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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 online order entry process in an integrated hospital information system.

In Kochi Medical School Hospital, many online order systems have been developed as a part of the integrated hospital information system named IMIS KOCHI. The prescription, laboratory and radiology orders are used frequently and entered into the system by physicians. The distribution of entry duration of these orders by physicians was analyzed and it was found that the order entry is a completely random event and the entry process consists of the two Poisson processes; the quick process and the slow process. The two Poisson processes were observed even in the do-prescription order without correction by trained physicians. It is speculated that the quick process depends on availability in the order entry system and the slow process depends on peculiarities in clinics, and the mental condition of physicians.

Drug Prescriptions↗
PubMed2004

Key elements for successful integrated health information systems: lessons from the States.

The Genetic Services Branch, Maternal and Child Health Bureau of the Health Services and Resources Administration has provided funding to state health departments to integrate their newborn dried blood-spot screening programs with other early child health information systems since 1999. In 2001, All Kids Count conducted site visits to these grantees to identify and describe best practices in planning, developing, and implementing their integration projects. The site visits were organized around 9 key elements considered critical to the success of an information systems integration project: leadership, project governance, project management, stakeholder involvement, organizational and technical strategy, technical support and coordination, financial support and management, policy support and evaluation. Best practices for each of the key elements and 5 lessons learned were documented in Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Sourcebook for Planning and Development. The lessons learned are overarching conclusions that agencies should consider when planning and implementing integrated information systems. This article briefly describes the key elements, their best practices as implemented by states, and the lessons learned.

Child↗
PubMed1995

Integrated clinical information system.

SIDOCI (Système Informatisé de DOnnées Cliniques Intégrées) is a Canadian joint venture introducing newly-operating paradigms into hospitals. The main goal of SIDOCI is to maintain the quality of care in todayUs tightening economy. SIDOCI is a fully integrated paperless patient-care system which automates and links all information about a patient. Data is available on-line and instantaneously to doctors, nurses, and support staff in the format that best suits their specific requirements. SIDOCI provides a factual and chronological summary of the patient's progress by drawing together clinical information provided by all professionals working with the patient, regardless of their discipline, level of experience, or physical location. It also allows for direct entry of the patient's information at the bedside. Laboratory results, progress notes, patient history and graphs are available instantaneously on screen, eliminating the need for physical file transfers. The system, incorporating a sophisticated clinical information database, an intuitive graphical user interface, and customized screens for each medical discipline, guides the user through standard procedures. Unlike most information systems created for the health care industry, SIDOCI is longitudinal, covering all aspects of the health care process through its link to various vertical systems already in place. A multidisciplinary team has created a clinical dictionary that provides the user with most of the information she would normally use: symptoms, signs, diagnoses, allergies, medications, interventions, etc. This information is structured and displayed in such a manner that health care professionals can document the clinical situation at the touch of a finger. The data is then encoded into the patient's file. Once encoded, the structured data is accessible for research, statistics, education, and quality assurance. This dictionary complies with national and international nomenclatures. It also contains personalized profiles: questionnaires based on the predetermined choices of the information most relevant to the specific user. The SIDOCI clinical dictionary also includes the hospital's suggested or mandatory interventions, clinical guidelines, and protocols. These clinical guidelines are customized at the hospital, service, and professional levels. Common interventions have been regrouped so that health professionals may apply the appropriate diagnostic, therapeutic, educational, or other intervention plans. The clinical dictionary also serves as a teaching and continuing education tool. The patient profile is a permanent record containing information on allergies, blood type, primary and secondary diagnoses, ongoing treatments, and prior hospitalizations. The problem list dealing with the current hospitalization includes symptoms, signs, and diagnoses. This standard clinical record facilitates communication between the services and provides a quick overview of the patient's history should emergency treatment be required. This health information system integrates Requests and Results, Progress Notes, and Analysis of the results. In addition, functions inherent to a patient's clinical cycle such as Administrative Management of episodes, Adaptation to physical and professional structures of the hospital, Messages between health professionals, and Electronic signature constitute the basis of SIDOCI. The most exciting aspect of this research project is its social impact: a more efficient health care system will improve the lives of all citizens. Moreover this applied research project involves the information industry and directly calls for the input of users such as doctors, nurses and hospital support staff.

Hospital Information Systems↗
PubMed1998

ARIANE: integration of information databases within a hospital intranet.

