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Results for “Systems Integration”

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At least 1,153 records · Page 64Linked to original sources
PubMed1993

The implementation of the composite health care system into total quality management in military medical treatment facilities.

The Composite Health Care System (CHCS) is a new medical computer system which will integrate into Total Quality Management (TQM) in Department of Defense hospitals. Both are examples of integrated systems which mandate a complete reshaping of the way the business of patient care is conducted. As a medical information management system, CHCS is an effective component of TQM and follows W. Edward Deming's TQM principles. With proper training, patience, and full support from end user and senior staff, CHCS and TQM can work together to maintain high quality standards for patient care in today's rapidly changing military medical service.

Database Management Systems↗
PubMedDate not supplied

Design and development of a new 193-nanometer excimer laser surgical system.

BACKGROUND: The 193-nanometer excimer laser is used for photoablative reprofiling of the cornea to correct refraction errors and to treat corneal pathologies. To use the unique properties of the excimer laser, some technical features should be provided by the excimer laser system. A new excimer laser system is presented. METHODS: The instrument has a fluence sensor for precise measurement of the actual fluence just before surgery, a new delivery system including an integrator system to homogenize the laser beam, a steelband with apertures and a zoom optic to get the desired form of central reprofiling, and an alignment system to reduce the possibility to decenter the optical zone. RESULTS: The fluence before surgery can be measured very precisely with the fluence sensor. The ablation zone size is at least 8 mm in diameter with a homogenous laser beam profile resulting in a smooth surface of the treated material. Different forms of ablations can be created using the steelband with different forms of apertures. The center of the ablation zone can be found using the alignment system. CONCLUSION: The new excimer laser system fulfills some important technical features for optimal use of the excimer laser in corneal surgery.

Cornea↗
PubMedDate not supplied

[Integrated data processing systems for a functional diagnostic service].

The paper discusses the problem of automation of the functional diagnostic service system on the basis of up-to-date informational technologies, gives recommendations on the minimum list of diagnostic procedures used for various service levels in medical institutions, outlines requirements for hard- and softwares needed for designing this system of integrated processing, provides specific recommendations on the structure of automatic complexes for the first two levels of functional diagnostic service.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Phosphodiesterase susceptibility of modified oligonucleotides studied in an integrated capillary electrophoresis system.

A capillary electrophoresis system that integrated an enzymatic reaction and capillary polymer sieving electrophoresis was used to check the enzymatic stability of oligonucleotides. Phosphodiesterase I was employed to assess the susceptibility to 3'-exonucleolytic breakdown of some unmodified and modified oligonucleotides. Before degradation, the purity of the synthetic oligodeoxynucleotides was checked by capillary electrophoresis with a replaceable hydroxyethyl cellulose polymer solution. Enzymatic breakdown was achieved inside the capillary by merging substrate and enzyme zones based on their difference in electrophoretic mobility. After reaction, oligonucleotide fragments were swept to the detector, where they were individually detected and the remaining substrate was quantified. The results from the in-capillary degradation were compared to an off-line incubation and separation.

Electrophoresis, Capillary↗
PubMed1995

Building consensus for integration.

Nearly one out of every three system integration efforts among healthcare organizations fails, and as many as nine of every ten fall short of expectations. Integration initiatives often prove unsatisfactory due to lack of attention to building consensus among all internal and external constituencies regarding the reasons for and objectives of an integration strategy. This article presents an organized plan for pursuing partnerships that pays careful attention to planning and consensus building. The plan is particularly applicable to most non-profit healthcare organizations.

Communication↗
PubMedDate not supplied

[Epidemiology of traffic accidents in the province of Trento: first results of an integrated surveillance system (MITRIS)].

