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At least 1,261 records · Page 70Linked to original sources
PubMed2003

Regional repositories, reintermediation and the new GMS contract: cardiovascular disease in Tayside.

BACKGROUND: The new contract for general medical practitioners will make increasing demands on the primary care informatics community. There are a number of potential ways to provide reports which meet the requirements for data on the quality of care being provided by practices. In Scotland there are four components of the national information technology strategy which make meaningful comparisons of data possible. OBJECTIVE: Using cardiovascular data as an example, to describe how the community health index number, managed clinical networks (MCNs), increasing consistency of Read codes, and regional repositories of data make the acquisition, processing and use of data more straightforward. METHOD: The cardiovascular MCN collects the majority of its data electronically and four properties are crucial to its success: automatic collection of electronic data from many sources, prioritisation of data derived from multiple sources, record linkage processes, and manual validation of electronic data. RESULTS: Clinicians in primary and secondary care enter data during consultations and see the results of consultations recorded elsewhere. Because all data from the region are able to be Read coded according to prespecified templates, we are able to indicate to practices where they are in relation to the new contract targets and indicate which patients need to be seen, or excluded from, calculations. CONCLUSION: Effectively integrated management is facilitated by provision of regular prompted recall and review of people with chronic disease by multidisciplinary teams collaborating across the health service and into the community. In Scotland, use of newer informatics tools are proving to be useful contributions from primary care computing to equitable, evidence-based care.

Cardiovascular Diseases↗
PubMed2002

Public health, GIS, and spatial analytic tools.

We review literature that uses spatial analytic tools in contexts where Geographic Information Systems (GIS) is the organizing system for health data or where the methods discussed will likely be incorporated in GIS-based analyses in the future. We conclude the review with the point of view that this literature is moving toward the development and use of systems of analysis that integrate the information geo-coding and data base functions of GISystems with the geo-information processing functions of GIScience. The rapidity of this projected development will depend on the perceived needs of the public health community for spatial analysis methods to provide decision support. Recent advances in the analysis of disease maps have been influenced by and benefited from the adoption of new practices for georeferencing health data and new ways of linking such data geographically to potential sources of environmental exposures, the locations of health resources and the geodemographic characteristics of populations. This review focuses on these advances.

Cluster Analysis↗
PubMed2004

Case analysis online: a strategic management case model for the health industry.

Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

Education, Graduate↗
PubMed2006

Integrated electronic health records management system.

Computer systems and communication technologies are making a strong and influential presence in the different fields of medicine. The cornerstone of a functional medical information system represents the electronic health records management system. Due to a very sensitive nature of medical information, such systems are faced with a number of stringent requirements, like security and confidentiality of patients' related data, different media type's management, diversity of medical data that need to be processed etc. At present most clinical software systems are closed with little or no operability between them, and the medical information are locked in a variety of different incompatible databases. As the result of these facts, it is very hard for the developers to provide the solution for an integrated health computing environment, which would considerably improve the quality of medical care in general. This paper presents the framework for a functional EHR management system that meets these demands, but also follows the initiative taken by the Next Generation Network (NGN) approach, which includes user mobility, service transparency and common communication platform for transferring and serving different types of information, services and media.

Computer Communication Networks↗
PubMed2025

Implementation of a Face-To-Face Vs Virtual Peer-Integrated Collaborative Care Intervention for Mental Health Treatment of Physical Trauma Survivors: A Qualitative Study of Lessons from the COVID-19 Pandemic.

