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At least 1,243 records · Page 69Linked to original sources
PubMed2003

Enterprise PACS and image distribution.

Around the world now, because of the need to improve operation efficiency and better cost effective healthcare, many large-scale healthcare enterprises have been formed. Each of these enterprises groups hospitals, medical centers, and clinics together as one enterprise healthcare network. The management of these enterprises recognizes the importance of using PACS and image distribution as a key technology in cost-effective healthcare delivery in the enterprise level. As a result, many large-scale enterprise level PACS/image distribution pilot studies, full design and implementation, are underway. The purpose of this paper is to provide readers an overall view of the current status of enterprise PACS and image distribution. reviews three large-scale enterprise PACS/image distribution systems in USA, Germany, and South Korean. The concept of enterprise level PACS/image distribution, its characteristics and ingredients are then discussed. Business models for enterprise level implementation available by the private medical imaging and system integration industry are highlighted. One current system under development in designing a healthcare enterprise level chest tuberculosis (TB) screening in Hong Kong is described in detail.

Computer Communication Networks↗
PubMed1996

Integrating public health information and surveillance systems.

The Centers for Disease Control and Prevention (CDC) recognizes sound public health information is the essential ingredient of all of its work and the key to effective public health decision making. A CDC/ATSDR committee reached a consensus that CDC needed to streamline and consolidate its public health surveillance and information systems into an integrated system. With integrated systems, a wide range of diverse individual information systems will continue to exist but these systems must be coordinated, interconnected, comparable, and easy to use. The "glue" that holds these systems together consists of (1) uniform data standards, (2) communications networks, and (3) policy-level agreements regarding data access, sharing, and reduction of data collection burdens. By putting the appropriate policy-making apparatus and resources in place, CDC believes the end result will be a streamlined process that meets the information needs of CDC and its partners with less confusion and frustration.

Humans↗
PubMed2001

A method to maintain introduced DNA sequences stably and safely on the bacterial chromosome: application of prophage integration and subsequent designed excision.

By application of prophage integration and subsequent intended excision, a method to maintain an introduced DNA sequence stably onto a bacterial chromosome has been proposed. Recently-constructed integration plasmids using Campbell-type prophage integration system in Lactobacillus casei strain Shirota and its temperate phage phi FSW was modified for this purpose and a chloramphenicol (Cm)-resistance gene was used as a model passenger DNA. On the integration plasmid having an erythromycin (Em)-resistance gene as a selection marker, N- and C-terminally-truncated Cm-resistance genes were inserted into both sides of the attP of phi FSW, within which the site-specific recombination took place with the attB of phi FSW on the recipient chromosome through the phi FSW integrase. Primary integrants of the modified plasmid (integration-excision vector) exhibiting Em-resistant and Cm-sensitive phenotype generated Em-sensitive and Cm-resistant derivatives under the nonselective conditions. Sequence analyses showed that one copy of the complete Cm-resistance gene resided at the attachment site on the host chromosome and the other vector-derived sequences were excised probably by endogenous homologous recombination in the host cells to derive final integrants. The Cm-resistant phenotype of the final integrants was stable for more than 50 generations under non-selective conditions. Frequency of the homologous recombination suggests that negative selection is also adoptable. Thus, this method using the integration-excision vector gives a stable and safe derivatives of the strain and is likely to be applicable to various bacteria, since Campbell-type prophage integration system and homologous recombination are prevalent among bacteria.

Bacteriophages↗
PubMed1997

Leukocyte filtration of single-donor platelet units through an integrated filter system for the Fresenius AS 104 blood cell separator.

BACKGROUND AND OBJECTIVES: White cell depletion of platelet concentrates is widely applied to reduce the incidence of transfusion complications. We investigated a new plateletpheresis kit with an integrated filter for leukocyte depletion of platelets. MATERIALS AND METHODS: Parameters of product quality were investigated before and after in-line filtration of 70 single-donor platelet (SDP) units obtained by apheresis. We studied three different filter batches manufactured for the Fresenius AS 104 blood cell separator, and evaluated different softwares and interface positions with respect to platelet (PLT) yield and white blood cell (WBC) contamination. RESULTS: PLT yields before and after filtration was not statistically different in the protocols studied. WBC contamination after WBC depletion was in the range of 10(4)/SDP unit. Glucose, lactate dehydrogenase, and the morphology score were not statistically different before and after filtration. CONCLUSIONS: In-line WBC filtration of SDP units sufficiently reduced WBC below 5 x 10(6)/unit. The study allowed definition of the filter composition and apheresis parameters to optimize PLT yield and minimize WBC contamination.

