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PubMed1975

[The Vienna General Medical Information System (WAMIS)].

The Vienna General Medical Information System is applied at the university clinics of the medical faculty of Vienna. The system consists of several components: 1. Program complex for the support of daily routine work, 2. documentation system, 3. Vienna laboratory system, 4. differential diagnosis and screening system, 5. medical information system, 6. medical evaluation system. The central part of the system is the patient-orientated data bank.

Austria↗
PubMed1999

[Experience in the development of information systems at the canton level].

In the aim of need and necessity of stronger orientation and more efficient aim realization 35 Strategy SZO (health information system) country members should have the health information system able to provide information support to their National strategy "Health for All until 2005". Such a health information system should provide the information support for the planning process, monitoring and health evaluation, health care and work in public-health services sector. The experiences in the work of information system organization in Tuzla Canton Public Health Institute should be seen from two aspects: Aspect of the information system significance in the framework of the social-medical, epidemiological, hygiene-ecological and other activities of the Institute; Aspect of the information system development within the Public Health facilities of Canton in relation to the automatic data processing important for registration, tracking and recognition of success and population health care needs. From the aspect of establishing the information system in the area of Tuzla Canton and the Public Health Institute role, there is a need for adequate high technology technical equipment, with the task to enable practical realization of defined projects and in such a way, varied acceleration of work giving as a result usable information. The canton Public Health Institute needs as follows: necessary resources for free information system work; to provide free computer access to all; to ensure connection with other PHI through communications. In this way the canton Public Health Institute information system would be connected with other information systems in the field of health. In would be a base for development of integrated health information system. The information system is desirable aim for the work of Public Health Institute, method of selection and leading content of modernization. Analysing the Bill of Law on Health Care, a defectiveness has been noticed, since the information system is not regulated. Therefore, the need to be issued by Lay is of great importance. A statement that all projects on local information systems, started before war or during the war have been stooped, joins to the aforesaid, and also a series of independent information system in different health segments, which are not connected into one, unique information system. In any case, this disparaged the quality of medical decision making and therefore, providing of high-quality services at all levels of health work.

Bosnia and Herzegovina↗
PubMed1990

The potential role of physicians in the management of hospital information systems.

The centralized management of manual and automated information systems in hospitals, including the medical record, is usually delegated to administrators rather than to physicians. It is also likely that the importance of automated information systems will increase rapidly as the medical record is electronified. Many significant changes have occurred in recent years relating to the manner in which information systems are managed in hospitals. To address the challenge of this new information environment, hospital Chief Executive Officers (CEOs) have begun to create a new executive hospital position called the Chief Information Officer (CIO). CIOs are included in the hospital executive cabinet and commonly direct all hospital information systems, telecommunications, and management engineering. Although the model of the physician-director of an information system is common at the departmental level with the Laboratory Information System as one example, physicians rarely serve within the central hospital administration as information specialists such as the CIO. Although many physicians would be suitably qualified to serve in this capacity, another option for them would be the position of Chief Medical Information Officer (CMIO) with responsibility for utilization review, medical records, and quality assurance. The CMIO would serve centrally on a part-time basis, continuing to practice simultaneously in a medical specialty. The medical information specialist must not be insulated from the flow of clinical information and discourse with medical colleagues because of the increasing use of information systems for improving work efficiency and the pursuit of quality goals.

Administrative Personnel↗
PubMed1989

Medicaid program; Medicaid management information system: revised definition of "mechanized claims processing and information retrieval system"--HCFA. Final rule with comment period.

We are making a number of revisions to regulations concerning mechanized claims processing and information retrieval systems ("system" or "systems"). We are revising definitions to show that we will not make available Federal funding at 75 and 90 percent of State Medicaid agency expenditures for eligibility determination systems because they do not meet the definition of a "mechanized claims processing and information retrieval system" or of an enhancement to that system. We are also conforming our regulations to changes made by section 9503(b)(2) and 9518 of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (Pub. L. 99-272), which involve technical changes. One change affects the frequency and scope of our system reviews, and the other involves the date by which States that are not exempt by law must have an operating system.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2003

A GIS-based modeling system for petroleum waste management. Geographical information system.

