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At least 325 records · Page 18Linked to original sources
PubMed2003

"Computers can land people on Mars, why can't they get them to work in a hospital?" Implementation of an Electronic Patient Record System in a UK Hospital.

OBJECTIVES: This paper aims to describe and interpret the implementation of a hospital information system in a large UK hospital. METHODS: The paper is based on a longitudinal case study over a three-year period in which a cross section of hospital staff involved with the information system were interviewed. RESULTS AND CONCLUSIONS: Ambitious government targets for the use of Information Technology in the UK National Health Service sit alongside a history of notable project failures. The decision by a UK hospital to install an advanced, integrated electronic patient record system therefore faced conflicting demands and expectations. This paper suggests that its simple categorisation as either a success or failure is problematic. Rather, the differing viewpoints that lead some clinicians to express "disappointment" with its performance, while others described its features as "tremendous" and managers suggested that the system had become "taken for granted" are explored. A number of broader phenomena relating to the organisational processes surrounding information systems implementation are also identified.

Attitude of Health Personnel↗
PubMed2001

Review of Expert System (ES), Geographic Information System (GIS), Decision Support System (DSS), and their applications in landfill design and management.

This paper provides the reader with a brief discussion on Expert System (ES), Geographic Information System (GIS), and Environmental Decision Support System (EDSS) technologies and their applications in environmental engineering in general and in landfill design and management in specific. It also brings into attention the benefits of integrating ESs and GISs together with simulation models (SM) in a decision support systems (DSS) framework to solve complex environmental problems, facilitated by the new advancements of computer technologies (both in hardware and software). Examples of such integration are provided to reflect how such a system can improve landfill design and management. Finally, the discussion concludes with the fact that although solving landfill design problems could greatly benefit from such a combination of technologies, there have been no attempts to combine ES, GIS, and SM for the comprehensive evaluation of landfill design and performance.

Decision Support Techniques↗
PubMed1992

User requirements for information systems in nuclear medicine.

In the field of COST cooperation (COST = European Cooperation in the Field of Scientific and Technical Research) a project B2 for Quality Assurance in Nuclear Medicine Software has been established. In a memorandum of understanding setting up this project, user requirements were to be defined for the hardware and software used for data acquisition, processing and presentation. A subgroup of the management committee of COST B2 were interested in the Advanced Informatics in Medicine, AIM, task T-734 'Quality Assurance of Medical Software', and the AIM Project 'A 1034', coordinated by Dr K. Britton, was initiated. The initial drafts of this document were written in Helsinki during 1988-1990, and submitted for comment by the members of the management committee of COST B2. These comments were integrated in the text and this document was finalized by the UK group so as to make it available for international discussion. It is anticipated that, after appropriate international discussion, these User Requirements for Information Systems in Nuclear Medicine will be adopted by the management committee of COST B2 as a COST document. Towards these ends, a working group chaired by Dr Britton, including the British and Finnish teams and Ulrich Noelpp from Switzerland, was appointed by the management committee of COST B2 in April 1990. While writing it we have had the pleasure of working with referees from different European hospitals in many countries. We are happy to thank all of them for their valuable contributions.

Europe↗
PubMedDate not supplied

Technical note: Rationale, development, use and evaluation of an equipment management and image storage system.

Lack of space and organization have become significant problems in the contemporary business world. Modern industries must eliminate mountains of paper and better organize themselves. With the incorporation of a fully automated equipment management system and image storage system, the Jacobi Medical Center has succeeded in correcting these problems. This technical note shows how the use of computer software and hardware components can be integrated to manage electronic patient care equipment. The adoption of this new technology was applied to equipment maintenance, tracking and record-keeping, thereby accomplishing the aims of space conservation and organization. As the components became more advanced, the technology included computer software products that could store more information and electronically effect a more rapid document retrieval. This will eventually allow for a paperless operation. The latest available equipment management software is supported by an image storage system that may contain important signature documents and outside vendor information. The applicability of these systems to the biomedical engineering field is obvious: (a) space efficiency eliminates folders and files; (b) simultaneous technician access to equipment history; and (c) rapid archive retrieval of data as well as vendor information and safety alerts.

Biomedical Engineering↗
PubMed2006

Purchasing a decentralized medication management system.

