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PubMed2004

Knowledge and process management in health care organizations.

OBJECTIVE: Medical knowledge management and care process management have become to be considered as valuable strategic assets that can lead to sustained increase in Health Care Organization (HCO) performance. Thus, it is essential to investigate which are the enablers for promoting knowledge-based organizations (people, organization, process, and system perspectives). Although they are essential for a HCO to manage knowledge effectively, it is still unclear how to employ them in more principled fashion. This requires innovative management strategies to determine effective ways of utilizing knowledge resources and capabilities available both within and outside the organization. METHOD: This paper reviews knowledge and process management theories, methods, and technologies that are potentially effective in building high performance HCOs. They come from a variety of fields behind computer science and medical informatics, e.g. from business and organization sciences to psychological and cognitive sciences, from epistemology to sociology. However, the success in developing future Health Information Systems (HIS) requires their incorporation into a new conceptual framework after recognizing how peculiar are the characteristics of HCOs with respect to other organizations. Investigating the nature of knowledge, in general, and of medical knowledge, in particular, is essential to define which services the future HIS should provide to foster collaboration between patients and health professionals. The knowledge creation process is then described in order to emphasize its dynamic and social characteristics. The potential of workflow technology for building innovative HISs is analyzed together with several basic research issues which are very challenging for researchers in the field. RESULT: A framework for augmenting the conceptual analysis of theories, methods, tools and effects of knowledge management in building high performance HCOs.

Health Facility Administration↗
PubMedDate not supplied

[Some characteristics and opinions of graduates from the master's course on epidemiology. Havana 1984--1999].

Data from the Teaching Department records on, age, gender origin and basic profession of foreign and Cuban students were analyzed, including the opinions of a sample of the Cuban graduates up to 1999, who were administered a survey designed to evaluate the impact of the course. "Pedro Kouri" Tropical medicine Institute is giving the Master's course on Epidemiology since 1984. Out of the 254 graduates up to 1999, 97 were foreigners (75 from Spain); 54.8% of the Cubans came from Havana City and Havana provinces. The mean age was 31 years for foreigners and 36.9 years for Cubans. Most of the students expressed their great satisfaction with the surveillance and research knowledge and skills acquired, stating that they had met their expectations in a good quality course, but others pointed out that they were not satisfied with the time allocated to Quantitative Techniques for Epidemiological Research, Statistics and Computer science modules. It was concluded that the differences in origins and age of the Cuban students makes it necessary to reformulate academic formation policies and strategies so as to increase the educational efficiency according to individual needs. No gender differences were found in the Cuban group where physicians prevailed. Generally speaking, opinions about the course were very positive.

Adult↗
PubMed2005

SOMWeb - Towards an Infrastructure for Knowledge Sharing in Oral Medicine.

In a net-based society, clinicians can come together for cooperative work and distance learning around a common medical material. This requires suitable techniques for cooperative knowledge management and user interfaces that are adapted to both the group as a whole and to individuals. To support distributed management and sharing of clinical knowledge, we propose the development of an intelligent web community for clinicians within oral medicine. This virtual meeting place will support the ongoing work on developing a digital knowledge base, providing a foundation for a more evidence-based oral medicine. The presented system is founded on the use and development of web services and standards for knowledge modelling and knowledge-based systems. The work is conducted within the frame of a well-established cooperation between oral medicine and computer science.

Humans↗
PubMed2005

Automatic annotation of medical records.

One of the research projects running at the medical informatics department of the Institute of Computer Science AS CR explores the problem of medical information representation and development of electronic health record (EHR). With respect to this effort an interesting problem arises: how to transfer knowledge from a medical record written in a free text form into a structured electronic format represented by the EHR. Currently, this task was solved by writing extraction rules (regular expressions) for every element of information that is to be extracted from the medical record. However, such approach is very time consuming and requires supervision of a skilled programmer whenever the target area of medicine is changed. In this article we explore the possibility to mechanize this process by automatically generating the extraction rules from a pre-annotated corpus of medical records. Since we are currently in the phase of data acquisition and preliminary tests we will not present any final results, rather we will sketch the technologies we intend to use and describe the tools that were developed so far as a part of this project.

Electronic Health Records↗
PubMed2005

[Advances in passive OP-FTIR].

