Timothy B. Patrick

Physician PDA Use and the HIPAA Privacy Rule

Physicians need better access to information when making patient care decisions. Hospitals should allow electronic data transfers to physician PDAs to improve patient care, and physicians must institute measures to secure the confidentiality of patient information on their PDAs. By explicitly excluding copies from their designated record set, hospitals need not maintain copies or track access of information on personally owned PDAs.

Marginalization and health geomatics

Marginalized groups have been defined as groups that have been peripheralized from the center of society. Increasing nursing knowledge of marginalized groups and the dynamics of population diversity will enable nurses to better recognize shifting health patterns, plan for utilization of health services, and determine ethnic and cultural differences that exist in marginalized populations. The authors of this article review theoretical models responsible for defining the concept marginalization, describe geographical information systems as a recommended tool to evaluate marginalized groups, and provide a case study utilizing tools and maps as a means of assessing marginal situations.

A World Wide Web-based health resource. Survey of Missouri school nurses to determine priority health information resources for SchoolhealthLink.

Two hundred ninety-two school nurses in Missouri participated in a mailed survey to aid in the design of SchoolhealthLink a World Wide Web (WWW)–based information service for Missouri school nurses and children. The nurses identified specific health information resources likely to benefit school nurses and school children and prioritized these resources. The school nurses assigned high priority to 11 types of health information resources: individualized health care plans, emergency care plans, communicable disease control plans, acute illness, injuries, communicable diseases, hotline numbers, medications in schools, immunization protocols and standards, community-based health care resources, and Department of Elementary and Secondary Education regulations that affect school nurse practice. The four most common health problems school nurses identified were asthma, attention deficit disorder, diabetes, and head lice. SchoolhealthLink will provide a one-stop WWW-based resource for school nurses and school children.

New Educational Strategies for Training Information Professionals: Building Awareness, Concepts, and Skills through Learning Technologies.

Libraries, Medical Informatics, and Health Care was an experimental distance-education course aimed at both health sciences and other librarians and graduate students. The course included three modalities for delivering instruction: a satellite broadcast, materials on the Internet, and an intensive seminar. The teleconference focused on two topics, consumer health care information and telemedicine and the relation of each to librarianship. The Internet-based materials covered the U.S. health care delivery system, the language of medicine, MeSH (Medical Subject Headings), and MEDLINE. The intensive seminar covered other health sciences resources, the biomedical community, trends in health sciences librarianship, and medical informat-ics. Each modality presented opportunities and challenges to the instructional team and the students. Evaluations revealed that participants were generally favorable about the experience but that there were more problems with the Internet section of the course than with the other sections.

Virtual Shelves in a Digital Library: A Framework for Access to Networked Information Sources

OBJECTIVE Develop a framework for collections-based access to networked information sources that addresses the problem of location-dependent access to information sources. DESIGN This framework uses a metaphor of a virtual shelf. A virtual shelf is a general-purpose server that is dedicated to a particular information subject class. The identifier of one of these servers identifies its subject class. Location-independent call numbers are assigned to information sources. Call numbers are based on standard vocabulary codes. The call numbers are first mapped to the location-independent identifiers of virtual shelves. When access to an information resource is required, a location directory provides a second mapping of these location-independent server identifiers to actual network locations. RESULTS The framework has been implemented in two different systems. One system is based on the Open System Foundation/Distributed Computing Environment and the other is based on the World Wide Web. CONCLUSIONS This framework applies in new ways traditional methods of library classification and cataloging. It is compatible with two traditional styles of selecting information searching and browsing. Traditional methods may be combined with new paradigms of information searching that will be able to take advantage of the special properties of digital information. Cooperation between the library-informational science community and the informatics community can provide a means for a continuing application of the knowledge and techniques of library science to the new problems of networked information sources.

