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PubMedDate not supplied

A clinical information system for ambulatory care.

This article describes a clinical information system developed for ambulatory care nurse practitioners. An overview of the clinical information system is presented, followed by a detailed description. The clinical information system uses the relational database structure proposed by Hettinger and Brazile (1992), and creates a longitudinal electronic health care record. The database design includes the Nursing Minimum Data Set and provides links to external aggregate data sets such as the U. S. Census data. Special features are discussed such as the ability to select from several problem classification schemes, including North American Nursing Diagnosis Association, Omaha, and International Classification of Diseases, 9th Revision; insert new menu selections whenever needed; create and track groups; and store detailed outcome data. A brief summary of implementation considerations is included.

Ambulatory Care Information Systems↗
PubMed2005

A surveillance information system as a management tool: a report from Papua New Guinea.

To have a very good surveillance system, it is paramount important to have a functional health information system that could be easily used for monitoring and investigation of disease outbreaks. In Papua New Guinea (PNG) a national health information system was developed, trailed and implemented nationwide. Furthermore to have the system working linked to it must be the local health system for sustainability and control. A public health manual for disease surveillance in PNG was developed and is now being used for surveillance. This paper describes how the health information system, particularly surveillance system was developed and implemented on the national scale, how it was integrated with other management information systems and how information has been used to support management decision-making and informed policy decision. It will highlight some of the hurdles that it has encountered while trying to implement the system. PNG has one of the best national health information system as compared to many developing countries but limited information generated from the system. There was also less feedback from all levels of the health sector. We need to improve surveillance on the basic principles of integration, focus, and sharing of work. There must be an appropriate and timely response and feedback. We need to improve on the current system rather than building a new one.

Decision Making, Computer-Assisted↗
PubMed2000

Demystifying the hospital information system/radiology information system integration process.

Most organizations planning to implement picture archiving and communications systems (PACS) are aware of the need to integrate the hospital information system (HIS) and radiology information system (RIS) with the PACS, yet few are acutely aware of the challenges associated with this requirement. This report highlights the results of collaborative efforts between Children's Hospital Medical Center-Cincinnati (CHMC) applications specialists with expertise in the HIS and CHMC information system, radiology staff familiar with the enterprise and radiology workflow and data flow requirements; and General Electric integration engineers familiar with the SMS HIS and RIS, and GE PACS. CHMC received Board approval, including full funding of the entire PACS project, in October 1998. An aggressive time frame for installation was established, as CHMC's PACS leadership committed to the selection, design, and implementation of PACS and computed radiography (CR) within 18 to 20 months. CHMC selected GE (Milwaukee, WI) as its PACS vendor in July 1999, and began its implementation in November 1999. We will present the four-stage integration process undertaken at CHMC: (1) planning the integration effort, (2) designing the Interface, (3) building the interface, and (4) testing the Interface.

Computer Systems↗
PubMed1999

Health information systems in developing countries: benefits, problems, and prospects.

Health information systems are important support tools in the management of health care services delivery in both developed and less developed countries. An adequate health information system is vital not only for assessing the health needs of populations and groups, but also for planning and implementation of health interventions. It is equally important in the evaluation of programmes from both the perspectives of effectiveness and coverage. This paper examines the practical difficulties of health care provision amidst inadequate statistics to inform decisions. Major obstacles to the introduction of effective health information systems in developing countries are examined, and practical suggestions on measures to overcome them discussed. It is concluded that the establishment of well co-ordinated information collection systems at the various levels of the health care system in developing countries, using appropriate staff, could contribute greatly to improvements in health care delivery.

Data Collection↗
PubMedDate not supplied

[Recording of venomous bites and stings by National Information Systems in Brazil].

This paper highlights the epidemiological surveillance of venomous bites and stings according to four national information systems: SINAN (National Databank of Major Causes of Morbidity), SINITOX (National Information System on Poisoning), SIH-SUS (Hospital Information System of the Unified Health System), and SIM (Mortality Information System). The authors conclude that each information system has specific characteristics and addresses different demands. Although they contain large amounts of data, even if combined they fail to reflect the real magnitude of disorders caused by venomous bites and stings in the country.

Animals↗
PubMed2002

Framework for a clinical information system.

The design and implementation of Clinical Information System architecture is presented. This architecture has been developed and implemented based on components following a strong underlying conceptual and technological model. Common Object Request Broker and n-tier technology featuring centralised and departmental clinical information systems as the back-end store for all clinical data are used. Servers located in the "middle" tier apply the clinical (business) model and application rules. The main characteristics are the focus on modelling and reuse of both data and business logic. Scalability as well as adaptability to constantly changing requirements via component driven computing are the main reasons for that approach.

