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Biomedical subjects

J P Glaser

Publications and source records attributed to J P Glaser.

At least 19 recordsLinked to original sources
PubMed1999

The Brigham integrated computing system (BICS): advanced clinical systems in an academic hospital environment.

The Brigham integrated computing system (BICS) provides nearly all clinical, administrative, and financial computing services to Brigham and Women's Hospital, an academic tertiary-care hospital in Boston. The BICS clinical information system includes a very wide range of data and applications, including results review, longitudinal medical records, provider order entry, critical pathway management, operating-room dynamic scheduling, critical-event detection and altering, dynamic coverage lists, automated inpatient summaries, and an online reference library. BICS design emphasizes direct physician interaction and extensive clinical decision support. Impact studies have demonstrated significant value of the system in preventing adverse events and in saving costs, particularly for medications.

Computer Security↗
PubMed1998

The challenge of integrating clinical information systems in an integrated delivery system.

The development and implementation of the information systems necessary to support an effective and efficient continuum of care and to measure the quality and cost of that care present complex information systems integration challenges. The article discusses the integration challenges and concludes with a review of strategies that an integrated delivery system can adopt to begin to address them.

Computer Systems↗
PubMed1998

Components of the optimal ambulatory care computing environment.

We present here a framework of core components of an ambulatory care computing environment, based on clinical and functional needs and workflow scenarios. We have established this framework through the use of two study devices: a vision of the clinical office of the future, and a survey of possible computer applications, both designed to help clinicians and practice directors communicate their information needs to systems designers. Clinicians prioritize applications based on strategic and practice goals: support for clinical users' workflow, improved quality of care, reduced cost of care, and the ability to measure performance and status. By reorganizing the needed functionality from a clinical viewpoint into a technical viewpoint, we are able to identify core information components for systems design. Based on this analysis, information needs in the ambulatory environment can be divided into five primary functions: patient data retrieval, documentation, communication, knowledge resources, and aggregate reporting. Three other fundamental processes--knowledge-based interventions, information integration, and confidentiality--run through all of these front-line functions. Component applications and data structures built with this framework in mind will afford a maximum combination of functionality and flexibility to handle future changes in the clinical environment.

Ambulatory Care↗
PubMed1997

Internet policy and procedures for health care organizations: the approach of Partners Healthcare System, Inc.

The internet, and in particular the World Wide Web, are becoming significant elements of health care organization's strategic information technology plans. The Internet, although having great potential, also poses risks to the organization, and its use must be managed. The article discusses the Internet policies and procedures developed by Partners Healthcare System, with emphasis on the philosophies behind and the major components of the policies and procedures.

Authorship↗
PubMed1993

The role of the chief information officer in the health care organization in the 1990s.

During the next decade, the role of the CIO will change in two major areas: 1. The relative importance of the CIO as the person who translates business and clinical needs into information technology ideas will diminish. Although this portion of the CIO role will not disappear, this role will be increasingly filled by senior management, clinicians, and other members of the hospital staff. 2. The CIO role will need to shift from an emphasis on managing implementations and projects to developing and advancing the infrastructure. CIOs need to distinguish between the expression of the asset (the application portfolio) and the information technology infrastructure (the remaining four components of the asset). While being pressured to deliver more applications, they can fail to invest in and manage the infrastructure. This is a mistake. By neglecting management of and investment in the infrastructure (e.g., staff training and data quality) or by failing to take advantage of new technologies, they can hinder the ability of an organization to deliver superior applications. Poor data quality will cripple an executive information system and a too-permissive stance toward hardware and operating system heterogeneity will hinder the ability to deliver a computerized patient record. Although some management of the infrastructure is in place, in general it is insufficient. Few organizations have both a distinct data management function and a technical architecture plan, and also develop and enforce key technical, data, and development standards. This insufficiency will hinder their ability to effectively and efficiently apply their information technology infrastructure. The role of the CIO will evolve due to several powerful forces.(ABSTRACT TRUNCATED AT 250 WORDS)

Diffusion of Innovation↗
PubMed1993

The future of clinical information systems: one hospital's perspective.

Developing advanced clinical information systems is a complex and arduous task. The pressures on the health care delivery system make the task imperative. Because of such a system's complexity, its potential to alter radically the practice of medical care, and the magnitude of the required investment, health care delivery organizations would be well served by a thoughtful determination of the perspectives, philosophies, and strategies that will govern the approach to this task. This article has presented a description of the results of the deliberations of the leadership of one organization, the Brigham and Women's Hospital. The ideas and activities described should prove useful to other organizations engaged in their own deliberations.

Academic Medical Centers↗
PubMed1993

Response to a trial of physician-based inpatient order entry.

Our group has developed a physician-operated inpatient order-entry system (BICS-OE). Mindful of the problems inherent in bringing a radical cultural change such as this to the hospital, we conducted two pilots of the system prior to its full implementation. Physicians and nurses both identified a number of benefits from the use of OE. Physicians reported a number of areas where OE use was difficult or could be improved; nurses reported fewer problems. Based on the pilot trials, we modified the interface and some data constructs. These changes have enhanced the usefulness of OE in patient care in our hospital, and can serve as a model to others developing order entry.

Attitude to Computers↗
PubMed1991

A very large PC LAN as the basis for a hospital information system.

Brigham and Women's Hospital is converting its financial, administrative and clinical information systems from a mini-computer environment to a platform based on MUMPS and a network of several thousand personal computers. This article describes the project rationale and status and provides an overview of the architecture of the new system. The initial results of the project indicate that the personal computer network can provide large amounts of processor power and storage at costs per unit of power and storage that are several times less expensive than the minicomputer environment. The performance of the converted Accounts Payable system indicates that the architecture can deliver acceptable performance.

Hospital Information Systems↗
PubMed1991

The Longwood Medical Area Network.

The Longwood Medical Area Network (LMAnet) is a high speed fiber optic network that connects several patient care, research, and educational organizations in Boston's Longwood Medical Area. This paper describes the architecture of the network, current and potential future uses of the network, network costs and administration, and management issues associated with the use of LMAnet.

Boston↗
PubMed1989

The difference between interfaced and integrated systems.

The definitions of an "integrated system" and an "interfaced system" are unclear. Consequently, purchasers and developers of systems are often unable to judge the degree to which a system is integrated. This paper presents definitions of integrated systems and interfaced systems, describes the differences between the two, and reviews resulting conclusions.

Computer Systems↗