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PubMed1994

Information integration in a decision support system.

Electronic medical records pose a challenge because of the complex types of data which are included. Decision support systems must be able to deal effectively with these data types. In the expert system demonstrated here, a diversity of data types are included. These data are processed by three different methods. However, the different methods of processing are transparent to the user. An overall rule-based interface integrates the different methods into one comprehensive system.

Artificial Intelligence↗
PubMed1997

Integrating information technology with an outcomes management program.

Health care changes are occurring rapidly. How successfully an institution keeps up with these changes depends on information and evaluation of outcomes of care. This article discusses how information technology is linked with outcomes management and measurement, types of data, development of data sets, quality issues related to data, and issues that must be addressed as computerized patient records become a reality. By incorporating information technology with outcomes measurement, a new era of outcomes management will be reached.

Case Management↗
PubMed2003

Procedural learning in perceptual categorization.

In two experiments, observers learned two types of category structures: those in which perfect accuracy could be achieved via some explicit rule-based strategy and those in which perfect accuracy required integrating information from separate perceptual dimensions at some predecisional stage. At the end of training, some observers were required to switch their hands on the response keys, whereas the assignment of categories to response keys was switched for other observers. With the rule-based category structures, neither change in response instructions interfered with categorization accuracy. However, with the information-integration structures, switching response key assignments interfered with categorization performance, but switching hands did not. These results are consistent with the hypothesis that abstract category labels are learned in rule-based categorization, whereas response positions are learned in information-integration categorization. The association to response positions also supports the hypothesis of a procedural-learning-based component to information integration categorization.

Association Learning↗
PubMed1984

Integrating pictorial information across eye movements.

Six experiments are reported dealing with the types of information integrated across eye movements in picture perception. A line drawing of an object was presented in peripheral vision, and subjects made an eye movement to it. During the saccade, the initially presented picture was replaced by another picture that the subject was instructed to name as quickly as possible. The relation between the stimulus on the first fixation and the stimulus on the second fixation was varied. Across the six experiments, there was about 100-130 ms facilitation when the pictures were identical compared with a control condition in which only the target location was specified on the first fixation. This finding clearly implies that information about the first picture facilitated naming the second picture. Changing the size of the picture from one fixation to the next had little effect on naming time. This result is consistent with work on reading and low-level visual processes in indicating that pictorial information is not integrated in a point-by-point manner in an integrated visual buffer. Moreover, only about 50 ms of the facilitation for identical pictures could be attributed to the pictures having the same name. When the pictures represented the same concept (e.g., two different pictures of a horse), there was a 90-ms facilitation effect that could have been the result of either the visual or conceptual similarity of the pictures. However, when the pictures had different names, only visual similarity produced facilitation. Moreover, when the pictures had different names, there appeared to be inhibition from the competing names. The results of all six experiments are consistent with a model in which the activation of both the visual features and the name of the picture seen on the first fixation survive the saccade and combine with the information extracted on the second fixation to produce identification and naming of the second picture.

Discrimination Learning↗
PubMed1988

Integrated Academic Information Management Systems (IAIMS). Part III. Implementation of integrated information services. Library/computer center partnership.

Information technologies are changing the traditional role of the library from that of a repository of information to that of an aggressive provider of information services utilizing electronic methods. In many cases, the library cannot realistically achieve this transformation independently but must work with the computer center to reach its objectives. Various models of the integration of libraries and computer centers are thus emerging. At the University of Maryland at Baltimore the Health Sciences Library and the Information Resources Management Division have developed a partnership based on functional relationships without changing the organizational structure. Strategic planning for an Integrated Academic Information Management System (IAIMS) acted as a catalyst in the process. The authors present the evolution of the partnership and discuss current projects being developed jointly by the two units.

Academic Medical Centers↗
PubMed1988

Integrated Academic Information Management Systems (IAIMS). Part II. Planning and implementing integrated information services. IAIMS infrastructure: technological base.

The IAIMS concept calls for the logical integration of information derived from databases in the functional areas of administration, clinical care, education, libraries, and research. To accomplish this task a technological base must be established. It is suggested that such an infrastructure will consist of a systems component, the linked databases component, and a management component. An IAIMS should rapidly evolve into an information utility and, within a decade, provide a knowledge management system.

Academic Medical Centers↗
PubMed1988

Integrated Academic Information Management Systems (IAIMS). Part II. Planning and implementing integrated information services. The management of change: lessons learned from the IAIMS experience.

The critical elements of the change process were designed into the strategic planning process and the pilot project for the Integrated Academic Information Management System (IAIMS) at the University of Maryland. These elements were: Support by the institutional leadership; a critical mass of interested participants from diverse groups across the organization, committed to the project and with ownership of the plan; a motivating level of dissatisfaction with the status quo; the construction of a scenario describing the desired future and an assessment of needs to achieve it; technical and consulting help; a pilot project with replicable features to demonstrate the concept and feasibility of the approach; and participation of opinion leaders initially with later identification of additional opinion leaders who would become part of the pattern of acceptance of the innovation and diffusion of the technology across the campus.

Academic Medical Centers↗
PubMed1988

Integrated Academic Information Management Systems (IAIMS). Part III. Implementation of integrated information services. Clinical linkages: IAIMS at the University of Utah.

The IAIMS project at the University of Utah has focused on clinical linkages to facilitate the research, teaching, and service mission of the Medical Center. The planning phase focused on the relationship among ther users and providers of the system and developed a scenario describing the professor and clinical clerk making rounds in the bedside setting. The prototype Health Evaluation through Logical Processes (HELP) system brings together three sources necessary to solve a medical problem: the patient database, the medical literature, and an expert in the subject. Microcomputers provide access to the HELP system and a complementary literature knowledge database.

