Defining Biomedical Informatics and its Relationship to Dental Research and Practice

Edward H. Shortliffe, MD, PhDCollege of Physicians & Surgeons

Columbia University

Dental Informatics & Dental Research: Making the Connection

National Institutes of Health, Bethesda, MarylandJune 12, 2003

What is Medical Informatics?

The scientific field that deals with the storage, retrieval, sharing, and optimal use of biomedical information, data, and knowledge for problem solving and decision making.

Medical informatics touches on all basic and applied fields in biomedical science and is closely tied to modern information technologies, notably in the areas of computing and communication.

Medical Informatics in Perspective

Basic Research

Applied Research

Methods, Techniques, and Theories

Public Health

ClinicalMedicine

Nursing

Veterinary Medicine

Dentistry

Molecular Biology

Visualization

Medical Informatics in Perspective

Basic Research

Applied Research

Methods, Techniques, and Theories

Public Health Informatics

ClinicalMedicine

Informatics

Nursing Informatics

Veterinary Informatics

Dental Informatics

Bioinformatics

Imaging Informatics

Medical Informatics in Perspective

Basic Research

Applied Research

Methods, Techniques, and Theories

Public Health Informatics

ClinicalMedicine

Informatics

Nursing Informatics

Veterinary Informatics

Dental Informatics

Bioinformatics

Imaging Informatics

ClinicalClinical

Medical Informatics in Perspective

Basic Research

Applied Research

Methods, Techniques, and Theories

Public Health Informatics

ClinicalInformatics

BioinformaticsImaging

Informatics

Medical InformaticsMedical Informatics

Medical Informatics in Perspective

Basic Research

Applied Research

Medical Informatics Methods, Techniques, and Theories

Imaging Informatics

Clinical Informatics

BioinformaticsPublic Health Informatics

Molecular andCellular

Processes

Tissues andOrgans

Individuals(Patients)

PopulationsAnd Society

Medical Informatics in Perspective

Medical Informatics Methods, Techniques, and Theories

Imaging Informatics

Clinical Informatics

BioinformaticsPublic Health Informatics

Medical Informatics in Perspective

Medical Informatics Methods, Techniques, and Theories

Imaging Informatics

Clinical InformaticsBioinformatics

Public Health Informatics

Bioinformatics Methods, Techniques, and Theories

??

??

Biomedical

??

Biomedical Informatics in Perspective

Basic Research

Applied Research

Biomedical Informatics Methods, Techniques, and Theories

Imaging Informatics

Clinical Informatics

BioinformaticsPublic Health Informatics

Molecular andCellular

Processes

Tissues andOrgans

Individuals(Patients)

PopulationsAnd Society

Examples of Growing Synergies Between Clinical and Bio- Informatics

• Applications at the intersection of genetic and phenotypic data

– e.g., pharmacogenomics

– e.g., identification of patient subgroups

• Shared methodologies with broad applicability

– e.g., natural language and text processing

– e.g., cognitive modeling of human-computer interaction

– e.g., imaging (organs, biomolecular, 3D)

– e.g., inferring structure from primary data

– e.g., data mining (knowledge extraction) from large datasets

Journal of Biomedical Informatics

• Formerly “Computers and Biomedical Research”

• Volume 36 in 2003

• Emphasizes methodologic innovation rather than applications, although all innovations are motivated by applied biomedical goals

Biomedical Informatics in Perspective

Biomedical Informatics Methods, Techniques, and Theories

Applied Informatics

BiomedicalDomain

Contributes to….

Draws upon….

ComputerScience

Draw upon….

Contribute to...

DecisionScience

CognitiveScience

InformationSciences

ManagementSciences

OtherComponent

Sciences

Core of Biomedical Informatics As An Academic Discipline

BiomedicalKnowledge

BiomedicalData

KnowledgeBase

DataBase

InferencingSystem

Biomedical Informatics Research Areas

BiomedicalKnowledge

BiomedicalData

KnowledgeBase

InferencingSystem

DataBase

DataAcquisition

BiomedicalResearch

Planning &Data Analysis

KnowledgeAcquisition

TeachingHumanInterface

TreatmentPlanning

DiagnosisInformationRetrieval

ModelDevelopment

ImageGeneration

Real-time acquisitionImagingSpeech/language/textSpecialized input devices

Machine learningText interpretationKnowledge engineering

Examples from a Recent Columbia Retreat: Cross Cutting Methodologies

• Natural language and text processing• Knowledge representation and

structuring / ontology development• Cognitive science in biomedical

informatics• Data mining• 3-dimensional modeling

Biomedical Informatics in Perspective

Bioinformatics

Structural Biology, Genetics,Molecular Biology

Contributes to….

