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At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Cognitive evaluation of decision making processes and assessment of information technology in medicine.

This paper describes cognitive methods for analyzing medical decision making and evaluating medical information systems. The overall approach focuses on understanding the processes involved in the decision making and reasoning of health care workers, both with and without the use of information technologies. The issue of developing appropriate evaluation tools, for use in the design and analysis of medical information systems is considered to be of great importance. However, conventional methods are limited in their ability to identify and characterize the effects of information technology on the cognitive processes involved in decision making and reasoning. In this paper a range of methods are described involving video recording for collecting data on the use of information systems. The techniques described allow for the collection of an integrated data set consisting of transcripts of health care workers as they 'think aloud' in interacting with a medical system, along with complete video records of user-computer interaction. In addition, the methods can be extended to allow for the collection of process data from video recording of systems in actual clinical and emergency situations. The use of a variety of approaches, borrowing from research in cognitive science, is discussed. The development and application of these evaluation methods within the Canadian Centres of Excellence network HEALNet is subsequently described. Finally, implications for the development and evaluation of medical information systems are considered.

Cognition↗
PubMed2005

Designing and implementing health data and information providers.

OBJECTIVES: To model and implement web portals providing access to certified and high-quality information in the domain of health. MATERIAL AND METHODS: The Unified Medical Language System (UMLS) knowledge sources of the U.S. National Library of Medicine and principles of implementation resulting from the previous ARIANE project are described. The XML technology that allows files transformations by the means of XSLT is briefly presented. RESULTS: The design and implementation of software modules that exploit knowledge sources, operate the translation of a user's query to selected information sources, and wrap obtained results are detailed. Querying documentary and factual medical databases are presented. DISCUSSION: Current implementation and wrapping perspectives are discussed in terms of integration and interoperability of health information and data resources.

France↗
PubMed2001

Integrated patient data for optimal patient management: the value of laboratory data in quality improvement.

Managed care organizations are shifting from traditional utilization management programs to focus on initiatives that improve the health of an insured population. This strategy requires sophisticated data integration to identify at-risk individuals and track outcomes. Laboratory data are becoming increasingly valuable tools for managed care organizations and healthcare providers. The HEDIS Effectiveness of Care measures have incorporated laboratory data into several key performance indicators. By building a comprehensive repository of laboratory data that includes both procedure codes and laboratory values, managed care organizations can realize substantial savings by avoiding the costly medical record reviews required when administrative data are incomplete. In addition to tracking clinical outcomes, laboratory data provide the ability to risk-stratify a population to target high-risk individuals for case management and disease management interventions. Healthcare organizations face several challenges in the integration of laboratory data into medical databases and practice management software. Confidentiality is a key consideration in view of recent healthcare regulations. Providers of laboratory services should work collaboratively with organizations setting standards for healthcare informatics to facilitate the pooling of data for quality improvement and outcomes research. Health Level Seven, Inc. (HL7), Logical Observation Identifier Names and Codes (LOINC), and Systematized Nomenclature of Medicine (SNOMED) will likely play a key role in this process.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Reinventing vital statistics. The impact of changes in information technology, welfare policy, and health care.

Vital statistics offers a case study in the potential of new information technology and reengineering to achieve better public sector performance. New technology--notably the shift from a paper to an electronic process for recording vital events and transmitting the data to public agencies--is creating opportunities to produce more timely, accurate, and useful information. The furthest advanced innovation is the electronic birth certificate. At the same time, changes in welfare policy and health care--including efforts to establish paternity at the time of birth and to improve health care outcomes--are creating pressures for more policy-relevant data about vital events. In addition, the rise of integrated health plans and health information networks is radically altering the organizational context of vital statistics. On the basis of a State-by-State survey of vital statistics officials, the authors estimate that at the end of 1994, 58 percent of all births in the United States were being recorded on an electronic birth certificate and communicated to a public agency electronically. Nearly all respondents reported that the electronic birth certificate brought improvements in both timeliness and accuracy of data. Achieving the full promise of the new technology, however, will require more fundamental changes in institutions and policies and a reconceptualization of the birth certificate as part of a broader perinatal information system.

Birth Certificates↗
PubMed2004

Perspectives on integrated child health information systems: parents, providers, and public health.

