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PubMed1986

The NCI Drug Information System. 6. System maintenance.

The NCI Drug Information System (DIS) is a collection of 24 interactively searchable databases which contain all the data associated with NCI's drug screening program. Data flow into all of these databases upon a daily basis, and maintenance procedures have been developed which provide a high degree of currency to the files. An extensive security system controls both write access and read access to the DIS and matches both to the authorization possessed by each specific user. Detailed usage statistics are collected automatically. The cost of the overall system in terms of both manpower and machine time is discussed briefly.

Antineoplastic Agents↗
PubMed2006

Diabetes information systems: a rapidly emerging support for diabetes surveillance and care.

BACKGROUND: With the rapid advances in information technology in the last decade, various diabetes information systems have evolved in different parts of the world. Availability of new technologies and information systems for monitoring and treating diabetes is critical to achieving recommended metabolic control, including glycosylated hemoglobin levels. The first step is to develop a registry, including a patient identifier that can link multiple data sources, which can then serve as a springboard to electronic mechanisms for practitioners to gain information on performance and results. OBJECTIVE: The aim is to review the provisions for diabetes surveillance in different parts of the world. This is a systematic review of national and regional information systems for diabetes surveillance. LITERATURE REVIEW: A comprehensive review was undertaken using Medline literature review, internet search using the Google search engine, and e-mail consultation with opinion leaders. TOPICS REVIEW: National/regional-level diabetes surveillance systems in Europe, the United States, Australia/New Zealand, and Asia have been reviewed. State-of-the-art diabetes information systems linking multiple data sources, with extensive audit and feedback capabilities, have also been looked at. RESULTS: National/regional-level audit databases have been tabulated. Diabetes information systems linking multiple data sources have been described. Most of the developed countries have now implemented systems such as diabetes registers and audits for diabetes surveillance in at least some regions, if not nationally. Developing nations are beginning to recognize the need for chronic disease management. CONCLUSIONS: With the advancements in information technology, the diabetes registers have the potential to rise beyond their traditional functions with dynamic data integration, decision support, and data access, as demonstrated by some diabetes information systems. With the rapid pace of development in electronic health records and health information systems, countries that are beginning to build their health information technology infrastructure could benefit from planning and funding along these lines.

Diabetes Mellitus↗
PubMed2004

Family perspectives on integrated child health information systems.

The perspectives of families, and especially parents of children with special health care needs, need to be better understood by the government agencies, health care providers, associations, and information systems vendors that are integrating child health information systems. To date, research on children with special health care needs has not included the perspectives of parents on integrated child health information systems. Interviews were conducted with a limited number of parents of children with special health care needs and a young adult with special health care needs about their perspectives on integrated health information systems needs. The interviews revealed common themes: (1) parents have experienced the benefits of information technology for health care purposes, (2) parents believe integrated health information systems could help to coordinate their children's health care, (3) parents believe information technology can help improve accuracy and timeliness of information, (4) parents of children with special health care needs believe their children's health information should be available to those who need it, but safeguards must be in place, (5) parents believe health information systems can improve health care, but it is not the highest priority health care issue for them, and (6) parents believe that their involvement in issues related to children with special health care needs, including information technology, is critical. Parents of children with special health care needs hold strong opinions about their children's health care, including health information systems. Parents need to be central to discussions about development of integrated child health information systems if we are to develop information systems that serve the needs of children with special health care needs and their families.

Adolescent↗
PubMed2003

Quality benefits of an intensive care clinical information system.

