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At least 1,189 records · Page 66Linked to original sources
PubMed2005

[Legal aspects of health telematics].

Specific legal issues arise from the distance of the participants in health telematics. Substandard care not meeting the state of the art can yield malpractice litigation, especially if a diagnosis or therapy conveyed via telematics proves to be deficient. On the other hand, communication deficiencies may bring about a reversal of the burden of proof. If the patient's damage can not be attributed to the responsible person due to the division of labour, a joint liability is likely to be adjudicated. A specific legal risk analysis is required as a basis for a risk-adequate design of any application in health telematics.

Computer Communication Networks↗
PubMed2005

[The telematic platform trial concept. An attempt at definition and clarification].

A telematic platform provides a comprehensive infrastructure for communication of health data among several participants in the health care system. The planned introduction of the electronic health card and accompanying measures in 2006 is the first step towards the realisation of a telematic platform. The course for further development of the platform will be set during this important initial phase.

Computer Communication Networks↗
PubMed2005

[Economic aspects of health telematics].

The economic aspects of the health telematics must be considered from two points of view. The administrative applications are suitable as start-applications, because their data structures and processes are well known, and the calculation of the individual monetary effects have a solid empirical basis. However, only the medical applications will exhaust the real potential of health telematics and only these applications will justify the political and financial effort involved.

Computer Communication Networks↗
PubMed2005

[Health telematics projects in the perspective of the German federal states].

Starting in autumn 2005 with pilot projects, the new German electronic health card (EHC) and electronic health professional cards (HPC) will be implemented in the German health system. These cards are constituents of the full coverage networking of more than 120,000 doctor's practices, 22,000 pharmacies, 2,200 hospitals and 300 health insurance companies. The functions of the EHC, for example electronic prescriptions, the digital medication recording and the European emergency database, need both the interactions with the HPCs and with a complex network of IT systems and telecommunication services, i. e. with a comprehensive health telematics infrastructure. Model regions for the construction of a telematics infrastructure have been established in numerous federal states, e. g. Baden- Wurttemberg, Bavaria, Bremen, Lower Saxony, North Rhine-Westphalia, Rhineland-Palatinate, Saxony and Schleswig-Holstein, and also recently in Mecklenburg-Vorpommern and Brandenburg. These model regions are designed in a way that allows smooth integration of the specifications of the so-called solution architecture of the EHC and also of electronic HPCs as soon as these are available. The implementation of first pilot trials in the model regions, each with 10,000 insured, is planned for the second half of 2005. A project task force was founded by a group from the German federal states in December 2004. The objective of these implementations is to establish a fully networked health system providing patients various e-Health applications which can be used any place and any time.

Computer Communication Networks↗
PubMed2005

[European perspectives of health telematics].

The European perspectives of the present German developments in the field of health telematics are discussed critically. It is pointed out that technical projects have been financed with considerable means in the EU, however with out having any lasting effect on the value of health telematics in the health systems of Europe. A decisive cause is that the "health" topic was not codified in the Roman contracts. The international, global market is a crucial factor for international development and thus also for the orientation of the German projects and their economical and political success. The USA plays a dominant role on the global market. Caused by different reasons a corresponding market potential in the EU cannot be expected in the foreseeable future. With regard to the new options provided by telematics, it is therefore recommended that the national health services be reorganized, thus increasing quality and efficiency. With regard to progressively individualized medical care, the subject of "health" should afterwards be included in the European contracts. In the long run, an adjustment of the systems and uniform use of telematics could be achieved. Till then the coordination between the national governments in the area of health politics is seen as the most effective means for European integration.

Computer Communication Networks↗
PubMed2005

[Electronic health professional cards as indispensable elements of the upcoming health telematics infrastructure. Interactions with electronic patient data cards].

The German law for the modernization of statutory health care defines a functional framework for the upcoming telematics infrastructure in health care based on electronic health professional cards, electronic patient data cards and the necessary information, communication and security infrastructure. The currently ongoing discussion for the implementation is strongly influenced by diverse particulate interests often hindering systematic development. This article presents the fundamental technical mechanisms usable for a stepwise and expandable solution. The interdependence of the components is illustrated using the example of the ATG concept for an electronic patient record. These facts call for a stepwise implementation of telematic infrastructure based on the presented mechanisms.