OBJECTIVE: We assessed the impact of the COVID-19 pandemic on the implementation of a peer-integrated enhancement of integrated clinical care intervention to address the mental health needs of 450 patients undergoing treatment for a physical injury. METHODS: Qualitative data were collected by 7 clinician investigators of a randomized controlled trial acting as participant observers in a trauma care setting of a major U.S. metropolitan hospital and analyzed in collaboration with an external mixed methods specialist. RESULTS: The pandemic created or exacerbated several implementation barriers, including increased risk of infection, homelessness, hospitalizations and comorbid conditions such as fentanyl overdoses that increased demand on emergency department and Trauma Center services, imposition of safety measures to reduce risk of infection in clinical settings, transition from face-to-face to virtual interactions with study patients, shortages of specialty mental health providers, suspension of recruitment of patients into the study, scheduling calls with patients, and an increased workload for the study clinical interventionists. Peer specialists perceived the transition to virtual interactions with patients reduced their effectiveness; however, this was not reflected in assessments of patient satisfaction with services received and may have inadvertently increased adoption by Trauma Center staff. Reduction in reach of the intervention to target population was temporary. CONCLUSIONS: The COVID-19 pandemic exacerbated existing barriers and created new barriers to successfully implementing evidence-based practices in trauma care settings, resulting in an attenuation of their effectiveness. However, the shift from face-to-face to virtual services delivery may have actually led to improved implementation outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03569878. Registered June 15, 2018.

Humans↗
PubMed2002

Disease transmission models for public health decision making: toward an approach for designing intervention strategies for Schistosomiasis japonica.

Mathematical models of disease transmission processes can serve as platforms for integration of diverse data, including site-specific information, for the purpose of designing strategies for minimizing transmission. A model describing the transmission of schistosomiasis is adapted to incorporate field data typically developed in disease control efforts in the mountainous regions of Sichuan Province in China, with the object of exploring the feasibility of model-based control strategies. The model is studied using computer simulation methods. Mechanistically based models of this sort typically have a large number of parameters that pose challenges in reducing parametric uncertainty to levels that will produce predictions sufficiently precise to discriminate among competing control options. We describe here an approach to parameter estimation that uses a recently developed statistical procedure called Bayesian melding to sequentially reduce parametric uncertainty as field data are accumulated over several seasons. Preliminary results of applying the approach to a historical data set in southwestern Sichuan are promising. Moreover, technologic advances using the global positioning system, remote sensing, and geographic information systems promise cost-effective improvements in the nature and quality of field data. This, in turn, suggests that the utility of the modeling approach will increase over time.

Bayes Theorem↗
PubMedDate not supplied

E-health & pharmaceuticals.

Drug firms are integrating technology into the continuum of care. They're enlisting physicians to use their technology in prescribing medications, reporting clinical data, and learning about new drugs. They're also building a loyal customer base, and they're doing it smartly.

Advertising↗
PubMedDate not supplied

Development of a computerized equipment management system using an IBAX health care system platform.

An integrated, computerized equipment management system based on a HIS platform can be developed with the cooperation of a hospital's data processing department. The goals and objectives for system development are based on the needs of individual departments. The resources available for meeting those goals and objectives vary from one institution to the next. When resources can be obtained from the data processing department, all the management tools and information needed by the technician can be readily available anywhere within the institution.

Biomedical Engineering↗
PubMed2005

Building a research consortium of large health systems: the Cancer Research Network.

Critical questions about cancer prevention, care, and outcomes increasingly require research involving large patient populations and their care delivery organizations. The Cancer Research Network (CRN) includes 11 integrated health systems funded by the National Cancer Institute (NCI) to conduct collaborative cancer research. This article describes the challenges of constructing a productive consortium of large health systems, and explores the CRN's responses. The CRN was initially funded through an NCI cooperative agreement in 1999 and has since received a second 4-year grant. Leadership and policy development are provided through a steering committee, subcommittees, and an external advisory committee. The CRN includes integral and affiliated research projects supported by a Scientific and Data Resources Core. Three characteristics of the CRN intensified the general challenges of consortium research: 1) its members are large health systems with legitimate concerns about confidentiality of data about enrollees, providers, and the organization; 2) CRN research projects often generate highly sensitive data about quality of care; and therefore 3) each participating organization wants a strong voice in CRN direction. CRN experience to date confirms that a consortium of health systems with internal research capacity can address a range of important cancer research questions that would be difficult to study in other venues. The advantages and challenges of consortium research are explored, with suggestions for the development, execution, and management of multisystem population laboratories.

Biomedical Research↗
PubMed1999

An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component.

Bayes Theorem↗
PubMed2001

The Norwegian approach to integrated quality development.