OBJECTIVE: This study was performed to quantify the quality benefits and staff perceptions of a computerized clinical information system implementation in an intensive care unit. Although clinical information systems have been available and implemented in many intensive care units for more than a decade, there is little objective evidence of their impact on the quality of care and staff perceptions. DESIGN: A longitudinal observational study before and after clinical information system implementation. SETTING: A 12-bed adult general intensive care unit in a large Australian tertiary referral teaching hospital. INTERVENTION: Implementation of a fully featured clinical information system to replace paper-based charts of patient observations, clinical records, results reporting, and drug prescribing. MEASUREMENTS AND MAIN RESULTS: The frequency of clinical adverse events over a 4-yr period using an established reporting system was examined. Pre- and postimplementation staff questionnaires were distributed and analyzed. There were significant reductions in the rates of medication, intravenous therapy, and ventilator incidents. There was a trend toward a reduction in pressure sores. The survey, utilizing a validated questionnaire, demonstrated a positive perception of the clinical information system by nursing staff, with less time spent in documentation and more time in patient care. Nursing staff recruitment and retention improved after clinical information system implementation. CONCLUSIONS: Implementation of a fully featured clinical information system was associated with significant improvements in key quality indicators, positive nursing staff perceptions, and some positive resource implications.

Adult↗
PubMed1993

A cost-benefit analysis for materials management information systems.

The cost-benefit analysis provided the system planners with valuable information that served many purposes. It answered the following questions: Why was the CCF undertaking this project? What were the alternatives? How much was it going to cost? And what was the expected outcome? The process of developing cost-benefit the document kept the project team focused. It also motivated them to involve additional individuals from materials management and accounts payable in its development. A byproduct of this involvement was buy-in and commitment to the project by everyone in these areas. Consequently, the project became a team effort championed by many and not just one. We were also able to introduce two new information system processes: 1) a management review process with goals and anticipated results, and 2) a quality assurance process that ensured the CCF had a better product in the end. The cost-benefit analysis provided a planning tool that assisted in successful implementation of an integrated materials management information system.

Cost Savings↗
PubMedDate not supplied

Regional health information systems: applying the IAIMS model.

In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed in the context of regional health information systems developed. The challenges of aligning the various information agencies and agendas in support or a regional health information system are complex; however, the potential rewards for health care in quality, efficacy, and cost savings are enormous.

Delivery of Health Care↗
PubMed1987

Information systems for oral health.

The global basis for an information system in oral health was introduced by WHO in 1971. Still very few countries have so far prepared a comprehensive national plan for oral health care of the entire population including an information system for monitoring and evaluation. Therefore it is important to realize that the global goals for oral health in the year 2000 introduced by WHO and FDI include a requirement to establish a national monitoring system for oral health. The WHO has developed a simple "Pathfinder' survey methodology for production of baseline data for a national plan for oral health care. This methodology has now been successfully applied in a number of countries. As a result the WHO Global Oral Data Bank contains a unique set of data on oral health worldwide. It should be understood, however, that within nations more comprehensive and sophisticated information systems are needed to support the activities related to the global goal of Health for All by the Year 2000. This paper gives a short introduction to the development of national information system for oral health utilizing statistics, records and ad hoc studies. The ultimate goal is to build a continuing surveillance system for oral health status and service organization.

Data Collection↗
PubMed2001

Attitudes towards information system security among physicians in Croatia.

To examine attitudes about information system security among Croatian physicians a cross-sectional study was performed on a representative sample of 800 Croatian physicians. An anonymous questionnaire comprising 21 questions was distributed and statistical analysis was performed using a chi-square test. A 76.2% response rate was obtained. The majority of respondents (85.8%) believe that information system security is a new area in their work. In general, physicians are not informed about European directives, conventions, recommendations, etc. Only a small number of physicians use personal computers at work (29%). Those physicians who have a personal computer use it mainly for administrative reasons. Most healthcare institutions (89%) do not have a security manual and the area of information system security is left to individual interest and initiative. Only 25% of physicians who have a personal computer use any type of password. A high percentage of physicians (22%) has never thought about the problem of personal data being used by organizations (e.g. police, banks) without legal background; a small, but still significant percentage of physicians (5.6%) has even agreed with such use. Results indicate that for the vast majority of physicians, information system security is a new area in their daily work, one which is left to individual interest and initiative. They are not familiar with the ethical, technical and legal backgrounds which have been defined for that area within the Council of Europe and the European Union. New aspects: This is the first study performed in Central and Eastern Europe dealing with information system security, performed on a representative nationwide sample of all the physicians.

Adult↗
PubMed2002

Information systems for health sector monitoring in Papua New Guinea.

