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PubMed2004

Overcoming barriers to evaluation of terminological systems.

Evaluation of terminological systems has been demonstrated to be a complicated task. This is due to the broad range of terminological systems, their application, and the clinical contexts in which they can be applied. We propose an evaluation framework that explicitly distinguishes an application-independent description of terminological systems, methods to determine application-dependent requirements, and methods to assess the applicability. In order to support a systematic application-independent description of terminological systems, we present a categorization of characteristics, including explicit questions. The answers to these questions can be mapped to the requirements for a certain application of a terminological system. This framework aims at reducing the efforts for determining which terminological system is applicable for a certain clinical setting.

Evaluation Studies as Topic↗
PubMed2004

Research and development of smart wearable health applications: the challenge ahead.

Continuous monitoring of physiological and physical parameters is necessary for the assessment and management of personal health status. It can significantly contribute to the reduction of healthcare cost by avoiding unnecessary hospitalisations and ensuring that those who need urgent care get it sooner. In conjunction with cost-effective telemedicine platforms, ubiquitous health monitoring can significantly contribute to the enhancement of disease prevention and early diagnosis, disease management, treatment and home rehabilitation. Latest developments in the area of micro and nanotechnologies, information processing and wireless communication offer, today, the possibility for minimally (or non) invasive biomedical measurement but also wearable sensing, processing and data communication. Although the systems are being developed to satisfy specific user needs, a number of common critical issues have to be tackled to achieve reliable and acceptable smart health wearable applications e.g. biomedical sensors, user interface, clinical validation, data security and confidentiality, scenarios of use, decision support, user acceptance and business models. Major technological achievements have been realised the last few years. Cutting edge development combining functional clothing and integrated electronics open a new research area and possibilities for body sensing and communicating health parameters. This paper reviews the current status of research and development on smart wearable health systems and applications and discusses the outstanding issues and future challenges.

Consumer Behavior↗
PubMed2003

Health informatics for improving the Dutch healthcare system.

Some recent developments around the organisation of ICT applications in healthcare in the Netherlands are discussed, in relation with the installation of a new National ICT Institute for Healthcare (NICTIZ). Some examples are given, especially from the field of Quality Assurance and Information Security.

Computer Security↗
PubMed2006

Next-generation applications in healthcare digital libraries using semantic service composition and coordination.

Healthcare digital libraries (DLs) increasingly make use of dedicated services to access functionality and/or data. Semantic (web) services enhance single services and facilitate compound services, thereby supporting advanced applications on top of a DL. The traditional process management approach tends to focus on process definition at build time rather than on actual service events in run time, and to anticipate failures in order to define appropriate strategies. This paper presents a novel approach where service coordination is distributed among a set of agents. A dedicated component plans compound semantic services on demand for a particular application. In failure, the planner is reinvoked to define contin- gency strategies. Finally, matchmaking is effected at runtime by choosing the appropriate service provider. These combined technologies will provide key support for highly flexible next-generation DL applications. Such technologies are under development within CASCOM.

Information Storage and Retrieval↗
PubMedDate not supplied

What is Health Level 7?

HL7 is a huge undertaking and continues to grow. We talked about certain main themes of the spec that I've found interesting and thought you might too. You can always find additional information-especially from the HL7 website itself at www.hl7.org or www.altisinc.com/ IE/hl7.html. The main thing to remember is that HL7 is a specification for describing, formatting, encoding, and sharing of clinical and administrative data in healthcare. An easy way to remember that is that the 7 in HL7 refers to the Application layer in the OSI model. The next time someone talks about their HL7 software or application, you'll know that they really mean their HL7 compliant software or application. Then be sure to ask them how many composites are in their OBX segments!

Communication↗
PubMed1994

Case-based information systems in Swedish health care. General aspects and experiences from the Stockholm County Council.

The paper gives a brief overview of some national case-based information systems in Swedish health care together with an application from the Stockholm County Council. A background section on the Swedish health care system is also included. Several case-based information systems have been developed within Swedish health care. They have different purposes and operate on different levels. General national registries include: discharge registry, medical birth registry, cancer registry and cause of death registry. They have been used mainly for research and planning of health services. Another type of national registries are related to specific patient groups. Such registries include information on results and complications of treatment. The initiative to these registries have come mainly from groups of consultants. The Stockholm County Council has replaced the traditionally global budgets of clinical departments with an activity based income. An evaluation project on health care utilization in five surgical specialties are presented. Preliminary results were: no division of in-patient care into multiple hospital stays and an increase in the number of discharges among the elderly. The Swedish health care system of today is characterized by organizational changes. Case-based information systems give the opportunity to study the developments of equity, quality and resource management in the new health care models. There is today an increased interest to use case-based information systems for quality assessment and continuous quality improvement. An increasing number of analyses are made at the local level. However, national case-based data are still very valuable to make regional comparisons possible and to produce relevant reference data in local applications.

Adolescent↗
PubMed2001

Experiences from development of home health care applications based on emerging Java technology.

