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[Importance of health information systems in the process of reform and reconstruction of health care].

Reform and reconstruction of health care system can not be carried out without health information systems and modern information and communication technologies. In other hand, health information system of The Federation of BiH must be an object of both reform and reconstruction. This thesis points out that reform of health information system is a crucial priorities in order to improve and fasten reform. There is a paradigmatic question: who provides service, to whom, what is the price, and what is the final solution? In order to answer this question, an integral health information system that will be computer supported is necessary. For integral work and information exchange, computers must be connected and follow the same operating procedures. Benefits of an integral health information system, as well as impact factors for its implementation are discussed in the paper.

Bosnia and Herzegovina↗

Using sustainable development indicators as a supplementary measure for the integrated management of environmental information system in Taiwan.

Environmental Information System (EIS) transfers environmental data and information to audiences in any field of knowledge or activity interested in environmental problems. Currently, numerous conventional EISs or Environmental Databases (EDs) are available in Taiwan. However, they fail to adequately address the strong correlations among the environmental, social and economic components. Notably, Sustainable Development Indicators (SDIs) combine environmental, social and economic dimensions, as well as illustrate the links among systems. Subsequently, developing a set of SDIs will provide an excellent opportunity to systematically consolidate the information scattered among many archives, as well as promoting an integrated EIS. This work presents an experimental model referred to as the 'Sustainable Development Information System of the Island Taiwan' (SDISIT). This system was developed to assist the integrated management of either EIS or ED. The Factor Analysis Method (FAM) is one tool that may prove useful in easing the developing process. Furthermore, by examining the correlations between the indicators, this method can apply existing SDIs to identify the structure of interrelationships among indicators.

Databases, Factual↗

The use of an information system architecture modeling tool in the development of disease management systems.

UNLABELLED: A Disease Management System (DMS) refers to an integrated healthcare delivery system that provides patient centered care throughout the course of the disease independent of delivery site. A fundamental barrier for the development, implementation and monitoring of a DMS is lack of an appreciation by care providers of the complexity of these systems, and what is required for their maintenance. Foremost in the development of these systems is the presence of information systems that attempt to deal with the temporal, spatial and information needs of the DMS. PURPOSE: The Zachman Framework for Information Systems Architecture is used in many industries in the development of information systems. Its choice is based on the recognition of a need for a methodology in the conceptualization and modeling of complex information systems. This paper provides a brief overview of the Zachman Framework and its potential application in DMS development. In particular it will be the focus on the need for "perspective" clarification as the first step in the development of such complex systems. RESULTS: This paper reviews DMS and their potential information needs. The clarification of "perspectives" provides a method toward team building and unification of purpose by decreasing conflict and recognizing the unique contributions that each perspective holder makes.

Delivery of Health Care, Integrated↗

Development and evaluation of a nursing service management and administration information system at district hospital.

The rapid development of information technology and the multiple usage of Information Systems make indisputable their appliance in all the sectors including the Nursing Service area. Information Systems that have been developed for the Nursing Service Administration are extremely useful in the processing and the categorisation of a large number of information, providing significant advantages such as information storage, information availability, information precision and reliability. In addition, the appliance of Information Systems provides important advantages in the administration of the nursing personnel's data, contributing to the improvement of the operating effectiveness of the Nursing Service. This paper describes the development and the evaluation of an Information System for the Nursing Service Administration that classifies all the information related to the nursing personnel and helps the administration to handle the appropriate nursing data. The method of Life Cycle Model was decided as the most appropriate for the development of the System, because of the important advantages that it offers. For the evaluation of our own designed system we based on the standards, which are used for evaluating Information Systems in general. The evaluation of this Information System is carried out by a survey among the undergraduate and the postgraduate students of the Nursing Department of the University of Athens and the Nursing Personnel of a number of Hospitals. Useful conclusions have been derived concerning those characteristics, which should be fulfilled by the system. Important conclusions have been also drown out concerning the dependencies of the variables under study, the future readjustments of the system, and the general perception of the newcomers in health profession towards the application of the information technology.

Age Factors↗

Issues in the design of a clinical microbiology database within an integrated hospital information system.