Computer Communication Networks↗
PubMed1991

The role of the clinical nurse specialist in information systems selection.

As computer utilization in the health care industry continues to expand, the role of the nurse in the system selection process increasingly becomes paramount. Information systems are more likely to have a nursing perspective if the nurse who is involved in the information system selection process is a clinical nurse specialist (CNS). Three principles of practice which should be utilized in structuring the role of the CNS in the information system selection process are discussed, along with practical guidelines to assist the CNS in participating effectively.

Choice Behavior↗
PubMed1995

Modeling and eliciting organizational and information system requirements.

Two things have influenced organizational development more than any other: the coffee machine and the computer. The reason for this is that they mediate social relationships. Computers are also being used more and more within every type of organization in an attempt to make the organization faster, more cost efficient, and more competitive. With the adoption of such technology we need to recognize that computers encapsulate social values and can consequently be seen as instruments of power. Within the area of safety critical systems, such as a medical information system, it is vital that, when specifying and capturing requirements about the system, the technical and social values are identified and made explicit. In this paper an outline of a modeling framework will be presented that allows for the encapsulation and analysis of the social and technical aspects of an organizational information system. A modeling language and notation will be constructed and used to construct and analyze both the static and dynamic models of organizations and organizational behavior. The construction and analysis is achieved through the use of concepts such as role and responsibility. The conceptual modeling framework is then applied to a case study. This case study is based upon an accident and emergency department of an inner-city hospital situated within the center of Dublin, Ireland.

Hospital Information Systems↗
PubMed1996

User requirements on the future laboratory information systems.

Today numerous information technology solutions exist for the clinical laboratory which operate either as stand-alone functionalities or with ad hoc integration solutions. The OpenLabs (A2028) AIM Project puts emphasis on the design and specification of a framework for the interoperability of existing systems and new advanced services, and consequently concentrates on the issue of integration. The purpose of the OpenLabs open architecture is to serve as a functional solution to this integration. A basic principle for this open architecture is that each of the advanced services shall be able to function individually or in any combination with an existing Laboratory Information System (LIS), and that it shall enable new modular functionalities to be incorporated in a 'plug-and-play' fashion. The synthesis of the main user needs and requirements implies that the future IT solutions: (a) must be highly flexible and maximally customizable--by the users themselves; (b) are based on the concept of open systems, both technically and functionally, which enables modular functionalities from different vendors to co-operate forming a global LIS functionality; (c) are future viable and able to incorporate already installed IT functionalities; (d) support management of failure prevention, of repair, of success, and of change. The establishment of an open architecture implies that a market will develop for modular, scaleable, and cost-effective LIS features without today's dependence on individual manufacturers and hardware/software platforms.

Clinical Laboratory Information Systems↗
PubMed1984

Evaluation protocol for information system planning.

Although some believe that electronic management information systems in the health care setting are of questionable value, I cannot support that position. There are undoubtedly health care institutions with management information systems (MISs) that are of dubious value, just as there are institutions in which the MIS is of enormous value. The question of the value of an MIS to an institution has more to do with an understanding of what an MIS is, what the institution's information needs are, and what the MIS can and should be doing for an organization, than it does with any inherent benefits that the system displays in and of itself exclusive of its environment. The views that follow address the process of evaluation that should take place to assess these issues and maximize the effectiveness of an information system in an organization. Figure 1 is a graphic representation of the evaluation process.

Decision Making↗
PubMed1993

Ariel: an information system for AIDS research.

An information system has been established at the National Institute for Biological Standards & Control for the exchange of knowledge in AIDS research, particularly in relation to vaccine design. This system, the AIDS information exchange link (Ariel), is designed to act as a central store of relevant information for scientists in the UK and abroad and was set up under the auspices of the Medical Research Council. It holds information on research materials (reagents), on genetic sequences and on projects. Several computers and database systems are involved. Access is obtained through Janet, the UK academic network, or PSS, the British Telecom public network. Both these networks are linked to international network systems, e.g. Internet, Earn, IPSS. Ariel has been in operation for 18 months and is accessed internationally.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Expert systems and the clinical laboratory information system.

Many of the tasks of the clinical laboratory involve the application of knowledge and experience to patient-specific problems. Expert systems that have ready access to patient data and expert knowledge have the potential to support many laboratory processes, especially those that involve the repetitive and reasonably predictable application of knowledge. Quality assurance and utilization improvement efforts requiring constant vigilance and surveillance of an array of laboratory processes especially may benefit. Expert system technologies, trends of their use in the clinical laboratory, their role in the total testing process, and their potential for influencing physician use of the laboratory through timely feedback are discussed.

