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=The Clinical Informatics Wiki -- Clinfowiki=
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Veterans Health Information Systems and Technology Architecture
  
The Clinical Informatics Wiki is an implementation of a [http://en.wikipedia.org/wiki/Wiki wiki] devoted to topics in clinical informatics. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki.
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The Veterans Health Information Systems and Technology Architecture (VistA) is an enterprise-wide information system built around an electronic health record, used throughout the United States Department of Veterans Affairs (VA) medical system, known as the Veterans Health Administration (VHA).  
  
Please see [http://meta.wikipedia.org/wiki/MediaWiki_i18n documentation on customizing the interface]
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VistA was developed using the M or MUMPS language/database. The VA currently runs a majority of VistA systems on InterSystems Caché. VistA can also run on GT.M, an open source database engine for Linux and Unix computers. Although initially separate releases, publicly available VistA distributions are now often bundled with the database in an integrated package. This has considerably eased installation.
and the [http://meta.wikipedia.org/wiki/MediaWiki_User's_Guide User's Guide] for usage and configuration help.
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You can test your edits as much as you want in the [http://en.wikipedia.org/wiki/Wikipedia:Sandbox Sandbox].
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The Department of Veterans Affairs has had automated data processing systems within its medical facilities since before 1985,beginning with the Decentralized Hospital Computer Program (DHCP) information system, including extensive clinical and administrative capabilities. In 1995, DHCP was enshrined as a recipient of the Computerworld Smithsonian Award for best use of Information Technology in Medicine.
  
[[Special:Listusers|We]] are currently working on [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles, and we [[JFWiki:To Do|need your help]] to complete this study of Clinical Informatics. See [[Special:Statistics]] for more complete information on the site.
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The most significant is a graphical user interface known as the Computerized Patient Record System (CPRS) for clinicians released in 1997.
  
== Free and Open Source Software (FOSS) licensing in medicine ==
 
see [[FOSSM]]
 
  
== Electronic Healthcare Communication ==
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By 2001, the VHA was the largest single medical system in the United States, providing care to 4 million veterans, employing 180,000 medical personnel and operating 163 hospitals, over 800 clinics and 135 nursing homes.[2] By providing electronic health records capability, VistA is thereby one of the most widely used EHRs in the world.
see [[Electronic Healthcare Communication]]
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== Electronic Medical Record (EMR) Systems==
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Reference
see [[EMR]]
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== Computer-based Provider Order Entry -- CPOE==
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1. Department of Veterans Affairs: Veterans Health Administration
see [[CPOE]]
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2. Brown, Stephen H. (2003). "VistA, U.S. Department of Veterans Affairs national scale HIS". International Journal of Medical Informatics 69: 135-156, Bethesda, MD (USA). doi:10.1016/S1386-5056\(02\)00131-4) (inactive 22 June 2008).
 