The need for a multidisciplinary team approach to life science workflows

Information retrieval for life science research (a broad rubric encompassing many traditional disciplines such as biochemistry, botany, cell biology, and molecular biology [1]) often involves the use of combinations of multiple information resources. Such combinations have been called “workflows” [2, 3] and may include factual databases such as Genbank [4], literature databases such as Entrez-PubMed [5], and analysis tools such as the Basic Local Alignment Search Tool (BLAST) [6]. Information resources can be combined in different ways toward the same goal; varying combinations may produce different results for the same research question. Combinations that produce different results may appear equivalent to a scientifically sophisticated user who lacks knowledge of metadata about the resources that may indicate the possibility of varying results. In addition, a user who pursues only a single combination of resources may not even realize that another combination might produce different results. This studys objective was to compare the results of three intuitively plausible and seemingly similar workflows for retrieving gene function information, with the goal of illustrating the importance of library science in bioinformatics and the need for a multidisciplinary team approach to authoring, vetting, and using life science workflows.

Design and Evaluation of SchoolhealthLink, a Web-Based Health Information Resource

SchoolhealthLink, a Web-based information service for Missouri school nurses, is a promising resource to reach school nurses isolated from traditional professional networks. It also may serve as an important adjunct to stay abreast of the latest health information. Using a strategy to identify the health information needs of school nurses and to test the site early in its development, this pilot study found school nurses reported SchoolhealthLink was an easy-to-use method to find high-quality, up-to-date information relevant to school nursing practice, was better than existing methods to access information, and could change the way they practiced. In order to continue to build SchoolhealthLink, a partnership with Barnes College of Nursing and the Missouri Association of School Nurses has been established to work together to continue to add health information resources useful to school nursing practice.

Semantic-Enhanced Query Expansion System for Retrieving Medical Image Notes

Most current image retrieval methods require constructing semantic metadata for representing image content. To manually create semantic metadata for medical images is time-consuming, yet it is a crucial component for query expansion. We proposed a new method for searching medical image notes that uses semantic metadata to improve query expansion and leverages a knowledge model developed specifically for the medical image domain to create relevant metadata. We used a syntactic parser and the Unified Medical Language System to analyze the corpus and store text information as semantic metadata in a knowledge model. Our new method has an interactive interface that allows users to provide relevance feedback and construct new queries more efficiently. Sixteen medical professionals evaluated the query expansion module, and each evaluator had prior experience searching for medical images. When using the initial query as the baseline standard, expanded queries achieved a performance boost of 22.6% in terms of the relevance score on first ten results (P-value<0.05). When using Google as another baseline, our system performed 24.6% better in terms of relevance score on the first ten results (P-value<0.05). Overall, 75% of the evaluators said the semantic-enhanced query expansion workflow is logical, easy to follow, and comfortable to use. In addition, 62% of the evaluators preferred using our system instead of Google. Evaluators who were positive about our system found the knowledge map-based visualization of candidate medical search terms helpful in refining cases from the initial search results.

Collaboration in digital libraries: Luminous ideas from health informatics, academic libraries, and historical archives

A widespread effort to develop digital libraries in science and academia in recent years has produced numerous success stories. This panel shares professional and personal experiences about the development and maintenance of digital libraries. As a group they offer a luminous description of how to apply methodologies, processes and workflow representations of collaboration to digital library creation and maintenance in various domains.

A text corpus approach to an analysis of the shared use of core terminology

We sought to investigate the shared use of core Ophthalmology terms in the domains of Ophthalmology, Family Practice and Radiology. A random sample of 450 terms was selected from the terms submitted as Ophthalmology terms in the NLM/AHCPR Large Scale Vocabulary Test. Two expert Ophthalmologists rated each term as Ophthalmic or non-Ophthalmic. When both raters agreed that a term was Ophthalmic, it was treated as a core Ophthalmology term for purposes of the study. We searched for the core terms in a text corpus of 38,695 MEDLINE abstracts covering 1970–1999 from journals representing the three domains of Ophthalmology, Radiology, and Family Practice. We compared proportions of abstracts from each domain for each term. We examined overlap of confidence intervals for proportions of abstracts for each core term and domain. Core Ophthalmology terms were used significantly more by Ophthalmology than by Radiology, or by Family Practice.