Large information systems handle massive volume of data stored in heterogeneous sources. Each server has its own model of representation of concepts with regard to its aims. One of the main problems end-users encounter when accessing different servers is to match their own viewpoint on biomedical concepts with the various representations that are made in the databases servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet and to propose a method to realize it. This method is based on the knowledge sources provided by the Unified Medical Language System (UMLS) project of the US National Library of Medicine. Experiments concern queries to three different information servers: PubMed, a Medline server of the NLM; Thériaque, a French database on drugs implemented in the Hospital Intranet; and a Web site dedicated to Internet resources in gastroenterology and nutrition, located at the Faculty of Medicine of Nice (France). Accessing to each of these servers is different according to the kind of information delivered and according to the technology used to query it. Dealing with health care professional workstation, the authors introduced in the ARIANE project quality criteria in order to attempt a homogeneous and efficient way to build a query system able to be integrated in existing information systems and to integrate existing and new information sources.

Computer Communication Networks↗
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↗
PubMed2006

Empowering nurses--Improving care with an Integrated Nursing Information System (INIS).

The nursing informatics project team within the Information Management Services Department of the Mater Misericordiae University Hospital, Dublin, Ireland is currently developing and implementing an Integrated Nursing Information System (INIS) in accordance with an "Information and Workflow Model" drawn up by the team in 1998. The three components of the INIS will be defined and progress in the hospital to date will be demonstrated. INIS will become part of the overall electronic patient record.

Humans↗
PubMed1998

A strategy and demonstration for integrated biotechnology information.

Bioinformatics has developed as a key discipline to support science. Integrated access to the various new and established information resources is a key requirement for their future utility. A strategy for this integration has been developed and is being demonstrated to a core group of European users.

Biotechnology↗
PubMed2003

Integrating health information systems: a critical appraisal.

OBJECTIVES: The aim of this paper is to critically assess some of the underlying assumptions behind these initiatives and analyze the dominant expressions, forms and mechanisms of integration. METHODS: This paper employs a discourse analysis to elicit the notion of integration of information systems and its consequences for electronic patient record systems. RESULTS AND CONCLUSIONS: An alternative strategy is outlined, encouraging a more decentralized, multi-vocal approach acknowledging the productive role of related and duplicated information and preserving the existing variety of information systems.

Ergonomics↗
PubMed1992

[Integration of informations gained from heterogeneic world of myocardial function and ischemia].

Currently, heterogeneity is the word to describe any inhomogeneous phenomenon observed in the ever changing living creatures. Myocardial function is dynamic in nature which is a summation of many inhomogeneous components. In fact, heterogenic phenomenon has been observed both at cellular and at ventricular levels during myocardial contraction and relaxation. However, this heterogenic behavior of myocardial activities serves as a source of monitoring parameters by which we can grasp what is happening in the patient. Reliance on only one of those parameters would lead to a wrong diagnosis and judgement in the heterogenic world. We, therefore, need to integrate those parameters to form more realistic image about patient's status. We have to have a cut off point to divide what is right and what is wrong. Although the truth may not be reached eventually from heterogeneous informations, an appropriate method to integrate informations in the heterogenic world will aid us to come closer to the reality.

Humans↗
PubMed2000

RadStation: client-based digital dictation system and integrated clinical information display with an embedded Web-browser.

RadStation is a digital dictation system having an integrated display of clinical information. The three-tiered system architecture provides robust performance, with most information displayed within one second after a request. The multifunctional client tier is a unique client/browser hybrid. A Web browser display window functions as the client application's data display window for clinical information, radiology reports, and laboratory and pathology results. RadStation provides a robust platform for digital dictation functionality. The system's internal status checks ensure operational integrity in a clinical environment. Also, the programmable dictation microphone and bar-code reader supplant the mouse as the system's primary input device. By merging information queries into existing work flow, radiologist's interpretation efficiency is maintained with instant access to essential clinical information. Finally, RadStation requires minimal training and has been enthusiastically accepted by our radiologists in an active clinical practice.

Computer Peripherals↗
PubMed1982

Respiratory therapy as a component of an integrated hospital information system: the Parkland On-Line Information System (POIS).

Information handling is an important part of the activities of health care professionals, and the Parkland On-line Information System (POIS)--a computerized hospital information system--was established to more efficiently handle the processing and storage of information in our institution. Computerization of a respiratory therapy department is more effective if done in the context of a comprehensive, integrated hospital information system. Information and requests for services flow into the respiratory therapy departmental computer from other hospital terminals, and information, such as patient charges and statistical data, flow out of the departmental computer to those requesting such information. POIS is an implementation of the IBM Patient Care System. We have found that a computerized hospital information system can facilitate patient care by easing the burden of information processing.

