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Biomedical subjects

R Haux

Publications and source records attributed to R Haux.

At least 55 records · Page 3Linked to original sources

Object-oriented business process analysis of the cooperative soft tissue sarcoma trial of the german society for paediatric oncology and haematology (GPOH).

The German Society for Paediatric Oncology and Haematology (GPOH) runs nation-wide multicentre clinical trials to improve the treatment of children suffering from malignant diseases. We want to provide methods and tools to support the centres of these trials in developing trial specific modules for the computer-based DOcumentation System for Paediatric Oncology (DOSPO). For this we carried out an object-oriented business process analysis for the Cooperative Soft Tissue Sarcoma Trial at the Olgahospital Stuttgart for Child and Adolescent Medicine. The result is a comprehensive business process model consisting of UML-diagrams and use case specifications. We recommend the object-oriented business process analysis as a method for the definition of requirements in information processing projects in the field of clinical trials in general. For this our model can serve as basis because it slightly can be adjusted to each type of clinical trial.

Clinical Trials as Topic↗

Analysis and modelling of the multi-professional treatment process: preliminary results.

This paper presents first results of a research project aimed at improving co-operative work initiatives in hospitals. A holistic analysis of the treatment process is presented as a precondition for process reengineering, quality measurements and improvement of multi-professional co-operation. Treatment process modelling attempts within the last years have concentrated on specialised points of views, such as business process modelling or communication modelling. In contrast, we have developed a framework consisting of several views of the treatment process. We tested our framework in a broad system analysis within the Department of Child and Adolescent Psychiatry of the Heidelberg University Hospitals. Our preliminary results support the framework. Weaknesses were described precisely in both the field of organisational procedures and information management.

Comprehensive Health Care↗

Recording clinical data--from a general set of record items to case report forms (CRF) for clinics.

Standardising a documentary language makes only sense if we use it for documentation consequently. Using an example of Paediatric Oncology in Germany we have developed a procedure that generates CRFs from a documentary language. The introduced procedure has proved to be feasible in practice. With it we can support developers of documentation systems in creating their CRFs; through the guaranteed use of the documentation terminology we further achieve that information recorded with the created CRFs may be statistically analysed across different institutions.

Clinical Trials as Topic↗

Integration of clinical practice guidelines into a distributed regional electronic patient record for tumour-patients using XML: a means for standardization of the treatment processes.

With the rising efforts to guarantee a high quality treatment in medicine and to reduce the costs in the health care system, Clinical Practice Guidelines (CPG) have developed into a very important reference in medicine. CPGs are especially useful for the standardization of multi-professional treatment processes like the care for patients with malignant diseases. The Tumour-Centre Heidelberg/Mannheim (Germany) leads a project to build up a regional, virtual distributed Electronic Patient Record (EPR) for patients with malignant diseases in the Rhein-Neckar-Area. Aims of the first stages of the project are the introduction of the distributed EPR to two co-operating pilot-clinics. In this context we intend to provide access for medical professionals not only to the data of the jointly treated patients, but also to relevant existing CPGs and other medical knowledge sources like Medline and Cochrane-Library. Knowledge and Patient data should be interlinked to offer patient-specific views on the CPG-information. As all professions have different information needs, this views should be presented individualized according to the demands of the users. We analysed three relevant CPGs and defined a meta-structure that will be refined to a common meta-structure for CPGs in Oncology. CPGs as well as structured patient-documents will be implemented in the Extensible Markup Language (XML), as this platform-independent technology seems to suit our needs for data exchange and presentation purposes best. The implementation process will be accompanied tightly with evaluations to gain experience for further expansions of the EPR. The vision of the project is, that by integrating CPGs in a shared distributed EPR, the way towards standardized treatment processes in a local, but multi-professional setting, and the efforts to guarantee a high quality treatment in Oncology can sufficiently be supported.

Computer Communication Networks↗

Using the eXtensible Markup Language (XML) in a regional electronic patient record for patients with malignant diseases.