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== Clinical Decision Support -- CDS==
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see [[CDS]]
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== Medical Devices, Computerized -- SmartDevices==
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see [[SmartDevices]]
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== Personal Health Records -- PHRs==
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see [[PHR]]
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== Personal Health Applications -- PHAs==
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see [[PHA]]
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== Informatics Students' Contributions==
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see [[Informatics Students' Contributions|Contributions]]
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==[[Ancillary Clinical Information Systems]]==
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==Blueprint for a Comprehensive HIT System==
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*[http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Introducing new categories of HIT tools, which compliment the ones above]
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*[http://wellness.wikispaces.com/Blueprint+for+an+Integrated+HIT+system+-+The+Patient+Life-Cycle+Wellness+System Blueprint for an Integrated HIT system]
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==Biobanking -- a.k.a. Biorepositories or Tissue Banks ==
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see [[BioBanking]]
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==Organizational issues==
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[[The Role of the CMIO]]
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==Regional Health Information Organizations -- RHIOs==
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see [[RHIO]]
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==Evidence-Based Medicine -- EBM==
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see [[EBM]]
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==Evaluation Methods in Informatics==
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An overview of qualitative and quantitative design methodologies used in informatics.  
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See [[Evaluation]]
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==Unintended Consequences of Health Information Technology ==
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see [[Unintended Consequences of HIT]]
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==Quality & Quality Informatics==
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see [[Quality Informatics|Quality & Quality Informatics]]
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==[[Public Health Informatics]]==
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*'''[[Health IT in Prisons & Jails]]'''
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==U.S. Federal Health Information Technology Initiatives==
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*'''[[Assistant Secretary for Planning & Evaluation]]'''
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*'''[[Office of the National Coordinator for Health Information Technology (ONC)]]'''
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*'''[[Council on the Application of Health Information Technology (CAHIT)]]'''
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*'''[[Agency for Healthcare Research and Quality (AHRQ)]]'''
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*'''[[Centers for Medicare and Medicaid Services (CMS)]]'''
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*'''[[U.S. Food and Drug Administration (FDA)]]'''
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*'''[[National Institutes of Health (NIH)]]'''
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*'''[[Indian Health Service (IHS)]]'''
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*'''[[Health Services and Resource Administration (HRSA)]]'''
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*'''[[Centers for Disease Control and Prevention (CDC)]]'''
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*'''[[U.S. Department of Commerce]]'''
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*'''[[Combined U.S. Department of Defense / Veterans Affairs Initiatives]]'''
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*'''[[U.S. Department of Defense (DoD) Initiatives]]'''
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*'''[[Department of Veterans Affairs Initiatives]]'''
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*'''[[U.S. Department of Homeland Security]]'''
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*'''[[Healthcare Information Technology Standards Panel (HITSP)]]'''
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==The E-Patient-Provider Relationship==
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*'''[[SMS, Blogs and the Patient-Provider Relationship: Enhancing Communication, Improving Treatment Outcomes]]'''
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==Interface Terminology==
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* '''[[Definition and Use of Interface Terminologies]]'''
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==[[:Category:New_Technology| New CIS-related Technologies]]==
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==Workflow==
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* '''[[Definition]]'''
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* '''[[Methods to capture it]]'''
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* '''[[Measurement]]'''
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* '''[[Importance of]]'''
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==Terminology and Coding==
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* '''[[ICD]]'''
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* '''[[SNOMED]]'''
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==Interface/Usability Testing==
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* '''[[Methods]]'''
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==International views==
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* '''[[Purpose and overview]]'''
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* '''[[UK]]'''
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* '''[[National Electronic Health Record Program in United Kingdom]]'''
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==Blogposium, April 2006==
+
 
