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PubMed1998

Availability of software services for a hospital information system.

Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital information system is designed and developed with these points in mind, it's availability of software services should increase greatly.

Computer Communication Networks↗
PubMed1992

Physician recruitment: the role of the hospital information system.

Hospital information systems can support physician recruitment activities by helping identify the type of physician the institution needs, describe the type of medical practice a physician can expect, support the institution's strategic plan for the future, and demonstrate the institution's ability to assist a physician with his or her office billing and other administrative functions.

Career Choice↗
PubMed2002

Integrating the lightweight authentication protocol (LAP) with access control mechanisms in wireless health care information systems.

Health information networks are expected to support information exchange that is authentic, accurate, private and available when, where and to whom is needed. With the increase of the shared medical information and resources in healthcare wireless information systems, unauthorized access to the information by illegal users also increases. The security of the transmitted information is a vital issue. In this paper, we report on the development of the Lightweight Authentication Protocol (LAP), which makes a mobile and distributed system more secure and flexible and we implement it in a Health Care Environment where the clinicians use mobile and wireless devices like PDAs. We also provide an indicative example of integrating the LAP with access control mechanisms. Context-based Team Access Control (C-TMAC) model is used in this example, since it provides great flexibility on user-permissions management in collaborative healthcare environments. LAP is indeed capable to support efficiently the advanced authorization procedures of such demanding active security models.

Computer Security↗
PubMed1994

Developing a clinical information system: the role of the chief information officer.

BACKGROUND: Chief information officers (CIOs) must play a pivotal role in the formation and implementation of a clinical information system, the subset of an organizational information system that deals specifically with support of clinical care activities. MAJOR ELEMENTS OF A CLINICAL INFORMATION SYSTEM: Major elements include the applications software, technology and data architecture, databases, and analysis. The organizational structures and processes that manage the development of improvement activities, including the clinical information system itself, are just as vital to the design of an information system as the hardware and software. THE ROLE OF THE CIO: To develop, sustain, and advance an information infrastructure, the CIO must help establish certain organizational precursors, such as medical staff involvement, experience with quality improvement, and ability to meet data needs. The CIO must then work with the senior administrative and medical leadership in developing a vision for the information system. The CIO must also create new roles and knowledge for information system and medical staff members. Interaction between information services and medical staff is vitally important to the success of a clinical information system. Organizational committees and structures that Brigham and Women's Hospital in Boston put in place to formalize the relationship between information systems and medical staff include the Clinical Initiative Development Program and the Center for Applied Medical Information Systems Research. CONCLUSION: Improving the clinical management of care and the efficacy of care processes involves complex changes in organizational culture and processes, medical practice and information system applications, technologies, staff, and data.

Academic Medical Centers↗
PubMed2000

Enhancing the financial performance of a health system laboratory network using an information system.

We describe the improvements created by successful implementation of a laboratory information system for a multi-institutional integrated delivery system, including an analysis of the financial results. Conditions at the outset of the project, methods of management and project design, selected aspects of services redesign and consolidation, integration of services among the sites and their effects on laboratory staff and productivity are illustrated. A method for and example of measuring the financial outcomes in the sense of quantifiable improvements in operating expenses and new revenue for a whole health system clinical laboratory computer system are discussed. In this health system, the measurable financial improvements facilitated by an information system were the ability to control operating expenses and to grow the hospital laboratory network through the development of an outreach program. With organizational commitment to process innovation and improvement, using team processes and customer-driven decision-making criteria, the financial performance of our consolidated laboratory network was enhanced substantially. A fully implemented laboratory information system is considered the major enabler of positive change when combined with a genuine commitment from all levels of staff and leadership. Over time, this system's financial return is several times that of the information system investment.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Taking the risk out of laboratory information systems.

Laboratory information systems (LISs) help laboratories deal effectively with regulations, technological change, economic pressures, and increased competition. Because they are such an essential part of the laboratory, it makes sense to do everything you can to reduce the risks associated with LISs. This article examines six areas of risk that could affect the successful acquisition and implementation of an LIS--vendor corporate failure, system failure, additional costs, delays in implementation, obsolescence, and noncompliance with regulations--and offers suggestions to help laboratory managers avoid these risk areas.