Computer Communication Networks↗
PubMed2005

[Telematics and quality. Implementation of a telematic platform in Hamburg].

Since the end of the year 2000 a group of interested people has been working on the subject of quality improvement in breast cancer. Within this framework the project "improvement of breast cancer treatment by telemedicine" was started. Based on a workflow analysis and interviews with patients as well as health professionals, it turned out that there are gaps and flaws in the communication process. These problems occurred between health professionals involved in the treatment of patients and between health professionals and patients as well. As a result a telemedicine network has been developed which is based on MPLS technology. Within this network a central communication unit facilitates optimization of the workflow for the treatment of breast cancer. It will also be possible to set up groups for integrated care. Currently the system is being evaluated in specific breast centres in Hamburg. As the net is based on a positive business plan, it can be foreseen that a broad implementation will follow.

Breast Neoplasms↗
PubMed2005

[The introduction of the electronic health card in Germany].

From 2006 onwards all members of the health insurance system in Germany will be issued an electronic health card which will replace the current health insurance card. The new health card will be technically upgraded to also include patient-related health data or provide access to such data in addition to its administrative functions. Therefore, it is evident that the health card be fitted with a microprocessor that permits authentication (electronic identity check), encryption and the electronic digital signature, thus ensuring maximum data safety and security. For easy identification of the insured person, the electronic health card will bear a photograph of the card holder.

Computer Communication Networks↗
PubMed2005

[Electronic health records in Germany].

Electronic health records (EGA), as overall medical applications for the documentation of medical information under the guidance and sovereignty of the patient, change the traditional doctor-patient relationship. Unlike the electronic patient record (EPA), which the treating physician is in charge of, the patient has the sole right to decide who may insert which data into it and who may see his electronic health record (EGA). Thus, the patient's right of informational self-determination and his possibilities to get involved in the treatment process are substantially strengthened. The current situation of the EGA in Germany is described and the parallel development of EGA and EPA is discussed. The electronic health record acquires extensive significance, especially in line with the imminent introduction of the electronic health card on the basis of a standardised telematics infrastructure in Germany.

Computer Communication Networks↗
PubMed2002

Information management and reading habits of German diabetologists: a questionnaire survey.

AIMS/HYPOTHESIS: Journals play an important part in continuing medical education and in influencing the prescription of drugs. Because little is known about reading habits and information management of specialists a questionnaire survey among German diabetologists was conducted. SUBJECTS AND METHODS: A non-randomised sample of 461 German diabetologists was selected from a database of German diabetologists ( n=1585). A questionnaire was developed (92 items) which consisted of eight sections: continuing education in general, decision making and problem solving, use of databases, reading habits, knowledge of technical terms and critical appraisal skills, personal data. RESULTS: The adjusted response rate was 57% (crude 52%). Most influential factors for therapeutic decision making were due to own experience, continuing education events, published material, and colleagues. The influence of industry related factors was perceived low. A relatively high rate of respondents (39%) perceived the influence by patients as rather low. Overall 90% had convenient access to the internet, MedLine or EMBASE but only 45% searched databases regularly (three searches per month). Median time for reading journals was 3 h a week. Five journals were read regularly, 25% of which were diabetological journals and 47% of the respondents did not read English written journals regularly. The methods section of an article was seldom read whereas the abstract and the discussion were almost always read. Most respondents had some understanding of technical terms but reported practices of appraising articles were inadequate. CONCLUSION/INTERPRETATION: It could be shown that reading expenditures and critical appraisal skills of diabetologists are slightly higher compared with non-specialists. But the concept of evidence-based medicine still does not seem to be incorporated in clinical practice.

Diabetes Mellitus↗
PubMed2001

Telemedicine in pediatric surgery.

Telemedicine is a new academic specialty at the crossroads of medical informatics whose potential is still largely untapped by pediatric surgeons. Telemedicine aims to alleviate travel concerns associated with the delivery of health care, to bring expert pediatric surgeons to areas where currently none exist, and to improve coordination between pediatric surgeons, transcending all barriers. Today, it is possible to transmit all digitized data--roentgenograms, echocardiograms, radiologic images, intraoperative photographs, histologic images, etc., and to consult specific experts in the subspecialties of childcare. It is possible to train and guide surgical trainees by experts without their physical presence. In the future, telemedicine will constitute an integral part of the health care of children and the training of pediatric surgeons.

