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Results for “Decision Support Systems, Management”

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PubMed1995

A generalizable framework for information systems for physician recruitment/referral.

Hospital information systems have evolved from data processing systems for patient billing and payroll to decision-support systems which support decision making at the middle and upper management levels. With the advancements in the areas of database management, expert systems and networks, important hospital functions such as physician recruitment and referral which historically were performed using traditional procedures, are now performed using these computer-based technologies. Develops a generalizable framework for information systems for physician recruitment and referral using technologies of database management, expert systems and networks. This GIS-PRR system may be used by hospitals and other health-care providers to improve the efficiency and effectiveness of the physician recruitment/referral process.

Database Management Systems↗
PubMedDate not supplied

A statistically rule-based decision support system for the management of patients with suspected liver disease.

The paper describes how a decision support system in liver diseases, mostly oriented to prediction of the necessity for liver biopsy, has been developed. The system designed is a hybrid one and consists of two parts: logical and statistical. The logical part contains rules, formulated on the basis of current medical knowledge, which enables recognition of clear cases; diseased or non-diseased. The unclear cases are classified on the basis of rules statistically extracted from databases. These rules have been reached after a comprehensive exploratory analysis of the sample of 165 patients with slightly to moderately raised levels of routine liver tests but without signs or symptoms of liver diseases. The extracted decision diagrams which simulate traditional medical diagnosis conduct have been found to be superior to discriminant analysis and probabilistic inductive learning. They use only a limited number of laboratory tests to detect the necessity for biopsy.

Algorithms↗
PubMedDate not supplied

Developing a decision support system to meet nurse managers' information needs for effective resource management.

This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.

Decision Support Systems, Management↗
PubMed1998

Managing smarter: a decision support system for mental health providers.

Financing of mental health care has changed radically, especially with managed care. Shrinking revenues have forced providers to look for creative ways in which to provide quality services at less expense. Delivery of quality services depends largely on the productive use of the provider's prime resource--the clinicians. Productivity was the focus of the PC-based decision support system developed for mental health providers in New York State. It enables administrators to track key indicators of productivity such as face-to-face time and non-face-to-face time against goals. Unmet goals can be pinpointed quickly, and clinicians' caseloads can be reviewed to determine the underlying causes. A key feature of the system is the conversion of raw data into actionable information to help in problem finding and problem solving. The system has been implemented in Ulster County, the pilot site for the project. The software can be customized easily to suit the data of other providers.

Decision Support Systems, Management↗
PubMedDate not supplied

Evidence-based medicine in the United States--de rigueur or dream deferred?

Although evidence-based medicine (EBM) is an important concept for promoting value in health care, meaningful application of EBM tools in commercial settings has proceeded slowly. Barriers to the use of EBM include patient preference, physician resistance, the lack of automated decision support systems, managed care failures, lack of research on which to base decisions, and the inherent subjectivity of interpretations of evidence. Political concern has mirrored these barriers; consequently, Medicare still lacks clear authority to apply many evidence-based decision tools. Dialogue and consensus will be critical in bridging public concern and the eagerness of researchers to apply EBM.

Attitude of Health Personnel↗
PubMedDate not supplied

[Optimization of radiation protection in the agrosphere: methods of optimization and computer systems for decision support with respect to management of protective measures].

Principles and methods of radiation protection optimisation for countermeasure implementation on areas subjected to radioactive contamination are discussed. Methodological aspects of the protective measures analysis in agrosphere are presented. Methods of estimation of intervention levels, examples of assessment and comparison of countermeasure effectiveness with the use of various criteria are considered. The brief review of up-to-date decision support systems is submitted along with the description of computer system PRANA DSS for estimation of the consequences and countermeasures management in agrosphere in the long-term period of liquidating the consequences of a nuclear accident.

Agriculture↗
PubMedDate not supplied

A decision support system for the management of accidental mushroom and plant poisoning.

In this paper the discussion focuses on a decision support system to be used as a tool in the treatment of poisoning cases attributable to mushrooms, plants and animals. In this first release, attention is focused on the risks related to fungi. Problems involved with mushroom poisoning and identification are analyzed to highlight which elements or characters must be taken into account in devising a computerized expert system. The components of such a system are presented, the different approaches are discussed and the choices made are motivated. Some preliminary results are also presented.

Artificial Intelligence↗
PubMed1996

Adopting a corporate perspective on databases. Improving support for research and decision making.

The Veterans Health Administration (VHA) is at the forefront of designing and managing health care information systems that accommodate the needs of clinicians, researchers, and administrators at all levels. Rather than using one single-site, centralized corporate database VHA has constructed several large databases with different configurations to meet the needs of users with different perspectives. The largest VHA database is the Decentralized Hospital Computer Program (DHCP), a multisite, distributed data system that uses decoupled hospital databases. The centralization of DHCP policy has promoted data coherence, whereas the decentralization of DHCP management has permitted system development to be done with maximum relevance to the users'local practices. A more recently developed VHA data system, the Event Driven Reporting system (EDR), uses multiple, highly coupled databases to provide workload data at facility, regional, and national levels. The EDR automatically posts a subset of DHCP data to local and national VHA management. The development of the EDR illustrates how adoption of a corporate perspective can offer significant database improvements at reasonable cost and with modest impact on the legacy system.