Decentralized medication management systems (DMMSs) are used in hospitals, long-term care facilities, prisons, outpatient clinics, surgery centers, and other places to manage the distribution of drugs. DMMSs consist of storage compartments for medications, with an internal computer that controls and records the administration of drugs. Some DMMSs are stationary cabinets and others are mobile carts. There have been important advances in DMMS technology since we evaluated these products in 1996, including enhanced computer memory and processing power, wider adoption of wireless networking, better user interfaces, and greater integration with other hospital information systems. To get the most out of a DMMS purchase or upgrade, facilities will need careful planning that involves assessing their own needs, selecting hardware and software configurations that meet those needs, and then choosing the right vendor and model. A properly selected DMMS can help to enforce medication distribution policies, prevent errors, and streamline processes.

Choice Behavior↗
PubMed2006

A database and tool, IM Browser, for exploring and integrating emerging gene and protein interaction data for Drosophila.

BACKGROUND: Biological processes are mediated by networks of interacting genes and proteins. Efforts to map and understand these networks are resulting in the proliferation of interaction data derived from both experimental and computational techniques for a number of organisms. The volume of this data combined with the variety of specific forms it can take has created a need for comprehensive databases that include all of the available data sets, and for exploration tools to facilitate data integration and analysis. One powerful paradigm for the navigation and analysis of interaction data is an interaction graph or map that represents proteins or genes as nodes linked by interactions. Several programs have been developed for graphical representation and analysis of interaction data, yet there remains a need for alternative programs that can provide casual users with rapid easy access to many existing and emerging data sets. DESCRIPTION: Here we describe a comprehensive database of Drosophila gene and protein interactions collected from a variety of sources, including low and high throughput screens, genetic interactions, and computational predictions. We also present a program for exploring multiple interaction data sets and for combining data from different sources. The program, referred to as the Interaction Map (IM) Browser, is a web-based application for searching and visualizing interaction data stored in a relational database system. Use of the application requires no downloads and minimal user configuration or training, thereby enabling rapid initial access to interaction data. IM Browser was designed to readily accommodate and integrate new types of interaction data as it becomes available. Moreover, all information associated with interaction measurements or predictions and the genes or proteins involved are accessible to the user. This allows combined searches and analyses based on either common or technique-specific attributes. The data can be visualized as an editable graph and all or part of the data can be downloaded for further analysis with other tools for specific applications. The database is available at http://proteome.wayne.edu/PIMdb.html CONCLUSION: The Drosophila Interactions Database described here places a variety of disparate data into one easily accessible location. The database has a simple structure that maintains all relevant information about how each interaction was determined. The IM Browser provides easy, complete access to this database and could readily be used to publish other sets of interaction data. By providing access to all of the available information from a variety of data types, the program will also facilitate advanced computational analyses.

Database Management Systems↗
PubMedDate not supplied

The promise--and peril--of integrated cost systems.

Recent advances in managerial accounting have helped executives get the information they need to make good strategic decisions. But today's enterprise resource planning systems promise even greater benefits--the chance to integrate activity-based costing, operational-control, and financial reporting systems. But managers need to approach integration very thoughtfully, or they could end up with a system that drives decision making in the wrong direction. Operational-control and ABC systems have fundamentally different purposes. Their requirements for accuracy, timeliness, and aggregation are so different that no single, fully integrated approach can be adequate for both purposes. If an integrated system used real-time cost data instead of standard rates in its ABC subsystem, for example, the result would be dangerously distorted messages about individual product profitability--and that's precisely the problem ABC systems were originally designed to address. Proper linkage and feedback between the two systems is possible, however. Through activity-based budgeting, the ABC system is linked directly to operations control: managers can determine the supply and practical capacity of resources in forthcoming periods. Linking operational control to ABC is also possible. The activity-based portion of an operational control system collects information that, while it mustn't be fed directly into the activity-based strategic cost system, can be extremely useful once it's been properly analyzed. Finally, ABC and operational control can be linked to financial reporting to generate cost of goods sold and inventory valuations--but again, with precautions.

Budgets↗
PubMed2002

Defining and assessing professional competence.