Clinical Laboratory Information Systems↗
PubMed2000

Information system issues facing clinical laboratories serving complex integrated delivery systems.

Laboratory information systems (LISs) have evolved into complex applications to meet the specialized needs of laboratories. As integrated delivery systems (IDSs) continue to emerge as a dominant model for healthcare delivery, clinical laboratories serving them face two imperatives that affect IS decisions. First, laboratories in IDSs must consolidate to reduce costs and duplication yet deliver service across a region in both inpatient and outpatient settings. Second, laboratories that successfully perform reference laboratory testing will increase revenue, generate referrals, and leverage excess capacity, and may provide a competitive advantage for the IDS. This article examines laboratory information management in complex IDSs, presents options for IS support of consolidating or integrating laboratory operations, and reviews functionality requirements for laboratory outreach activities.

Clinical Laboratory Information Systems↗
PubMed1982

The trustee's guide to vendors of hospital information systems.

Hospital information systems (HISs) vary in their breadth of application, in the depth of support their vendors will provide, and in their costs and benefits. Included here in clear, succinct tables is a guide to the leading HIS vendors that highlights some of these differences.

Computers↗
PubMed1991

Why spend the money? Justification of laboratory information systems.

Laboratory information systems (LISs) represent a major budget expense. Justification of their acquisition can be conducted through several methods. Work flow, work load, LIS experience, organization, and markets vary among laboratories; thus, each laboratory faces different challenges in determining if LIS acquisition can be justified on a sound business basis.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

[Methodology for the development of nursing information systems].

The present study has as objective to describe the methodologies for development of systems of information in health and the nursing, reflecting on aspects theoretical and practical based of this proposal. In this perspective, it focuses, critically, the hard and soft vision of the information system, the alternative methodologies and the necessities of new approaches in the system of information in nursing. It concludes emphasizing the necessity of if developing information systems that are extracted of the necessities of the practical of nursing and with the participation of these professionals.

Information Systems↗
PubMed1998

Experimental assessment of the feasibility of integrating an endoscopic imaging system into an existing hospital information system.

The National Cheng Kung University (NCKU) Hospital operates a comprehensive integrated hospital information system. This was designed and installed as an integral component of the building of the hospital, which opened in 1988. The information system provides a service to all staff in the hospital, administrative and clinical, across the whole of the hospital. To make sure that the information is accessible, where and when it is needed, a comprehensive communications network consisting of both hardware and software mechanisms supports the information system. This paper explores the requirements for a computerised image system for endoscopy and assesses two approaches to the implementation of such a system, as a stand-alone system and as a subsystem of the NCKU hospital information system already in place. The latter would satisfy the original design specification of developing a single system to cover all aspects of hospital operation but places additional demands on the endoscopy systems designer to ensure integration. Both operational modes are set out in the paper and their implications assessed.

Computer Systems↗
PubMed2002

Developing and integrating an adverse drug reaction reporting system with the hospital information system.

We have developed an adverse drug reaction (ADR) reporting system integrating it with Hospital Information System (HIS) of the University of Tokyo Hospital. Since this system is designed with JAVA, it is portable without re-compiling to any operating systems on which JAVA virtual machines work. In this system, we implemented an automatic data filling function using XML-based (extended Markup Language) files generated by HIS. This new specification would decrease the time needed for physicians and pharmacists to fill the spontaneous ADR reports. By clicking a button, the report is sent to the text database through Simple Mail Transfer Protocol (SMTP) electronic mails. The destination of the report mail can be changed arbitrarily by administrators, which adds this system more flexibility for practical operation. Although we tried our best to use the SGML-based (Standard Generalized Markup Language) ICH M2 guideline to follow the global standard of the case report, we eventually adopted XML as the output report format. This is because we found some problems in handling two bytes characters with ICH guideline and XML has a lot of useful features. According to our pilot survey conducted at the University of Tokyo Hospital, many physicians answered that our idea, integrating ADR reporting system to HIS, would increase the ADR reporting numbers.