Clinical Laboratory Information Systems↗
PubMed1996

Assessment of the diagnoses of Crohn's disease and ulcerative colitis in a Danish hospital information system.

BACKGROUND: Our aim was to estimate the completeness-that is, whether all patients were included in the system-and the validity-that is, whether the diagnostic criteria were fulfilled for the patients registered-of the diagnoses of Crohn's disease and ulcerative colitis in a Danish hospital system. METHODS: Information in a regional hospital system, in the County of North Jutland, Denmark, was compared with hospital records and information in a pathology system. RESULTS: The analysis of the completeness included 143 patients with Crohn's disease and 285 patients with ulcerative colitis. The completeness of the regional hospital system using the pathology system as a reference standard was 94% for both diseases. The analysis of the validity included 281 patients registered as having Crohn's disease and 506 patients registered as having ulcerative colitis. The validity of the two diagnoses was 97% and 90%, respectively. CONCLUSIONS: The regional hospital system showed few misclassifications of the diagnoses of Crohn's disease and ulcerative colitis. Thus the nationwide hospital system (based on the regional hospital systems) may provide a unique study base for future research.

Colitis, Ulcerative↗
PubMedDate not supplied

START: an advanced radiation therapy information system.

START is an advanced radiation therapy information system (RTIS) which connects direct information technology present in the devices with indirect information technology for clinical, administrative, information management integrated with the hospital information system (HIS). The following objectives are pursued: to support decision making in treatment planning and functional and information integration with the rest of the hospital; to enhance organizational efficiency of a Radiation Therapy Department; to facilitate the statistical evaluation of clinical data and managerial performance assessment; to ensure the safety and confidentiality of used data. For its development a working method based on the involvement of all operators of the Radiation Therapy Department, was applied. Its introduction in the work activity was gradual, trying to reuse and integrate the existing information applications. The START information flow identifies four major phases: admission, visit of admission, planning, therapy. The system main functionalities available to the radiotherapist are: clinical history/medical report linking function; folder function; planning function; tracking function; electronic mail and banner function; statistical function; management function. Functions available to the radiotherapy technician are: the room daily list function; management function: to the nurse the following functions are available: patient directing function; management function. START is a departmental client (pc-windows)-server (unix) developed on an integrated database of all information of interest (clinical, organizational and administrative) coherent with the standard and with a modular architecture which can evolve with additional functionalities in subsequent times. For a more thorough evaluation of its impact on the daily activity of a radiation therapy facility, a prolonged clinical validation is in progress.

Medical Records Systems, Computerized↗
PubMed2005

Health information system for community-based multiple screening in Keelung, Taiwan (Keelung Community-based Integrated Screening No. 3).

BACKGROUND: Community-based multiple screening for common cancers and chronic diseases has increasingly gained attention. However, as infrastructure and evaluation system are more diversified and complicated compared with single screening, the development of a novel health information system is paramount. METHODS: The main goal of our health information system was to support the multiple screening program not only from technical aspect but also from a broad range of perspectives including quality assurance system, organized features appertaining to screening, economic evaluation (cost-effectiveness or cost-utility analysis), epidemiological applications, behavior risk factor surveillance system, and social impact due to the introduction of the Keelung Community-Based Integrated Screening (KCIS) program. RESULTS: Health information system was designed and programmed on the basis of the demand derived from KCIS within which five cancers and three chronic diseases were included. In addition to the detailed description of infrastructure and process, design, relevant database and security involved in health information system, an innovative and extensive evaluation system in accordance with the main goals was included in our health information system. CONCLUSION: Our information system proposed several aspects regarding organized screening system that has never been addressed in computerized system supporting for single screening. These included quality assurance system, organization features, co-morbidity profiles, epidemiological applications and social and economic considerations.

Community Health Services↗
PubMed1996

Health professional workstations and their integration in a hospital information system: the pragmatic approach MEDIAS.

Within the daily workload at a ward there is a considerable amount of information processing. It is the task of a systematic management of hospital information systems to provide health professionals with the right information in the right place at the right time. This paper deals with the consequences for the management of hospital information systems if health professional workstations are introduced as a means for this information logistic and with the experiences gained in the Heidelberg University Hospital. Health professional workstations are formally defined in the context of a three level graph-based model of hospital information systems. It is found that health professional workstations have communication needs not only on the physical level of computer systems in the hospital information system but also on the logical tool level, which is the level of application systems. On this level communication servers or brokers are of considerable importance. In Heidelberg there are about 200 health professional workstations (MEDIAS) in routine use.

Computer Communication Networks↗