OBJECTIVE: Different data sources are available for the surveillance of road traffic accidents. Taken separately all have important limits. Therefore the integration of medical and non medical data are essential for the construction of a surveillance system able to direct preventive and repressive actions. DESIGN: Cross sectional study. A computerized system for the rapid and precise unification of medical data with data collected by the police force has been realized. The model is embedded in a Geographic Information System (WebGIS), providing the facility for additional spatial data analysis and modelling. Maps of the spatial density of the accidents which consider also the severity of the injuries from a medical point of view have been developed. Risk factors associated with the severity of the injuries have been evaluated by uni- and multivariate statistical analysis. The statistical significance of the associations have been tested with Pearson's test. Confidential intervals of the Odds ratios were calculated with a probability of 95%. SETTING: Province of Trento, Italy. MAIN OUTCOME MEASURES: Number, dynamics and localization of road traffic accidents, activity of ambulance services, access to emergency departments and hospital admissions RESULTS: For 805/930 injured persons it was possible to link the medical data to those collected by the police forces. 111 (16%) accidents have been classified as severe (with hospital admission) and 694 as moderate (without hospital admission). The most important risk factors associated with the severity are represented by the frontal crash and by being a vulnerable road user (pedestrian, cyclist and motorcyclist), specially those <15 years of age. The classification of the most important sites of road traffic accidents in the Trento municipality was significantly modified by the integration of the medical data giving more importance to the more dangerous sites in terms of severity of the injuries. CONCLUSION: This study shows the feasibility of an integrated surveillance of road traffic accidents by using routinely collected data on a local basis.

Accidents, Traffic↗
PubMedDate not supplied

[The system of the integration of man with the environment].

Systemic integrity of man consists not only in comprehensive evaluation from the medical-biological and social standpoints-nothing can be said against that-but also in systemic approach to the environment he lives and acts in, -and not from the point of view of its investigation, which is in itself indisputable, but mainly in a final goal-control of the quality of the external environment through influence on economic structures and their functioning. It is a matter of ecological-hygienic optimization of economic structure according to toxicometric criteria. In view of the aforestated, it is suggested that a uniform regional ecologic-and-hygienic rating (standardization) of environmental factors be developed.

Ecology↗
PubMed2006

Three-way bipolar forceps: a novel bipolar coagulator system for nerve stimulation and detection of nerve potentials.

Preoperative characterization of brain anatomy by magnetic resonance imaging and intraoperative functional characterization of the nervous system is essential in patients undergoing radical resection of brain tumors. A novel integrated system was developed combining conventional bipolar forceps with an electric stimulator and an oscilloscope. The system consists of a mechanical switching circuit allowing a wide range of electric characteristics and was designed to perform intraoperative electrophysiological studies, including functional mapping and measurements of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs). This system achieved a significant reduction in exchange time (from 3.63+/-1.00 sec to 1.12+/-0.42 sec) between coagulation and stimulation, and reproducible measurement of MEPs from porcine limbs by cortical stimulation using the bipolar forceps. Functional mapping under awake craniotomy was carried out by cortical stimulation in patients with glioblastoma, and median nerve SEPs with high signal-to-noise ratio were elicited from the bipolar forceps on the sensory cortex of patients under general anesthesia. This integrated system is technically easy to operate and allows functional monitoring of an area that would otherwise be difficult to access using conventional methods. This three-way bipolar forceps system may reduce postoperative complications in patients undergoing neurosurgical procedures.

Adult↗
PubMed1994

Dimensions associated with successful implementation of a hospital based integrated order entry system.

Implementation of an integrated electronic medical record requires direct physician order entry. This application involves multi-level changes in the whole system of care, from physicians attitudes to interdepartmental relations. This study reports the results of the first round of a modified Delphi, where a diverse group of individuals were asked to identify the most important facilitating and impeding factors associated with implementation of an order entry application. From a Q-sort of their responses, we identified 20 systemic, behavioral, and attitudinal dimensions perceived to be causal factors in successful implementation. We also explored how these dimensions may influence success by comparing successful with unsuccessful hospitals in terms of the frequency with which these dimensions were differently mentioned by respondents. We found that although available functionality was the most commonly mentioned factor by all participants, hardware availability, physician involvement, administration support, and medical administration involvement were more often mentioned by successful hospitals than by less successful hospitals. These results suggest that these factors were not present in the less successful hospitals. We also found that the frequency of responses within each category varied depending on the institutional role of the individuals responding. Those involved in support tended to see organizational variables as more important than those in clinical positions, whereas clinicians viewed administrative support and involvement of the chief as more important. These findings support the notion that the changes involved in instituting a physician order entry system are system wide and involve individual as well as organizational factors.

