Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 10708255

Framework for a clinical information system.

R Van de Velde
View original source ↗Export metadata ↓

Abstract

The current status of our work towards the design and implementation of a reference architecture for a Clinical Information System is presented. This architecture has been developed and implemented based on components following a strong underlying conceptual and technological model. Common Object Request Broker and n-tier technology featuring centralised and departmental clinical information systems as the back-end store for all clinical data are used. Servers located in the 'middle' tier apply the clinical (business) model and application rules to communicate with so-called 'thin client' workstations. The main characteristics are the focus on modelling and reuse of both data and business logic as there is a shift away from data and functional modelling towards object modelling. Scalability as well as adaptability to constantly changing requirements via component driven computing are the main reasons for that approach.

Explore related subjects

Appointments and SchedulesArtificial IntelligenceDatabases as TopicEquipment DesignHumansInformation SystemsLocal Area NetworksMedical Records Systems, ComputerizedSoftwareSystems IntegrationUser-Computer InterfaceJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R Van de Velde. 2000. Framework for a clinical information system.. https://doi.org/10.1016/s1386-5056(99)00062-3

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Computer modeling of patient flow in a pediatric emergency department using discrete event simulation.

UNLABELLED: Increasing patient census and department overcrowding are universal concerns in pediatric emergency medicine. Accurate predictions of patient flow and resource utilization in the pediatric emergency department (PED) are important in determining what aspects of PED activity could be modified to improve patient flow, reduce patient waiting times, and increase staff efficiency and morale, and thus direct change more effectively. BACKGROUND: We report (1) the construction of a Patient Flow Model (PFM) using discrete event simulation to test simulated PED staffing scenarios that were designed to alleviate the pressures that result from increased census and overcrowding, and (2) a Physician Scheduling Analysis Tool to assist in physician scheduling. METHODS: Arena discrete event simulation modeling software was used to develop a model of PED patient flow after extensive interviews with PED staff and direct observation of patient flow in July 2005. A total of 517 patients were directly observed, and all modeled aspects of their interaction with PED staff and resources were recorded. Historical demographic patient arrival information was combined with observed patient flow data to provide simulated patient arrival rates for the PFM and was also used to construct the Physician Scheduling Analysis Tool. Validation of the PFM was performed by comparing annual simulated patient flow data with actual patient flow data. Previously determined staffing scenarios were applied to the simulation and the resulting performance indicator outputs examined. RESULTS: The PFM was validated on model-wide and process-specific levels, with excellent validation observed on high acuity-patient length of stay and for highly detailed processes such as triage and registration. Simulation of the addition of a hospital volunteer and a second triage nurse demonstrated reductions in pretriage waiting time and the proportion of patients waiting longer than 30 or 60 minutes for pretriage. Simulation of an extra physician shift to the staff schedule demonstrated reductions in length of stay for patients of all triage categories. CONCLUSIONS: The PFM accurately represents patient flow through the department and can provide simulated patient flow information on a variety of scenarios. It can effectively simulate changes to the model and its effects on patient flow.

Appointments and Schedules↗
PubMed2006

Use of time by physiotherapists and occupational therapists in a stroke rehabilitation unit: a comparison between four European rehabilitation centres.

PURPOSE: The aim of this study was to compare the time allocated to therapeutic activities (TA) and non-therapeutic activities (NTA) of physiotherapists (PT) and occupational therapists (OT) in stroke rehabilitation units in four European countries. METHOD: Therapists documented their activities in 15-min periods for two weeks. They recorded: activity, number of patients, number of stroke patients, involvement of other people, location and frequency of each activity. Kruskal-Wallis tests and negative binomial regression models were used to compare activities between professional groups and between units. RESULTS: The average proportion of TA per day ranged between 32.9% and 66.1% and was higher for PT than for OT in each unit. For OT, significant differences emerged between the units in the proportion of time allocated to TA compared to NTA with British OTs spending significantly less time in TA. In the Belgian unit, three times less time was spent on patient-related co-ordination activities (e.g., administration, ward rounds) compared to the British and Swiss units. CONCLUSIONS: Time allocation differed between PT and OT and between units, affecting the time available for TA. Further investigation is necessary to study the effect of work organization in stroke rehabilitation units on the efficiency of rehabilitation regimes.

Appointments and Schedules↗