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The Blogposium, held from April 18-20, was an innovation in collaborative blogging and wiki building.
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The effort marshalled the expertise and energy of several dozen health bloggers and volunteers to expand and refine this Clinical Informatics Wiki. Bloggers posted their first drafts of entries as posts or links to this wiki and invited readers to provide comments and edit suggestions.
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*[[:Category:Blogposium|All articles resulting from the BlogPosium collaboration]]'''
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While many bloggers and readers contributed to this Web 2.0 innovation in collaborative work, key participants included the follow blogs. Please visit them and thank them for their contributions:
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* [http://thielst.typepad.com/my_weblog/Christina's Considerations] on Regional Health Information Organizations
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* [http://www.conmergence.com/ Conmergence] on Telehealth
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* [http://www.drugwonks.com/ Drugwonks] on FDA Critical Path Initiative
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* [http://www.bloglines.com/blog/eHealth eHealth] on Integration of Personal Health Records and Electronic Medical Records
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* [http://www.emrandhipaa.com/ EMR and HIPAA] on Electronic Medical Records and Biometric Integration
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* [http://fardj.prblogs.org/ Envisioning 2.0] on The E-Patient-Provider Relationship
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* [http://www. healthnex.org HealthNex] (two other topics: Biobanking and Genetic Privacy Issues
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* [http://www.hitsmit.com/ HITsmit] on e-MAR Systems
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* [http://blog.hittransition.com/ HIT Transition] on RHIO Startup Funding and Finance
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* [http://www.rodspace.co.uk/blog/blogger.html Informaticopia] on International Perspectives on Clinical Informatics
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* [http://marketplace.md/community/blogs/marketplace.md_blog/default.aspx Marketplace.MD] on the Consumer-Driven Health Care Movement
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* [http://medicalconnectivity.com/ Medical Connectivity] on Integrating Medical Devices into EMRs
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* [http://www.enochchoi.com/thoughts/ medmusings] on Mobile Access to EMR/EHR/PHR for Providers and Patients
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* [http://usemed.com/ Usemed]  on Ongoing and Completed EHR, CPOE and CDS Implementation Projects
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* [http://wellness.wikispaces.com/ WellnessWiki] an ever-evolving virtual encyclopedia of the healthcare crisis and potential remedies
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==Departments of Biomedical or Medical Informatics==
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See [[List of Informatics Departments]]
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==Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics==
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see [[Endowed Professorships]]
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== Leading Health Informatics and Medical Informatics Journals ==
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===Ranking of ISI/SCI listed e-Health and Medical Informatics Journals===
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Footnotes:
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(i) Impact Factors rounded to one decimal point. Source: Medical Informatics Category, ISI/SCI Journal Citation Reports, published June 2008
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(ii) PMC= Pubmed Central. Note that starting in 2008, all NIH grantees must make their manuscripts available in Pubmed Central
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(iii) not ranked in the Medical Informatics category
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{|
+
|
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|'''Rank'''
+
|'''Abbrev Journal Title'''
+
|'''Impact Factor''' (i)
+
|'''Open Access'''
+
|'''In PMC''' (ii)
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|'''Editor in Chief'''
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|'''Publisher'''
+
|'''ISSN'''
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|'''Focus (keywords or quotes from instructions for authors)'''
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|----
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|'''TOP Journals'''
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|1
+
|[http://www.jamia.org J Am Med Inform Assn]
+
|3.1
+
|No
+
|after 6 months
+
|R. Miller
+
|Elsevier
+
|1067-5027
+
|clinical informatics, US-focus
+
|----
+
|
+
|2
+
|[http://www.jmir.org J Med Internet Res]
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|3.0
+
|Yes
+
|immediately
+
|G. Eysenbach
+
|Eysenbach
+
|1438-8871
+
|Web, consumer health, ehealth innovations, interdisciplinary, clinical Internet applications, intl ICT policy, public health, telecare
+
|----
+
|'''Good Journals'''
+
|3
+
|Med Decis Making
+
|2.2
+
|No
+
|No
+
|M. Helfand
+
|Sage
+
|0272-989X
+
|clinical decision making
+
|----
+
|
+
|4
+
|J Biomed Inform
+
|2.0
+
|No
+
|No
+
|E.H. Shortliffe
+
|Elsevier
+
|1532-0464
+
|"methods that generalize across biomedical domains"
+
|----
+
|'''Middle of the Pack'''
+
|5
+
|Artif Intell Med
+
|1.8
+
|No
+
|No
+
|K.P. Adlassnig
+
|Elsevier
+
|0933-3657
+
|artifical intelligence
+
|----
+
|
+
|6
+
|Int J Med Inform
+
|1.6
+
|No
+
|No
+
|C. Safran, J. Talmon
+
|Elsevier
+
|1386-5056
+
|clinical systems
+
|----
+
|
+
|7
+
|J Eval Clin Pract
+
|1.6
+
|No
+
|No
+
|A. Miles
+
|Blackwell
+
|1356-1294
+
|evaluation of clinical practice
+
|----
+
|
+
|8
+
|Stat Med
+
|1.5
+
|No
+
|No
+
|
+
|
+
|0277-6715
+
|statistical methods in medicine
+
|----
+
|
+
|9
+
|Stat Methods Med Res
+
|1.5
+
|No
+
|No
+
|B. Everitt
+
|Sage
+
|0962-2802
+
|statistical methods in medicine
+
|----
+
|
+
|10
+
|Method Inform Med
+
|1.5
+
|No
+
|No
+
|R. Haux
+
|Schattauer
+
|0026-1270
+
|"scientific fundamentals of processing data, information"
+
|----
+
|
+
|11
+
|IEEE T Inf Technol B
+
|1.4
+
|No
+
|No
+
|
+
|IEEE
+
|1089-7771
+
|telemedicine, clinical networks, broadband technologies
+
|----
+
|
+
|12
+
|Int J Technol Assess
+
|1.4
+
|No
+
|No
+
|E.Jonsson
+
|Cambridge
+
|0266-4623
+
|development, evaluation, diffusion and use of health technology
+
|----
+
|'''Low-Impact Journals'''
+
|13
+
|IEEE Eng Med Biol
+
|1.1
+
|No
+
|No
+
|
+
|IEEE
+
|0739-5175
+
|biomedical and clinical engineering (technical)
+
|----
+
|
+
|14
+
|CIN-Comput Inform Nu
+
|1.0
+
|No
+
|No
+
|L. Nicoll
+
|Lippincott
+
|1538-2931
+
|use of computers in nursing practice
+
|----
+
|
+
|15
+
|Med Biol Eng Comput
+
|0.9
+
|No
+
|No
+
|J.A.S. Spaan
+
|Springer
+
|0140-0118
+
|biomedical and clinical engineering, incl cellular engineering and molecular imaging
+
|----
+
|
+
|16
+
|Comput Meth Prog Bio
+
|0.9
+
|No
+
|No
+
|T. Groth
+
|Elsevier
+
|0169-2607
+
|computing methodology and software systems derived from computing science
+
|----
+
|
+
|(iii)
+
|J Telemed Telecare
+
|0.9
+
|No
+
|No
+
|R. Wootton
+
|RSM
+
|
+
|telemedicine and telecare
+
|----
+
|
+
|(iii)
+
|Telemed J E-Health
+
|0.9
+
|No
+
|No
+
|R.C. Merrell
+
|Liebert
+
|1530-5627
+
|clinical telemedicine practice, US-focus
+
|----
+
|'''"Throw-Away" Journals'''
+
|17
+
|Biomed Tech
+
|0.6
+
|No
+
|
+
|
+
|
+
|0013-5585
+
|
+
|----
+
|
+
|18
+
|Med Inform Internet
+
|0.5
+
|No
+
|
+
|
+
|
+
|1463-9238
+
|
+
|----
+
|
+
|19
+
|J Med Syst
+
|0.5
+
|No
+
|No
+
|R.R. Grams
+
|Springer
+
|0148-5598
+
|
+
|----
+
|
+
|20
+
|J Cancer Educ
+
|0.3
+
|No
+
|
+
|
+
|
+
|
+
|
+
|----
+
|}
+
 
