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PubMed1990

Trends in laboratory information systems: 1980-1990.

Laboratory information systems are charged with the responsibilities of controlling costs, improving productivity, improving reporting and expanding management control over operations. The LIS that can meet these challenges must allow significant flexibility, interfacing and integration with other systems, efficient operations and enhanced information management. In the current environment of "do more with less," a well-designed, cost-effective laboratory information system is essential to the economic survival of today's laboratory.

Clinical Laboratory Information Systems↗
PubMed2001

Economic analysis of a filmless system based on the hospital information system.

A filmless system (FLS) based on a picture archiving and communication system (PACS) equipped with UNIX work- stations and a local area network (LAN) specialized for viewing radiographs has not been deemed acceptable, for reasons of economics. However, personal computers (PCs) have recently become more powerful, to the point where PCs approach UNIX workstations in terms of capabilities. As a result, a PC-based image viewing workstation (IVW) has sufficient functions for practical use. Diagnostic resolution is not equal to that of film, but is comparable. Since the hospital information system (HIS) includes many PC terminals connected by a LAN, the cost problem can be resolved by using these PC terminals as the IVWs. In order to investigate the practicability of this idea, two types of FLSs using HIS facilities were designed: one is a system based on the use of high-resolution cathode ray tubes (H-CRTs), and the other is based on the use of conventional CRTs and radiologist reports, minimizing the number of H-CRTs. The total costs of the two systems were analyzed. As a result, the former FLS was found to be about 15% more expensive than the latter, which was less expensive than a film-based system (FBS). However, whether the FLS is more profitable than the FBS from the viewpoint of hospital management strongly depends on the medical insurance system.

Costs and Cost Analysis↗
PubMed1989

[Information systems in epidemiology].

At present epidemiological informations are dispatched from epidemiological departments of regional hygiene stations in different forms to different departments. The separate follow up of partial information leads to the development of different isolated information systems. Individual information systems help to resolve information problems in epidemiology, they provide, however, only limited opportunities when causal relations are sought and applied in the control of diseases. Surveillance calls for a uniform information system which concentrates scattered information in a single epidemiological centre. The author formulates possible approaches to the solution of the information problem in epidemiology.

Epidemiology↗
PubMed1998

Toward a standardised information system for dentistry.

Information technology is growing rapidly in both its capability and capacity to support the delivery of health care. This paper describes the work of the Dental Interspec project, commissioned by the Department of Health. The aim of the project is to provide a framework for the development of information management and technology in dentistry. It is hoped that the work of this project can be built on to eventually produce integrated information systems which would have the potential to improve primary dental care delivery for both patients and dentists.

Computer Communication Networks↗
PubMed1995

Coding systems and controlled vocabularies for hospital information systems.

Modern healthcare information systems are requested to support an increasing interaction among professionals (inside and across the borders of the hospital) and a growing integration of specialised tasks (provision of care, reimbursement, document retrieval, optimisation of resource use, clinical audit, etc.). Coding systems were conceived and optimised independently for various specific purposes. They are now facing each other and thus conflicting into this new environment; the solution will be in a more application-independent representation of concepts. Developments are going towards three complementary directions: (i) to separate different functions about the management of terms and concepts, and thus to produce more specialised software components; (ii) to develop a new class of software which is able to manage terminological diversity without imposing uniformity; and (iii) to enhance reusability of concepts, and facilitate a spontaneous convergence among controlled vocabularies.

Artificial Intelligence↗
PubMed1992

A computerized cancer information system.

Cancer information was made available via a computer to patients visiting the University of Connecticut Dental Clinics. The computer program was menu driven. An option allowed users to leave messages for the system owners. The computer program generated a log of usage, user comments and items chosen. The user could choose from the following topics: (1) general information on cancer; (2) diet, nutrition and cancer; (3) smoking; (4) the environment, occupations and cancer; and (5) physical checkups. An option to leave a message for the system operators was the option chosen least. Analysis of the usage log shows that the system was used substantially while people were waiting in the clinic and that at least three or four individuals used the system every clinic day. Such information systems can provide important information to the public. The novelty of the system and the lack of supervision did not deter public use.

Connecticut↗
PubMed1987

Enhancing CEOs' decision making through information systems.

Although healthcare management information systems significantly enhance the decision-making capacity of the chief executive officer (CEO), some CEOs make limited use of this potentially powerful management ally. A central management issue is finding the optimal fit between the CEO's roles and responsibilities and the capacity of information systems to adapt to and support these functions. Thus data system designers must clearly understand the CEO's needs, management tasks, and unique responsibilities. An often misunderstood concept is that data by themselves are not immediately useful and applicable to managerial needs. To become useful information, data must be timely, accurate, relevant, and actionable. CEOs may be disappointed with management information systems because of an inherent conflict between what the computer can do best--rapid, routinized solutions--and what top management usually requires. The CEO's decisions are generally singular, and the system's data may not be structured to serve those decision-making requirements. Building a system that is responsive to the CEO's needs requires an equal partnership between the CEO, data manager, and system designer. The CEO also must be willing to invest a lot of time in shaping the facility's system. In addition, because of the considerable and escalating cost of developing, using, and maintaining organizational data systems, CEOs must assess the cost/benefit ratio of obtaining additional information from existing data bases.

Computer Systems↗
PubMedDate not supplied

Health managers' perception of the primary health care management information system: a case of Bama Local Government in northern Nigeria.