With an urgent need for effective management of petroleum-contaminated sites, a GIS-aided simulation (GISSIM) system is presented in this study. The GISSIM contains two components: an advanced 3D numerical model and a geographical information system (GIS), which are integrated within a general framework. The modeling component undertakes simulation for the fate of contaminants in subsurface unsaturated and saturated zones. The GIS component is used in three areas throughout the system development and implementation process: (i) managing spatial and non-spatial databases; (ii) linking inputs, model, and outputs; and (iii) providing an interface between the GISSIM and its users. The developed system is applied to a North American case study. Concentrations of benzene, toluene, and xylenes in groundwater under a petroleum-contaminated site are dynamically simulated. Reasonable outputs have been obtained and presented graphically. They provide quantitative and scientific bases for further assessment of site-contamination impacts and risks, as well as decisions on practical remediation actions.

Decision Support Techniques↗
PubMed2005

[Development of information system at Sestre Milosrdnice Clinical Hospital].

Information Systems (IS) in healthcare are complex with a heterogeneous structure. They support decision making in healthcare and therefore must be integrated, consistent, reliable, secure and simple for use and maintenance. Data entry is strongly controlled, data are coded and ready for inventory printing or scientific analysis. Efforts in developing the Integrated Hospital Information System (IHIS) at Sestre Milosrdnice University Hospital, Zagreb (Croatia) from a Hospital Information System (HIS) are presented. From the very beginning, the Information System was developed without planning, only to satisfy the current needs and to stay within financial possibilities. Today, many hospital departments have their own Information Subsystems and one or two servers. All local area networks and offline computers are connected to optical ring and through the farm of servers (firewall, www, e-mail, DNS-Domain Name System) to the Internet. We need a long time to achieve the current degree of development of IS. However, today we can obviously recognize a few layers of information applications just like business application, medicine application, scientific application, education application, telemedicine and Internet application. Very powerful information technology and very fast progress in communications leads to digital or paperless hospital.

Croatia↗
PubMed1987

Megatrends in hospital information systems.

The "megatrends" identified for hospital information system in this article require an innovative shift in hospital management perspective. Hospital chief executive officers and decision-makers must adopt a new model for planning and utilizing hospital information systems resources. Because of changes in the healthcare environment, prospective payment strategies for using information are very different from former retrospective reimbursement methods. The purpose of this article has been to identify emerging "megatrends" for structuring future hospital information systems. The primary causes of these significantly different demands is the prospective payment system. Medicare DRGs will probably expand into an all-encompassing payment plan which will alter the essence of hospital information systems. This article has reviewed the challenges of these "megatrends," and provided some preliminary management strategies for addressing these new demands on healthcare professionals.

Hospital Administration↗
PubMed1982

Applying management information systems to staffing.

A management information system (MIS) is a tool for managing resources effectively. After reviewing some concepts and principles for effective data management, Hanson clearly applies the concepts to nurse staffing systems, which manage human resources. He defines a seven-step process for establishing an MIS, from defining the management objective to implementing the system. Pointing out that an MIS need not be computerized to be effective, Hanson presents a positive perspective and clarifies some often-misconceived notions about management information systems and the paper printouts they generate. In the next issue of JONA, a second article by Hanson will take a more detailed look at the variety, use, and usefulness of staffing statistics available from an MIS for staffing. These articles are based on material in a forthcoming book, Management Systems for Nursing Service Staffing, to be published by Aspen Systems Corporation, Rockville, Maryland.

Information Systems↗
PubMed1989

Compatible information systems a key to merger success.

Information systems compatibility can directly affect the benefits an organization receives from a merger or acquisition. At the macro level, the degree of compatibility determines whether consolidating systems is feasible and cost effective. At the micro level, information systems compatibility is closely tied to every benefit a merger or acquisition brings. Potential merger partners can assess whether their systems will mesh with an information systems compatibility index.

Abstracting and Indexing↗
PubMed2002

The development of systematic quality control method using laboratory information system and unity program.

