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At least 37 records · Page 2Linked to original sources
PubMed2005

Development of functional requirements for electronic health communication: preliminary results from the ELIN project.

BACKGROUND: User participation is important for developing a functional requirements specification for electronic communication. General practitioners and practising specialists, however, often work in small practices without the resources to develop and present their requirements. It was necessary to find a method that could engage practising doctors in order to promote their needs related to electronic communication. MATERIALS AND METHODS: Qualitative research methods were used, starting a process to develop and study documents and collect data from meetings in project groups. Triangulation was used, in that the participants were organised into a panel of experts, a user group, a supplier group and an editorial committee. RESULTS: The panel of experts created a list of functional requirements for electronic communication in health care, consisting of 197 requirements, in addition to 67 requirements selected from an existing Norwegian standard for electronic patient records (EPRs). Elimination of paper copies sent in parallel with electronic messages, optimal workflow, a common electronic 'envelope' with directory services for units and end-users, and defined requirements for content with the possibility of decision support were the most important requirements. CONCLUSIONS: The results indicate that we have found a method of developing functional requirements which provides valid results both for practising doctors and for suppliers of EPR systems.

Attitude of Health Personnel↗
PubMed1996

Linking patient information systems to bibliographic resources.

Medical informatics researchers have explored a number of ways to integrate medical information resources into patient care systems. Particular attention has been given to the integration of on-line bibliographic resources. This paper presents an information model which breaks down the integration task into three components, each of which answers a question: what is the user's question?, where can the answer be found?, and how is the retrieval strategy composed? Twelve experimental systems are reviewed and their methods for addressing one or more of these questions are described.

Computer Systems↗
PubMed1993

Data interchange for clinical neurophysiology.

Clinical Neurophysiology is rapidly moving towards complete dependence on digital instrumentation and computer-based systems. ASTM E 1467-92 "Standard Specification for Transferring Digital Neurophysiological Data Between Independent Computer Systems" was developed to allow exchange of multichannel electrophysiological waveforms, embedded textual annotations, results of mathematical processing, and clinical interpretive reports between various instruments and systems. This will permit integration of the neurophysiology laboratory interaction with hospital and clinic informations systems, and sharing of data between institutions for clinical or research purposes.

Computer Systems↗
PubMed1997

The help of formal models for healthcare security policies.

This article is a personal contribution (i.e., from a strict security expert point of view) towards the help for specification, validation and/or evaluation of reliable, but also secure, healthcare security policies (HSP). The first part is dedicated to show, according to the various aspects of the security policy concept, that healthcare information systems (HIS) offer such a diversity of particularities and potential security needs, that it is necessary for healthcare security policies to be defined as flexible, but also as robust, as possible. Then the formal modelling approach, a wide area of solutions providing both flexibility (by means of modelling) and robustness (by means of formalization), is presented. The most well-known examples of security models are recalled. All of them try to use formal models as a security policy specification/validation tool, but none of them can be helpfully used in the very demanding context of HIS. Lastly, a new approach for the modelling of healthcare security policies, based on modal logic (i.e., epistemic and/or deontic logic) is proposed. It permits to take into account the flexibility (by means of high expressiveness due to modality) and the robustness (by means of high provability due to modelling) needs.

Computer Security↗
PubMed1999

The holistic architectural approach to integrating the healthcare record in the overall information system.

The integration and evolution of existing systems represents one of the most urgent problems facing those responsible for healthcare information systems so that the needs of the whole organisation are addressed. The management of the healthcare record represents one of the major requirements in the overall process, however it is also necessary to ensure that the healthcare record and other healthcare information is integrated within the context of an overall healthcare information system. The CEN ENV 12967-1 'Healthcare Information Systems Architecture' standard defines a holistic architectural approach where the various, organisational, clinical, administrative and managerial requirements co-exist and cooperate, relying on a common heritage of information and services. This paper reviews the middleware-based approach adopted by CEN ENV 12967-1 and the specialisation necessary for the healthcare record based on CEN ENV 12265 'Electronic Healthcare Record Architecture'.

Computer Systems↗
PubMed1992

Bringing social worlds together: computers as catalysts for new interactions in health care organizations.

In this case study, computer systems are explored as catalysts for new interactions between departments in health care organizations. Hypotheses investigated changes in the extent to which members of different departments (1) exchange information and (2) understand each other's work following implementation of an integrated medical information system. Analyses showed that communication-based forms of involvement in implementation (communicating with systems personnel and trainers, communicating about new ways to use the system, and receiving support from supervisors for doing so) were overwhelmingly more important than either general participation or computer use in predicting increases in interdepartmental interaction. Changes in tasks and roles also led to new, informal, face-to-face contacts to support computer system use, as well as greater administrative control over the organization as a whole. In addition, results of interviews and observations over the two-year study period illustrate the importance of work group identification in predicting changes accompanying computerization.

Appointments and Schedules↗
PubMedDate not supplied

Value of a long-term clinical database.

To study the value of historical clinical information, which we defined as data more than one year old, we measured the frequency and patterns of use of historical laboratory data among 87 providers in a multispecialty group practice delivering ambulatory care. During a one-month observation period, 38% of the providers requested historical data for use in clinical decision making. The requests were made for 19% of the patients, and represent 4% of the provider-initiated transactions on the computing system (328 per month). A survey also indicated that historical data are beneficial in clinical decision making.

Attitude of Health Personnel↗
PubMed2000

An XML-Java system for HL7-based healthcare informatics.

Health-Level (HL) 7 message semantics allows effective functional implementation of Electronic Medical Record (EMR)--encompassing both clinical and administrative (i.e. demographic and financial) information--interchange systems, at the expense of complexity with respect the Protocol Data Unit (PDU) structure and the client-side application architecture. In this paper we feature the usage of the Extensible Markup Language (XML) document-object modelling and Java client-server connectivity towards the implementation of a Web-based system for EMR transaction processing. Our solution features an XML-based description of EMR templates, which are subsequently transcribed into a Hypertext Markup Language (HTML)-Javascript form. This allows client-side user interfaceability and server-side functionality--i.e. message validation, authentication and database connectivity--to be handled through standard Web client-server mechanisms, the primary assumption being availability of a browser capable of XML documents and the associated stylesheets. We assume usage of the Internet as the interchange medium, hence the necessity for authentication and data privacy mechanisms, both of which can be constructed using standard Java-based building blocks.

Computer Communication Networks↗
PubMed1993

Advanced patient records: some ethical and legal considerations touching medical information space.

The application of advanced computer-based information technology to patient records presents an opportunity for expanding the informational resource base that is available to health-care providers at all levels. Consequently, it has the potential for fundamentally restructuring the ethics of the physician/patient relationship and the ethos of contemporary health-care delivery. At the same time, the technology raises several important ethical problems. This paper explores some of these implications. It suggests that the fundamental ethical issue at stake in these developments is the status of the electronic record which functions as the analog of the health-care consumer in health-care decision making. Matters such as control and patient dignity are implicated. Other important ethical issues requiring solution include data ownership, data liability, informed consent to use and retrieval, security and access. The paper suggests that the ethical problems that arise cannot be solved in piecemeal fashion and on a purely national basis. They should be addressed in a coordinated international fashion and receive appropriate legal expression in the relevant countries and be incorporated into appropriate codes of ethics.

Computer Security↗