Filtration↗
PubMed2002

Integration mechanisms and hospital efficiency in integrated health care delivery systems.

This study analyzes integration mechanisms that affect system performances measured by indicators of efficiency in integrated delivery systems (IDSs) in the United States. The research question is, do integration mechanisms improve IDSs' efficiency in hospital care? American Hospital Association's Annual Survey (1998) and Dorenfest's Survey on Information Systems in Integrated Healthcare Delivery Systems (1998) were used to conduct the study, using IDS as the unit of analysis. A covariance structure equation model of the effects of system integration mechanisms on IDS performance was formulated and validated by an empirical examination of IDSs. The study sample includes 973 hospital-based integrated health care delivery systems operating in the United States, carried in the list of Dorenfests Survey on Information Systems in Integrated Health care Delivery Systems. The measurement indicators of system integration mechanisms are categorized into six related domains: informatic integration, case management, hybrid physician-hospital integration, forward integration, backward integration, and high tech medical services. The multivariate analysis reveals that integration mechanisms in system operation are positively correlated and positively affect IDSs' efficiency. The six domains of integration mechanisms account for 58.9% of the total variance in hospital performance. The service differentiation strategy such as having more high tech medical services have much stronger influences on efficiency than other integration mechanisms do. The beneficial effects of integration mechanisms have been realized in IDS performance. High efficiency in hospital care can be achieved by employing proper integration strategies in operations.

Cross-Sectional Studies↗
PubMed1995

Rehabilitation services in an integrated delivery system.

For rehabilitation providers, managed care means cutting costs 20 percent to 40 percent and responding to a major shift from acute inpatient rehabilitation to subacute, outpatient, and home-based services. By becoming more efficient and joining integrated networks, rehabilitation providers can participate in the continuum of care and align their economic incentives with other providers and HMOs. But in this month's Director's Notebook, rehabilitation leaders also worry that the shorter lengths of stay they must impose could compromise patient recovery.

California↗
PubMed2004

Integrated health system for chronic disease management: lessons learned from France.

Rated number one in overall health system performance by the World Health Organization, the French spend less than half the amount on annual health care per capita that the United States spends. One contributing factor may be the attention given to chronic care. Since the mid-1900s, the French have developed regional community-based specialty systems for patients with chronic respiratory insufficiency or failure. COPD is the major cause of respiratory failure, the fourth leading cause of death in the United States, and its prevalence is increasing. Despite the clinical success of home mechanical ventilation and the potential for cost savings, providing such services in the United States remains a challenge. Lessons from France can inform the development of cost-effective chronic care models in the United States In this article, we review the French experience in the context of the United States Supreme Court's Olmstead decision, mandating that people in "more restrictive settings" such as nursing homes be offered community-based supports. We suggest that regional demonstration projects for patients with chronic respiratory failure or insufficiency can provide an important step in the development of effective chronic care systems in the United States

Aged↗
PubMed1997

Integrated delivery systems and the gastroenterologist.

This article describes the current managed care environment for gastroenterologists, and also explains the various merger and networking options that are currently available. The article contains a detailed discussion of regional versus national merger options. Specific integration models are outlined for forming a regional, single-specialty, gastroenterology network.

Delivery of Health Care, Integrated↗
PubMed1994

A networked patient-based integrated care system as a basis for the achievement of quality in practice.

Traditionally, telematics initiatives have mainly been used to link patients with specific conditions to monitoring services located in acute hospitals. However, latest application of telematics to the networking of integrated electronic records for ambulatory or community care has great potential to measure and assure the quality of health care delivery to a large sector of the population in a structured and comprehensive way. This paper categorizes the major quality opportunities of a pioneering initiative now achieving operational status.

Computer Communication Networks↗