The LASTWORD hospital information system contains a clinical microbiology database which permits both review of patient reports and retrospective data searches using clinical and/or demographic criteria. The elements supporting this database are dictionary tables of coded phrases, a general purpose query language (Tandem ENFORM), an HL7 interface to a laboratory computer system, and long-term data storage of demographic, microbiology and other clinical data in a relational database.

Clinical Laboratory Information Systems↗

Developing an information systems strategy for nursing.

With the rapidly changing health care environment and information technology advances, organizations need to engage in strategic, planned change in order to allocate limited resources, achieve the organization's goals, and fulfill its mission [1]. One of the most important aspects of the organization's planned strategies for change concerns the information systems. The involvement of the nursing department in this process is critical. This poster presentation will communicate how nurses can develop an information systems strategic plan that will enable them to play an active role as contributors and vital participants in the strategic and business planning processes for information systems. This information systems strategy for nursing will: a) provide direction and purpose, b) guide nursing in identifying the kinds of information technology needed, c) assist in timely implementation of a system that supports nursing, and d) identify desired outcomes and benefits of an information system. The nursing information systems plan must be built on, and support, the organization's mission and business plan and integrate into the over-all information systems plans [2]. Components of the nursing strategic plan include the nursing mission statement and vision, an assessment of the current environment to identify supporting technology needed to achieve the nursing vision, expectations/anticipated outcomes, environmental considerations, and special staffing/expertise considerations. The nursing vision and mission statement is an articulation of the overall direction and purpose of the nursing organization. An assessment of the nursing organization, problem areas, opportunities for growth, the physical environment, existing systems, communications requirements, and resources is carried out to help identify areas where new technologies and automated methods of managing information could be applied. Special staffing and expertise not currently available in the organization, but necessary to the successful implementation of the plan, should be identified, and plans for filling those needs should be included in the planning and prioritization process. Based on the mission and assessment findings, goals or anticipated outcomes are developed. These goals must be realistic, financially feasible, and logistically achievable; they should also provide direction for action and decision-making [3]. Measurable objectives and detailed action plans can then be developed from these goals when implementation of this aspect of the strategic plan is begun. It is especially important, even at a strategic planning level, to consider change management techniques, including specific steps to involve individuals who will be affected by the change and to ensure open communication throughout the process. Efforts to collaborate with all affected departments and to offer input and educational opportunities to the various members of the health care team should be included in the strategic plan. A business plan describing the mission, goals, and objectives for a specific system implementation is the final step in the strategic planning process. The business plan includes expected outcomes and cost justification and may be done in cooperation with other departments (in the organization) that will be involved with this system. The business plan is used to communicate the information system's needs to the administration and governing board of the organization. With a good information systems strategy, nursing will be prepared to make more timely and better informed decisions related to applying information technology within the nursing department. The end results of this planning should be evident in the improved utilization of information technology to support the nursing vision and mission.

Arizona↗

The pharmacy as part of an integrated hospital information system: a focus on benefits.

An integrated hospital information system benefits not only the pharmacy but also each department within a hospital, including the physician and patient. The Composite Health Care System (CHCS) is a fully integrated healthcare information system that has been developed for the Department of Defense's medical treatment facilities. CHCS provides modules for Patient Administration, Patient Appointment Scheduling, Radiology, Laboratory, Pharmacy, and Physician/Nursing Order Entry and Results Retrieval, which serve to integrate inpatient wards, clinical services, administrative departments, and remote outpatient clinics. CHCS provides an integrated patient profile to care givers throughout the medical facility, improving the quality of their clinical decisions. The integrated hospital information system also helps to coordinate the delivery of patient care and automates many interdepartmental transactions, which allows for more efficient use of resources and increases the turnaround time for delivery of services. This article focuses on the system's pharmacy component to demonstrate the benefits realized with an integrated hospital information system.

Clinical Pharmacy Information Systems↗

Information systems for IDSs: meeting the challenges.

Integrated delivery systems (IDSs) face many challenges in implementing information systems. An IDS's senior management staff can meet these challenges by choosing the right information systems design team and ensuring that information systems staff have sufficient training and expertise to successfully assemble the needed information systems capabilities. To effectively fulfill its role, the information systems design team needs to understand the IDS's managed care strategy, know the level of information systems functionality required, obtain components from a limited number of vendors while using technology that integrates disparate components, build or enhance communication networks, consolidate where possible, and be willing to adopt new tools.

