Download PDF
Methods Inf Med 1983; 22(03): 124-130
DOI: 10.1055/s-0038-1635429
Original Artical
Schattauer GmbH

A Comprehensive Model for Medical Information Processing

Ein Umfassendes Modell Zur Verarbeitung Medizinischer Information
J. H. Van Bemmel
1   (From the Dept. of Medical Informatics, Free University Amsterdam)
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2018 (online)

    Permissions and Reprints

At first sight, the many applications of computers in medicine—from payroll and registration systems to computerized tomography, intensive care and diagnostics—do make a rather chaotic impression. The purpose of this article is to propose a scheme or working model for putting medical information systems in order. The model comprises six »levels of complexity«, running parallel to dependence on human interaction. Several examples are treated to illustrate the scheme. The reason why certain computer applications are more frequently used than others is analyzed. It has to be strongly considered that the differences in complexity and dependence on human involvement are not accidental but fundamental. This has consequences for research and education which are also discussed.

Auf den ersten Blick machen die vielen Anwendungsmöglichkeiten des Computers in der Medizin — von Gehaltsliste und Registrierungssystemen bis zur Computertomographie, Intensivstation und Diagnostik — einen ziemlich chaotischen Eindruck. Ziel dieses Artikels ist es, ein Schema oder Arbeitsmodell vorzuschlagen, um medizinische Informationssysteme zu ordnen. Das Modell umfaßt sechs »Ebenen der Komplexität«, die parallel zur Abhängigkeit von menschlichem Eingreifen laufen. Verschiedene Beispiele werden abgehandelt, um das Schema zu erläutern. Der Grund, warum bestimmte Computeranwendungen häufiger verwendet werden als andere, wird analysiert. Es muß definitiv berücksichtigt werden, daß die Unterschiede in Komplexität und Abhängigkeit von menschlicher Einflußnahme nicht zufällig auftreten, sondern grundlegend sind. Dieser Umstand zeitigt Folgen für Forschung und Bildung, die ebenfalls erörtert werden.