As an OP-FTIR(Open Path FTIR) technology, passive OP-FTIR not only has the advantages of OP-FTIR, but also has the ability to collect data from any direction without prior background information. This technology allows mobile, fast, man-held and stand-off detection of hazardous chemical cloud.The present paper presents some developments of passive OP-FTIR, including high altitude atmospheric pollution detection, auto-detection of toxic cloud, hot gases detection (such as the determination of major combustion products in aircraft exhausts, remote sensing of smoke plumes, and remote sensing of volcano emissions), temperature and combustion products determination (including cloud temperature determination). The present paper also gives the application of passive OP-FTIR in the military. With the development of FTIR and computer science, more and more applications of OP-FTIR to environment supervision, aviation and space flight, engine exhausts, combustion and military will be fulfilled.

English Abstract↗
PubMed2005

Policy analysis using patient flow simulations: conceptual framework and study design.

How do we know that innovations in healthcare delivery would work? In this paper, we discuss the idea of applying the methodology of group-randomized intervention studies to evaluation of surgical care policies using data from simulation experiments. We argue that a new interdisciplinary framework, which links health services research, operations research, and computer sciences, is required. Specifically, the methodological rigor of evaluative studies should be applied to the analysis of simulation experiments. In turn, the evaluation of policy initiatives should include the simulation of health-system operations. We introduce the framework and study design to evaluate methods for improving the peri-operative process with the use of patient flow simulations.

Adult↗
PubMedDate not supplied

[Registry of the Italian Institute for Occupational Prevention and Safety of local productive units: methodology and structure].

The Italian Institute for Occupational Prevention and Safety (ISPESL) carried out a register of enterprises operating in industry, services and agriculture sector to provide information on their location, economical activity and occupational data. This database has been built merging administrative files from the National Institute of Social Security (INPS) and the Computer Science Society of Italian Chambers of Commerce (InfoCamere). Enterprises have been classified by economic sector - in accordance with ISTAT (National Statistics Institute) "Ateco91" classification--and by accuracy level of the record linkage. In details, three different subsystems have been set up: (A) enterprises satisfying linkage; (B) enterprises in InfoCamere file not linked with INPS file; (C) enterprises in INPS file not linked with InfoCamere file. In the whole, 6.026.676 factories have been collected, of which 1.188.784 in group A, 4.543.091 in group B and 294.801 in group C. Establishing a database of information on industries may be useful to improve preventive programs and to plan health care surveillance systems.

Academies and Institutes↗
PubMedDate not supplied

[Information technology for the management of health care data: the EPIweb project].

In the US, the Center for Disease Control and Prevention has produced has increased the permeability of the computer science technologies, in order to achieve a better and more efficient management of health care data. In this context, the present paper proposes a discussion regarding a web-based information system, called EPIweb. This system allows researchers to select the centers for the data entry, collect and elaborate health care data, produce technical reports and discuss results. Such a system aims to be easy-to-use, totally configurable and particularly suitable for the management of multicenter studies. The paper shows the EPIweb features, proposes a sample system run, and concludes with a discussion regarding both the advantages and the possible improvements and extensions.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Where to in the next ten years of health informatics education?

OBJECTIVES: To explore whether education in health/medical informatics should continue to evolve along the lines pursued since the early seventies, or whether a change is advisable. METHODS: Roots and key resulting characteristics for European and US American approaches HI education are identified. In Europe holistic approaches based on a synthesis of medicine and informatics (= computer science) with programs ranging from vocational training through university programs to doctoral and postdoctoral programs were characteristic. The US American approaches emphasized the higher levels of education and a diverse selection of specialized subjects. Changes in health and health informatics are summarized. RESULTS: Two types of changes are identified: high-tech applications arising at the interface of imaging, robotics, and the -omics (genomics, proteomics, metabolomics), and invasive applications centering on consumer health informatics and a move from curative to prospective health care. CONCLUSIONS: It is proposed that curative medicine is adequately served by current educational approaches, but that the move towards prospective health care requires a move towards education and change management for health professionals and health informatics professionals.

Delivery of Health Care↗
PubMed2006

[Characteristics of references between GSCC and CST for Semi-Luvisols].