Child↗
PubMed2006

Models for guideline representation.

Despite the great emphasis that the medical community has dedicated to clinical practice guidelines in the last few decades, it has become clear that it is difficult to adequately distribute texts (paper-based guidelines) and for them to be used by final users. The reasons for this are manifold: the large number of guidelines delivered each year, their necessary updates on the face of new scientific evidence, the text is not always free from ambiguities, etc. When these problems became evident, the medical informatics community hypothesised that more formal electronic versions would increase the probability of the effective diffusion of guidelines and also physicians' compliance to them. This claim was based on a few hypotheses: one is that formal models, such as flowcharts or other graphical metaphors, provide a more friendly and immediate way of reading a guideline, thus improving learning and absorbing of the guideline content (e. g. using formal models as educational/simulation tools); another hypothesis is that formal models allow easier guideline integration with the daily clinical workflow, raising the possibility of building real-time decision support systems, which again should improve physicians' compliance. This paper focuses on the issues that must be taken into account when modelling guidelines to ensure their effective implementation in real-world computerised environments.

Computer Simulation↗
PubMed2005

Can we trust cancer information on the Internet?--A comparison of interactive cancer risk sites.

OBJECTIVE: To investigate the prevalence and quality of interactive cancer risk sites on the Internet. METHODS: A cancer risk site was defined as a website that gave an estimate of the individual risk of developing cancer. Six search engines and one Meta crawler were used to search the Internet for cancer risk sites (including breast, prostate, colon, and lung cancer). A set of defined quality criteria for health related websites was used to evaluate the websites during 2001 and 2002. RESULTS: The number of cancer risk sites, as defined above, increased by 50% between 2001 and 2002. Only two out of 22 cancer risk sites fulfilled the quality criteria adequately. No signs of a change in trend (with regard to the quality criteria met) were noted in January 2005. CONCLUSIONS: The overall quality of the documentation on the cancer risk sites was poor and no improvement was seen during the study period. The majority of the cancer risk sites do not give reliable risk estimates.

Humans↗
PubMed1999

Web alert.

Explore the source record for details and available documents.

Complementary Therapies↗
PubMed1992

Dimensions of knowledge sharing and reuse.

Many workers in medical informatics are seeking to reuse knowledge in new applications and to share encoded knowledge across software environments. Knowledge reuse involves many dimensions, including the reapplication of lexicons, ontologies, inference syntax, tasks, and problem-solving methods. Principal obstacles to all current work in knowledge sharing involve the difficulties of achieving consensus regarding what knowledge representations mean, of enumerating the context features and background knowledge required to ascribe meaning to a particular knowledge representation, and of describing knowledge independent of specific interpreters or inference engines. Progress in the area of knowledge sharing will necessitate more practical experience with attempts to interchange knowledge as well as better tools for viewing and editing knowledge representations at appropriate levels of abstraction. The PROTEGE-II project is one attempt to provide a knowledge-base authoring environment in which developers can experiment with the reuse of knowledge-level problem-solving methods, task models, and domain ontologies.

Artificial Intelligence↗
PubMed1994

A database schema for public-domain medical software.

The quantity of public-domain medical software available is huge, and a classification schema may be therefore helpful. We developed a schema that includes identification data (name of the software, author, etc.), description (hardware and software requirements), classification (software category, application domain, etc.) and evaluation data (external quality and internal quality factors). The schema was tested on the public-domain software available at the SCAMC meetings (about 36 Mb). We also classified the software by employing students from a master course in computer science and medical informatics. We stored the high quantity of information collected in a database we developed using Paradox.

Databases, Factual↗
PubMed1991

Status and progress of hospital information systems (HIS).

Expectations for hospital information systems (HIS) have yet to be realized. Requirements have been defined by the International Medical Informatics Association, health care futurists, and others. With a volatile marketplace and evolving technologies, computerization has been a non-trivial task. However, recent advances in architecture and communication standards promise to make networking possible. In addition, the development of professional workstations and of computer-based patient records linked to new tools and applications can transform health care. For HIS to realize these expectations, however, technology assessment and outcome analysis must play critical roles.

Hospital Information Systems↗