Database Management Systems↗
PubMed2001

From I.T. to information management with casemix data.

The Australian investment in technological support for the collection and analysis of hospital data has paid off in the creation of data depositories that can be used for system and policy analysis. Yet the inquiries that would inform decision for quality and efficiency improvement are made at the operational levels where there has not been equivalent investment in developing human capacity. This article suggests strategies and methods for using standard healthcare information that is now so much more readily available.

Database Management Systems↗
PubMed1999

Decision support systems in health economics.

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

Computer Simulation↗
PubMed1998

A decision analytic approach to commissioning ambulance cardiac services.

The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services. Strategies for the management by ambulance personnel of victims of cardiac arrest and persons with acute chest pain of cardiac origin were modelled in a decision-event tree, and a bibliographic database established. The international research literature prior to 1997 was searched in order to derive probability values for the tree. However, after checking whether the subgroupings of results in the papers were in accordance with the variables in the tree, the number of useful papers on acute chest pain was found to be only two. In the almost complete absence of information--even from small observational studies--on the management of the great majority of patients with cardiac symptoms transported by ambulance, the local ambulance service and the main providers of hospital services in the district are now collaborating in field studies of cardiac care in order to improve the inputs into the model.

Algorithms↗
PubMedDate not supplied

Health care decision-support systems needed now.

The technology exists now for developing a "Health Care Web" that would greatly improve health care decision making and research. But leaders must first be willing to cooperate to build the system.

Cooperative Behavior↗
PubMed2002

A shotgun wedding: business decision support meets clinical decision support.

By effectively closing the loop between the data, analytics, processes, and methods supporting business and clinical decision making, a healthcare organization closes the loop between its knowledge generation activities and its actions at the bedside: knowledge guiding actions, actions generating knowledge.

Database Management Systems↗
PubMed1997

A process model basis for evolving hospital information systems.

Hospitals often invest significant resources in the development of large and complex information systems that must be modified and extended to respond to changing requirements and to exploit the capabilities offered by modern technologies. A disciplined approach of managing the evolution of hospital information systems is then required so that to meet the increasing demands for effective and efficient use of scarce resources. This paper takes a process oriented view of the hospital and presents an approach based on hospital process modeling which aims at assessing the current status of computer support within a hospital and at identifying new opportunities for automation. The approach is illustrated by an example taken from a major Greek hospital.

Clinical Laboratory Information Systems↗
PubMed2005

Uraba lugens (Lepidoptera: Nolidae) in New Zealand: pheromone trapping for delimitation and phenology.

A synthetic sex pheromone trapping survey of the leaf skeletonizer Uraba lugens Walker (Lepidoptera: Nolidae) demonstrated the unexpectedly widespread distribution of the insect across > 40,000 ha of urban Auckland, New Zealand. A survey of eucalyptus trees planted in parks and other public areas showed a significant spatial correlation between trap catch and breeding populations, validating the trap survey results. Traps in trees showing damage had four-fold higher catches than traps placed in undamaged or nonhost trees, and < 1% of damaged trees with traps failed to catch adult moths. Damage by larval feeding was correlated with male trap catch in the previous generation, offering good prospects for a pest management decision support system, provided that an economic threshold is developed. Catches increased by 3.4-fold in the same georeferenced trapping grid between November and December 2003 and between March and April 2004 across two generations, over the summer. A vertical transect showed that catches increased with height up to the top trap at 13 m (60% of mean tree height). Options for managing the insect will need to overcome the high rate of increase, the rate of spread, and the vertical distribution of the insect on tall eucalyptus trees.

Animals↗
PubMed2001

Case study: a data warehouse for an academic medical center.

The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students.

Academic Medical Centers↗
PubMed2005

Knowledge logistics as an intelligent service for healthcare.

OBJECTIVES: The technology of grid services is developing fast. This paper presents an approach to the implementation of an intelligent grid service that configures a hospital taking advantage of the knowledge logistics idea. METHODS: The presented approach is based on synergistic integration of knowledge acquired from distributed sources in order to obtain new or complement insufficient knowledge. Presented approach uses ontologies and the formalism of object-oriented constraint networks for knowledge representation and applies ILOG to constraint-based problem solving. RESULTS: The application of the approach is illustrated via a decision support system for a fictitious case study of a hospital configuration in the Binni region. The system showed the ability to produce interrelated solutions for subtasks of the hospital configuration task based on the built ontology and input parameters. Besides, such preferences as cost or time minimization are also considered by the implemented fuzzy logic module that finds a feasible solution. CONCLUSIONS: KL would benefit from the grid, and particularly from the concept of a semantic grid. The scalable architecture of the approach enables its extension with regard to knowledge/information sources number and, thereby, with regard to factors taken into account during complex problem solving. Utilizing ontologies allows integration of the approach into existing processes and facilitates knowledge sharing with similar systems. Application of constraint networks allows rapid problem manipulation and usage of such existing efficient technologies as ILOG.

Artificial Intelligence↗