Home health care is an expanding area within the health care system. The idea of moving parts of the health care process from expensive specialised hospital care to primary health care and home health care might be attractive in a cost perspective. The introduction of home health care applications must be based on a rigorous analysis of necessary requirements to secure a safe and reliable health care. This article reports early experiences from the development of a home health care application based on emerging Java technologies such as the OSGi platform. A pilot application for follow-up of diabetes patients is presented and discussed in relation to a list of general requirements on home health care applications.

Blood Glucose Self-Monitoring↗
PubMed1997

The surgical pathologist in a client/server computer network: work support, quality assurance, and the graphical user interface.

Cympathy is a relational client/server database application designed to integrate the departmental work flow in anatomic pathology, segment information appropriately, and allow flexible interaction with standalone microcomputer programs. The database resides in a minicomputer server connected to 40 client microcomputers. Patient histories on consultation requests are scanned and maintained as bitmapped files; all information is stored on fixed disks. Client microcomputers use a graphical interface to update a patient-related status bar and retrieve any of the nearly 40 data entry tables for accessioning, ordering special stains and studies, block and slide production, reports, gross and microscopic findings, evaluation of analyses, Systematized Nomenclature in Medicine (SNOMED) coding, conference scheduling, logging of borrowed materials, queries, and specialized functions such as electron microscopy, including indexes for blocks, grids, and photonegatives. The application radically reduces the need for administrative personnel. Cympathy allows major refinements in the method of composing, distributing, and storing report information. Quality assurance protocols can be expanded to relate the frequency and quantification of microscopic findings retrieved in a structured query to the individual pathologist for a given type of specimen and diagnosis. Such queries can extend output to include the number of blocks and slides and all analyses, services, and procedures applied to each case. Debiting is automated through a flexible dependence on SNOMED codes, analyses, and number of slides generated. Any number of structured queries can be written and saved within Cympathy, addressed directly to the database server, or composed in microcomputer programs linked to the database by open database connectivity drivers. Within Cympathy, query results are output in a fixed table format, which can be expanded to include, for example, tabulations of gross and microscopic findings and analysis results. The application offers the opportunity for research and quality assurance in anatomic pathology without the need for hard copy output.

Databases, Factual↗
PubMedDate not supplied

Medical informatics education: the University of Utah experience.

The University of Utah has been educating health professionals in medical informatics since 1964. Over the 35 years since the program's inception, 272 graduate students have studied in the department. Most students have been male (80 percent) and have come from the United States (75 percent). Students entering the program have had diverse educational backgrounds, most commonly in medicine, engineering, computer science, or biology (59 percent of all informatics students). A total of 209 graduate degrees have been awarded, with an overall graduation rate of 87 percent since the program's start. Alumni are located in the United States (91 percent) and abroad (9 percent); half (51 percent) have remained in Utah. Former students are employed in a wide variety of jobs, primarily concerned with the application of medical informatics in sizable health care delivery organizations. Trends toward increasing managerial responsibility for medical informatics graduates and the emergence of the chief information officer role are noted.

Education, Professional↗
PubMedDate not supplied

From research to "best practices" in other settings and populations.

OBJECTIVE: To review the genesis and current status of best practices" thinking, its application in health promotion practice, and in generalizing research to alternate populations, places and times. METHODS: A presbyopic eye is cast over the recent evolution of the concept of "best practices" from medicine to public health. RESULTS: Some discontinuities are found in the migration of this concept from medicine, where it applies with some consistency to the relatively homogeneous physiology of the human species, to health behaviorwhere social, cultural, economic, and other heterogeneities make the generalizability of any research more suspect. CONCLUSIONS: Health promotion and other applications of health behavioral research need to replace "best practices" with "best processes."

Benchmarking↗
PubMed2003

Systems development in a complex stakeholder environment: NTCP Chronicle 2.0.

The CDC's National Tobacco Control Program (NTCP) is developing it's Chronicle 2.0 an online grant application and progress reporting system. This system in it's 1.0 version is used by 51 CDC-funded state tobacco control programs to facilitate the collection of state data supporting progress on key performance measures. This poster highlights the application development process for Chronicle 2.0 and presents lessons learned.

Centers for Disease Control and Prevention, U.S.↗
PubMed1998

Exploring the ontology of surgical procedures in the Read Thesaurus.

The Read Thesaurus is a comprehensive user-led clinical vocabulary developed from earlier, and structurally simpler, versions of the Read Codes, with substantial input from United Kingdom health care professionals. A constituent template table underpins a range of functions, including semantic definition of concepts using object-attribute-value triples. Concept representation for surgical procedures has been investigated by a number of groups and a standard European structure has been proposed. Over 50% of the surgical procedures in the Read Thesaurus have been fully characterised using a number of attributes each with a defined concept field. We report progress to date and, based on our large-scale experience, examine the applicability of the European model to a user-defined terminology.

Europe↗
PubMed1997

Designing medical hypermedia: the FORUM project.

Medical activity in learning stages or in usual tasks is a wide field for information technologies. But it would be a mistake to focus on technologies and minimize the organisational, social and cultural aspects of integrating such technologies. Medical hypermedia design based only on a technological approach is a case in point. This paper describes our experience in hypermedia development. It reports on the technical, methodological and organizational aspects destined to help the medical community get involved in the development of such applications.

Computer Communication Networks↗