Quality control (QC) process is performed to detect and correct errors in the laboratory, of which systematic errors are repeated and affect all the laboratory process thereafter. This makes it necessary for all the laboratories to detect and correct errors effectively and efficiently. We developed an on-line quality assurance system for detection and correction of systematic error, and linked it to the Unity Plus/Pro (Bio-Rad Laboratories, Irvine, USA), a commercially available quality management system. The laboratory information system based on the client-server paradigm was developed using NCR3600 (NCR, West Columbia, USA) as the server and database for server was Oracle 7.2 (Oracle, Belmont, USA) and development tool was Powerbuilder (Powersoft Burlignton, UK). Each QC material is registered and gets its own identification number and tested the same way as patient sample. The resulting QC data is entered into the Unity Plus/Pro program by in-house data entering program or by manual input. With the implementation of in-house laboratory information system (LIS) and linking it to Unity Plus/Pro, we could apply Westgard's multi-rule for higher error detection rate, resulting in more systematic and precise quality assurance for laboratory product, as well as complementary to conventional external quality assessment.

Chemistry, Clinical↗
PubMed2003

[Development of a hospital information system simulator for education].

When teaching students the hospital information system, it is impossible to use an actual hospital information system because of security reasons. To overcome this problem, a simulator of the hospital information system for student education has been developed. The purpose of this system is to help students understanding a hospital information system from actual experience. The characteristics of this system are as follows: 1) Students can easily learn a hospital information system on the Web pages in the computer training room. 2) The present system is not as complete as a hospital information system, however, helpful explanations regarding the data processing have been inserted. 3) The fictional patient data have been prepared for the pages relating to the electronic medical chart. Consequently, students can understand what kind of data has been saved in this system. Through a questionnaire, students evaluated this system in terms of understandability. The result from four years between 1999 and 2002 showed that 70% of them evaluated it as good system. We therefore consider this system to be effective over a short period of time, and useful for medical education.

Computer Simulation↗
PubMed2003

Information system concepts for quality measurement.

BACKGROUND: Health care information systems in use today frequently fall short of what is needed to meet the demands for data and reporting on performance. Many observers believe substantial improvements in information systems will be necessary if the potential of a national quality measurement and reporting system (NQMRS) is to be realized. A shared vision will facilitate progress in improving information systems. OBJECTIVES: To articulate a set of guiding principles and operational steps for the development of functional information systems in health care. RESEARCH DESIGN: Experience in building such systems for one health care delivery system was used to develop an approach. This was discussed with Strategic Framework Board members and integrated with other considerations for going from a local system to one that could accumulate information for national purposes. FINDINGS: The key elements of a functional information system include provisions that (1) data should be collected once, (2) aggregation of data for higher-level reports should be anticipated, (3) issues related to privacy and confidentiality must be addressed, and (4) measurement systems should include an audit standard. A seven-step process for developing a functional information system is outlined. CONCLUSIONS: A shared national measurement framework is essential because the data systems that health care delivery organizations use are not static. A long-term vision can guide the growth of a data system over time. An NQMRS can be the vehicle that provides the needed vision.

Confidentiality↗
PubMed1993

Managing pharmacy information systems.

The current state of pharmacy information systems is described, and a future direction for information management efforts is proposed. Today's pharmacy information systems are supported by excellent hardware and software. Systems are less expensive, more responsive, more flexible, and smaller than ever before. However, we have been ineffective at tailoring information systems to the pharmaceutical-care needs of patients. Instead, there is overemphasis on traditional requirements to support unit dose drug distribution, i.v. admixture preparation, and admission-discharge-transfer and billing systems. Deficiencies of current systems include a lack of real-time interfaces among hospital systems; redundancy of effort by users; ineffective capturing, reporting, and integration of data; and a cumbersome order-entry process. A vast amount of information is circulating; the challenge is to focus on those clinical and financial data on which patient-care decisions can be based. Each hospital pharmacy should develop a clinical information management strategy. Existing systems should be examined to determine which functions are not being used and which could be enhanced without major software modifications; enhancements might include routine entry of drug allergy information so that all orders may be screened and the use of networks and interfaces to provide medication profiles to physicians and nurses.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Pharmacy Information Systems↗
PubMed1999

Examining associations between childhood asthma and traffic flow using a geographic information system.

