6.872--Medical Computing

Spring Term 1997
Prof. Peter Szolovits (psz@mit.edu)
Class times: MW 3:00-4:30pm (Note change from Schedule!)
Room 38-166

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Course Announcement

Medicine is (finally) in the middle of an information processing revolution. Dramatic improvements in computer technology are making possible comprehensive record-keeping systems, automated laboratories and therapeutic devices, and sophisticated visualization techniques. Societal demands for cost-effective care result in vast collections of clinical outcomes data that provide opportunities to learn from experience. New organizational structures for providing health care (such as HMO's) and an increased importance of the role of the patient in his or her health care provide additional new opportunities for innovative technical contributions.

This class will analyze the computational needs of clinical medicine, review the history of interesting systems and approaches that have begun to support those needs, and present the computer technologies that appear most applicable to contributing to revolutionary advances. We will also have numerous real databases available from Boston-area hospitals, and the participation of doctors from those institutions who are currently developing new systems and applications.

Some of the homework and a final paper will be based on innovative applications of sophisticated computing techniques to real clinical data. We will explore topics in automated diagnosis, monitoring, detection of errors in treatment, learning new models from data, personalizing explanations to specific patients, etc. We will also examine the architectures of recently-built comprehensive clinical information systems.

Students are expected to have a flexible competence in programming, because assignments will involve use of diverse databases and programming languages. A knowledge of artificial intelligence at the level of 6.034 will also be assumed, as many AI techniques will find application in the class material. The class is open to both undergraduate and graduate students, and will qualify for Graduate H credit.


Instructor: Peter Szolovits 253-3476 psz@mit.edu
Course secretary: Heather Grove 253-5860 heather@medg.lcs.mit.edu

Textbook for the class will be Shortliffe, et al., Medical Informatics: Computer Applications in Health Care, Addison-Wesley 1990. It is now available from Quantum Books (not from the Coop, I think), at $45.95, which is a slight discount off list price. We will also hand out readings from other, more recent sources. In citations to these in the class schedule, I use the abbreviation SCAMC for the Symposium on Computer Applications in Medical Care, a yearly conference that began in the mid-1970's, whose title has officially changed to the AMIA Fall Symposium in 1996.

Class notes will regularly be posted on the World-Wide Web at URL:

In general, we will not be able to post copyrighted material, but notes, class lists, outlines, and reading lists will appear there. Members of the class interested in posting material or providing cross-references to other URL's should please contact me. See material contributed thus far, below.

Course conduct and grading

Grades will be based on grades assigned on a class project or projects and on a final paper that will be expected from each student. Members of the class are encouraged to collaborate with each other on projects, and co-authored project write-ups will be happily accepted. The final paper must be written individually, though sharing of ideas and discussion with others is fine.

The class will be "interactive," and students will be asked to make brief presentations at almost all class meetings.


I plan to have a number of guest lectures by Boston-area medical computing specialists, but we do not yet have a final schedule of guests or indeed daily topics. The schedule will grow as it gets more firmly established.



Reading Assignment
(read in time for corresponding class)

Feb 5 Introduction
Feb 10 Nature of Clinical Data Text: Preface, Chapters 1 and 2
Feb 12 Overall System Design and Evaluation Text: Chapters 4 and 5. (Skim 4; you should already know this.) Coiera, E. "Clinical Communication: A New Informatics Paradigm", SCAMC 96.
Feb 18 Hospital Information Systems (Tue, Feb 18 = Mon, Feb 17 by MIT fiat) Text: Chapter 7
Feb 19 Medical Record Systems (guest lecture by Dr. G. Octo Barnett) Text: Chapter 6
Feb 24 Laboratory and Pharmacy Systems Text: Chapters 9 and 10
Feb 26 Nursing Information Systems and Health Assessment Systems Text: Chapters 8 and 18
Mar 3 Discussion of class projects and available data access Kent, W. "A Simple Guide to Five Normal Forms in Relational Database Theory", CACM 83.
Mar 5 Data Modeling Children's Hospital Clinicians' Workstation data model
Mar 10 Ethnographic Design of the Clinicians' Workstation (guest lecture by Dr. Isaac S. Kohane) Kohane, I. S. "Getting the Data In: Three Year Experience with a Pediatric Electronic Medical Record System", SCAMC 94.
Mar 12 Office Practice and Research Systems Text: Chapters 13 and 16.
Mar 17 More on Data Modeling--Entity Relationship Diagrams and Database Consistency Various odd references
Mar 19
Mar 24, 26 Spring Break
Mar 31 Guest lecture by Dr. Charles Safran
Apr 2 Experience with Home Care (guest lecture by Dr. Robert Friedman)
Apr 7 Protecting Electronic Health Information National Research Council, For the Record: Protecting Electronic Health Information
Apr 9 De-identification and anonymization of medical datasets (guest lecture by Latanya Sweeney)
Apr 14 Decision support systems based on probabilistic reasoning Text: Chapters 3 and 15
Apr 16 Flowchart encoding of decision support Clancey & Shortliffe, Chapter 4
Apr 21 Patriot's Day
Apr 23 Frame-based decision support Clancey & Shortliffe, Chapters 6 and 8
Apr 28 Rule-based systems Clancey & Shortliffe, Chapters 5 and 9
Apr 30 Model-based systems
May 5 Temporal reasoning systems (guest lecture by Dr. Isaac Kohane)
May 7 Project Presentations
May 12 Project Presentations
May 14 Wrap-up


The following are some of the topics that will be covered:

References and Pointers

I am happy to collect appropriate pointers to reference information and index them here. Your contributions are welcome.

Duke University's Medical Informatics Links.

Thanks to Tom Lee for another pointer to Web Health Related Sites.

Jiri Schindler has contributed the following bibliography.

The following references about clinical practice guidelines were contributed to the MEDINF-L mailing list by Alvaro Margolis, M.D., Dept. of Medical Informatics, U. of Utah School of Medicine. He also points out that there is also on the Web a list of AHCPR clinical guidelines.

Here is an extensive set of notes for Columbia University's Introduction to Medical Informatics course on the Web. Here are some other Web sites I have found interesting:

Visible Human Project
Sunrise Home Page for Health Care Informatics Standards
CBR Medical Demos and Project Descriptions
Privacy and Integrity of Computerized Medical Records
MSDS Healthcare Standards Home Page

Last update: psz@mit.edu - 2/12/97