The efforts of families, health care providers, and public health programs to optimize health care and health outcomes for children are often limited by the lack of timely, complete, and accurate health information. Families frequently serve as the messenger between providers in providing clinical details that they may not understand, because the paper record of previous care is unavailable. Providers believe in the value of good information, but haven't the time, training, or financial resources to create better data sharing methods. Public health programs often must rely on unacceptably slow, redundant, or otherwise limited data collection efforts to provide population-based assessments of child health problems that inform public policy and program development. Integrated child health information systems allow the appropriate, secure sharing of health data that are critical to improving these processes. Developing such systems will require a strong commitment from these 3 stakeholder groups and attention to human values as well as technical challenges.

Attitude↗
PubMed2002

New perspectives on the use of Geographical Information Systems (GIS) in environmental health sciences.

At first glance, the domain of health is no typical area to applicate Geographical Information Systems (GIS). Nevertheless, the recent development clearly shows that also within the domains of environmental health, disease ecology and public health GIS have become an indispensable tool for processing, analysing and visualising spatial data. In the field of geographical epidemiology, GIS are used for drawing up disease maps and for ecological analysis. The striking advantages of GIS for the disease mapping process are the considerably simplified generation and variation of maps as well as a broader variety in terms of determining a real units. In the frame of ecological analysis, GIS can significantly assist with the assessment of the distribution of health-relevant environmental factors via interpolation and modelling. On the other hand, the GIS-supported methods for the detection of striking spatial patterns of disease distribution need to be much improved. An important topic in this respect is the integration of the time dimension. The increasing use of remote sensing as well as the integration into internet functionalities will stimulate the application of GIS in the field of Environmental Health Sciences (EHS). In future, the integration and analysis of health-relevant data in one single data system will open up many new research opportunities.

Ecology↗
PubMed2003

Application of QSTRs in the selection of a surrogate toxicity value for a chemical of concern.

As part of the EPA's mission to protect the environment, chemicals of concern (CoCs) at Superfund or other hazardous waste sites are cleaned up based on their potential toxicity to humans and the surrounding ecosystem. Oftentimes, there is a lack of experimental toxicity data to assess the health effects for a CoC in the literature. This research describes a method using Quantitative Structure Toxicity Relationships (QSTRs) for identifying a surrogate chemical for any given CoC. The toxicity data of the surrogate chemical can then be used to rank hazardous waste-site chemicals prior to cleanup decisions. A commercial QSTR model, TOPKAT, was used to establish structural and descriptor similarity between the CoC and the compounds in the QSTR model database using the Oral Rat Chronic LOAEL model. All database chemicals within a similarity distance of < or = 0.200 from the CoC are considered as potential surrogates. If the CoC fails to satisfy model considerations for the LOAEL model, no surrogate is suggested. Potential surrogates that have toxicity data on Integrated Risk Information System (IRIS), Health Effects Assessment Summary Tables (HEAST), or National Center for Environmental Assessment (NCEA) provisional toxicity value list become candidate surrogates. If more than one candidate surrogate is identified, the chemical with the most conservative RfD is suggested as the surrogate. The procedure was applied to determine an appropriate surrogate for dichlorobenzophenone (DCBP), a metabolite of chlorobenzilate, dichlorodiphenyltrichloroethane, and dicofol. Forty-seven potential surrogates were identified that were within the similarity distance of < or = 0.200, of which only five chemicals had an RfD on IRIS, HEAST, or on the NCEA provisional toxicity value list. Among the five potential surrogates, chlorobenzilate with an RfD of 2 x 10(-2) mg/kg-day was chosen as a surrogate for DCBP as it had the most conservative toxicity value. This compared well with surrogate selection using available metabolic information for DCBP and its metabolites or parent compounds in the literature and the provisional toxicity value of 3 x 10(-2) mg/kg-day that NCEA developed using a subchronic study.

Algorithms↗
PubMed1992

Analysis of OSHA inspection data with exposure monitoring and medical surveillance violations.

Occupational Safety and Health Administration (OSHA) inspection data from the Integrated Management Information System (IMIS) enforcement data base are presented for lead, ethylene oxide, and formaldehyde for fiscal years 1985, 1987, and 1989, and are discussed with emphasis on exposure monitoring or medical surveillance section violations. These data suggest that the exposure monitoring section of these standards is more commonly used to cite workplaces below these standards than is the medical surveillance section. Medical surveillance violations more commonly resulted in fines, but there were no differences in the magnitude of the fines for exposure monitoring or for medical surveillance violations. Implications of these findings are discussed.