Communication between different institutions which are responsible for the treatment of the same patient is of outstanding significance, especially in the field of tumor diseases. Regional electronic patient records could support the co-operation of different institutions by providing ac-cess to all necessary information whether it belongs to the own institution or to a partner. The Department of Medical Informatics, University of Heidelberg is performing a project in co-operation with the Thoraxclinic-Heidelberg and the Department of Clinical Radiology, University of Heidelberg with the goal: to define an architectural concept for interlinking the electronic patient record of the two clinical institutions to build a common virtual electronic patient record and carry out an exemplary implementation, to examine composition, structure and content of medical documents for tumor patients with the aim of defining an XML-based markup language allowing summarizing overviews and suitable granularities, and to integrate clinical practice guidelines and other external knowledge with the electronic patient record using XML-technologies to support the physician in the daily decision process. This paper will show, how a regional electronic patient record could be built on an architectural level and describe elementary steps towards a on content-oriented structuring of medical records.

Computer Security↗

Systematic evaluation of computer-based nursing documentation.

The documentation of the nursing process is an important, but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems, such as low quality, are reported and it is still unclear if computer-based documentation systems can reduce these problems. We therefore introduced a computer-based nursing documentation system on four wards of the University Hospitals of Heidelberg. We systematically evaluated its preconditions and its effects in a pre-test post-test intervention study. We combined objective data (e.g., based on quality checklists) with subjective data drawn from questionnaires and interviews. In this paper, we present preliminary results, focussing on detailed results from the first two wards.

Attitude to Computers↗

Mobile information and communication tools in the hospital.

Mobile information and communication systems in clinical routine have the potential to greatly improve communication, facilitate information access, eliminate double documentation, and increase quality of patient care in the long run. Projects to date have focused, for the most part, on highly specialized applications of the mobile computer. In our research project, 'Cooperative Problem Solving in Health Care', we have, among other things, designed a multifunctional mobile information and communication assistant. A prototype version of this system was implemented. This article outlines the close-to-reality evaluation of our prototype in a 1-week simulation study in a Heidelberg University hospital. We describe methods, aims, design and results of the simulation study, as well as discuss our methodology and the results we have obtained. We argue that the diverse requirements of different professional groups cannot be fulfilled by a single multifunctional device and propose, therefore, a 'multi-device mobile computer architecture'. Finally, we present consequences for the future computing infrastructure.

Attitude of Health Personnel↗

The medical informatics curriculum at the University of Heidelberg/School of Technology Heilbronn: new developments in its 5th revision.

We report about new developments in the 5th version of the medical informatics program at the University of Heidelberg/School of Technology Heilbronn, reflect our approaches for the revision and discuss our current curriculum in relationship to other curricula in health informatics and medical informatics. The specialised university curriculum for medical informatics at the University of Heidelberg/School of Technology Heilbronn is one of the oldest educational approaches in the field of medical informatics. During more than 25 years approx. 1000 students graduated. The program belongs to the category of dedicated master programs for medical informatics and is based on the concept of medical informatics as a medical discipline of its own. It covers the total spectrum of medical informatics ranging from information systems in health care, biosignal and medical image processing, medical documentation, to information and knowledge processing in medicine. It is a 4.5 years program with a strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. For the 5th version of the Heidelberg/Heilbronn curriculum on medical informatics, having started at winter semester 1997/98, we hope to have reflected the evolution of medical informatics as a separate discipline, moving one step further towards educating medical informatics, and not 'just' medicine and informatics.

Curriculum↗

Thoughts about curricula in health informatics.

In this contribution it is argued that it is difficult to talk of medical informatics education since the groups that need education in this field are not very homogeneous. Also these groups overlap. WG 1 of IMIA is in the process of producing recommendations for curricula in medical informatics. The target groups are defined by their career type, which is categorised using three axes: discipline, stage of career and level of expertise. An example is given of the knowledge requirements for medical students.

Career Choice↗

IPHIE: an International Partnership in Health Informatics Education.