Using geographic information systems (GIS) and routinely collected data, we explored whether childhood residence near busy roads was associated with asthma in a low-income population in San Diego County, California. We examined the locations of residences of 5,996 children [less than/equal to] 14 years of age who were diagnosed with asthma in 1993 and compared them to a random control series of nonrespiratory diagnoses (n = 2,284). Locations of the children's residences were linked to traffic count data at streets within 550 ft. We also examined the number of medical care visits in 1993 for children with asthma to determine if the number of visits was related to traffic flow. Analysis of the distribution of cases and controls by quintiles and by the 90th, 95th, and 99th percentiles of traffic flow at the highest traffic street, nearest street, and total of all streets within a 550-ft buffer region did not show any significantly elevated odds ratios. However, among cases, those residing near high traffic flows (measured at the nearest street) were more likely than those residing near lower traffic flows to have two or more medical care visits for asthma than to have only one visit for asthma during the year. The results of this exploratory study suggest that higher traffic flows may be related to an increase in repeated medical visits for asthmatic children. Repeated exposure to particulate matter and other air pollutants from traffic exhaust may aggravate asthmatic symptoms in individuals already diagnosed with asthma.

Adolescent↗
PubMed1997

Telematics and smart cards in integrated health information system.

Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole network of services involved will be monitored for the duration of the project. The system users will also include general practitioners, social workers, physicians, health operators, pharmacists, laboratory workers and administrative personnel of the municipality and of the health structures concerned.

Aged↗
PubMed1985

[Analysis of the symptoms of ischemic heart disease with a lesion of the trunk of the left coronary artery by using an automated information system].

Using an information system, the authors compared the results of the examination of 169 patients with coronary heart disease and left coronary artery trunk lesions and of 605 patients without such lesions. The functioning of the system was controlled by a complex of programmes designed according to the modular principle. It comprises the following modules: modules of the formation and control of the data pool, modules of the formation of sub-pools according to a given set of signs and modules of data processing. The patients with coronary heart disease and a lesion of the left coronary artery trunk had a number of clinical characteristics including frequent and severe anginal attacks, a large zone of myocardial ischemia, a low exercise tolerance and a considerable depression of the ST segment on the ECG, as well as a long rehabilitation period.

Adult↗
PubMed1992

Ongoing development of the Critical Care Information System: the collaborative approach to automating information management in an intensive care unit.

Point-of-care (bedside) clinical information systems can fulfill a variety of functions. Included in these functions are: becoming receptacles for patient data and allowing data to be manipulated into formats that facilitate clinical decision making; functioning as sources for billing and auditing processes; interfacing to other hospital systems and bringing distant data to the bedside; and being a repository for information used in the development of hierarchical and/or relational databases. The initial and ongoing development of these systems in a dynamic clinical environment requires the construction of processes and work pathways to ensure that the needs and requirements of myriad personnel, departments and agencies within the health center milieu are addressed.

Administrative Personnel↗
PubMed1995

Computerized pharmacokinetics on an institutional clinical information system.

Computer-based hospital information systems (HISs) are an integral part of the current hospital environment. Traditionally, the HIS hospital information system has performed drug distribution-related activities for the pharmacy. Clinical applications have been limited to monitoring for drug interactions, duplication of therapy, drug allergies, and dosage range checking. Personal computers have been used for more clinical applications and individualized dosing. At Hamot Medical Center, the integration of the pharmacokinetics consultation service with the HIS has been accomplished. The pharmacokinetic equations were programmed into the HIS. Data needed for the equations were extracted from information in the database, thereby eliminating the need to enter the majority of the data. The program was designed to print the pharmacokinetic consultation for the chart. The integration of the pharmacokinetic consultation service with the HIS has saved time and increased efficiency.

Clinical Pharmacy Information Systems↗