In this paper, the references between Genetic Soil Classification of China (GSCC) and the Chinese Soil Taxonomy (CST) for GSCC-Semi-Luvisols were conducted, and their quantitative and spatial distribution characteristics within CST were studied, based on the 1 : 1 M Soil Database of China, which consists of 1 : 1 M digital soil map, soils profiles attribution database and soil reference system of China. Being a reference system for converting soil names in GSCC into those in CST, ST and WRB, respectively, Chinese Soil Reference System was a computerized retrieving system jointly developed by the experienced scientists of pedology and computer science. The comparison fields and laboratory investigation data of their soil profiles with diagnostic horizons and characteristics related in the target soil classification systems, and 2,540 typical soil species names corresponding in CST, ST and WRB systems were determined, respectively, which were selected from Soil Attributes Database because of their complete sets of attribute data. Finally, the system and reference database were established. "GIS linkage based soil type" method linked the records in the Soil Reference Database to the Soil Spatial Database. In this method, all records of soil profiles in Soil Reference Database as well as their soil reference name in other classification systems were allocated one by one onto corresponding soil type polygons in Soil Spatial Database on the GIS platform, according to the principles of soil type identity and similarity, parent material identity and likeness, and the location of soil profiles relative to linked target polygons. Area statistcs of all soils were conducted based on the polygons. The results showed that GSCC-Semi-Luvisols was a type of GSCC soil with a total area of 427,843.1 km2,which could be sorted to 4 CST Orders, i. e., Luvisols (51.3%), Cambosols (35.2%), Isohumosols (10.7%) and Anthrosols (2.8%), and further into CST 22 Groups and 38 Subgroups. All dark grey forest soil, superficial gleyed black soil, and leached dry red soil of GSCC subgroups could be sorted to Calcaric Hapli-Gelic Cambosols, Pachic Argi-Udic Cambosols and Typic Ferri-Ustic Luvisols of CST subgroups, respectively, and all grey cinnamon-like soil, calcareous grey cinnamonic soil and dry cinnamon soil could be sorted to Typic Ustic Cambosols. Making the reference was so complicated that there was no one to one reference relationship among other soils. The analysis of the area ratios and standard deviations of a certain GSCC soil classified by CST showed that the lower the unit for reference, the easier the reference would be. The results of this study were of high reference value to proper reference GSCC and CST, and to the application and development of CST.

China↗
PubMed2006

[Optical mapping of the membrane potential with voltage-sensitive dyes].

Optical mapping of the membrane potential with voltage-sensitive dyes is an advanced approach that involves in many theories such as molecular photonica, physiology and computer science. Compared with the conventional techniques of membrane patch-clamp and microelectrode, the optical mapping system can measure not only the changes of a single membrane potential from multiple sites simultaneously but also the conduction properties of the cell populations. So this technique provides an important method for studying the electrophysiology of the small cell, the tiny neurite and the cardiac arrhythmia, etc. Because this technique can also avoid the electromagnetic interferences, it uniquely provides an ideal means for studying the mechanisms such as cardiac defibrillation. In this paper the principles and the system structure of the optical mapping are introduced, its applications and future developments are also presented at the same time.

Animals↗
PubMed2006

Making the procedure manual come alive: A prototype relational database and dynamic website model for the management of nursing information.

The nursing procedural manual is an essential resource for clinical practice, yet insuring its currency and availability at the point of care remains an unresolved information management challenge for nurses. While standard HTML-based web pages offer significant advantage over paper compilations, employing emerging computer science tools offers even greater promise. This paper reports on the creation of a prototypical dynamic web-based nursing procedure manual driven by a relational database. We created a relational database in MySQL to manage, store, and link the procedure information, and developed PHP files to guide content retrieval, content management, and display on demand in browser-viewable format. This database driven dynamic website model is an important innovation to meet the challenge of content management and dissemination of nursing information.

Information Management↗
PubMed2006

[A review on applications of infrared spectroscopy to the study of traditional Chinese medicine].

Infrared spectroscopy is well suited for the rapid and nondestructive identification and quantification of traditional Chinese medicine (TCM) for its high resolution, easy operation and strong specialization of absorbance bands. It is becoming an efficient methodology in the quality control of TCM. The present paper reviews the applications of infrared spectrometry in the qualitative and quantitative analysis of TCM, especially to the discrimination and effective content determination of traditional Chinese medicinal materials (including different parts of the same medicinal material, TCM from different geographical areas, easily confusing TCM, and true and false TCM) and Chinese patent medicine (such as TCM formula particles, injections, etc.). With the ceaseless rapid development and popularization of FTIR spectrometer and computer science, infrared spectrometry will greatly accelerate the process of TCM modernization and internationalization by all means.

Medicine, Chinese Traditional↗
PubMed1991

[Revolution of paradigm in clinical diagnosis--from the mechanization to the intelligent being].