BACKGROUND: Evaluating the quality and performance of Primary Health Care (PHC) systems depend on the information system's capacity to generate reliable and accurate information, within social, cultural, and economic context. This paper reports an assessment of a PHC health management information system from PHC Managers'perspectives, METHODS: An adapted 3-part Donabedian model informed our assessment of the structure, process and outcomes of the PHC health information system. Pre-tested, semi-structured questionnaires were administered to the PHC Coordinator, 6 Deputy Coordinators, and 18 officers responsible for the health facilities in Bama Local Government Area of Borno State. RESULTS: Majority of the respondents (n=11) believed that staffing at PHC level was inadequate. Only 5 (27.8%) of the managers had training specific to completing HMIS forms. All the facilities were reported to possess registers for the study year (1993), but their numbers dropped by half consecutively down the preceding years to 1990. None reported a health facility that had a copy of the requisite M&E manual guide to HIMIS. Nonetheless 14 reported that report submissions were timely; chief factors causing delays were lack of transport (35.5%), bad roads (16.1%), and scarcity of forms (9.7%). Twelve (12) of the managers judged that the data collected were always or sometimes accurate. Though only 5 crosschecked data to verify accuracy of the submissions. Eight (8) were of the opinion that computerisation was not necessary for rural PHC information system, and eleven (11) felt that the Bama PHC was not ready for computerisation. Twelve (12) of them felt that the quality of the PHC information system had improved since its devolution to the LGA, however, the main suggestions offered to improve the MIS in general were personnel training (32%), feedback from higher levels (20%), and availability of transportation (16%). CONCLUSION: The information system is only as good as the organisation it serves. Results of this study show majorgaps in the structure of the HMIS at the PHC level which is responsible for gathering data onward to the federal level that culminates in epidemiological and health information for the country. Emphasis for intervention for strengthening information systems should be on starting with generating information for local use, and building local capacity to utilise derived information for daily PHC planning, decision-making and management before the prospect of collecting data for upward submission to higher levels.

Attitude of Health Personnel↗
PubMed2001

From legacy and client/server systems to components in healthcare information systems in Finland.

A strategy and toolset (FixIT) for migrating a specific type of legacy systems--based on the FileMan DBMS of the U.S. Department of Veterans Affairs--to a two-tier client/server and web browser-based architecture was presented in MEDINFO'98. In the current paper we discuss the further migration to a multitier software component architecture. A literature survey and industry contacts were used to specify an open, component-based target architecture for healthcare information systems to be reached by the year 2005, as well as a phased migration strategy from the present FileMan/FixIT-based systems towards the target. The target architecture is based on large-grained business components and accommodates heterogeneous elements on the intra-component, intra-application, intra-organization and inter-organizational levels. Four logical tiers are identified within a business component. Three migration paths are specified for different cases: the tier-by-tier, piece-by-piece, and web-wrapping paths. It is argued that the architecture, supported by off-the-shelf toolsets, application frameworks and a new software development process, makes it possible to turn legacy systems into a valuable asset, split monolithic applications into reusable components, and ultimately replace the legacy parts at a feasible pace

Database Management Systems↗
PubMed1998

Health services research, outcomes, and perinatal information systems.

The progress in information and communication technology, together with the search for the most effective and efficient ways to use the limited resources for health care, are opening new areas for research and development in perinatal care. Information systems and practice oriented by evidence-based medicine are modifying the operation of health services, and the quality of their management is being monitored by the success of their outcomes. As a study case, a Perinatal Information System widely used in Latin America and the Caribbean is discussed in some detail. Future challenges in the compatibility of information systems and databanks, the need for longer follow-up periods and measurement of health-related quality of life as outcomes for perinatal care, and the strategies to integrate all these concepts for the improvement of daily practice are discussed.

Caribbean Region↗
PubMed1991

Open systems architecture. The multivendor hospital information system.

Optimum productivity and performance are attained by permitting each functional division of a hospital to choose the optimum information system for its own needs. Quality patient care depends on the ability to coordinate and communicate the information generated in each department to the patient's bedside. Communication standards are now available to facilitate the melding of these two disparate requirements.

Database Management Systems↗
PubMed2001

Securing interoperability between chip card based medical information systems and health networks.

Health information systems supporting shared care are going to be distributed and interoperable. Dealing with sensitive personal medical information, such information systems have to provide appropriate security services, allowing only authorised users restricted access rights to the patients' data according to the 'need to know' principle. Especially in healthcare, chip card based information systems occur in the shape of patient data cards providing informational self determination and mobility of the users as well as quality, integrity, accountability, and availability of the data stored on the card, thus improving the shared care of patients. The DIABCARD project aims at the implementation and evaluation of a chip card based medical information system (CCMIS) for facilitating communication and co-operation between health professionals in different organisations or departments caring the same patient with diabetes as an example. In co-operation with the EC-funded TrustHealth(2) project, communication and application security services needed are provided like strong authentication as well as the derived services such as authorisation, access control, accountability, confidentiality, etc. The solution is based on Health Professional Cards and Trusted Third Party services. In addition to the secure handling of the patient's chip card and data in DIABCARD workstations, the secure communication between these workstations and related departmental systems has been implemented. Based on the results of this feasibility study, an enhanced security services specification for the DIABCARD example of a CCMIS is provided which will be implemented in the framework of a health network being established in the German federal state Bavaria. Beside the preferred solution of a combination of Patient Identification Card and Patient Data Card, lower level alternatives using card-verifiable certificates are explained in some details. Finally, a few legal issues, future trends like the XML standard set and their implications for the solution presented as well as for distributed health information systems in general are shortly discussed.

Computer Security↗