Code red: ready to roll. New advances in enterprise software enable healthcare organizations to strengthen their emergency-response capabilities.
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Disaster Planning↗
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Results for “Integrated Advanced Information Management Systems”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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The effects of advanced information technology on organizational design.
Illustrates several issues associated with the effects of advanced information technology on the organizational design function. Explores the relationship between technology and organizational design. Cites some early empirical studies and identifies with some contemporary challenges. Also mentions implications for new organizational forms within the context of a realigned health-care industry perspective. Concludes that organizational theorists and information systems scholars must integrate their efforts in order to appreciate the changes within this field of management theory, thought and practice.
Health Facility Merger↗
Academic medicine meets managed care: a high-impact collision.
The managed care revolution is sweeping the country as a result of intense marketing on the part of managed care organizations and the widespread belief that price-sensitive managed care systems will control health costs. Although few believe that managed care alone can adequately stem the growth of nation health care spending, competition based on price has emerged as a powerful force in the health care sector. Academic health center (AHCs) stand to suffer with this new managed care regime because their special missions of teaching, research, and highly specialized clinical care make them more expensive than nonacademic hospitals and place them at a noncompetitive disadvantage. The traditional focus of the acute care hospital with individual departmentally designed programs will be narrow. Major changes will be required on the part of AHCs if they are to survive and preserve patient volume, maintain the integrity of medical education, advance scientific research, and provide highly specialized care. AHCs will have to make unprecedented adjustments in virtually every phase of their operations, particularly in the areas of clinical decision making and speedy patient-related information flow. A premium will be placed on multidisciplinary, inclusive medical services that can assume total health care risks for large populations. New ways of educating students in ambulatory settings with an emphasis on outcomes and population-based health will be needed along with the traditional responsibility of pursuing new approaches to the diagnosis, treatment, and prevention of disease. The extent to which managed care will ultimately alter the traditional role of AHCs in the American health care system is unclear, but successful adaptation in the short term will require them to respond broadly, flexibly, and in a timely fashion to the anticipated health care scene.
Academic Medical Centers↗
A new clinical laboratory information system architecture from the OpenLabs project offering advanced services for laboratory staff and users.
The OpenLabs project aims to improve the efficiency and effectiveness of clinical laboratory services by integrating decision support systems with laboratory information systems and equipment. Standards for electronic data interchange between laboratories and other medical systems using the EUCLIDES/OpenLabs coding scheme and an open architecture for clinical laboratory information systems have been specified. This article gives an account of the proposed architecture and outlines new software applications being developed using the architecture which provide advanced services for ordering and reporting of laboratory tests, advanced instrument workstation and laboratory management services, including an OpenLabs Service Manager application which co-ordinates the available services.
Chemistry, Clinical↗
Advanced information support. Abstracting evidence from clinical practice research.
Suzanne M. Austin, M.H.A., and E. Andrew Balas, M.D., Ph.D., of the Health Services Management Program at the University of Missouri-Columbia, present research on exchange of information in clinical practices. Their findings have led them to develop an integrated knowledge base aimed at enhancing cognition and supporting action rather than increasing confusion and indecision.
Expert Systems↗
Locomotor system assessment by muscle magnetic resonance imaging.
Clinical evaluation of the locomotor system has long been hampered by difficulty in assessing the morphologic and functional integrity of skeletal muscles. Diagnostic imaging represents a major advance in the diagnosis and management of patients with locomotor dysfunction through the possibility of probing beyond overlying soft tissues to identify muscle lesions, determine their extent, characterize their composition, direct invasive procedures, and monitor therapies. Magnetic resonance imaging (MRI) appears to be the most promising of available imaging methods, because of its great sensitivity to changes in muscle water distribution and fat content. Also, it can distinguish between individual deep and superficial muscles. Serial evaluations of many muscles are practical because of the safety of MRI. While the cost effectiveness in the workup of locomotor dysfunction remains to be determined, the scientific and practical clinical information now available merits further investigation by clinicians and radiologists alike. The purpose of this review is to describe the potential role of skeletal muscle MRI in evaluating the locomotor system.
Humans↗
A management information system to study space diets.
A management information system (MIS), including a database management system (DBMS) and a decision support system (DSS), was developed to dynamically analyze the variable nutritional content of foods grown and prepared in an Advanced Life Support System (ALSS) such as required for long-duration space missions. The DBMS was designed around the known nutritional content of a list of candidate crops and their prepared foods. The DSS was designed to determine the composition of the daily crew diet based on crop and nutritional information stored in the DBMS. Each of the selected food items was assumed to be harvested from a yet-to-be designed ALSS biomass production subsystem and further prepared in accompanying food preparation subsystems. The developed DBMS allows for the analysis of the nutrient composition of a sample 20-day diet for future Advanced Life Support missions and is able to determine the required quantities of food needed to satisfy the crew's daily consumption. In addition, based on published crop growth rates, the DBMS was able to calculate the required size of the biomass production area needed to satisfy the daily food requirements for the crew. Results from this study can be used to help design future ALSS for which the integration of various subsystems (e.g., biomass production, food preparation and consumption, and waste processing) is paramount for the success of the mission.