CONTEXT: Current assessment formats for physicians and trainees reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice, including interpersonal skills, lifelong learning, professionalism, and integration of core knowledge into clinical practice. OBJECTIVES: To propose a definition of professional competence, to review current means for assessing it, and to suggest new approaches to assessment. DATA SOURCES: We searched the MEDLINE database from 1966 to 2001 and reference lists of relevant articles for English-language studies of reliability or validity of measures of competence of physicians, medical students, and residents. STUDY SELECTION: We excluded articles of a purely descriptive nature, duplicate reports, reviews, and opinions and position statements, which yielded 195 relevant citations. DATA EXTRACTION: Data were abstracted by 1 of us (R.M.E.). Quality criteria for inclusion were broad, given the heterogeneity of interventions, complexity of outcome measures, and paucity of randomized or longitudinal study designs. DATA SYNTHESIS: We generated an inclusive definition of competence: the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and the community being served. Aside from protecting the public and limiting access to advanced training, assessments should foster habits of learning and self-reflection and drive institutional change. Subjective, multiple-choice, and standardized patient assessments, although reliable, underemphasize important domains of professional competence: integration of knowledge and skills, context of care, information management, teamwork, health systems, and patient-physician relationships. Few assessments observe trainees in real-life situations, incorporate the perspectives of peers and patients, or use measures that predict clinical outcomes. CONCLUSIONS: In addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork promise a multidimensional assessment while maintaining adequate reliability and validity. Institutional support, reflection, and mentoring must accompany the development of assessment programs.

Attitude↗
PubMed2005

Evolution of a mature clinical informationist model.

Achieving evidence-based practice will require new approaches to providing information during health care delivery and to integrating evidence and informatics at the point of care. To support evidence-based practice, Vanderbilt University Medical Center's Eskind Biomedical Library (EBL) introduced the role of clinical informationist, an information specialist with sufficient knowledge and insight to function as a true partner in the health care team. To further disseminate evidence-based knowledge, the Vanderbilt University Medical Center's (VUMC) electronic medical record system and pathway development processes integrate advanced information synthesis capabilities provided by clinical informationists. Combining clinical informationist expertise with informatics tools is an effective strategy for delivering the evidence needed to support patient care decisions.

Academic Medical Centers↗
PubMed1999

Recent advances in telemedicine.

With continuing advances in information technology, the applications of computers in medicine are increasing rapidly. Modern information technology not only affects the delivery of health care, but also significantly influences the doctor-patient relationship. Since the 1990s, technologic developments in high-bandwidth telecommunications systems and digitizing devices have led to a surge of interest in telemedicine. In recent years, the Internet, with its powerful penetration and scalability, has become an increasingly popular medical information resource and a new platform for telemedicine. The impact of modern technology on the advancement of telemedicine in Taiwan started with the 1995 National Information Infrastructure project, which uses networks of different bandwidths for teleconsultation and distance education programs. In 1998, National Taiwan University and Taipei Medical College in Taiwan, and the University of Pittsburgh and the University of Iowa in the USA, began cooperation on a new Cyber Medical Center (CMC) project that integrates the technologies of multimedia, database management, a multiple-site videoconferencing system, and the World Wide Web. The aim of the CMC is to create a multimedia network system for the management of electronic patient records, teleconsultation, online continuing medical education, and information services on the Web. In the future, telemedicine systems in Taiwan are expected to combine the Internet and cable television to connect clinics, hospitals, insurance organizations, and public health administrations; and, finally, to extend health services to every household.

Humans↗
PubMed2004

From SARS to systems: developing advanced knowledge management for public health.

Historically, public health has been at the forefront of data processing applications but it is lagging behind other areas of health care in the application of advanced interconnected and mobile information technologies. Ready to use technologies are lacking not only for the management of emerging infections or bio-terrorism but also for the coordination of prevention and chronic care initiatives. Advanced information and knowledge management for community health should expedite the transfer of research evidence to practice and provide essential logistical support for action. We need to find ways to integrate new scientific knowledge into our environment in order to expedite the translation of research to practice.

Decision Support Techniques↗
PubMedDate not supplied

An Internet-based bar code tracking system: coordination of confusion at mass casualty incidents.

The alpha test of the EPTS system has demonstrated that it is possible to coordinate efforts and reduce the confusion of MCIs. A carefully planned communication system is essential to rapidly categorize victims, coordinate and track the transportation of victims, manage EMS resources, and allow hospitals to build on the initial information. Having real-time data, the IC can allocate advanced life support, basic life support, or buses, and hospitals can plan their response on the basis of accurate estimates of victims and their conditions. Health and welfare inquiries can interact with public health and acute care facilities more efficiently and accurately. Most important, mass casualty victims are spared additional chaos because they are cared for within a coordinated, integrated system.

Communication↗
PubMedDate not supplied

Automated scheduling of radiologic procedures.

