff before hand, others come in pretty much cold, with just the basic syntax of HTML. About 3 days should be set aside to learn ANSI SQL though, since that won't ever change: again nothing heavy, just SELECT,FROM,WHERE and a few others: again 80% you will never use, and the extra propreitary stuff just makes it difficult to migrate databases anyways. SQL is actually taught in our first year informatics course so they have that covered already.
Speaking of GUI apps though, first-timers also like Delphi/Kylix for making Windows and Linux apps: a nice gui-based 'hello world' in five minutes. Just drag the components on the form, a line or two of an event handler to set a properties and press a build button. Done. Delphi also ships with integrated database, so just dropping in the wired dropdowns there..a week or so to learn what is needed. Delphi has the drawback of Pascal though, but the object-oriented things are the same regardless.
•There is no way you could program a medical informatics database and distribution system with such minimal exposure. It would take you a good year or more to develop the kind of software programming skills you need to build a medical informatics system from scratch, and thats only for the most techno savvy of people.•
An industry exists in rapid-prototyping software and high level languages now, specifically to shorten the learning curve. Sometimes the software will be non-free, but then again, a doctor's worth per hour is also high, so there is more often a gravitation to high level languages, that don't need a year to learn. Things don't need to be written in assembler any more, computer hardware is at the level that interpreted programs can be run without much noticied difference to a optimized compiled version.
However, 1 year (or better yet spread out over 3 years--in a residency program) could certainly be well-spent improving one's skills, and learning from a mentor in techniques and deployment. Hence the forthcoming of the informatics/medical residency. Most students aren't going to be coming in cold anyways; they will have tried out some programming on their own, found that they like it, and want to train more in that field. This is the same as the other residency options, that the student got an introduction to the field and want to follow that career, and the way that it should be.
•You dont need an MD to do medical informatics, and in fact if medical informatics is what you want to do then you are wasting your time with an MD.•
This misses the critical factor that the physician has an insight into the problem at hand that others with only a technical background don't have. This is why so many of the health service oriented dot-coms failed: there were very skilled technical people creating the software, but it didn't fit the need of what was actually needed in the field.
•All medical informatics is just creating and maintaining data access systems.•
That seems to be a somewhat narrow generalization of medical informatics. Data systems are certainly one important component of the field, but I don't think that covers all the aspects.
•This topic goes back to my earlier post about doctor's use of technology. Everyday I hear of some doctor that is supposedly "revolutionizing" the field of medicine with technology, when in reality all he/she did was use a device or machine on a patient that was designed/built/tested by non MD personnel.•
That seems to be a bit of a generalization also. There are some cases where the physician designs, some cases where the physician is the end user only, and cases some in-between. In all product implementations (not just medical software and hardware) the best people will start to address the problem useing some libraries or components, so that they don't need to spend resources reinventing the wheel, and also to keep the cost of the end product down, since health care costs are so high. There is no reason for me to write a tiff library for a radiology telemedicine app, its been done, just drop it in. Ditto for the digital device, the end cost will be lower if a PC device is used insteed of custom bit of hardware built from scratch for the product. There is little sense in building a new scripting language for the application (though in some cases the physician does anyways), just use a language that exists. Write the software that you want to solve the problem, and enjoy the results.
Best wishes, roo
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I agree if you use super high level GUI development environments that are built on text-based languages that you can create full blown applications in days.
Take LabView for example. The engine of Labview compilation is based on C++, but the user doenst need to know a single command in C++ to do Labview. Its completely graphical, so really someone in first grade could do the basic stuff, because all you are doing is dragging icons into a workspace and wiring them together.
But try writing the code for Labview in C++. Thats an ENTIRELY different scope. It would take YEARS to write the Labview source code from scratch using C++. So is someone who is using Labview really writing code in C++? No, of course not.
My point is that you cant just walk up to a computer, start writing in C++ code, and expect to have a GUI system up and running in a day. Even the simplest GUI in C++ takes around 500 lines of code.
What you are talking about is super high level software packages with GUI interfaces that are based on lower level text based languages. I was talking about using text based languages, not GUI development apps. Using GUI development apps IS NOT writing code. IN fact, you arent writing anything, you are just dragging icons and routing them together.
If, as you say, medical professors can learn the basics of medical informatics development in the scope of a single weekend, doesnt it seem like overkill to go to a residency for years devoted to this subject?
Sure, you use some medical knowledge, but its all textbook knowledge than can be found in a library. You certainly dont need to know clinical skills to write programs for databases.