This paper describes (i). how a national health information System was designed, tested and implemented in Papua New Guinea, (ii). how the system was integrated with other management information systems, and (iii). how information has been used to support decision-making. It concludes that central coordination of systems design is essential to make sure that information systems are aligned with government priorities and can deliver the information required by managers. While there is often scope for improving the performance of existing information systems, too much emphasis can be placed on revising data collection procedures and creating the perfect information system. Data analysis, even from imperfect systems, can stimulate greater interest in information, which can improve the quality and completeness of reporting and encourage a more methodical approach to planning and monitoring services. Our experience suggests that senior decision-makers and political leaders can play an important role in creating a culture of information use. By demanding health information, using it to formulate policy, and disseminating it through the channels open to them, they can exert greater influence in negotiations with donors and other government departments, encourage a more rational approach to decision-making that will improve the operation of health services, and stimulate greater use of information at lower levels of the health system. The ability of information systems to deliver these benefits is critical to their sustainability.

Decision Support Systems, Management↗
PubMed1989

Computer based information systems in primary health care--why?

The delivery of health care is information based. A host of computer-based information systems have been developed and implemented in the health care environment. The mere availability of the computer as a tool for information handling should, in itself, not be the cause for developing computer-based information systems. The earlier assumption of a cost-benefit impact with the development of such systems has not been effectively shown in all cases, and as seen in a report by van Bemmel, the recent trend is to apply other criteria in systems evaluation. Information is essential in health care related decision making. The properties of information are described to present a case for a computer-based information system to support primary health care delivery.

Computer Systems↗
PubMed1997

Medical informatics training programme to support the Romanian Health Care Management Information System.

The Health Management Information System (HMIS) project initiated by the 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; 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.

Computer Literacy↗
PubMed1997

Hospital information system engineering using the PROMISE architecture.

This paper presents the novel Process Oriented Medical Information System Architecture (PROMISE) which has been developed in detail especially for the requirements of hospital information system engineering processes. The architecture is given in three columns and three layers along the following three dimensions: business process modeling, process specification and engineering. The heart of the architecture is a purpose-built framework for hospital information systems called PROSIGHT whose implementation can be used easily as a workbench. The single components can be customized according to detailed modeled hospital business processes which form in common a complete hospital information system. Any other framework can be used instead PROSIGHT if it can be used as a reference hospital information system in the same manner. Although the PROMISE architecture is presented in common with the given framework it can be seen as an open architecture. The hospital information system engineering process comprising the development as well as the adaptation process for a certain hospital will be skeched out.

Hospital Information Systems↗
PubMed1990

Structured analysis: methodology for developing a model for defining nursing information system requirements.

Including nurses in decisions to purchase or design information systems is an increasingly common phenomenon. Without previous informatics experience, nurses may need help defining specific requirements for information systems that will assist in managing and administering nursing care. The Model for Defining Nursing Information System Requirements was developed to serve as a guiding framework for deriving nursing information system (NIS) requirements. Structured analysis techniques were used to develop the model. The model was tested by surveying 75 registered nurses who had made decisions about NISs. Subjects supported the model's completeness and usefulness for defining NIS requirements.

Decision Trees↗
PubMed2006

CSI-ISC--Concepts for smooth integration of health care information system components into established processes of patient care.

OBJECTIVES: The introduction of information system components (ISCs) usually leads to a change in existing processes, e.g. processes of patient care. These processes might become even more complex and variable than before. An early participation of end users and a better understanding of human factors during design and introduction of ISCs are key factors for a successful introduction of ISCs in health care. Nonetheless no specialized methods have been developed until now to systematically support the integration of ISCs in existing processes of patient care while taking into account these requirements. In this paper, therefore, we introduce a procedure model to implement Concepts for Smooth Integration of ISCs (CSI-ISC). METHODS: Established theories from economics and social sciences have been applied in our model, among them the stress-strain-concept, the contrastive task analysis (KABA), and the phase model for the management of information systems. RESULTS: CSI-ISC is based on the fact that while introducing new information system components, users experience additional workload. One essential aim during the introduction process therefore should be to systematically identify, prioritize and ameliorate workloads that are being imposed on human beings by information technology in health care. To support this, CSI-ISC consists of a static part (workload framework) and a dynamic part (guideline for the introduction of information system components into existing processes of patient care). CONCLUSIONS: The application of CSI-ISC offers the potential to minimize additional workload caused by information system components systematically. CSI-ISC rationalizes decisions and supports the integration of the information system component into existing processes of patient care.

