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PubMed2000

Implementation and day-to-day usage of a client-server-based radiology information system.

Implementation of a second-generation radiology information system (RIS) requires attention to many issues, including work flow, system design, training, consideration for emerging technologies, and support. This presentation covers the issues, and solutions, involved in implementation and subsequent day-to-day usage of a client-server-based RIS tightly integrated with a hospital information system (HIS) using "thin client" software to limit hardware requirements for the client computers. The software and hardware implementation had to be designed for potential enterprise-wide scalability of the RIS for a system involving 11 hospitals. Issues arose regarding initial increased turnaround times, errors in importation of historical data, and problems with implementation of interfaces between the RIS and the billing system and between the RIS and the digital dictation system. Network errors and difficulties in using a thin client implementation had to be overcome. Hierarchical training was implemented, as support was switched from an "on-site" support group to a central Information System Division with responsibility to the entire enterprise.

Computer Systems↗
PubMed2004

Respiratory care management information systems.

Hospital-wide computerized information systems evolved from the need to capture patient information and perform billing and other financial functions. These systems, however, have fallen short of meeting the needs of respiratory care departments regarding work load assessment, productivity management, and the level of outcome reporting required to support programs such as patient-driven protocols. The respiratory care management information systems (RCMIS) of today offer many advantages over paper-based systems and hospital-wide computer systems. RCMIS are designed to facilitate functions specific to respiratory care, including assessing work demand, assigning and tracking resources, charting, billing, and reporting results. RCMIS incorporate mobile, point-of-care charting and are highly configurable to meet the specific needs of individual respiratory care departments. Important and substantial benefits can be realized with an RCMIS and mobile, wireless charting devices. The initial and ongoing costs of an RCMIS are justified by increased charge capture and reduced costs, by way of improved productivity and efficiency. It is not unusual to recover the total cost of an RCMIS within the first year of its operation. In addition, such systems can facilitate and monitor patient-care protocols and help to efficiently manage the vast amounts of information encountered during the practitioner's workday. Respiratory care departments that invest in RCMIS have an advantage in the provision of quality care and in reducing expenses. A centralized respiratory therapy department with an RCMIS is the most efficient and cost-effective way to monitor work demand and manage the hospital-wide allocation of respiratory care services.

California↗
PubMed1992

Visual documentation of neoplasms as part of the REGISTRY Nomenclature Information System.

The REGISTRY Nomenclature Information system (RENI) is a program which runs on IBM-compatible personal computers. It includes internationally accepted diagnostic criteria for tumors and pre-neoplastic lesions in the rat to be used in toxicologic pathology. A video disk system, connected to the computer, provides colored pictures of histopathological reference slides, which are used for a visual documentation of the written criteria.

Animals↗
PubMed1992

An analysis of the relationship between a pathology department and its laboratory information system vendor.

The ongoing collaborative relationship between a pathology department and the vendor of its laboratory information system is vitally important because of the strategic importance of the laboratory information system in managing the information product of the department. Laboratory information system vendors are value-added resellers in that they produce software and package it with hardware manufactured by another manufacturer. The success of laboratory information system value-added resellers in creating information systems that are highly functional depends on their forward vertical quasi-integration into pathology departments. Because of this relationship, laboratory information system value-added resellers exert a significant degree of control over departments, largely through the creation of switching costs. There are a number of strategies by which departments can exercise greater control over vendors, one of which is to serve as either an alpha- or beta-development site for the vendor's software. Such a strategy is not without risk, but it achieves the dual purpose of enhancing both the expertise of departmental personnel and the quality of the software product.

Clinical Laboratory Information Systems↗
PubMed1998

On the way to a Web based hospital information system: concepts for the use of a medical data dictionary to present context sensitive information in an intranet environment.

Many authors have promoted the www-paradigm to build modern hospital information systems. However currently web-based applications are better suited to information "browsing" than to build complex data entry features. This prompted us to start with our first web based developments inside the Giessen University Hospital Information System in the field of pure presentation of stored knowledge and information. This article describes the concepts which will be used in Giessen to convert available information sources to the www paradigm and to implement context-sensitive knowledge presentation mechanisms inside the clinical information system. The approach is based upon a web-based medical data dictionary server. The data dictionary is used to map terms of interest, chosen from the clinical user during work with a HIS-application, to a semantic network of relationships. The dictionary server will follow those semantic links in order to find and display the webpages, which are linked to the subject.

Dictionaries as Topic↗
PubMed1979

NCTR computer systems designed for toxicologic experimentation. V. Post-experiment information system.