Draws upon….

Draw upon….

Contribute to...

ComputerScience,DecisionScience,CognitiveScience,

InformationSciences,

ManagementSciencesand other

ComponentSciences

Biomedical Informatics Methods, Techniques, and Theories

Dental Informatics

• Significant opportunities for research across the spectrum of biomedical informatics application areas (bioinformatics, imaging, clinical, public health)

• Challenges exist that can help to drive innovation and scientific contributions in biomedical informatics and in other, non-biomedical, areas of application

Biomedical Informatics in Perspective

Dental Informatics

Oral Medicine, Dentistry,

Craniofacial Surgery, Dental

Research

Contributes to….

Draws upon….

Draw upon….

Contribute to...

ComputerScience,DecisionScience,CognitiveScience,

InformationSciences,

ManagementSciencesand other

ComponentSciences

Biomedical Informatics Methods, Techniques, and Theories

Challenges For Academic Informatics

• Explaining that there are fundamental research issues in the field in addition to applications and tool building

• Finding the right mix between research/training and service requirements

• Developing and nurturing the diverse collegial and scientific relationships typical of an interdisciplinary field

Academic Informatics: Lessons We Have Learned

• Service activities can stimulate new research and educational opportunities

• Need to have enough depth in faculty to span a range of skills and professional orientations

• Need to protect students from projects on critical paths to meeting service requirements

• Institutional support and commitment are crucial

–Financial stability

–Visibility and credibility with colleagues in other health science departments and schools

Training FutureBiomedical Informatics Professionals

The Problem:There are too few trained professionals, knowledgeable about both biomedicine and the component sciences in biomedical informatics

The Solution:Formal training in biomedical informatics, with the definition of a core discipline and specialized elective opportunities

Curriculum Development

Perspective of our Department of Biomedical Informatics

• Basic objectives: fundamental areas of biomedicine, computer science and mathematics that are prerequisites for further study in Biomedical Informatics

• Core objectives: essential skills required by all Biomedical Informatics students

• General objectives: ability to conduct research and participate in the educational activities of the field

• Specialized objectives: application of general methods and theories in at least one of four different areas: bioinformatics, imaging informatics, clinical informatics, and public health informatics

Biomedical Informatics Disciplines

BiomedicalInformatics

Cognitive Science& Decision Making

ManagementSciences

ClinicalTopics

Basic BiomedicalSciences

EpidemiologyAnd Statistics

Bioengineering

Computer Science

(hardware)

Computer Science

(software)

Biomedical Informatics Curriculum

Major subject areas:

1. Biomedical Informatics

2. Biomedicine

3. Computer Science

4. Decision and Cognitive Sciences

5. Public Policy and Social Issues

1. Biomedical Informatics Courses

• Computer applications in health care

• Computer-assisted medical decision making

• Bioinformatics (computational biology)

• Biomedical imaging (imaging informatics)

• Programming projects course

• Weekly student seminars (topic review or research report by students)

• Weekly research colloquium

• Biomedical informatics “civics”

Medical Informatics Textbook

(2nd edition)

Springer Verlag - 2000

Biomedical Informatics Textbook

(3rd

edition)

Bio

2004?

Program Characteristics

Steady-state program size: 45-50 students

– Dental informatics postdocs

3 students

Applications per year: ~130 candidates

Admissions per year: 8-10 students

Principal faculty: 30

Participating and consulting faculty: ~20

Trainees generally supported on a training grant, as graduate research assistants on sponsored projects, or as teaching assistants

Doctoral Research in Informatics

• Although they are inspired by biomedical application goals, dissertations in biomedical informatics must:

–offer methodological innovation, not simply interesting programming artifacts

–generalize to other domains, within or outside biomedicine

• Inherently interdisciplinary, biomedical informatics provides bridging expertise and opportunities for collaboration between computer scientists and biomedical researchers and practitioners

Career Paths for Biomedical Informatics Professionals

• Academic biomedical informatics research and development, and educational support

• Clinical, administrative, and educational management

• Operational service management

• Health system chief information officer or medical/nursing director for information technology

• Digital library development and implementation

• Corporate research and development

• Biotechnology/pharmaceutical companies

Trends

• Creation of several new biomedical informatics departments or independent academic units

• Reasonably strong job market for graduates of informatics degree programs

• Government investment in training and research is reasonably strong, especially for applications and demonstrations

• Increasing acceptance of biomedical informatics as an emerging subspecialty area by biomedical professional societies

• Increasing recognition that biomedical problems can drive the development of basic theory and capabilities in information technology research