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PubMed1998

Cost-volume-profit and net present value analysis of health information systems.

The adoption of any information system should be justified by an economic analysis demonstrating that its projected benefits outweigh its projected costs. Analysis differ, however, on which methods to employ for such a justification. Accountants prefer cost-volume-profit analysis, and economists prefer net present value analysis. The article explains the strengths and weaknesses of each method and shows how they can be used together so that well-informed investments in information systems can be made.

Accounts Payable and Receivable↗
PubMed1983

The Georgetown University Library Information System (LIS): a minicomputer-based integrated library system.

Georgetown University's Library Information System (LIS), an integrated library system designed and implemented at the Dahlgren Memorial Library, is broadly described from an administrative point of view. LIS' functional components consist of eight "user-friendly" modules: catalog, circulation, serials, bibliographic management (including Mini-MEDLINE), acquisitions, accounting, networking, and computer-assisted instruction. This article touches on emerging library services, user education, and computer information services, which are also changing the role of staff librarians. The computer's networking capability brings the library directly to users through personal or institutional computers at remote sites. The proposed Integrated Medical Center Information System at Georgetown University will include interface with LIS through a network mechanism. LIS is being replicated at other libraries, and a microcomputer version is being tested for use in a hospital setting.

Computers↗
PubMed1999

When health information systems fail.

The failure of health care information systems is a topic of critical importance for information management professionals. Such failure is also important for the consumers of health services who rely on the informed activity of health care workers for their well-being. This article presents case studies of two information systems projects within the British National Health Service that are generally viewed as having failed. The article provides an analysis of these failures, and examines whether the British National Health Service is particularly prone to the phenomenon of information systems failure.

Ambulances↗
PubMed1998

Medical informatics training programme to support the Romanian health care management information system.

The Health Management Information System (HMIS) project initiated by the Romanian Ministry of Health as a component of the healthcare reform is aiming to ensure the technical, functional and operative support for: (i) a better overview of the population health status, of the medical care needs and of the Health System performances; (ii) the improvement of the resource allocation and consumption; and (iii) reform support. This system is supposed to assure a better information flow from the lower to the upper levels of the healthcare network by help of a modern IT support. In the first development stage the system is planned to link the Ministry of Health with the 41 District Health Authorities (DHAs) and with more than 200 pilot health units. The implementation of such a large system raises serious problems of acceptability and a thorough training programme for both technical staff and end users must be considered in order to face this challenge.

Health Care Rationing↗
PubMed2005

The role of web-based environmental information in urban planning--the environmental information system for planners.

The Environmental Information System for Planners (EISP) is a proof of concept web-based system designed to support decision making within the UK planning framework by making information on environmental issues more widely accessible. It incorporates relevant outputs from the Natural Environment Research Council (NERC) Urban Regeneration and the Environment (URGENT) research programme and from research directly commissioned by the Office of the Deputy Prime Minister (ODPM). It supports three principal planning functions carried out by local authorities: pre-planning enquiries, development control decisions and strategic planning. Eleven environmental science themes are incorporated: Air quality, Shallow undermining, Landslide susceptibility, Groundwater protection, Flood risk, Drainage, Land contamination, Proximity to landfill, Biodiversity, Natural and Man-made heritage. Decision flow diagrams represent detailed analysis of workflow in each theme, taking account of best practice, regulatory responsibilities and planning guidance. Industry-standard web technologies integrate the flows and provide access to the system via secure web pages. Underpinning the system is an environmental geographical information system (GIS) containing up-to-date data, information and models relevant to each theme. The modular system design allows new legislation and local priorities and datasets to be easily incorporated. Web technology delivers information and research data that have hitherto been difficult for the non-specialist to access and have therefore been under-exploited. The study has demonstrated a successful application of the principles of e-Governance in an area where informed decisions commonly require specialist information. The system, if rolled out nationally, offers potential economic benefits and efficiency savings for both planners and developers.

City Planning↗
PubMed2000

ARCHIMED: a Network of Integrated Information Systems.

ARCHIMED is a Network of Integrated Information Systems (NIIS). This novel concept of hospital information system has a major advantage over the currently used distributed systems. The normalized representation structure of its databases enable its Navigators to reach simultaneously not only the data coming from different hospital departments, laboratories, and other hospital facilities, but also the data from different hospitals associated in the network.

Computer Communication Networks↗
PubMed1999

Security in health-care information systems--current trends.

Ever since health-care information systems have been implemented, their security is being considered an important issue, especially in the light of the fact that their data are deemed to comprise extremely sensitive information. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised health-care information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised health-care providers, in order to ensure the proper treatment of the patient. The principal aim of the present paper is, however, not to make a new contribution to the subject of security per se, but rather to give an overview of current trends in the security aspects of health-care information systems. The final section of the paper will be devoted to a number of proposals for further research possibilities in the domain of health-care information systems security.

Computer Security↗
PubMed2002

How to build an information system application to the health domain.

Computer based information systems aim at improving knowledge, evaluation and management processes. Such tools are still developing in the non-profit sector. This paper aims at: a) reminding how to evolve from data to management information systems b) describing how to build a population based health information system c) describing the concepts required for conceiving a retrieval system and a system for inserting data d) documenting the importance of conceiving the system not only from a user driven perspective, but also taking into account the requirements of an information management system.

Community Health Planning↗
PubMed1998

[More information on infectious diseases provided by a national information system].