Academic Medical Centers↗
PubMed1988

Integrated Academic Information Management Systems (IAIMS). Part III. Implementation of integrated information services. Medical informatics education.

Medical informatics is still in its early stages of evolution and definition. If informatics is to obtain the status of a specialized field of study within the health science curriculum, its ambiguity must be eliminated. This article discusses the term "medical informatics" and the impact of the new field of study on curriculum, education, and training of health care professionals, and health care information systems research and development.

Academic Medical Centers↗
PubMed2002

An open, component-based information infrastructure for integrated health information networks.

A fundamental requirement for achieving continuity of care is the seamless sharing of multimedia clinical information. Different technological approaches can be adopted for enabling the communication and sharing of health record segments. In the context of the emerging global information society, the creation of and access to the integrated electronic health record (I-EHR) of a citizen has been assigned high priority in many countries. This requirement is complementary to an overall requirement for the creation of a health information infrastructure (HII) to support the provision of a variety of health telematics and e-health services. In developing a regional or national HII, the components or building blocks that make up the overall information system ought to be defined and an appropriate component architecture specified. This paper discusses current international priorities and trends in developing the HII. It presents technological challenges and alternative approaches towards the creation of an I-EHR, being the aggregation of health data created during all interactions of an individual with the healthcare system. It also presents results from an ongoing Research and Development (R&D) effort towards the implementation of the HII in HYGEIAnet, the regional health information network of Crete, Greece, using a component-based software engineering approach. Critical design decisions and related trade-offs, involved in the process of component specification and development, are also discussed and the current state of development of an I-EHR service is presented. Finally, Human Computer Interaction (HCI) and security issues, which are important for the deployment and use of any I-EHR service, are considered.

Abstracting and Indexing↗
PubMed1997

Control method for preloading with priority information in an integrated radiology information system/picture archiving and communication system.

More than 10 years has passed since the concept of picture archiving and communication systems (PACS) was first proposed. A great deal of effort has been expended to make PACS suitable for routine use in clinical settings, but only a few systems are currently used in this manner. A major reason is the lack of the assurance of throughput equivalent to that of a conventional system based on order sheets and analog films. In this report, two techniques to increase throughput have been introduced and studied. The first is the preloading of data elements from the various information systems and the PACS. The second is the use of the priority information to rank order the examinations placed on the list for interpretation. We have applied these techniques to an actual system and have measured the distribution of time for processing examinations. These two techniques appear to make PACS useful in routine practice because most of the urgent cases were interpreted within the target time of 40 minutes.

Hospital Communication Systems↗
PubMed1989

Informed consent and moral integrity.

Informed consent is required for any medical procedure although the situations in which it is given are beset by uncertainties and indeterminacies. These make medicolegal scrutiny of such situations very difficult. Although some people find the decision in the Sidaway case incomprehensible because of its continuing regard for a 'professional practice standard' in informed consent, I will argue that an important fact in many cases is the moral integrity of the doctor concerned and the pattern of his practice. This may provide the only morally principled and legally accessible evidence enabling a correct decision to be made in a difficult case. Although the epistemological significance of a professional practice standard is thereby defended the 'prudent patient standard' for what counts as consent is left intact.

Communication↗
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↗
PubMed2003

Probabilistic constraint satisfaction at the lexical/phonetic interface: evidence for gradient effects of within-category VOT on lexical access.

Research in speech perception has been dominated by a search for invariant properties of the signal that correlate with lexical and sublexical categories. We argue that this search for invariance has led researchers to ignore the perceptual consequences of systematic variation within such categories and that sensitivity to this variation may provide an important source of information for integrating information over time in speech perception. Data from a study manipulating VOT continua in words using an eye-movement paradigm indicate that lexical access shows graded sensitivity to within-category variation in VOT and that this sensitivity has a duration sufficient to be useful for information integration. These data support a model in which the perceptual system integrates information from multiple sources and from the surrounding temporal context using probabilistic cue-weighting mechanisms.

Eye Movements↗
PubMed2004

Assessing organizational readiness and capacity for developing an integrated child health information system.

The Tool for Assessment and Planning (the Tool) assists public health teams in designing child health information integration projects from planning through early implementation. The tool is a companion to Integration of Newborn Screening and Genetic Services Systems with Other Maternal and Child Health Systems: A Sourcebook for Planning and Development (the Sourcebook). The Tool and the Sourcebook focus on 9 key elements considered critical to supporting information systems integration. The 9 key elements are: leadership, project governance, project management, stakeholder involvement, organizational and technical strategies, technical support and coordination, financial support and management, policy support, and evaluation. Project teams can use the Tool to assess their organizational readiness and capacity by examining the critical components and strategies required to support success based on the 9 key elements. The questions are intended to promote discussion among project team members and to identify specific action steps. The Tool includes a planning matrix to track those action steps and to identify accountable personnel. Strategically examining the critical elements and documenting next steps increases the likelihood of a successful integration project.

Child↗
PubMed1983

Information systems approach to integrated responses in the respiratory control system.

The appropriateness of integrated information systems to the description of integrated biological systems is discussed. An integrated information system in the physiology of the regulation of respiration is argued to be a structural mathematical model of the system and the relational data base, which it can compute. In contrast to the customary method of applying nonspecific statistical or control system formulations to data, the model-data base combination attempts to produce insight by reproducing from a single formulation many sets of experimentally validated data. The model then may predict results for experiments not yet done. An information system (thus defined) has both explanatory power and heuristic value.

Biomedical Engineering↗