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Biomedical subjects

A R Bakker

Publications and source records attributed to A R Bakker.

At least 19 recordsLinked to original sources
PubMed2001

Integration of information systems: assessing its quality.

Due to organizational and technological changes the need for integrating information systems within healthcare institutions, has increased enormously. Although the technical means for systems integration have definitely matured, integration methodologies are still in their infancy. Two important questions regarding systems integration are hardly ever addressed in a systematic way: how to derive integration requirements, and how to check whether the requirements are met in a given integrated system. These two questions must be answered if we want to assess or improve the quality of integration of a given set of systems. In this article we present a nine-step method for deriving integration requirements from a business process model, and we assess the quality of integration of a given integrated system against these requirements. The method is demonstrated by elaborating two case studies from the health care domain.

Computer Simulation↗
PubMed1999

Evolution of an integrated HIS in The Netherlands.

This article considers the 26 years history of an integrated hospital information system (HIS). The system emerged from an experimental government sponsored project in the Leiden University Hospital and is now the leading HIS in The Netherlands. The evolution during these 26 years is presented and discussed in this article with an emphasis on the organisational setting and financing besides the aspects functionality, technology/architecture and evaluation aspects. Recently HISCOM was acquired by the BAAN-group completing the evolution and bringing the HIS to the international health care IT market.

Computer Communication Networks↗
PubMed1998

Constructing an enterprise viewpoint: evaluation of four business modelling techniques.

Business process modelling is presented as an important first step in the process of designing a distributed system by integrating pre-existing components. The elements describing a business process are derived from the ODP-enterprise viewpoint language. One of the viewpoints distinguished in the Open Distributed Processing standard is the enterprise viewpoint. This viewpoint describes the organizational context in which the distributed system to be constructed will be used. In this paper we will review four business modelling techniques and their suitability for expressing the enterprise viewpoint is evaluated.

Computer Simulation↗
PubMed1996

The complexity of transactions: a means for assessing interoperability.

Interoperability seems to be a major focal point of the activities within the Informatics Society in general, and the Medical Informatics society in particular. In both Europe and the USA standardization efforts are pursued in order to enable interoperability. However, even if the technical requirements are met, interoperability is sometimes not feasible because the message exchange needed is too complex. This complexity is influenced by at least three factors: the volume of the data to be exchanged, the functionality of the information exchange, and the communication standard adopted.

Computer Communication Networks↗
PubMed1996

Guidelines for secure system development and secure implementation.

In this paper the present state of development of the guidelines for both secure system development and secure implementation, as being drafted within the scope of the SEISMED project, are briefly described. For system development there is a lot of literature how to cope with security requirements. For secure implementation of systems within an organization hardly any literature was found. By consequence there is a significant difference in maturity of the two sets of guidelines.

Computer Security↗
PubMed1995

Assessment of effects and costs of information systems.

Insight into the effects and costs of information systems is becoming increasingly important. A key problem is to provide evidence which is transportable among sites. Transportability demands agreement on how to carry out assessment of information systems. In the VISTA study, three Dutch hospitals developed together an evaluation protocol for the assessment of the effects and costs of the nursing information system VISION. This protocol is based on a quasy-experimental study design allowing filtering for non-VISION influences. The protocol also included a uniform cost model. Based on a cost calculation for the three hospitals, the costs for hospital-wide implementation of VISION in a 445- and 800-bed hospital were extrapolated. VISTA is considered as a trial for application of one evaluation protocol at various sites. It is recommended to extend this national trial to a multi-national one, for instance by applying the cost model more broadly.

Computer Systems↗
PubMed1995

Retrieval from a large, integrated HIS-database through formal descriptions and SQL.

This paper outlines the realization of rich retrieval facilities and comprehensive data administration in an existing, large, integrated Hospital Information System (HIS) using SQL as a query-language and using a large collection of formal data descriptions stored in the Data Dictionary and Directory System (DD/DS). It is emphasized that the approach to enhance the access to the database is more important than the technology. Nevertheless, the facilities are presented that support non-routine retrieval. The Data Dictionary and Directory System functions as a catalog of the information system. The vehicle that facilitates the communication with the database is an implementation of SQL-in a number of appearances. It is stressed that only full benefit can be gained through a combined action of a large integrated HIS, a complete and correct DD/DS, and strong retrieval functions.

Hospital Information Systems↗
PubMed1995

Effects measured in the evaluation of automated information systems.

The results of a literature search show that most of the evaluation studies of automated information systems are dealing with structure measures. Only 15 of 91 studies investigated effects on the outcome of the care process. Probably one of the reasons for this lack of investigated "outcome" measures is the fact that many of the evaluated systems were not in routine use at the moment of evaluation. It is, however, possible to obtain indicators of outcome measures by investigating the relationship between process measures and outcome measures. In the context of many developments, such as the trend of increasing attention to the evaluation of outcomes of the care process and the increasing costs of health care, the effect of automated information systems on the outcome of the health care process becomes more and more important. In the attempts to develop guidelines for the evaluation of automated information systems, it is therefore important to pay attention to the relationship between process and outcome.