+
 
+
Based on: [http://www.slideshare.net/guest886354/impact-factors-medical-informatics-journals Impact Factors Medical Informatics Journals]
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+
===Not listed / ranked in ISI/SCI===
+
 
+
* BMC Med Dec Mak Med Informatics
+
 
+
==External Links==
+
*[http://www.cpoe.org Website of the Provider Order Entry Team from Oregon Health]
+
*[http://hittransition.com/tools.htm Links to online tools for HIT/RHIO development]
+
*[http://www.hitdashboard.com/unitedStates.aspx Health Information Technology Dashboard]
+
*[http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Wellness Wiki: Use Evolving Health Information Technology Tools]
+
 
+
==External Medical Reference Links==
+
*[http://www.emedicine.com/ eMedicine] Physician contributed medical articles and CME
+
*[http://www.kmle.com KMLE Medical Dictionary] Medical dictionary and medical related links
+
*[http://www.merckmedicus.com Merck Medicus] Contains a significant number of textbook resources (requires free registration
+
*[http://www.nlm.nih.gov NLM] (US National Library of Medicine) contains resources for patients and health care professionals)
+
*[http://www.webmd.com WebMD] General comprehensive online health information
+
*[http://www.open.medicdrive.org Medicine 2.0] Comprehensive online Personal health record information.
+
*[http://www.searchmedica.com SearchMedica.com] Searches medical literature for health care professionals
+
 
+
==External Informatics Organizations Links==
+

Revision as of 22:02, 19 January 2009

Veterans Health Information Systems and Technology Architecture

The Veterans Health Information Systems and Technology Architecture (VistA) is an enterprise-wide information system built around an electronic health record, used throughout the United States Department of Veterans Affairs (VA) medical system, known as the Veterans Health Administration (VHA).

VistA was developed using the M or MUMPS language/database. The VA currently runs a majority of VistA systems on InterSystems Caché. VistA can also run on GT.M, an open source database engine for Linux and Unix computers. Although initially separate releases, publicly available VistA distributions are now often bundled with the database in an integrated package. This has considerably eased installation.

The Department of Veterans Affairs has had automated data processing systems within its medical facilities since before 1985,beginning with the Decentralized Hospital Computer Program (DHCP) information system, including extensive clinical and administrative capabilities. In 1995, DHCP was enshrined as a recipient of the Computerworld Smithsonian Award for best use of Information Technology in Medicine.

The most significant is a graphical user interface known as the Computerized Patient Record System (CPRS) for clinicians released in 1997.


By 2001, the VHA was the largest single medical system in the United States, providing care to 4 million veterans, employing 180,000 medical personnel and operating 163 hospitals, over 800 clinics and 135 nursing homes.[2] By providing electronic health records capability, VistA is thereby one of the most widely used EHRs in the world.

Reference

1. Department of Veterans Affairs: Veterans Health Administration 2. Brown, Stephen H. (2003). "VistA, U.S. Department of Veterans Affairs national scale HIS". International Journal of Medical Informatics 69: 135-156, Bethesda, MD (USA). doi:10.1016/S1386-5056\(02\)00131-4) (inactive 22 June 2008).