Computers↗
PubMed1995

Implementation of the totally integrated hospital information system (Humane) in Osaka University Hospital.

On September 1, 1993, in the new Osaka University Hospital, we implemented a new hospital information system named "HUMANE" (Human oriented Universal Medical Assessment system by Network Environment). We had planned to organize a more effective and efficient medical care system in the new hospital and improve the medical services to patients. To succeed in constructing a totally integrated hospital information system, the original data must be entered. Most of it would be entered by doctors who are not accustomed to the operation of a computer system, thus the production of a good man-machine interface is indispensable. For this reason, we adopted a micro-medium-main frame link system for the system configuration. The interface program and the copy of the master data about each subsystem are located on the microframe. Although, all patient data is stored on the mainframe, most of the active patients' data is delivered to the mediumframe before the data is requested. This system design makes it possible to shorten the response time and to use a comfortable user interface. On the basis of this system configuration, we made subsystems that support hospital management, for example, an ordering system, a reporting system, a reservation system, a supporting system for hospitalization, a nurse supporting system, and so on. These systems promote automation control in each central service division; pharmacy, radiology, laboratory for clinical investigation and accounting section, resulting in man-power being saved. At the same time, medical service to patients is improved, because waiting time is shortened and redundant examinations or prescription are avoided.

Computer Systems↗
PubMed1989

Neural integration of information specifying structure from stereopsis and motion.

When one views a two-dimensional parallel projection of dots on the surface of a rotating globe, the direction of rotation is ambiguous, and the perceived direction of rotation of the two-dimensional figure is unstable over time. Stability can be temporarily induced by adaptation to a three-dimensional globe with a direction of rotation unambiguously specified by stereo disparity; adaptation causes the two-dimensional figure to appear to rotate in the direction opposite that experienced during stereoscopic adaptation. This adaptation effect is selective for axis of rotation but is not shape-specific. It does depend on simultaneous stimulation by multiple depth planes defined by elements moving in different directions. Evidently information about stereopsis and information about structure from motion are integrated within a common neural site in the brain.

Adaptation, Ocular↗
PubMed2005

[Effect of er'bao granule on integration of ingestion behavior-related information by neurons in lateral hypothalamic area of anorexia rats].

OBJECTIVE: To confirm the effect of Er'bao granule (EBG) on the sensitivity to peripheral afferent signal of neurons in lateral hypothalamic area (LHA) to illustrate the central mechanism of EBG in promoting ingestion behavior. METHODS: The anorexia rat model was established by feeding special prepared forage for one week, and all the model rats were administrated with EBG by gavage for 3 weeks. The spontaneous discharge of LHA neurons was recorded using electro-physiological extracellular recording method, and its response to electrical stimulus on gastric vagus nerve and intravenous injection of glucose were observed and compared among the normal, model and treated groups. RESULTS: As compared with the normal group, among the LHA neurons responding to afferent gastric vagal impulse, the proportion of glycemia-sensitive neurons in the model group was significantly decreased (P <0.01), but insignificant difference was shown in comparison between the treated group and the normal group. CONCLUSION: EBG play a role in regulating the sensitivity of LHA neurons to peripheral afferent signal and thus to influence the multi-afferent information integration of ingestion central neurons.

Afferent Pathways↗
PubMed2004

Surveillance of occupational noise exposures using OSHA's Integrated Management Information System.

BACKGROUND: Exposure to noise has long been known to cause hearing loss, and is an ubiquitous problem in workplaces. Occupational noise exposures for industries stored in the Occupational Safety and Health Administration's (OSHA) Integrated Management Information System (IMIS) can be used to identify temporal and industrial trends of noise exposure to anticipate changes in rates of hearing loss. METHODS: The noise records in OSHA's IMIS database for 1979-1999 were extracted by major industry division and measurement criteria. The noise exposures were summarized by year, industry, and employment size. RESULTS: The majority of records are from Manufacturing and Services. Exposures in Manufacturing and Services have decreased during the period, except that PEL exposures measured by federal enforcement increased from 1995 to 1999. CONCLUSIONS: Noise exposures in manufacturing have been reduced since the late 1970s, except those documented by federal enforcement. Noise exposure data outside manufacturing is not well represented in IMIS.

Hearing Loss, Noise-Induced↗