The dramatic advances in radiology have increased the number and type of machines and of daily performed exams. Consequently, workload and management organization problems have also markedly increased. Automated, computerized scheduling of radiologic exams is certainly a step forward in a modern rational management of a Diagnostic Imaging service: the relationship with the patient is improved with the optimization of care delivered and of the radiologist's work, who with the new technology is able to rapidly consult the previous exams as well as the list of exams to be performed. The advances in health care information technology imply communications at a distance. From each ward of the hospital, requests for radiologic exams can be automatically scheduled or kept on a dynamic waiting list for automated input in future work shifts. Via the same system, reports (and also radiologic images) can by rapidly transmitted to the wards. At the "Università Cattolica del S. Cuore" from several years, an integrated information system has been implemented for management of patient data, exams and care delivered. Radiology represents one of major departmental systems of the network for the number of machines installed and the amount of information supplied. The system will be soon able to store images from all digital and nondigital machines, and visualize on dedicated workstations the images of ongoing exams or stored previous ones.

Appointments and Schedules↗
PubMed2026

Invisible Threats, Relentless Hunters: Biosurveillance of Airborne Plant Pathogens.

Airborne dispersal enables plant pathogens to travel across fields, regions, and continents, fueling rapid epidemics and emerging disease threats. Biosurveillance, the systematic monitoring of airborne inoculum, offers the opportunity to detect pathogens before symptoms appear and informs timely, risk-based management. Recent advances in air sampling, molecular diagnostics, metagenomics, and imaging technologies have expanded the scale and resolution of pathogen monitoring, from single-species qPCR assays to community-level aerobiome surveys. Integration of biosurveillance data with decision-support systems, remote sensing, and artificial intelligence is transforming early-warning capabilities and providing novel insights into pathogen ecology, evolution, and fungicide resistance. Yet major challenges remain, including assay standardization, data interpretation, and translation into actionable tools for growers. This review synthesizes current approaches, highlights case studies in which biosurveillance has advanced disease management, and outlines future directions toward coordinated surveillance networks and precision agriculture applications.

Air Microbiology↗
PubMed2004

Implementing the HL7v3 standard in Croatian primary healthcare domain.

The mission of HL7 Inc. is to provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services. The scope of this work includes the specifications of flexible, cost-effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems. In the field of medical information technologies, HL7 provides the world's most advanced information standards. Versions 1 and 2 of the HL7 standard have on the one hand solved many issues, but on the other demonstrated the size and complexity of the health information sharing problem. As the solution, a complete new methodology has been adopted, which is being encompassed in version 3 recommendations. This approach standardizes the Reference Information Model (RIM), which is the source of all domain models and message structures. Message design is now defined in detail, enabling interoperability between loosely-coupled systems that are designed by different vendors and deployed in various environments. At the start of the Primary Healthcare Information System project, we have decided to go directly to HL7v3. Implementing the HL7v3 standard in healthcare applications represents a challenging task. By using standardized refinement and localization methods we were able to define information models for Croatian primary healthcare domain. The scope of our work includes clinical, financial and administrative data management, where in some cases we were compelled to introduce new HL7v3-compliant models. All of the HL7v3 transactions are digitally signed, using the W3C XML Digital Signature standard.

Croatia↗
PubMedDate not supplied

Clinical nurse specialist leadership in computerized provider order entry design.

PURPOSE: The purpose of this clinical project was to design and implement a computerized provider order entry system. BACKGROUND: Well-designed clinical computer systems can advance best practice and quality decision making, leading to improvements in patient and organizational outcomes. DESCRIPTION OF THE PROJECT: An Orders Design Group composed of clinical nurse specialists (CNSs), staff nurses, and information management personnel was formed. CNSs used competencies in the system sphere to lead the integration of the needs of patients, nurses, and organizations into new technologies. OUTCOME: CNSs facilitated implementation of a collaboratively designed interdisciplinary computerized order entry process. CONCLUSION: Evaluation of the design and implementation process demonstrated greater success with the order entry system under the leadership of CNSs than past initiatives where CNSs were not in leadership roles. IMPLICATIONS FOR NURSING PRACTICE: CNS competencies in designing and implementing innovative system-level solutions are key to clinical information systems design.

Benchmarking↗
PubMed1999

Applying disease management strategies to Medicare.

Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have not yet advanced to end-stage renal disease would benefit from management of diabetes and hypertension, avoidance of nephrotoxic substances, and better preparation for dialysis. Administrative support could take the form of clinical guidelines, physician-led multidisciplinary teams, integrated delivery systems, provider and patient education, and new information technologies. Medicare reflects the long-term public perspective, and thus should further this new direction by supporting education, reimbursing for prevention efforts and allied health services, encouraging efficiency, and monitoring cost and quality outcomes.

Community Health Planning↗