Search PubMed⌕ Search

Biomedical subjects

D A Tribble

Publications and source records attributed to D A Tribble.

11 recordsLinked to original sources
PubMed2001

The Health Insurance Portability and Accountability Act: security and privacy requirements.

The security and privacy requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and their implications for pharmacy are discussed. HIPAA was enacted to improve the portability of health care insurance for persons leaving jobs. A section of the act encourages the use of electronic communications for health care claims adjudication, mandates the use of new standard code sets and transaction sets, and establishes the need for regulations to protect the security and privacy of individually identifiable health care information. Creating these regulations became the task of the Department of Health and Human Services. Regulations on security have been published for comment. Regulations on privacy and the definition of standard transaction sets and code sets are complete. National identifiers for patients, providers, and payers have not yet been established. The HIPAA regulations on security and privacy will require that pharmacies adopt policies and procedures that limit access to health care information. Existing pharmacy information systems may require upgrading or replacement. Costs of implementation nationwide are estimated to exceed $8 billion. The health care community has two years from the finalization of each regulation to comply with that regulation. The security and privacy requirements of HIPAA will require pharmacies to review their practices regarding the storage, use, and disclosure of protected health care information.

Confidentiality↗
PubMed1998

Accuracy of three automated compounding systems determined by end-product laboratory testing and comparison with manual preparation.

The accuracy of three parenteral nutrient (PN) automated compounding systems and the usefulness of end-product laboratory testing of PN solutions were evaluated. Ten identical PN solutions were prepared by the Nutrimix (Abbott), MicroMacro 23 (Baxa), and Automix-Micromix (Clintec) compounders and manually. Three samples were removed from each of the 40 solutions. Dextrose was measured by high-performance liquid chromatography using a modified sorbitol assay; sodium, potassium, calcium, and magnesium were measured by atomic absorption spectroscopy. Theoretical concentrations of ingredients in the PN solution were adjusted by the actual concentrations in the source containers. The solutions differed significantly in their concentrations of glucose, calcium, and magnesium but not in their concentrations of sodium and potassium. The mean glucose concentrations produced by the manual method and Nutrimix system matched the adjusted theoretical values and by the MicroMacro and Automix-Micromix compounders were within the manufactures' accuracy specifications. The sodium concentrations of all solutions were higher than the adjusted theoretical concentration but within the manufacturers' specifications. Potassium and magnesium concentrations were lower in all solutions than the adjusted theoretical concentrations. Calcium concentrations were above the adjusted theoretical value in all solutions. Differences in compounder accuracy, even when significant, were not consistent and not appreciable. Multiple samples of the same solution should be tested if laboratory analysis is part of quality control.

Automation↗
PubMed1995

Interfaces between computer systems.

Interfaces between computer systems are reviewed. An interface establishes a physical connection between two computer systems, a conversational syntax, a format for logical messages passed between the systems, and a data-encoding structure understood by both systems. Interfaces are usually implemented as software modules and consist of three "layers." The physical layer contains the actual physical connection and the hardware, firmware, and software that make the connection work. The protocol layer ensures that the bits of data sent across the interface by the sending system are received intact and in the correct sequence. The logical layer organizes the data to be sent into a form that can be read by the other system. Interfaces can be described by whether they operate in batch or real time, whether they are unidirectional or bidirectional, and the medium used to establish the physical connection (e.g., the exchange of a floppy disk or with an RS-232 serial connection). The real challenge to producing an interface lies in ensuring that the transactions between the two systems are meaningful. An interface engine allows one computer system to interface with several others through a single connection. A good interface has invisibility, reliability, timeliness, flexibility, terseness, and utilities. In planning an interface, goals and the proposed exchanges of data should be clearly defined. The interface should be the simplest one that meets a pharmacy's needs. When the specifications for the interface are completed, the pharmacy should thoroughly test the interface.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1987

A prescription for better pharmacy computerization.

The net effect of these features in an integrated system is that the pharmacist spends time more productively managing patient drug therapy, not the computer system. The patient's location and demographics, once entered, are immediately available in a clinically useful form. Information about medications, the patient's responses to them and all other clinical parameters is available in the pharmacy without leaving the pharmacy application, making the pharmacist more effective and efficient. Physicians' orders are qualified by the system as they are entered, minimizing the number of nonproductive encounters between the pharmacist and the physician. Medication orders arrive at the pharmacy in a more timely manner and with fewer problems. The pharmacy can, in turn, be more responsive, helping the patient receive medication that is timely, accurate and clinically appropriate. These benefits arise primarily as a by-product of the pharmacy being integrated into an information system environment in which data is easily and directly accessed and shared. The more closely the pharmacy and its information requirements are examined, the more important the integration component appears. Many of the above benefits are not achievable with a dedicated stand-alone pharmacy computer system; some are achievable with an interface to a stand-alone nursing-station based HIS. In the pharmacy, is to increase and flourish in its role as an important and integral part of the healthcare delivery team, then access by the pharmacist to all patient information, and access by other providers to information contributed by the pharmacy is a necessary requisite. Improvement inpatient care can be the only result of such enhanced interchange.

Hospital Information Systems↗