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Taking inventory.

The eighth annual Most Wired Survey and Benchmarking Study is ready for the taking. It's an opportunity to get a comprehensive view of your hospitals IT systems and see how you stack up against your peers.

Benchmarking↗

Built to crash.

The first article in our IT cover package looks at how hospitals often invest huge sums of money on the latest clinical technology, but fail to build the infrastructure to support it. In the second article,"Digital Docs," Senior Editor Matthew Weinstock examines the growing trend among hospitals to hire physicians to lead their clinical IT efforts.

Decision Making, Organizational↗

[Review of the development of ophthalmic informatics].

Digitized information technology, which is rising and permeating into other scientific domains, is a major trend of contemporary science development. The overlap between ophthalmology and informatics creates ophthalmic informatics, a new and developing discipline. Ophthalmic informatics utilizes the computer as the primary tool and with the aid of ophthalmic knowledge, develops a system to analyze patient data and evaluates the accuracy of the system. It also provides a new method for the development of traditional ophthalmology. In order to let more ophthalmologist to handle the knowledge of ophthalmic informatics and to use it in the practice, this article carries a comprehensive review of ophthalmic informatics, with emphasis on the principle, content and method of ophthalmic informatics. Some relevant studies on ophthalmic informatics in China in recent years are enumerated, as well as the basic frame for studying ophthalmic informatics.

Medical Informatics↗

Informatics tools to improve clinical research.

During the conduct of complex clinical trials, there are numerous sources and types of data collection and project coordination problems. Methods and approaches to address the conduct of a trial vary in both the cost and time to perform and the potential benefit. Informatics tools can help trial coordinators and investigators ensure the collection of high quality research data during all phases of a clinical trial.

Clinical Trials as Topic↗

Evaluating the web as a clinical knowledge base.

Medical diagnostic decision support systems are some of the most visible applications of medical informatics. Many of these systems, however, were created in the pre-WWW era, when access to clinical knowledge was much more limited than it is currently. Using the Google(tm) Java API1, we created a simple program to extract potential diagnoses from a general web search. Our system performed at a level comparable to other medical expert systems.

Algorithms↗

Developing a framework for conducting economic evaluations of community-based health information technology interventions.

This study describes a framework for conducting economic analyses for health information technology (HIT) interventions, in the context of three interventions that are currently being implemented in a community-based health network caring for 17,779 Medicaid beneficiaries in Durham County, North Carolina. We show that if the HIT interventions were to redirect only 10% of low-severity emergency room encounters to outpatient care, it will result in $12,523 of monthly savings.

Ambulatory Care↗

Technological and administrative factors implementing a virtual human biospecimen repository.

The value of human biospecimens available for research dramatically increases when linked with their accumulated clinical and molecular (genomic, proteomic, subcellular modeling) data. Further, informatics tools make it possible for researchers (both intra- and inter-institutionally) to locate tissue needed for research faster and more reliably. We are developing a virtual human biospecimen repository to both inventory and link all human biospecimens with clinical and genomics data to optimize their value for research, while satisfying all privacy and human subjects protections regulations.

Biological Specimen Banks↗

Health information exchange networks: understanding stakeholder views.

As the National Health Information Infrastructure (NHII) gains momentum, regional health information exchange networks are developing as a means to support this structure. While successful networks exist, their sustainability is complicated by the existence of multiple stakeholders with differing incentives for participation. Interviews conducted regarding the development of the NMESH network produced several key areas of stakeholder focus, an important step in creating network sustainability.

Delivery of Health Care↗

Information infrastructure for emergency medical services.

The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

Emergency Medical Services↗

Question analysis for biomedical question answering.

We are developing a biomedical question answering system. This paper describes our system's architecture and our question analysis component. Specifically, we have explored the use of various supervised machine learning approaches to filter out unanswerable questions based on physicians' annotations.

Artificial Intelligence↗

The path towards eHealth: obstacles along the way.

OBJECTIVES: The two authors of this article share both a strong interest in, and deep concerns about, the use of eHealth (electronic information and communication technologies for improving or maintaining health). In this article, we identify some unanticipated obstacles to effective use of eHealth. METHODS: We reflected upon the potential of information and communication technologies to transform the health system and its failure to achieve that potential. RESULTS: We chose seven obstacles: the insufficient emphasis on health in eHealth, the lack of time for reflection, the development of a fortress mentality, poor evaluation of efforts, lack of involvement of youth, inequity, and a parochial attitude that precludes economies of scale. Whenever possible, we provided examples of innovative initiatives that illustrate potential ways to meet our current challenges. CONCLUSION: We believe that the obstacles we describe in this article can be overcome. The impediments are not only technological, but also cognitive, financial and political. To succeed will require a major shift from our ethic of competition to one of generosity, commitment, and collaboration; enlightened, as opposed to narrow, self-interest.

Internet↗

e-Care integration: To meet the demographic challenge.

Current multi-agency models of care will be wholly unsustainable when faced with the forecast doubling of over 65s in the developed and developing nations to around 40% of their populations of the next decades. The resulting imbalance between demand and skilled resources is beginning to force radical change towards a fully "joined up" cross-disciplinary, cross-agency service that spans the wide spectrum of medical and social care. This paper offers a basis for a radically revised model that combines end-to-end service processes optimization; the use of integrated assistive technology systems to help the elderly maintain an independent lifestyle; personal risk reduction through medical and status monitoring; extended care-watch and service co-ordination. It then develops an IPTV based approach to provide the necessary infrastructure to underpin provision of these facilities both at home and in the community. These substantial benefits are reviewed and weighed against the inherent loss of privacy that can result from the pervasive computing aspects of the care watch approach, together with the trust building and change management aspects that are inevitably involved in the rationalisation process.

Activities of Daily Living↗

Managing chronic disease through home telehealth.

This article describes the use of telehealth to monitor chronic illness in a home setting. It discusses the state of the art in commercial telehealth systems as well as 3 research projects undertaken by the University of Minnesota's program in health informatics that explore the potential of home telehealth to aid in care of patients with chronic conditions.

Aged↗