Attitude of Health Personnel↗
PubMed1997

Ataxia and altered dendritic calcium signaling in mice carrying a targeted null mutation of the calbindin D28k gene.

Intracellular calcium-binding proteins are abundantly expressed in many neuronal populations. Previous evidence suggests that calcium-binding proteins can modulate various neuronal properties, presumably by their action as calcium buffers. The importance of calcium-binding proteins for nervous system function in an intact integrated system is, however, less clear. To investigate the physiological role of a major endogenous calcium-binding protein, calbindin D28k (calbindin) in vivo, we have generated calbindin null mutant mice by gene targeting. Surprisingly, calbindin deficiency does not affect general parameters of development and behavior or the structure of the nervous system at the light microscopic level. Null mutants are, however, severely impaired in tests of motor coordination, suggesting functional deficits in cerebellar pathways. Purkinje neurons, the only efferent of the cerebellar cortex, and inferior olive neurons, the source of the climbing fiber afferent, have previously been shown to express calbindin. Correlated with this unusual type of ataxia, confocal calcium imaging of Purkinje cells in cerebellar slices revealed marked changes of synaptically evoked postsynaptic calcium transients. Their fast, but not their slow, decay component had larger amplitudes in null mutant than in wild-type mice. We conclude that endogenous calbindin is of crucial importance for integrated nervous system function.

Animals↗
PubMedDate not supplied

Integrated delivery systems: mergers and acquisitions.

Mergers and acquisitions are usually the way an IDS is built. The CNO and/or CNOs/DONs have an integral role in the resolution of the M/A process. During this time of significant change, during which there may even be chaos, the CNOs work to maintain stability so there is as little impact as possible on patient outcomes, a core responsibility of the CNOs. The CNOs should focus on identifying and working with the highly skilled individuals in the organization to get to the recovery stage of the M/A process, at which time a high-performing organization is achieved. To build this new organization or IDS, the old organizations of the M/A must be changed (Moss Kanter, 1994). The successful CNOs will manage the trade-offs and will become experts in collaboration. The CNO's goals are to maximize the quality of patient care, the professional satisfaction of the nurse, and the goals of achieving cost effectiveness for the system (Clifford, 1998), and keeping this focus through the M/A process will yield success.

Cooperative Behavior↗
PubMed2004

Assessing what child health information systems should be integrated: the Michigan experience.

This project examined which child health data would be appropriate and useful to integrate with an existing real-time Michigan Department of Community Health (MDCH) application, such as the Michigan Childhood Immunization Registry. A consultant was secured to conduct data gathering analysis activities. An advisory committee of MDCH Administrators convened to guide the project. Interviews were conducted with MDCH administrators, program managers and representatives from the public and private health care provider community. These interviews focused on answering three main questions: (1) What MDCH data resources do you currently use? (2) How do you use and access these data? and (3) What is your vision for expanding, enhancing, and linking these data to meet Michigan's future health goals? Acceptance of the Michigan Childhood Immunization Registry by the pediatric and family practice community demonstrates the utility of providing more information electronically to the medical community in Michigan. The MDCH has completed a stakeholders analysis and is moving forward with requirements gathering sessions in order to create an integrated child health data system. The integrated child health data system will include data from immunizations, newborn screening, newborn hearing, lead, the Women, Infants, and Children program, and Medicaid.

Child↗