The Infectious Diseases Information System (ISIS) was established to improve the exchange of information about infectious diseases among those combating these diseases. Information about infectious diseases is obtained from municipal health services by means of a data processing system elaborated by the National Institute for Public Health and the Environment. After adjustment to the new Act on Combating and Tracing of Infectious Diseases it will be introduced nation-wide in 1998. Information about pathogens is obtained from medical microbiological laboratories (MMLs) through automatic storage of positive and negative results in a central data bank. After a pilot project had shown that the data from one MML, Arnhem, were complete and reliable, the MMLs of Roermond and Tilburg were also connected. For feedback of information to medical microbiologists and infectious diseases specialists, but also to, for instance, GPs, data from the whole country are presented daily on a public Internet site (http:/(/)www.isis.rivm.nl).

Communicable Diseases↗
PubMed1991

Fast personal computer based retrieval system for a high-volume database of a radiology information system.

A personal computer system has been used to facilitate search and analysis of a radiology information system database (RADOS) for research purposes. The system enables flexible retrieval of examination data and radiographic findings with subsequent graphical manipulations. With modifications it could be implemented on other radiology information systems.

Medical Records Systems, Computerized↗
PubMed1997

Trends in health information systems technology.

Major trends in health information systems technology are described. The new paradigm for information systems is integrated, patient-centered computing. The computer system and files are designed around information-capture needs along the continuum of care instead of around charge capture or inventory. The need for patient information in the future will not be limited to the health system but will extend to work sites and homes. Health systems will move to full client-server architecture, higher-speed data transmission, and greater network capacity. Computing standards will be instituted nationwide. With changes in the economics of health care, physician order-entry systems are inevitable. Many health systems and system vendors are making progress in achieving the computer-based patient record (CPR); health systems will require the CPR if they are to be truly integrated. Trends in health care and health care information technology will require that pharmacists innovate and adapt as never before.

Continuity of Patient Care↗
PubMed1995

Integrated information systems: tools for affiliation.

The development of healthcare information systems as tools to facilitate business success traditionally has focused on a single profit center. The cataclysmic changes that are reshaping American healthcare have accelerated the affiliation of provider entities to form systems that have broader geographic coverage, deliver a larger portion of the provider continuum of care, and are more attractive partners for purchasers of healthcare services. Integrated and/or standardized information system technologies can provide great benefit in containing costs and optimizing quality among partners resulting from healthcare mergers and acquisitions as the new entity positions itself to increase market share and enhance its bottom line. Graduate Health System (GHS) in the Philadelphia area has demonstrated the efficacy of its investment to build a system-wide information network that delivers multiple standardized, integrated systems for both the financial and operational advantage of all component institutions. Building on its patient information system as the centerpiece of its information strategy, GHS has deployed a variety of tools across its network infrastructure that have brought new capabilities and savings to its member hospitals. In light of some of GHS's successes, other hospitals and healthcare systems may be able to re-create similar savings and efficiencies by applying like strategies in cooperation with their affiliated partners.

Cost-Benefit Analysis↗
PubMed1989

The emergence of local delivery systems: a new generation of IS (information systems).

Market surveys show that a dramatic organizational and economic restructuring of medical care delivery is taking place at the local level. These changes suggest a trend in which a finite number of umbrella corporations within each local area will be established and will control the majority of medical care provided. Information systems will play a critical role in determining the success or failure of these organizations.

Commerce↗
PubMed1981

Types and uses of hospital information systems expand.

Computerized hospital information systems are expanding to use new technological developments and to perform new applications, but planning, management, and costs of these systems continue to be major concerns.

Computers↗
PubMed2005

Using operational information and information systems to improve in-patient flow in hospitals.

PURPOSE: To consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed. DESIGN/METHODOLOGY/APPROACH: The literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements. FINDINGS: The National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service. RESEARCH LIMITATIONS/IMPLICATIONS: The work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England. PRACTICAL IMPLICATIONS: Some bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology. ORIGINALITY/VALUE: There has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.

Acute Disease↗
PubMed1993

Managing the implementation of a pharmacy information system.

The stages by which a pharmacy information system should be implemented are described. Implementation can be divided into three stages. The first stage is preimplementation, during which the hardware vendor installs and configures the operating system, the software is installed, the site is prepared, files are built, policies and procedures are modified or written, staff members are trained, functions or programs are tested, and supplies are purchased. The second stage is implementation, in which the new system becomes operational and is expanded. There are four basic implementation strategies: abrupt switchover, parallel conversion, conversion of one location at a time, and conversion of functions or modules in stages. The final stage is postimplementation, which consists of testing of the system, acceptance or rejection of the system, and the institution of quality control procedures. The acceptance criteria should be developed before the system is purchased. It is important to involve the pharmacy staff and other hospital departments in the planning for an information system. Careful management before, during, and after the implementation of a new pharmacy information system is essential to a smooth and timely conversion.

Clinical Pharmacy Information Systems↗
PubMed1998

OOMM--Object-Oriented Matrix Modelling: an instrument for the integration of the Brasilia Regional Health Information System.

The development of Health Information Systems is widely determined by the establishment of the underlying information models. An Object-Oriented Matrix Model (OOMM) is described which target is to facilitate the integration of the overall health system. The model is based on information modules named micro-databases that are structured in a three-dimensional network: planning, health structures and information systems. The modelling tool has been developed as a layer on top of a relational database system. A visual browser facilitates the development and maintenance of the information model. The modelling approach has been applied to the Brasilia University Hospital since 1991. The extension of the modelling approach to the Brasilia regional health system is considered.

Brazil↗