Biomass↗
EHR standards--A comparative study.
For ensuring quality and efficiency of patient's care, the care paradigm moves from organization-centered over process-controlled towards personal care. Such health system paradigm change leads to new paradigms for analyzing, designing, implementing and deploying supporting health information systems including EHR systems as core application in a distributed eHealth environment. The paper defines the architectural paradigm for future-proof EHR systems. It compares advanced EHR architectures referencing them at the Generic Component Model. The paper introduces the evolving paradigm of autonomous computing for self-organizing health information systems.
Database Management Systems↗
A semantic-based kernel for advanced health information systems.
This paper reports on the design and development of an infrastructure allowing one to share and exchange multimedia data in the context of a health network. A single technology exploiting a semantic model of the hospital universe provides users with information and data of diverse origins, generated by the various actors or departments of the health organization. Functions provided include act management and patient record management governed by domain semantics. The functionality has been validated through laboratory experiments against the requirements of protocol directed care and health networks. The functionality is integrated into a clinician workstation exploited in the Internet/Intranet environment thanks to a commercial browser. These results have been obtained with the support of several projects in the frame of the Health-Care Telematics Applications Programme of the European Community and of the Eurêka Programme.
Artificial Intelligence↗
Overview of digital imaging in pathology. The fifth wave.
During the last decade, pathologists have witnessed dramatic advances in computer hardware and software technology. The major impact of these technologies has been in the management of text information. Significant benefits, however, lie in the manipulation and use of digital images of pathology specimens. Digital images may be analyzed to extract feature information, processed to enhance the visual image, archived to aid diagnostic efforts and education, or transmitted to facilitate communication between pathologists. These components can be integrated with information management systems to form the basis for a work-station for diagnostic pathology. Such technology will likely improve the productivity and diagnostic ability of pathologists in the coming years.
Image Processing, Computer-Assisted↗
Clinical information systems: strategic imperatives driving IDNs forward.
Reviewing the "state of the art" of clinical information systems in healthcare, one can't help but be struck by how many promises remain unfulfilled. Yes, there have been advances in electronic medical information systems in the past three decades, but in many ways, the same problems exist today that have existed all along. Implementation of clinical information systems (CIS) still requires major changes in workflow. And those core problems continue to dog the progress of integrated healthcare delivery systems, which are struggling to demonstrate value to purchasers, payers, providers, and consumers as they aggregate vertically and horizontally across the continuum. At the same time, mastering the "people" issues, those that revolve around how technology is integrated into the clinical practice of medicine, continues to be the key success factor for producing a usable solution, even with all the advances in hardware and software.
Computer Communication Networks↗
Information systems drive health care into the 21st century.
Beyond the initial cost of upgrading and networking computer information systems, outcome measures are diminishing in cost as technological advances occur. Physicians, labs, pharmacies, teaching institutions, financial monitors, and administrative offices can be linked electronically to communicate and share information in real time. With the aid of electronic databases connected by satellite, health care systems of the future will rely on a seamless network of information sources, forming integrated delivery systems. Philosophical and control issues may always present challenges to establishing integrated delivery systems. But the advantages of an integrated delivery system, tied together by electronic management and clinical software, seem to far surpass the risks for both providers and insurers. This article explores the overwhelming benefit to physicians who wish to practice medicine with fewer of the traditional administrative burdens.
Communication↗
Automated patient care documentation: what's in it for us? An expert system emergency drug card printout.
This article summarizes experiences to date for a collaborative approach, utilizing systems analysis and decision support methods, to design, develop, and implement automated patient centered documentation. Current manual methods for retrieving patient centered data for treatment activities and evaluation of practice are laborious, frustrating and often uneventful. Accessing specific patient information in an arrest or emergent situation, in the hospital and out patient clinical setting, is fraught with difficulties of data and information availability, reliability, legibility, integrity, security, and obsolescence. Treatment decisions made during an arrest or emergent situation, whether for an in-patient or clinical out patient, utilize Advanced Life Support guidelines and also may vary based on the heuristics of the lead practitioner on duty at the time. Walking the informatics talk of "managing and processing data to information to knowledge" lead to standardization for best practice of emergency drug calculations and treatments (1). An expedient and reliable method for retrieving patient specific data to calculate 26 medications, 3 treatments, and upwards of 40 criteria to consider during an arrest or emergent situation was achieved and implemented, as a by product of height and weight charting, across most all patient care areas at Primary Children's Medical Center in Salt Lake City Utah.
Attitude to Computers↗
Leading IDSs heed the call to invest in IT.
