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PubMed1998

How groups co-ordinate their concepts and terminology: implications for medical informatics.

Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.

Concept Formation↗
PubMed2005

Hospital rules-based system: the next generation of medical informatics for patient safety.

PURPOSE: The hospital rules-based system (HRBS) and its subsystems at a major medical center are described. SUMMARY: The HRBS was implemented at the Mayo Clinic to rapidly identify and communicate crucial information to the clinician in order to optimize patient care. The system also enhances workload efficiency and improves documentation and communication. The system is used by the infectious-diseases division, pharmacy services, nutritional support services, infection control, and the nursing department. The six HRBS subsystems are Web-based programs that share a common structural design and integrate computerized information from multiple institutional databases. The integrated data are presented in a user-friendly format that improves the efficiency of data retrieval. Information, such as monitoring notes and intervention information, can be entered for specific patients. The subsystems use rules designed to detect suboptimal therapy or monitoring and identify opportunities for cost savings in a timely manner. CONCLUSION: The HRBS enhances the identification of drug-related problems while optimizing patient care and improving communication and efficiency at a major medical center.

Hospital Information Systems↗
PubMed2006

The use of medical informatics as a management tool for community health services during the 2006 Israel-Lebanon War.

BACKGROUND: During war the health management organizations have tremendous difficulty monitoring members' needs according to geographic spread. OBJECTIVES: To describe how an HMO used its health information technology in a way that enables its management to receive updated online information on the needs of the insured, according to their distribution throughout the country during the time of the war in Lebanon in July-August 2006. METHODS: Data were derived from the computerized medical records of Maccabi Healthcare Services--the second largest HMO in Israel, providing care to more than 1.7 million members nationwide. Data on healthcare utilization by northern members were compared to the geographic distribution of clinics. RESULTS: The war was characterized by the massive evacuation of citizens southwards. During this period there was an abrupt decline in the utilization of medical services by northern members in the northern region. This decline returned to normal 10 days after the ceasefire. A reciprocal increase was noted in the use of health services by citizens from the north in other regions. This increase returned to normal after the war. No such pattern was noticed during the same period in 2005. CONCLUSIONS: Real-time surveillance of trends in consumption of health services by citizens in times of regular daily living as well as during emergencies and wars is a vital management tool for medical directors responsible for providing health services.

Catchment Area, Health↗
PubMed1998

[Medical informatics on the eve of the 21st century and the tasks of the dental service in Russia].

The problems and tasks of information provision of dental service in Russia for all levels, from federal to regional health center are discussed as well as the concept of development and program of information provision in dentistry, software for automated working places of dentists, local network for dental centers and dentistry departments, software for differential diagnosis and treatment of the main dental diseases, such as caries, pulpitis, periodontitis, diseases of the periodontium and buccal mucosa, benign tumors, etc., for rapid screening of dental patients for AIDS and other diseases, design and software for computers intended for computer training of students and dentists, stomatology search and reference information system, etc.

Computer-Assisted Instruction↗
PubMed2002

Medical informatics: quo vadis?

In this contribution some comments are given regarding an article of Haux et al., which is published in the same issue. After discussing some general aspects of the paper, the comments focus on patient-centred care and genomics. Trends that are observed today are used to predict the situation with respect of the use of ICT in healthcare in the year 2013. It is postulated that a shared electronic patient record in which both healthcare provider and patient enter and retrieve data will be available. The role of the patient in the management of her disease will be much larger than it is now. The impact of new knowledge coming from the field of genomics will be large. It is not possible to predict the impact on functionality and the use of healthcare information systems in 2013.

Attitude of Health Personnel↗
PubMed1996

Medical informatics. The future is here.

Informatics is an indispensable discipline for leaders and managers--of patients, facilities, and organizations--because the most important assets of those organizations are their information processing technologies, and the key skills are those that help them to manage information. Managers and executives will increasingly need to anticipate trends in information management technologies that could affect their business. In health care, computer-based patient records, integration engines, online analytical processing systems, telemedicine, expert systems, and the Internet have become vital to having the competitive advantage. Those who do not understand the promise and limitations of these technologies and the need for strong leadership to establish standards for data and transaction systems will not lead their organizations well.

Computer Communication Networks↗
PubMed1998

SCP-ECG and Vital Signs Information Representation--two examples of successful transcontinental cooperation in medical informatics standardization.

During the past 2-3 decades, development work on Medical Devices focused on improving their functionality (device control, signal analysis, pattern recognition and classification). At present, the dominant user requirement is information integration. This requires interconnectivity and interoperability of devices and device systems. Today, due to all major manufacturers operating globally, this requirement can only be met if standards with global relevance are developed. The first standard discussed is the Standard Communications Protocol for Computerized Electrocardiography (SCP ECG). The rapid finalization of the standards document itself was possible due to some of the experts being involved on basic problems for greater than 10 years. Their knowledge and long standing cooperation contributed significantly to a fast consensus finding process as well as quick implementation. The second standard discussed in this paper deals with Vital Signs Information Representation. Before starting to write the document, an International inventory workshop was held to document the state of the technology and of user requirements. This common base of problem understanding makes consensus finding less difficult. Continuous cooperation between the IEEE P1073 group and the CEN/TC251 WG5 project team also ensures early harmonization of the related standards. Finally, early implementation projects in Europe and the US allow verification and modifications based on feed-back from practical experience.

Electrocardiography↗
PubMedDate not supplied

Integrating medical informatics and health services research: the need for dual training at the clinical health systems and policy levels.

Reams of data pertaining directly to the core health services research mission are accumulating in large-scale organizational and clinical information systems. Health services researchers who grasp the structure of information systems and databases and the function of software applications can use existing data more effectively, assist in establishing new databases, and develop new tools to survey populations and collect data. At the same time, informaticians are needed who can structure databases that serve the needs of health service research and who can design and evaluate applications that effectively improve health care delivery. As long as health services researchers and informaticians work in separate spheres, however, opportunities to use data from health care encounters to improve care, expand knowledge, and develop more effective policies will be missed. This paper provides a brief exploration of 1) existing successful collaborations between health services researchers and informaticians and 2) needs and opportunities for additional joint work in several core research areas.

Curriculum↗