Environmental Exposure↗
PubMedDate not supplied

Development of an integrated stroke outcomes database within Veterans Health Administration.

A fundamental goal of the Rehabilitation Outcomes Research Center of Excellence is to improve care and outcomes for veterans with rehabilitation needs. To achieve this goal, the Center's primary objective is increasing research capacity. The Integrated Stroke Outcomes Database is a collection of Veterans Health Administration (VHA) clinical and administrative data containing patient information on a cohort of stroke patients found in the Functional Status Outcomes Database (FSOD), National Patient Care Database (NPCD), and other VHA sources. Clinical and administrative data were abstracted from several VHA data sources and linked to form an integrated outcomes database. A primary cohort of stroke patients treated during fiscal year (FY) 2001 was identified from the FSOD. Matching data from the NPCD, Decision Support System, Health Economics Resource Center, and the National Veterans Survey were obtained, merged, and reported in brief. This integrated database structure will provide valuable support to enhance the VHA capacity to perform stroke rehabilitation research.

Ambulatory Care↗
PubMedDate not supplied

[Sources and evaluation of study methods in public health research].

The statistical sources available in Russia's healthcare and the potentialities of such sources for evaluating the general level of the population health were comparatively analyzed. The most informative sources were defined; additionally to the stable data of the medical-and-demographic nature and with due respect to the data of medical documents known by respondents integrated parameters of health were suggested, which are based on questionnaires and self-evaluation of health. The above methods of health investigation and evaluation accepted in the world practice ensure the comparability of data and a more active cooperation within joint healthcare projects.

Environmental Monitoring↗
PubMed1995

Communication standards: impact on nursing practice.

1. BACKGROUND INFORMATION. In order to meet the demands of processing large amounts of data, hospitals must look to innovative methods of information handling. One new method currently in use is the computerized patient record (CPR) (Dick & Steen, 1991). To successfully implement the CPR, many factors must be considered, including: (a) the fact that the database is dependent upon several different departments and resources for information; (b) the information needs of each department differs, making selection of a single information system that encompasses all users' needs difficult; and (c) operating systems may be incompatible, hampering the process of networking and exchanging, processing, and retrieving data in an integrated manner. Yet the integration of systems is central to the successful development of the CPR. 2. PURPOSE. Establishment of communication standards for health care promotes the effective integration of patient information across various computer systems (McDonald, 1990). To achieve this level of automation, standard organizations must unite in the development and implementation of communication standards for health care. This poster will explore: (a) data on communication standards; (b) the process of reaching standards; (c) established communication standards; and (d) the impact of communication standards on nursing practice. In addition, we will present a model for an integrated patient focused system of the future. Today, communication standards continue to evolve in health care. Many professional organizations share the goal of developing communication standards between clinical systems (McDonald, 1990). Standards to be explored in this poster include: the American Society for Testing and Materials (ASTM), the Medical Data Interchange Standard (MEDIX), the Medical Information Bus (MIB), and Health Level (HL7). Evolving standards will define protocols and procedures for the effective exchange of easy integration of information systems. Once standards are established for health care, society will benefit from the ability to: (a) compare health care costs; (b) measure the effectiveness of treatment; and (c) provide clinicians with comprehensive patient information (Rishel, 1992). 3. IMPLICATIONS. There is very little in existing literature and research studies on the impact of communication standards on nursing practice. Nurse researchers willing to assume the challenge of conducting studies on the impact of communication standards on nursing practice will forge new territory. Implications for nursing from the development of communication standards include: (a) increased productivity, (b) definition of a clinical data set, (c) improved quality patient care, and (d) easier system implementations.

Humans↗
PubMed1999

Integrating integrated laboratory information into health care delivery systems.

Attention to integration of laboratory data and its integration into clinical processes and enterprises can help make the laboratory's work a more integral part of clinical practice. The resulting integration holds great potential for improving the quality and effectiveness of care and adding to the clinical value of the laboratory work.

Clinical Laboratory Information Systems↗