Healthcare databases and resources LIS 4785 Introduction to Health Informatics Fall 2015, Week 9-1 Instructor: Dr. Sanghee Oh

Show & Tell Lauren Potter Jan van Konijnenburg

Health Information Resources “The complexity of modern American medicine is exceeding the capacity of the unaided human mind” “It is likely that clinicians are so busy that they have no idea what new educational resources are available to them. They would like to move from the “information jungle” to the “information highway” but who will show them the way?

Challenges Faced by Clinicians Education Diffusion of information Translational Evolutionary Retention Accessibility

Point-of-Care Tools A synthesized resource that can easily provide evidence-based answers to questions during the patient visit UpToDate (hosted by Ebsco) eMedicine (Integrated to Medscape) (http://www.medscape.com/) DynaMed (hosted by Ebsco) ACP Smart Medicine (used to be ACP-PIER): Accessible through FSU Library (http://smartmedicine.acponline.org/index.aspx) FirstConsult (http://www.firstconsult.com/php/465344227-7/home.html)

ACP Smart Medicine Class Activity http://smartmedicine.acponline.org/index.aspx

Ideal Medical Resources Evidence based with references and level of evidence Updated frequently Simple to access with a single sign-on Available at the point of care Capable of being embedded into an electronic health record Likely to produce an answer with only a few click Useful for primary care physicians and specialists Written and organized with the end user in mind

UpToDate UpToDate® is the premier evidence-based clinical decision support resource, trusted worldwide by healthcare practitioners to help them make the right decisions at the point of care. Contains the equivalent of over 77,000 pages of original, peer-reviewed text. It combines broad coverage of adult primary care, subspecialty internal medicine, ob/gyn, general surgery and pediatrics. It is written, reviewed and continuously updated by over 5,100 physicians to ensure that the content remains current. This expert faculty synthesizes all relevant information, including the latest evidence, and provides specific, practical recommendations for diagnosis and treatment.

UpToDate Demos http://www.uptodate.com/home/help-demo

ACP Smart Medicine Developed by American College of Physicians (ACP) A Web-based decision support tool designed to provide clinicians with rapid point-of-care evidence-based guidance. Contains 500 modules that provide guidance and information on a broad range of diseases and conditions. Concise, bulleted evidence-based recommendations organized into readily accessible point-of-care categories: prevention, screening, diagnosis. Differential diagnosis tables assist in securing the correct diagnosis Triggered updates whenever there is new, relevant information or guidelines.

MEDLINE An online version of journal citations and abstracts for biomedical literature The U.S. National Library of Medicine® (NLM) premier bibliographic database Contains over 21 million references to journal articles in life sciences with a concentration on biomedicine.  The records are indexed with NLM Medical Subject Headings (MeSH®) PubMed provides free access to MEDLINE and links to full text articles when possible.

MeSH Class activity

Medical Subject Headings (MeSH) http://www.nlm.nih.gov/mesh/meshhome.html The National Library of Medicine's controlled vocabulary thesaurus. It consists of sets of terms naming descriptors in a hierarchical structure that permits searching at various levels of specificity. MeSH descriptors are arranged in both an alphabetic and a hierarchical structure.  The MeSH thesaurus is used by NLM for indexing articles from 5,400 of the world's leading biomedical journals for the MEDLINE®/PubMED® database. It is also used for the NLM-produced database that includes cataloging of books, documents, and audiovisuals acquired by the Library. Each bibliographic reference is associated with a set of MeSH terms that describe the content of the item. Similarly, search queries use MeSH vocabulary to find items on a desired topic.

MeSH Practice http://www.nlm.nih.gov/mesh/MBrowser.html

MeSH Example

Sponsored Medical Websites E-meducation (http://www.e-meducation.org/) Free medical portal (medical search engine) sponsored by Alfa Institute of Biomedical Studies Links to open access resources Filtered to ensure high standards Covers 10+ specialists

Sponsored Medical Websites Medscape (http://www.medscape.com/) A free all-purpose medical website sponsored by WebMD Covers 30+ medical specialists as well as sections for nurses, medical students, dental professionals & pharmacists Provides updates, continuing medical education (CME), conference schedules, Medline, drug searches and multiple specialty articles. Daily medical news and weekly newsletters and updates (MedPulses) Drug and Device Digest providing the latest in alerts and approvals Clinical practice guidelines

Sponsored Medical Websites Mayo Clinic http://www.mayoclinic.org/ Free multi-faceted web portal, sponsored by Mayo Clinic Covers information about medical developments (called Clinical Updates) Mayo Clinic publications Video presentations on health issues (Grand Rounds)

Government Medical Websites National Library of Medicine http://www.nlm.nih.gov/ PubMed Provides free access to MEDLINE, NLM’s databse of citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, health care systems, and preclinical sciences Links to many sites providing full text articles and related resources NLM Gateway Provide one-stop shopping for many NML information resources Offer citations, full text, video, audio, and images Toxnet Cluster of database covering toxicology, hazardous chemicals, environmental health and related areas. Unified Medical Language System A set of files and software that brings together many health and biomedical vocabularies and standards to enable interoperability between computer systems.

MedlinePlus Premier online patient education site Service of NLM and NIH Covers over 750 health topics Drugs, supplements and herbal information Medical dictionary, encyclopedia, and news 165 interactive video tutorials and surgical procedure videos Links to major patient education and advocacy sites such as Mayo Clinic, NIH, American Heart Association, etc.

MedlinePlus Connect This service allows health organizations and health IT providers to link patient portals and electronic health record (EHR) systems to MedlinePlus, an authoritative up-to-date health information resource for patients, families, and health care providers. MedlinePlus Connect accepts requests for information on diagnoses (problem codes), medications, and lab tests, and returns related MedlinePlus information. Problem code standards ICD-9-CM ICD-10-CM SNOMED CT Medication code standards RXCUI (RxNorm Concept Unique Identifier) NDC (National Drug Code) Lab test requests LOINC Context-Aware Knowledge Retrieval Standard HL7