Germany↗
PubMed2005

CHMIS-C: a comprehensive herbal medicine information system for cancer.

A comprehensive herbal medicine information system for cancer (CHMIS-C) has been developed. The current version of the database integrates information on more than 200 anticancer herbal recipes that have been used for the treatment of different types of cancer in clinic, 900 individual ingredients, and 8500 small organic molecules isolated from herbal medicines. Furthermore, subsidiary databases of literature references and molecular targets have been constructed. A number of web-based searching tools have been developed and integrated into the information system for efficient data mining. The compounds in the database have been linked to the corresponding entries in the National Cancer Institute's database, and to a database of drugs approved by the U.S. Food and Drug Administration. This paper provides a description of the individual subsidiary databases, integration of the entire database, and data mining tools. We demonstrate that this comprehensive information system may be used as an effective informatics tool for anticancer drug discovery.

Antineoplastic Agents, Phytogenic↗
PubMed1992

Integrating Radiology and Hospital Information Systems: the advantage of shared data.

Information management is central to modern patient care. Computerization of information management has resulted in both departmental systems which serve information needs in locations such as the Radiology Department and in hospital-wide information systems which seek to integrate management of clinical data from many departments. For each of these systems to achieve the goal of maximizing both the effectiveness of health care workers and the quality of patient care, they need to share the data that they capture. Below we discuss a variety of applications, both currently available and in the realm of research protocols, that depend on a high level of communication between Radiology Information Systems and Hospital Information Systems. These examples suggest the benefits of integrating the medically relevant data collected by all of the computer-based information systems in the hospital setting.

Decision Making, Computer-Assisted↗
PubMed1994

Orienting health care information systems toward quality: how Group Health Cooperative of Puget Sound did it.

BACKGROUND: Group Health Cooperative of Puget Sound (GHC), a large staff-model health maintenance organization based in Seattle, is redesigning its information systems to provide the systems and information needed to support its quality agenda. PLANNING PROCESS: Long-range planning for GHC's information resources was done in three phases. In assessment, interviews, surveys, and a benchmarking effort identified strengths and weaknesses of the existing information systems. We concluded that we needed to improve clinical care and patient management systems and enhance health plan applications. In direction setting, we developed six objectives (for example, approach information systems in a way that is consistent with quality improvement principles). Detailed planning was used to define projects, timing, and resource allocations. MAJOR EFFORTS: Some of the most important efforts in the resulting five-year plan include the development of (1) a computerized patient record; (2) a provider-based clinical workstation for access to patient information, order entry, results reporting, guidelines, and reminders; (3) a comprehensive set of patient management and service quality systems; (4) reengineered structures, policies, and processes within the health plan, supported by a complete set of integrated information systems; (5) a standardized, high-capacity communications network to provide linkages both within GHC and among its business partners; and (6) a revised oversight structure for information services, which forms partnerships with users. CONCLUSIONS: A quality focus ensured that each project not only produced its own benefits but also supported the larger organizational goals associated with "total" quality.

Health Maintenance Organizations↗
PubMed2001

System requirements for a computerised patient record information system at a busy primary health care clinic.

A prototyping approach was used to determine the essential system requirements of a computerised patient record information system for a typical township primary health care clinic. A pilot clinic was identified and the existing manual system and business processes in this clinic was studied intensively before the first prototype was implemented. Interviews with users, incidental observations and analysis of actual data entered were used as primary techniques to refine the prototype system iteratively until a system with an acceptable data set and adequate functionalities were in place. Several non-functional and user-related requirements were also discovered during the prototyping period.

Data Display↗