The medical advancements, during the 20th century symbolize the industrialization of medical technologies, i.e., many clinical tests are carried out by the highly advanced automated machines. Also, the concept of intelligent processing of clinical diagnosis seems to have been established in the practice. However, it may be an illusion caused from the term artificial intelligence (AI) which attracts the attention of not only specialists of computer science but also clinicians. The essential nature of AI, especially of expert consultation systems is the same as the existing theories, such as Bayes' theorem, Boolean algebra, multivariate statistical analysis, and Fussy theorem, i.e., the evaluation of a weighted sum of multiple parameters. The weak point of these theories is the lack of time parameter. Therefore, the models using a time parameter including physiological simulation, dynamics model, Weibull model and Markov process are important to realize the revolution of clinical diagnosis from the standpoint of intelligent science and technology.

Artificial Intelligence↗
PubMed1991

Implementing a complex internetwork: a case study.

This paper concerns the implementation of a complex internetwork in late 1989 through early 1990. The purpose is to discuss the methods and approaches employed. The context is that as technology improves and computer science advances, the same problems are re-solved over and over for slightly different environments. The perspective is that the methods and approaches will remain viable while the hardware and software changes.

Local Area Networks↗
PubMed1991

[Bloodless emergent laparotomy for acute abdominal syndrome].

Bloodless laparotomy (BL) is defined as an opened exploration of the abdominal cavity that yields negative results, i.e., "provides no information as to the cause of the clinical and paraclinical symptoms responsible for prompting the surgical investigation". The authors report a retrospective study spanning January 1975 to December 1989, on the incidence of and mortality associated with emergent BL in patients with acute abdominal syndrome, with the intent of reducing its frequency. Over this period, 24 BL occurred in 3480 emergent laparotomies, i.e., 0.63%. These involved 7 men, 5 women, 5 boys and 7 girls, aged 4 to 52 years (mean age = 19.5 years). Indications for surgery were based on clinical signs, as well as on laboratory findings such as chest X-ray and plain radiography and needle-puncture of the abdomen. Surgical data indicated:liver cirrhosis--3 cases; mesenteric adenopathy--3 cases; intestinal parasitosis--1 case; bilateral adnescitis--1 case; polycystic ovaries--1 case; wall abscess--1 case; unexplained pain--14 cases. The mortality rate was 2/24. Use of other paraclinical investigations, namely ultrasonography, laparoscopy and peritoneal lavage, and of computer science methods after a prior clinical examination initiated by history-taking, might help reduce the rate of BLs, which are non-devoid of mortality.

Abdomen, Acute↗
PubMed1991

[Expert systems and antibiotic sensitivity test].

Artificial intelligence is a part of computer science that deals with programs mimicking intelligence of man. Artificial intelligence is now used to check the quality of the determination of antibiotics susceptibility of bacteria. This application is useful because antibiotic susceptibility is subject to biological and technical variation that have to be detected. Three types of reasoning are used either by the biologist or by expert systems: low level quality checking dealing with individual results, microbiological interpretation of the whole set of results and medical interpretation of the results. The use of artificial intelligence in these fields is sustained by the structured nature of the knowledge. Two type of expert systems are already of routine use, either based on production rules (ATB plus EXPERT, bioMerieux, La Balme-les-Grottes, France and SIR, 12A, Montpellier, France), or on object-oriented representation of the knowledge (EXPRIM from our laboratory). The main problem is, as usually in artificial intelligence applications, to transfer human expertise into an adapted knowledge base. The advantage of experts systems over man are their reproducibility of answer and their availability.

Artificial Intelligence↗
PubMed1990

Plasma fibronectin: a study of 340 assays.

The authors report the results of 322 assays of plasma fibronectin. The object of this study was to specify its diagnostic contribution. The assays have been effected from February 1987 to October 1988 by the laser nephelometric method in all the hospitalized patients without exclusion. We have defined two populations on clinical diagnostic criteria into 193 control cases and 129 patients suffering from inflammatory rheumatisms or bone neoplasias. The statistical processing has been effected in the Department of Medical Computer Science. The results are as follows: The rate of plasma fibronectin is inclined to increase with age (p = 1 X 10(-4) a little higher among men than among women (p = 0.05). With regard to the other biological markers of inflammation, there was no obvious correlation with the rate of fibrin, the sedimentation rate at the first hour, or the presence of C-reactive protein. This study does not confirm the specificity of this assay in the inflammatory rheumatisms although our two populations are strictly comparable with respect to age and sex, and the clinical and biological parameters (sedimentation rate and fibrin) would allow us to discern the difference, if any, between the two populations. Plasma fibronectin assay has no diagnostic or discriminating value on a large scale.

Aging↗