What kind of hardware is done with medical informatics? Are you talking about just buying different components and installing them in pre-existing computer systems, or are you saying that doctors DESIGN computer chips, processors, and other components?
Take LabView for example. The engine of Labview compilation is based on C++, but the user doenst need to know a single command in C++ to do Labview. Its completely graphical, so really someone in first grade could do the basic stuff, because all you are doing is dragging icons into a workspace and wiring them together.
But try writing the code for Labview in C++. Thats an ENTIRELY different scope. It would take YEARS to write the Labview source code from scratch using C++. So is someone who is using Labview really writing code in C++? No, of course not.
My point is that you cant just walk up to a computer, start writing in C++ code, and expect to have a GUI system up and running in a day. Even the simplest GUI in C++ takes around 500 lines of code.
What you are talking about is super high level software packages with GUI interfaces that are based on lower level text based languages. I was talking about using text based languages, not GUI development apps. Using GUI development apps IS NOT writing code. IN fact, you arent writing anything, you are just dragging icons and routing them together.
If, as you say, medical professors can learn the basics of medical informatics development in the scope of a single weekend, doesnt it seem like overkill to go to a residency for years devoted to this subject?
Sure, you use some medical knowledge, but its all textbook knowledge than can be found in a library. You certainly dont need to know clinical skills to write programs for databases.
What kind of hardware is done with medical informatics? Are you talking about just buying different components and installing them in pre-existing computer systems, or are you saying that doctors DESIGN computer chips, processors, and other components?
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Well, I plan to integrate technology to family practice/public health after residency. I'm adept at computers currently, having programmed in BASIC and HTML... but certainly not a real language such as C++. There are already some software out there for individual doctors and their practices. Some offices use them quite efficiently. For hospitals, there are some good electronic medical record systems as well (eg. VA systems). And then there are software for point-of-care research (eg. Inforetriever). Most of these software are written by computer scientists with input from docs. Some software wisely use the computer for integrating data, for example drawing beautiful graphs of lab studies over time. Some are stupidly trying to reproduce the highly inefficient paper chart. The technology is getting there. A few tech-savvy docs are jumping on the bandwagon of technology integration, and I think it's wonderful. I'll still have to graduate from med school and go thru residency before joining the group pushing and advancing computers in medicine. Hopefully by then, a path would have been laid out for me. A residency programs for those of us who are technology-minded as well as health conscious is not a bad idea. But I would agree that 4 years of med school is a bit overkill if the person plans to just design programs after. If the person wants two careers, one programming and one taking care of patients, the person had better go into a residency that adequately trains them to take care of patients (3+ years of patient care, as in every other primary care field). That's my only point, really, that if a doc wants to take care of patients, s/he has got to get adequate training for that. Otherwise, we are certainly smart enough to carry two very distinct and difficult professions.
PS. I don't know of any programs specifically teaching infomatics, but some are requiring Palm Pilot use, some are electronic medical record based, some have faculty who are interested in infomatics, some are affiliated with say a health evaluation sciences school that offers a masters in infomatics. I'm not far enough along in my residency application process to know more details, but that's what I've seen so far.
Holy Tech-talk! C3P0 would be proud.
To respond to your original question, Idon'tknow??, you might consider a residency at a major university that also offers advanced degrees (m.s. or ph.d.)in medical informatics through a computer science, library science, or maybe biomedicalGUIdataC++superJAVAcomputer departments. You might pursue some sort of dual-degree arrangement, if you are a super-human. I know that UC Davis has a strong MI program. At this time, medical informatics for physicians remains a field where training comes on the job, and though life experience. Hopefully, this will change, as it is powerful and exciting stuff.
I always hate to hear medical or nursing staff say "this computer system sucks!". Often they are right - take the time to ask how it could be better.
later.
To respond to your original question, Idon'tknow??, you might consider a residency at a major university that also offers advanced degrees (m.s. or ph.d.)in medical informatics through a computer science, library science, or maybe biomedicalGUIdataC++superJAVAcomputer departments. You might pursue some sort of dual-degree arrangement, if you are a super-human. I know that UC Davis has a strong MI program. At this time, medical informatics for physicians remains a field where training comes on the job, and though life experience. Hopefully, this will change, as it is powerful and exciting stuff.
I always hate to hear medical or nursing staff say "this computer system sucks!". Often they are right - take the time to ask how it could be better.
later.