Adverse Drug Reaction Reporting Systems↗
PubMed2003

A Web-based patient information system--identification of patients' information needs.

Research described here was carried out to explore possibilities of creating a web-based patient information system within the areas of thoracic surgery. Data were collected to distinguish and assess the actual information needs of patients (1) prior to surgical treatment, (2) before discharge, and (3) 8 months after the hospitalization using a follow-up questionnaire. Interviews were performed with patients undergoing heart surgery. The study included material of 19 consecutive patients undergoing coronary artery bypass surgery (12) and valve replacement (7), age 35-74, 13 males and 6 females with nonacademic background. Patient satisfaction with given information was high. Analysis of the interviews held at the hospital resulted in seven different categories describing and giving a picture of the patients' information needs and apprehension of received care. The results found in this study can be used as guidance for developers in their design and development process of a health information system.

Adult↗
PubMed1994

Interfacing a stand-alone diagnostic expert system with a hospital information system.

Few diagnostic decision-support systems are in routine clinical use, mainly because these systems typically require time-consuming manual data entry. This research investigated the feasibility of reducing manual data entry by integrating a stand-alone diagnostic expert system with an existing comprehensive hospital information system (HIS). A knowledge-based intervocabulary mapping technique was developed to map disparate vocabularies. The results of a retrospective study indicate that transferring clinical data from the HIS to the diagnostic expert system at the beginning of workup significantly reduces the manual data entry required for generating the correct diagnoses for patients.

Diagnosis, Computer-Assisted↗
PubMed2005

3LGM(2)-Modelling to Support Management of Health Information Systems.

Both regional health information systems and hospital information systems need systematic information management. Due to their complexity information management needs a thorough description or model of the managed HIS. The three layer graph based meta model (3LGM(2)) and the 3LGM(2) tool provide means for effectively modeling HIS. The 3LGM(2) tool has been used to build a model of the health information system of the German federal state Saxony. The model is not only used to support the further development of the Saxonian health information system but also for supporting strategic information management planning in the medical center of Leipzig University. Acceptance of the method depends strictly on its integration in management structures on the institutional, regional, national or even European level.

Disease Management↗
PubMed2005

A parent-driven, computer-based vaccine information system: addressing variability in information needs for the varicella vaccine.

OBJECTIVE: To determine the variability of parental interest in the depth of detail provided regarding vaccine information. PARTICIPANTS AND METHODS: We performed a cross-sectional, observational study in a primary care pediatric practice from September 1 to September 30, 1995. We provided each participant an opportunity to use a self-directed, computer-based information system using the varicella vaccine as a prototype. The system covered 7 topics regarding the vaccine and offered 5 stages of information, ranging from general, indisputable information at stage 1 to less common, potentially unresolved details at stage 5. Parents viewed stage 1 information for each topic. Parents would then choose to either view more stages or view the next topic. RESULTS: Of 130 parents visiting the pediatric practice, 112 (86%) agreed to participate. We found substantial variability in the amount of information sought. Some parents stopped with stage 1 information (15%-45%, depending on the topic), whereas others indicated they would seek more information beyond the fifth stage (2%-14%). Overall, parents reported high satisfaction with the system. CONCLUSION: Quantifiable variability exists in parents' requirements for vaccine information, and our information system addresses this issue.

Adult↗
PubMed2002

Automated production of an on-line laboratory reference manual from a laboratory information system.

Laboratories provide information beyond test results, including information related to patient preparation, specimen collection and handling, test methodology, test availability, and interpretation of results. Most laboratories publish reference manuals to distribute this information to clients, while relying on the laboratory information system to provide this information to laboratory staff. Maintaining duplicate sources of information is expensive and error-prone, and printed materials become rapidly outdated. We developed a process to automate the production of a web-based reference manual directly from the laboratory information system, using a combination of MUMPS programs and HTML templates. We now focus our resources to assure that the laboratory information system database is accurate and complete, and then with minimal additional effort or expense produce an up-to-date on-line reference manual. We are therefore able to provide better sources of information in a sustainable manner.

Clinical Laboratory Information Systems↗