Communication↗

Automated identification of shortcuts to patient data for a wireless handheld clinical information system.

Inadequate access to patient information at the point of care has been identified as an impediment to the health care process. To create clinical computing tools that are useful to and used by clinicians, developers of clinical information systems must have accurate models of the users for whom their systems are intended. To create these models, the information needs of clinicians must be understood. While the wireless handheld environment offers many advantages such as the ability to provide mobile access to information, there are a number of challenges. Developing for this environment differs from the laptop and desktop environments due to features such as processing power, screen size, input mechanism, and bandwidth. PalmCIS (Palm-based Clinical Information System) is a clinical application being developed at New York Presbyterian Hospital (NYPH) that provides clinicians with access to patient data via a wireless handheld device. We are using an automated technique to uncover patient-specific information needs of clinicians while using a patient record system. With the results, we can enhance PalmCIS.

Computers, Handheld↗

Modelling and simulation of information systems on computer: methodological advantages.

Modelling and simulation of information systems by the means of miniatures on computer aim at two general objectives: (a) as an aid to design and realization of information systems; and (b) a tool to improve the dialogue between the designer and the users. An operational information system has two components bound by a dynamic relationship, an information system and a behavioural system. Thanks to the behaviour system, modelling and simulation allow the designer to integrate into the projects a large proportion of the system's implicit specification. The advantages of modelling to the information system relate to: (a) The conceptual phase: initial objectives are compared with the results of simulation and sometimes modified. (b) The external specifications: simulation is particularly useful for personalising man-machine relationships in each application. (c) The internal specifications: if the miniatures are built on the concept of process, the global design and the software are tested and also the simulation refines the configuration and directs the choice of hardware. (d) The implementation: stimulation reduces costs, time and allows testing. Progress in modelling techniques will undoubtedly lead to better information systems.

Computers↗

Automated discovery of patient-specific clinician information needs using clinical information system log files.

Knowledge about users and their information needs can contribute to better user interface design and organization of information in clinical information systems. This can lead to quicker access to desired information, which may facilitate the decision-making process. Qualitative methods such as interviews, observations and surveys have been commonly used to gain an understanding of clinician information needs. We introduce clinical information system (CIS) log analysis as a method for identifying patient-specific information needs and CIS log mining as an automated technique for discovering such needs in CIS log files. We have applied this method to WebCIS (Web-based Clinical Information System) log files to discover patterns of usage. The results can be used to guide design and development of relevant clinical information systems. This paper discusses the motivation behind the development of this method, describes CIS log analysis and mining, presents preliminary results and summarizes how the results can be applied.

Critical Pathways↗

Economic analysis of linking operating room scheduling and hospital material management information systems for just-in-time inventory control.

UNLABELLED: Operating room (OR) scheduling information systems can decrease perioperative labor costs. Material management information systems can decrease perioperative inventory costs. We used computer simulation to investigate whether using the OR schedule to trigger purchasing of perioperative supplies is likely to further decrease perioperative inventory costs, as compared with using sophisticated, stand-alone material management inventory control. Although we designed the simulations to favor financially linking the information systems, we found that this strategy would be expected to decrease inventory costs substantively only for items of high price ($1000 each) and volume (>1000 used each year). Because expensive items typically have different models and sizes, each of which is used by a hospital less often than this, for almost all items there will be no benefit to making daily adjustments to the order volume based on booked cases. We conclude that, in a hospital with a sophisticated material management information system, OR managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the OR information system with the hospital's material management information system to achieve just-in-time inventory control. IMPLICATIONS: In a hospital with a sophisticated material management information system, operating room managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the operating room information system with the hospital's material management information system to achieve just-in-time inventory control.

Computer Simulation↗

The TEAM methodology for the evaluation of information systems in biomedicine.