Medical informatics contributes significantly to high quality and efficient health care and medical research. The need for well educated professionals in the field of medical informatics therefore is now worldwide recognized. Students of medicine, computer science/informatics are educated in the field of medical informatics and dedicated curricula on medical informatics have emerged. To advance and further develop the beneficial role of medical informatics in the medical field, an international orientation of health and medical informatics students seems an indispensable part of their training. An international orientation and education of medical informatics students may help to accelerate the dissemination of acquired knowledge and skills in the field and the promotion of medical informatics research results on a more global level. Some years ago, the departments of medical informatics of the university of Heidelberg/university of applied sciences Heilbronn and the university of Amsterdam decided to co-operate in the field of medical informatics. Now, this co-operation has grown out to an International Partnership of Health Informatics Education (IPHIE) of 5 universities, i.e. the university of Heidelberg, the university of Heilbronn, the university of Minnesota, the university of Utah and the university of Amsterdam. This paper presents the rationale behind this international partnership, the state of the art of the co-operation and our future plans for expanding this international co-operation.

Curriculum↗

Analysis and modeling of the treatment process characterizing the cooperation within multi-professional treatment teams.

We would like to introduce several aspects of the analysis and modeling of the treatment process characterizing the cooperation within multi-professional treatment teams. We will determine what is meant by a treatment process in order to then look at five views and four levels of their description. We will introduce possible methods for surveying and describing it. Currently an extensive analysis of the current state of the treatment process and of the weaknesses is underway in the Department of Child and Adolescent Psychiatry of the Heidelberg University Medical Center.

Computer Simulation↗

Requirements and design aspects of a data model for a data dictionary in paediatric oncology.

German children suffering from cancer are mostly treated within the framework of multicentre clinical trials. An important task of conducting these trials is an extensive information and knowledge exchange, which has to be based on a standardised documentation. To support this effort, it is the aim of a nationwide project to define a standardised terminology that should be used by clinical trials for therapy documentation. In order to support terminology maintenance we are currently developing a data dictionary. In this paper we describe requirements and design aspects of the data model used for the data dictionary as first results of our research. We compare it with other terminology systems.

Child↗

Purpose and structure of strategic plans for information management in hospitals.

Information management in hospitals requires a strategic plan that gives directives for the construction and development of a hospital information system. The paper describes the purpose and a suggested structure for those strategic plans. This structure is a central component for a guideline that may be used for creating and updating strategic plans.

Germany↗

Integrating specialized application systems into hospital information systems--obstacles and factors for success.

Hospital information systems are often huge and heterogeneous systems. To support physicians with their daily clinical work, application systems are developed which are dedicated to particular medical fields or tasks and which have to be integrated into the hospital information system. The integration process is quite complicated, because it makes the information system's infrastructure even more heterogeneous. We developed an application system for documentation and therapy planning in pediatric oncology (DOSPO) and we started to introduce it into the Department of Pediatric Oncology of Heidelberg University Hospital. The fact that DOSPO is developed as a universal system for nationwide use made the integration process more difficult. In any case, the introduction of specialized application systems has to be planned systematically in advance, regarding the prevailing information system's infrastructure, available resources and established processes. To simplify the integration process comprehensive electronic patient records for the future should be designed in a way that they can be enhanced easily by new clinical functions.

Child↗

Web-based training: a new paradigm in computer-assisted instruction in medicine.

Computer-assisted instruction (CAI) programs based on internet technologies, especially on the world wide web (WWW), provide new opportunities in medical education. The aim of this paper is to examine different aspects of such programs, which we call 'web-based training (WBT) programs', and to differentiate them from conventional CAI programs. First, we will distinguish five different interaction types: presentation; browsing; tutorial dialogue; drill and practice; and simulation. In contrast to conventional CAI, there are four architectural types of WBT programs: client-based; remote data and knowledge; distributed teaching; and server-based. We will discuss the implications of the different architectures for developing WBT software. WBT programs have to meet other requirements than conventional CAI programs. The most important tools and programming languages for developing WBT programs will be listed and assigned to the architecture types. For the future, we expect a trend from conventional CAI towards WBT programs.

Artificial Intelligence↗