Key-Words

Model - Complexity - Interaction - Education - Computer

Schlüssel-Wörter

Modell - Komplexität - Eingreifen - Bildung - Computer
 

  • References

  • 1 Albisser A. M.. Devices for the control of diabetes mellitus. Proc. IEEE 1979; 67: 130S-1320.
    PubMedGoogle Scholar
  • 2 Barker A. R.. Scope and limitations of a mini-based centralized HIS. In Lindberg D. A. B., Kaihara S.. Eds MEDINFO 80 pp 505-509 Amsterdam: North-Holland 1980;
    PubMedGoogle Scholar
  • 3 Barlow J. S.. Computerized clinical electroencephalography in perspective. IEEE Trans. bio-med. Eng. BME 1979; 26: 377-391.
    PubMedGoogle Scholar
  • 4 Barnett G. O., Justice N. S., Somand M. E., Adams J. B., Waman B. D., Beaman P. D., Parent M. S., Deusen F. R., van Greenlie J. K.. COSTAR—A computer-based medical information system for ambulatory care. Proc. IEEE 1979; 67: 1226-1237.
    CrossrefPubMedGoogle Scholar
  • 5 Bemmel J. H.van. The role of computers in cardiology and clinical physiology. In Shires D. B., Wolf H. K. (Eds) MEDINFO 77 pp 819-827 Amsterdam: North-Holland 1977;
    PubMedGoogle Scholar
  • 6 Bemmel J. H.van. Strategies and challenges in biomedical pattern recognition. In Fu K. S., Pavlidis T.. (Eds): Biomedical Pattern Recognition and Image Processing, pp 13-26 Dahlem Workshop Reports, Life Sciences, Vol. 15. Weinheim: Verlag Chemie 1979
    PubMedGoogle Scholar
  • 7 Bemmel J. H.van. The system behind medical computer applications. In Lindberg D. A. B., Kaihara S.. (Eds) MEDINFO 80 pp 353-357 Amsterdam: North-Holland 1980;
    PubMedGoogle Scholar
  • 8 Bemmel J. H.van. Status and analysis of medical computing in the Netherlands. Med. Inform 1983; 8: 95-107.
    PubMedGoogle Scholar
  • 9 Bemmel J. H.van. Inleiding Medische Informatica. Utrecht: Bohn, Scheltema en Holkema 1981
    PubMedGoogle Scholar
  • 10 Bemmel J. H.van. Recognition of electrocardiographic patterns. In Krishnaiah P. R., Kanal L.. (Eds) Handbook of Statistics Vol. 2, pp 501-526 Amsterdam: North-Holland 1982;
    PubMedGoogle Scholar
  • 11 Bemmel J. H.van. Stages in biological signal processing. In Ingram D., Block R.. (Eds) Mathematical Methods in Medicine. New York: Wiley 1983. (in print).
    Google Scholar
  • 12 Bemmel J. H. van, Willems J. L.. (Eds) Trends in Computer-Processed Electrocardiograms. Amsterdam: North-Holland 1977
    PubMedGoogle Scholar
  • 13 Budinger T. F.. Nuclear medicine imaging. In Enlander D.. (Edit.) Computers in Laboratory Medicine, pp 102-129 New York: Academic Press 1975;
    PubMedGoogle Scholar
  • 14 Budinger T. F.. Computed tomography. In Fu K. S., Pavlidis T.. (Eds) Biomedical Pattern Recognition and Image Processing, pp 179-212 Dahlem Workshop Reports, Life Sciences, Vol. 15. Weinheim: Verlag Chemie 1979
    PubMedGoogle Scholar
  • 15 Collen M. F.. (Edit.) Hospital Computer Systems. New York: Wiley 1974
    PubMedGoogle Scholar
  • 16 Cox J. R., Nolle F. M., Arthur R. M.. Digital analysis of the EEG, the blood pressure wave and the ECG. Proc. IEEE 1972; 60: 1137-1164.
    CrossrefPubMedGoogle Scholar
  • 17 Dombal F. T.de. Computer diagnosis of abdominal pain. Brit. med. J 7972 II 9-13.
    PubMedGoogle Scholar
  • 18 Drets M. F.. BANDSCAN—A computer program for online scanning of human banded chromosomes. Comput. Progr. Biomed 1978; 8: 283-294.
    CrossrefPubMedGoogle Scholar
  • 19 Dumermuth G.. Digital processing of bioelectric data in clinical neurophysiology. In Shires D. B., Wolf H. K.. (Eds) MEDINFO 77 pp 811-818 Amsterdam: North-Holland 1977
    PubMedGoogle Scholar
  • 20 Gelsema E. S., Landeweerd G. H.. White blood cell recognition. In Krishnaiah P. R., Kanal L.. (Eds) Handbook of Statistics Vol. 2, pp 595-607 Amsterdam: North-Holland 1982;
    PubMedGoogle Scholar
  • 21 Grémy F.. Information and medical methodology: Random reflections about clinical data bases. Med. Inform 1982; 7: 85-91.
    PubMedGoogle Scholar
  • 22 Groth T.. Biomedical modelling. In Shires D. B., Wolf H. K.. (Eds) MEDINFO 77, pp 775-784 Amsterdam: North-Holland 1977;
    PubMedGoogle Scholar
  • 23 Hasman A.. Computers in radiotherapy. CRC Reviews 1983 acc. for publ
    PubMedGoogle Scholar
  • 24 Holt J. H., Barnard A. C. L., Lynn M. S.. The study of the human heart as a multiple dipole source. Circulation 1969; 40: 687-710.
    CrossrefPubMedGoogle Scholar
  • 25 Julesz B.. Experiments in the visual perception of texture. Sci. Amer 1975; 232: 34-43.
    PubMedGoogle Scholar
  • 26 Kanal L. N.. Patterns in pattern recognition. IEEE Trans. Inform. Theor. IT 1974; 20: 697-722.
    PubMedGoogle Scholar
  • 27 Klig V.. Biomedical applications of microprocessors. Proc. IEEE 1978; 66: 151-161.