The Post-Experiment Information System (PEIS) is an automated data collection and reporting system composed of three specialized subsystems: Pathology, Chemistry and Microbiology. These subsystems function either independently or collectively to construct and maintain a comprehensive data base of all experimental values derived from, or associated with, an animal carcass. All data are retrievable by the unique Carcass Identification (CID) number assigned at death, which is the correlative of the Unique Identification Number (UIN) assigned to the animal at birth and used throughout its lifespan. Elements processed under the PEIS include gross and microscopic pathological observations, organ weights, hematologic data, chemical data, and microbiological analyses. The ability of the system to integrate the post-experiment data with the information collected on an animal from birth (BIS) and during the experiment (EIS) provides a complete animal history to the Principal Investigator or other requestor.

Animals↗
PubMed1999

[Role of information system for the health care delivery in community].

Sophisticated information technologies have been applied in hospitals as well as in clinics. However, almost no information system has been developed which links hospitals and clinics. Medical care and welfare services are still separated activities and there are no information systems which exchange the data between the two sectors. Emergency medical information systems have been developed in the past, but they are usually used only for the exchange of bed occupancy information. Doctors started using the Internet, but there have been few medical books in Japanese in cyber space. Initiatives of medical personnel who are engaged in the daily health care delivery are necessary to solve the above stated problems. Some promising systems are emerging by the efforts of pioneers. Administrative agencies should assist the efforts of these initiatives to improve the community health care delivery. In the near future, the information systems will have some influence on the shape of medical care. Patient's medical data will be disclosed to patients. Specialty of hospitals will be also disclosed to the public. As a result, doctors will start to seek for more objective evidence for their medical care to patients. Clinical practice guidelines will be produced for common diseases in Japan as in Europe. Hospitals will cooperate with each other in the delivery of care, because it will be impossible for one hospital to give all types of care to patients. Hospitals in a community will function as if a virtually single hospital even though they are different in management.

Community Health Services↗
PubMed1990

Functionality of the ARPIA ambulatory information system.

Although database-based medical information systems are becoming popular, experiments done by researchers tell us that physicians still do not fully accept them. Key factors for changing physicians' practice habits are the availability of more powerful methods and tools for interactive data acquisition and retrieval. Problems involving human engineering usually require the identification of and experimentation with many novel approaches before the most suitable answer is discovered. ARPIA is an ambulatory information system experimenting on the effectiveness and acceptability (by medical users) of new intelligent and friendly interaction techniques and tools. In particular, it tests a novel flexible dialogue-based man-machine interface offering physical and logical data 'independence' during retrieval operations. Other features of the system are: a fast and robust data acquisition environment; a text- and picture-based data presentation and report generation facility; finally, a set of modules offering the ambulatory staff effective assistance in some extra complex interactive tasks. A user-oriented description of the main functionality of ARPIA is given; users' feedback summarizing almost 2 years of usage of the system is also reported.

Ambulatory Care Information Systems↗
PubMed1991

Status and progress of hospital information systems (HIS).

Expectations for hospital information systems (HIS) have yet to be realized. Requirements have been defined by the International Medical Informatics Association, health care futurists, and others. With a volatile marketplace and evolving technologies, computerization has been a non-trivial task. However, recent advances in architecture and communication standards promise to make networking possible. In addition, the development of professional workstations and of computer-based patient records linked to new tools and applications can transform health care. For HIS to realize these expectations, however, technology assessment and outcome analysis must play critical roles.

Hospital Information Systems↗
PubMed1998

Timing is everything. Time-oriented clinical information systems.

Time is important in clinical information systems. Representing, maintaining, querying, and reasoning about time-oriented clinical data is a major theoretical and practical research area in medical informatics. In this nonexhaustive overview, we present a brief synopsis of research efforts in designing and developing time-oriented information systems in medicine. These efforts can be viewed from either an application point of view, distinguishing between different clinical tasks (such as diagnosis versus therapy) and clinical areas (such as infectious diseases versus oncology), or a methodological point of view, distinguishing between different theoretical approaches. We also explore the two primary methodological and theoretical paths research has taken in the past decade: temporal reasoning and temporal data maintenance. Both of these research areas include efforts to model time, temporal entities, and temporal queries. Collaboration between the two areas is possible, through tasks such as the abstraction of raw time-oriented clinical data into higher-level meaningful clinical concepts and the management of different levels of temporal granularity. Such collaboration could provide a common ground and useful areas for future research and development. We conclude with our view of future research directions.

Artificial Intelligence↗
PubMed1984

Clinical problems in organophosphate insecticide poisoning: the use of a computerized information system.