Case studies of 11 leading integrated delivery systems (IDSs) found all of these organizations are committed to investing in the development of sophisticated IT systems. The case-study IDSs' primary concerns regarding IT investments were related to achieving adequate financial and patient care returns, accessing capital, finding qualified IT staff, finding reliable IT vendors, achieving physician acceptance, and sharing software and IT solutions with other IDSs. Among the competitive advantages these IDSs have gained from advanced IT capabilities are improved patient satisfaction due to superior service outcomes and the IDS's ability to access clinical information from any point within its delivery system, reduced prescription errors and adverse drug reactions, enhanced quality-improvement efforts, reduced costs associated with telephone calls and paper processing, and enhanced ability to recruit clinical personnel.
Contract Services↗
The dynamics of market-level change.
Health care exhibits a competitive dynamic today that increasingly resembles that in other service industries. Organizations are becoming larger to achieve scale economies and to increase market power. Vertical integration, whether through ownership or complex contracts, is also being pursued both to seek efficiencies and to improve the bargaining position of the organization. External forces that are driving these changes include more aggressive activities on the part of purchasers to contain their costs, developments in information technology, management innovation in other service industries, and advances in medical technology. Within the health care industry, there is a pattern of organizations taking the initiative to respond to these external forces--often in anticipation of them--and other organizations then responding to the pressures in turn placed on them. Although information on strategies is communicated rapidly throughout the country, what is attempted and what succeeds differs a great deal across communities. The nature of current health care institutions in the community, including the presence of large entities with extensive capital and strong management in a particular segment of the health system and the community's experience with managed care are important factors in the path that change takes.
Delivery of Health Care, Integrated↗
Combining advanced networked technology and pedagogical methods to improve collaborative distance learning.
Making educational material be available on a network cannot be reduced to merely implementing hypermedia and interactive resources on a server. A pedagogical schema has to be defined to guide students for learning and to provide teachers with guidelines to prepare valuable and upgradeable resources. Components of a learning environment, as well as interactions between students and other roles such as author, tutor and manager, can be deduced from cognitive foundations of learning, such as the constructivist approach. Scripting the way a student will to navigate among information nodes and interact with tools to build his/her own knowledge can be a good way of deducing the features of the graphic interface related to the management of the objects. We defined a typology of pedagogical resources, their data model and their logic of use. We implemented a generic and web-based authoring and publishing platform (called J@LON for Join And Learn On the Net) within an object-oriented and open-source programming environment (called Zope) embedding a content management system (called Plone). Workflow features have been used to mark the progress of students and to trace the life cycle of resources shared by the teaching staff. The platform integrated advanced on line authoring features to create interactive exercises and support live courses diffusion. The platform engine has been generalized to the whole curriculum of medical studies in our faculty; it also supports an international master of risk management in health care and will be extent to all other continuous training diploma.
Cooperative Behavior↗
Integrated waste management--looking beyond the solid waste horizon.
Waste as a management issue has been evident for over four millennia. Disposal of waste to the biosphere has given way to thinking about, and trying to implement, an integrated waste management approach. In 1996 the United Nations Environmental Programme (UNEP) defined 'integrated waste management' as 'a framework of reference for designing and implementing new waste management systems and for analysing and optimising existing systems'. In this paper the concept of integrated waste management as defined by UNEP is considered, along with the parameters that constitute integrated waste management. The examples used are put into four categories: (1) integration within a single medium (solid, aqueous or atmospheric wastes) by considering alternative waste management options, (2) multi-media integration (solid, aqueous, atmospheric and energy wastes) by considering waste management options that can be applied to more than one medium, (3) tools (regulatory, economic, voluntary and informational) and (4) agents (governmental bodies (local and national), businesses and the community). This evaluation allows guidelines for enhancing success: (1) as experience increases, it is possible to deal with a greater complexity; and (2) integrated waste management requires a holistic approach, which encompasses a life cycle understanding of products and services. This in turn requires different specialisms to be involved in the instigation and analysis of an integrated waste management system. Taken together these advance the path to sustainability.
Conservation of Natural Resources↗
Quantitative image analysis: software systems in drug development trials.
Multi-dimensional image analysis is being used increasingly to arrive at surrogate end-points for drug development trials. Various imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and ultrasound are used to analyze treatments for diseases such as cancer, multiple sclerosis, osteoarthritis, and Alzheimer's disease. However, extracting information from images can be tedious and is prone to high user variability. The medical image analysis community is moving towards advanced software systems specifically designed for drug development trials. These systems can automatically identify the anatomy of interest in medical images (segmentation methods), can compare the anatomy over time or between patients (registration methods) and allow the quantitative extraction of anatomical features and the integration of the data and results into a database management system, automatically tracking the changes made to the data (audit trail generation). In this article, we present a case study using a prototype system that is used for quantifying multiple sclerosis lesions from multivariate MRI.
Clinical Trials as Topic↗