    CrossrefPubMedGoogle Scholar
  • 28 Lindberg D. A. B., Kaihara S.. (Eds) MEDINFO 80. Amsterdam: North-Holland 1980
    PubMedGoogle Scholar
  • 29 Lodwick G. S., Tully R. J., Marktvee C. R.. Missouri automated radiology system. A dynamic, interactive, diagnostic and management system for radiant images. J. med. Syst 1977; 1: 237-250.
    PubMedGoogle Scholar
  • 30 Ludwig D.. Mathematical models for the spread of epidemics. Comput. Biol. Med 1973; 3: 137-139.
    CrossrefPubMedGoogle Scholar
  • 31 Lusted L. B.. Clinical decision making. In Dombal F. T., de F.Grémy. (Eds) Decision Making and Medical Care, pp 77-99 Amsterdam: North-Holland 1976
    PubMedGoogle Scholar
  • 32 McCorduck P.. Machines Who Think. San Francisco: Freeman 1979
    PubMedGoogle Scholar
  • 33 Mellner C, Selander H., Wolodarski J.. The Karolin-ska Hospital Information System. Meth. Inform. Med 1974; 13: 125-140.
    PubMedGoogle Scholar
  • 34 Miller R. A., Pople H. E., Myers J. D.. INTERNIST-I—An experimental computer-based diagnostic consultant for general internal medicine. New Engl. J. Med 1982; 307: 468-477.
    CrossrefPubMedGoogle Scholar
  • 35 Nudelman S., Fisher H. D., Frost M. M., Capp M. P., Ovitt T. W.. A study of photoelectronic-digital radiology. Parts I—III. Proc. IEEE 1982; 70: 700-727.
    PubMedGoogle Scholar
  • 36 Pavlidis T.. Structural Pattern Recognition. New York: Springer 1977
    PubMedGoogle Scholar
  • 37 Pronk R. A. F.. EEG Processing during Cardiac Surgery. Thesis. Amsterdam: Free University 1982
    PubMedGoogle Scholar
  • 38 Pryor T. A., Morgan J. O., Clark S. J.. HELP—A computer system for medical decision making. Computer 1975; 8: 34-38.
    PubMedGoogle Scholar
  • 39 Rumelt M. B.. Microcomputers in clinical ophthalmology. In Greenfield R. H., and Colenbrander A.. (Eds) Computers in Ophthalmology, pp 39-43 New York: IEEE Press 1978;
    PubMedGoogle Scholar
  • 40 Sauter K.. Data bases in medical information systems. In Lindberg D. A. B., Kaihara S.. (Eds) MEDINFO 80, pp 444-452 Amsterdam: North-Holland 1980;
    PubMedGoogle Scholar
  • 41 Schutte F., Bemmel J. H.van, Veth A. F., 1 Wooed H.van der. Educational aspects in medical informatics. In Anderson J.. (Edit.) Medical Informatics Europe 78, pp 330-337 Lecture Notes in Medical Informatics, Vol. 1. Berlin: Springer 1978
    PubMedGoogle Scholar
  • 42 Sheppard L. C.. The computer in the care of critically ill patients. Proc. IEEE 1979; 67: 1300-1306.
    PubMedGoogle Scholar
  • 43 Shortliffe E. H.. Computer Based Medical Consultations, MYCIN. Amsterdam: North-Holland 1976
    PubMedGoogle Scholar
  • 44 Shortliffe E. H.. Knowledge engineering for medical decision making. Proc. IEEE 1979; 67: 1207-1224.
    CrossrefPubMedGoogle Scholar
  • 45 SNOMED: Systematized Nomenclature of Medicine. Chicago: College of American Pathologists. 1979
    PubMedGoogle Scholar
  • 46 SNOP: Systematized Nomenclature of Pathology. Chicago: College of American Pathologists. 1975
    PubMedGoogle Scholar
  • 47 Stone D. A.. The Loma Linda University computerized radiology information system. In Sixth Conference on Computer Applications in Radiology, pp 380-386 New York: IEEE Press 1979;
    PubMedGoogle Scholar
  • 48 Terdiman J.. A micro/minicomputer-based distributed data processing system for medical applications. In Abe, H. (Edit.): MEDIS 78, pp 508-511 Osaka: The Medical Information System Development Center 1978;
    PubMedGoogle Scholar
  • 49 Trussell M. J.. Processing of X-ray Images. Proc. IEEE. 1981; 69: 615-617.
    PubMedGoogle Scholar
  • 50 Tsai M. J.. Automatic classification of Spirometric data. IEEE Trans. bio-med. Eng. BME 1979; 26: 293-298.
    PubMedGoogle Scholar
  • 51 Veth A. F. L.. Modelling the Foetal Circulation. Thesis. Amsterdam: Free University 1976
    PubMedGoogle Scholar
  • 52 Wartak J.. Computer program for pattern recognition of ECG’s. Comput. biomed. Res 1970; 3: 344-374.
    CrossrefPubMedGoogle Scholar
  • 53 Weed L. L.. Medical Records, Medical Education and Patient Care. Chicago: Case Western Univ. Press 1971
    PubMedGoogle Scholar
  • 54 Willems J. L., Pipberger H. V.. Arrhythmia detection by digital computer. Comput. biomed. Res 1972; 5: 263-278.
    CrossrefPubMedGoogle Scholar
  • 55 Wist A. O., Horowitz R. E., Megargle R.. Computers in the clinical laboratory. In Schwartz M. D.. (Edit.) Applications of Computers in Medicine, pp. 254-267 New York: IEEE Press 1982
    PubMedGoogle Scholar
  • 56 Zahniser D. J.. The development of a fully automated system for the prescreening of cervical smears. Thesis. Nijmegen 1979
    PubMedGoogle Scholar