Computer Systems↗
PubMed1994

ATIM, accompanying measure on the assessment of information technology in medicine.

ATIM is an Accompanying Measure under the AIM programme which aims at developing consensus on methods and criteria for assessment of Information Technologies applied in health care and at the application of these methods in two AIM project lines: (a) Knowledge Based and Decision Support Systems and (b) Medical Multimedia Workstations and Images. ATIM builds on, and coordinates assessments and evaluations which are planned in current AIM projects. It consists of workshops, meetings and the coordination of assessments in the two project lines. Networking is an essential element. The main goal of ATIM is to demonstrate the value of assessment to the various actors in this field. One of the end-products of ATIM will be a handbook on how to assess information technologies in medicine, with practical examples from AIM projects.

Artificial Intelligence↗
PubMed1994

Presentation of electronic patient data and medical audit.

With the increasing use of computers to store patient data and to use these data as an electronic patient record to support the direct patient care these data now play an essential role in the care process. Such a role can be expected to expand in the years to come. It is widely recognised that such use of data for direct support of patient care increases the need for security (in particular integrity and availability). However, until now little attention has been paid to the requirements for the system from the point of view of medical audit. If the data retrieved may play an important role in the care process it is important to be able to judge whether the health care professional has acted properly in view of the electronic information that was (or could have been) at his disposal. During one of the IMIA working conferences this issue was identified. In this paper the issue is explored further. Both requirements and technical consequences are discussed.

Computer Communication Networks↗
PubMed1992

Workshop aims, outline of the program.

This workshop on the Technology Assessment of PACS has been organized as a rounding off of the Technology Assessment activities which were initiated within the Dutch PACS Project (1986-1989). It is made possible by a funding from the Dutch Ministry of Health Care (WVC). We hope it will be not only a rounding off, but will contribute to more intensive cooperations in this area. In the scope of the Dutch PACS project, the software package CAPACITY for cost analyses of PACS has been developed, to stimulate the dialogue and exchange of data. During the workshop, the data which were collected with CAPACITY are used as a framework for discussions. This paper presents the outline of the workshop, its background, its aims and the program.

Cost-Benefit Analysis↗
PubMed1992

Do the benefits outweigh the costs of PACS? The results of an International Workshop on Technology Assessment of PACS.

On May 26-27, 1991, an International Workshop on the Technology Assessment of PACS was held at Enkhuizen, The Netherlands. During this workshop 35 experts in the field, from 13 different countries, discussed amongst others the required functionality of PACS, diagnostic aspects and the quality of care and organizational aspects. The key question was whether, when and how PACS is feasible, both from a financial and a clinical point of view. Data which were collected with the aid of the software tool CAPACITY formed the starting point of this meeting. This paper gives an outline of the discussions during this workshop. The main conclusion is that more clinical research is needed, to get a better insight into the costs and the clinical benefits of PACS. Because of the high costs of the PACS technology, international cooperation in this field is requested. It is recommended that the CAPACITY project, which is set up to stimulate the international dialogue and data exchange on PACS, is continued.

Cost-Benefit Analysis↗
PubMed1991

Benefits and threats of new technologies.

In this paper first the effect of new hardware and software technologies on threats to data integrity and usage integrity is considered. Next the potential is considered of new technical facilities for improving the protection. It is concluded that the increasing risks for data and usage integrity are not counter balanced at present by new protection measures. A concerted action is proposed to face this problem. Especially action is proposed to develop methods for quality assurance of software, for access control in networks and to improve data/usage integrity around PC's.

Computer Security↗
PubMed1990

Picture archiving and communication system design issues: the importance of modelling and simulation.

Picture archiving communication system (PACS) development turns out to be very complex. Due to both the vast amount of data and the complexity of hospital organizations, currently only small-scale systems have been realized. And although the experiences obtained with these systems are essential, there is a risk for underestimating the complexity and requirements inherent in hospital-wide PACS systems. In this paper, it is advocated that modelling and simulation be used as tools to obtain insight into the behavior and structure of future PACS systems. Modelling and simulation can also be used to actively support the design of PACS, especially its software. In order to capture the full complexity of PACS in a simulation model, and to take full advantage of simulation as a design tool, the development of a new modelling method has begun. This method is based on semantic data models and decision processes, and can be used for both system analysis and design. The first systems modelled with this method were imaging procedures in a hospital and a computer network. The resulting simulation models are a direct reflection of reality, and have a high degree of modularity. Consequently, in spite of the complexity of the systems, their models are easy to understand and maintain.

Computer Simulation↗