A computerized medical information system has been constructed, which contains clinical data from 236 case records of organophosphate and carbamate insecticides poisoning in Israel. A computer program was used to retrieve, analyze, and cross- tabulate data contained in 162 variables per patient. Clinical criteria were used to distinguish mild (66%) from moderate (19%) and severe (15%) cases. The majority of exposures were occupational (58%), whereas the rest were accidental (31%) or suicidal (11%). Parathion was the toxic compound most frequently involved (153 cases). Grouping signs and symptoms according to the cholinergic synapse systems showed peripheral muscarinic signs to be the most prevalent (92.5% of cases), whereas involvement of all three synapse systems was rare (17%). Listing individual symptoms emphasized the high prevalence of nonspecific symptoms such as vomiting (142 cases) and abdominal pain (115 cases). The mean atropine dose given to adult patients during the first 24 hr after poisoning ranged from 6.0 +/- 0.7 mg in mild cases to 49.8 +/- 4.5 mg in severe cases. Evaluation of clinical decision making was demonstrated through analysis of the guidelines used by physicians to gauge atropine administration. Five of the eighteen fatalities were delayed deaths, one of which was due to a polymorphous ventricular arrhythmia. The same arrhythmia occurred also in four nonfatal cases. Other delayed effects included nonspecific EEG changes and neuropsychiatric symptoms. Matching individual cases with comparable cases in the data bank was demonstrated, using a previously published case report. Computerized consultation may help inexperienced physicians to improve the quality of medical care given to cases of organophosphate insecticide poisoning in small hospitals located in rural areas.

Adolescent↗
PubMed2002

euGenes: a eukaryote genome information system.

euGenes is a genome information system and database that provides a common summary of eukaryote genes and genomes, at http://iubio.bio.indiana.edu/eugenes/. Seven popular genomes are included: human, mouse, fruitfly, Caenorhabditis elegans worm, Saccharomyces yeast, Arabidopsis mustard weed and zebrafish, with more planned. This information, automatically extracted and updated from several source databases, offers features not readily available through other genome databases to bioscientists looking for gene relationships across organisms. The database describes 150 000 known, predicted and orphan genes, using consistent gene names along with their homologies and associations with a standard vocabulary of molecular functions, cell locations and biological processes. Usable whole-genome maps including features, chromosome locations and molecular data integration are available, as are options to retrieve sequences from these genomes. Search and retrieval methods for these data are easy to use and efficient, allowing one to ask combined questions of sequence features, protein functions and other gene attributes, and fetch results in reports, computable tabular outputs or bulk database forms. These summarized data are useful for integration in other projects, such as gene expression databases. euGenes provides an extensible, flexible genome information system for many organisms.

Animals↗
PubMed1985

Computer-based information systems models. Perspectives for nursing.

A synthesis of theories from the management information systems (MIS) field provided the conceptual framework to describe how to design and develop effective computer-based information systems. An analysis of activities and interviews with nurse managers in a tertiary care medical center provided the basis for describing five major nursing department functions and the information requirements arising from those functions. The MIS framework was applied to the nursing department information requirements in order to derive MNIS, a normative model of a nursing information system, which was then used to "bench mark" the current status of commercially available nursing information systems. The researchers compared the MNIS with 28 nursing information systems that vendors are currently developing or marketing. The comparison revealed large gaps between nursing department needs and vendor-provided solutions.

Commerce↗
PubMedDate not supplied

Reimbursement comes of age. EMPOWER: a management information system.

A management information (MI) system for general and academic medical practices is imperative in a changing environment. Funded by a grant from the MGMA Academic Practice Assembly, EMPOWER is relevant to all types of medical practice. The software package supports financial/time allocation models, income/expense models and incentive cost center approaches.

Academic Medical Centers↗
PubMed2003

[The Beilstein CrossFire Information System and its use in pharmaceutical chemistry].

The Beilstein CrossFire database system is one of the most popular, most extensive, and most accomplished systems presenting information about chemical substances, including drugs, and covering the basic identification, physico-chemical, ecological, and pharmacological data. The present article offers an overview of historical evaluation of the Beilstein CrossFire database system, beginning from its founder Prof. Friedrich Conrad Beilstein till the most recent prospects about the connection of classical data with full-text databases. The article also offers a review of the development of electronic information systems in the Slovak Republic, a definition of basic functionality of the Beilstein CrossFire database system, and an example of targeted selection of active substances structurally similar to novel COX-2 inhibitors having an approved anti-inflammatory activity.

Chemistry, Organic↗
PubMed1994

Translating traditional principles of system development into a process for designing clinical information systems.

Traditional software development methodologies enhanced by a clinical component result in information systems that support the practice of nursing. This paper describes the clinical informatics model used to develop and evaluate a mobile computer assessment tool. Data entry of atomic-level elements, with storage in a relational database, allows the synthesis and analysis by multiple disciplines to aid in real-time decision making. The system is designed to improve the recording and accessibility of patient data and nursing observations on a geriatric unit at the Salt Lake VA Medical Center.

Clinical Medicine↗
PubMed1999

Synchronous and asynchronous brain-state-in-a-box information system neural models.

Synchronous and asynchronous information system neural models are proposed that are hybrids of Pawlak's information system and Brain-State-in-a-Box (BSB) neural models. The stability of the proposed models is studied using LaSalle's Invariance Principle. Applications to an analysis of the United Nations activities are presented as examples.

Information Systems↗