The TEAM evaluation methodology for information systems in biomedicine (Total Evaluation and Acceptance Methodology) is a unifying methodology for any computer-based information system based on a three dimensional framework; these dimensions being Role, Time and Structure. The theory is derived from how the information system relates to the general system where it should operate, the properties of information flow within a general system and the relation between a system and its models. As a system can in theory be modelled from many perspectives, a perspective to be modelled is built up by formulating criteria relevant to that perspective which can be evaluated by quantitative and qualitative assessment methods. Key characteristics of the methodology include the insistence on a global rather than partial approach to the evaluation of information systems, also the dynamic nature of an information system which is continually in modification as it more successfully deals with the inherent complexity of the environment in which it is operating. The role dimension identifies four main categories, designer, specialist user, end user and stakeholder from which several sub-categories may be identified. The time dimension has four main phases towards relative stability of the information system. The structural dimension distinguishes strategic, tactical or organisational and operational levels that often are confused together with risk of dilution in current approaches. It is believed that this framework and methodology can provide a basis for future standardisation of evaluation methodologies.

Evaluation Studies as Topic↗

Issues and challenges in the design of curriculum information systems.

Medical schools are increasingly using curriculum information systems to better manage their curricula, to incorporate alternative learning environments, to expand subject-specific instruction, or to adapt the curricula to the changing health care environment. A curriculum information system contains key features, selected by the system's designers, that describe the objectives, the specific content, and/or the educational activities that compose the curriculum. The underlying purpose of such a system is to document and describe the knowledge, behaviors, skills, attitudes, or activities students will be expected to develop or learn. While it might be ideal to have one system that would meet the needs of all possible users, the programming and maintenance requirements of such a single system would exceed most medical schools' resources. Thus, designers of curriculum information systems must first identify the primary intended-user group: students, faculty, or administrators. The system designed for one group will typically differ from the systems for other groups in the emphasis on and level of content detail and curriculum structure information. The general structure and purposes of curriculum information systems are expressed in three distinct system designs: a curriculum database (most helpful for administrators), a curriculum textbase (for faculty), and an electronic syllabus (for students). The authors describe these different designs, and they discuss challenges faced by system designers.

Curriculum↗

A systems engineering perspective on the human-centered design of health information systems.

The discipline of systems engineering, over the past five decades, has used a structured systematic approach to managing the "cradle to grave" development of products and processes. While elements of this approach are typically used to guide the development of information systems that instantiate a significant user interface, it appears to be rare for the entire process to be implemented. In fact, a number of authors have put forth development lifecycle models that are subsets of the classical systems engineering method, but fail to include steps such as incremental hazard analysis and post-deployment corrective and preventative actions. In that most health information systems have safety implications, we argue that the design and development of such systems would benefit by implementing this systems engineering approach in full. Particularly with regard to bringing a human-centered perspective to the formulation of system requirements and the configuration of effective user interfaces, this classical systems engineering method provides an excellent framework for incorporating human factors (ergonomics) knowledge and integrating ergonomists in the interdisciplinary development of health information systems.

Artificial Intelligence↗

Progress toward a second generation Laboratory Information System (LIS).

A Laboratory Information System (LIS) is a convenient organization of programs and hardware designed to meet the health care delivery needs of a department of pathology. A full service LIS is now a commercially viable product and after 2 years of experience, certain desirable design features are evident for a second generation system. Such variables as hardware configuration, physical plant, libraries, diagnostic algorithms, system usage and surveillance, and manpower and human engineering are now significant operational features and essential for LIS acceptance by a department of pathology as well as the practicing medical staff.

Data Display↗

A generalizable framework for information systems for physician recruitment/referral.

Hospital information systems have evolved from data processing systems for patient billing and payroll to decision-support systems which support decision making at the middle and upper management levels. With the advancements in the areas of database management, expert systems and networks, important hospital functions such as physician recruitment and referral which historically were performed using traditional procedures, are now performed using these computer-based technologies. Develops a generalizable framework for information systems for physician recruitment and referral using technologies of database management, expert systems and networks. This GIS-PRR system may be used by hospitals and other health-care providers to improve the efficiency and effectiveness of the physician recruitment/referral process.

Database Management Systems↗

National information system on hospital treatment.

National information system on hospital treatment (HOSTREAT) supports health management system applied by the Ministry of Health and its professional services at the Public Health Institute of Slovenia. The main project objective was data quality, having in mind advanced analytical methods such as knowledge discovery in databases. The step was a huge one, as the related national statistics rests on every single hospital event, called an episode. By the project definition, an episode covers therapeutic treatment of one sick or injured person in one hospital within one health service specialty. So, many problems arose within the three years of project phases. Much research work was to be done on programming tools and the information system itself. This paper deals with five strategic problems and corresponding corrective actions.

Data Collection↗