The UK NHS quality proposals require all NHS organisations to develop an "integrated approach " to quality. In other countries, health care organisations are also working to ensure that the many different quality methods and systems used in health organisations do not duplicate or conflict with each other. The question this paper addresses is "what would an integrated approach to quality look like and how might managers and clinicians develop such an approach in their organisation?" The findings from the Norwegian total quality management experiment in six hospitals were that TQM could not be applied in its pure form in public health care services to ensure integration. The paper draws on this research to describe these hospitals' approach to integrate the different projects and systems which were stimulated by their initial quality programmes. The paper describes the "integrated quality development" approach which characterised these programmes.

Critical Pathways↗
PubMedDate not supplied

Developing and implementing a relational database for heart failure outcomes in an integrated healthcare system.

A need to capture patient-specific data related to heart failure outcomes led to the development of a relational database to allow for data entry at the point of care. This database provided standardization of data collection at four of the system's acute care hospitals. The data are reported to the Heart Failure Clinical Effectiveness Team to track indicators for demonstration of best practice outcomes, internal benchmarking, and identification of opportunities for performance improvement on a healthcare system level. The database development, steps toward implementation, data collection tools, and the utilization of the outcomes data are discussed.

Databases, Factual↗
PubMed1992

Re-assessing disability: the impact of schistosomal infection on daily activities among women in Gezira Province, Sudan.

Schistosoma mansoni is often perceived by governments and international aid agencies to present a major public health problem in the tropical and sub-tropical world. This perception persists in spite of the fact that biomedical practitioners and research workers disagree about the nature and extent of disease and disability caused by schistosomes. This paper raises the question of whether S. mansoni should continue to be given priority as a public health problem in Gezira Province, Sudan. Biomedical and continuous observational data are blended with ethnographic information in order to develop a more integrated picture of the impact of S. mansoni on daily activity patterns among women. Research took place in one village in the Gezira/Managil irrigation scheme. The study is characterized by a small sample and a paired design. That is, 11 infected women were paired with 11 uninfected women. These women were engaged in agricultural activities in the cotton picking season and they were matched for a wide range of social and economic factors that might otherwise have affected their working activities. Observations were conducted on a minute by minute basis in the cotton fields. These data, in combination with ethnographic information and data indicating female productive output, showed that infection with S. mansoni significantly altered activity patterns in the cotton fields. That is, infected women (with an arithmetic mean egg output of 1958 eggs/g) attempted to pick as much cotton as possible in the shortest time period feasible in the morning. This pattern was partially repeated by infected women who returned to the fields in the afternoon. However, a significant number of infected women felt too weak to sustain this work regime and the economic implications of this finding are discussed. Finally, Fisher's exact probability test showed that infected women were significantly less likely to undertake personal care activities between cotton picking sessions and this result suggests they may have been too tired and/or had a diminished perception of their own well-being. The implications of these results for public health policy in Gezira Province are discussed.

Activities of Daily Living↗
PubMed1993

Large-scale, population-based prospective studies in Japan.

Large scale, population-based prospective studies have increasing importance for the study of common cancers in view of the possibility of advancing the understanding of different risk factors in the initiation, promotion and progression phases during what is thought to be the long process of human carcinogenesis. The permanent registration system in Japan ("Koseki") simplifies the follow-up of registered participants of such cohorts. The population-based cohort studied by Hirayama and the cohort of the atomic bomb survivors started during the 1960s are examples of such possibilities in Japan. Rapidly changing patterns of disease and lifestyles during the last 30 years require new population-based prospective studies focusing on a different set of exposures and with increased detail of exposure assessment. We have established a new population-based prospective study, the "Koseisho" cohort, between 1990 to 1992, following a cross-sectional study, using various biomarkers in five health centre districts. The Koseisho cohort comprises approximately 170,000 people aged 40-59 or 40-69 in 12 different health centre districts. The data are linked with the mass screening program registry data every year, and the sera and buffy coats collected at the beginning of the study will be stored at -80 degrees C for at least 10 years. We intend to integrate various sources of information about health conditions for the prevention of chronic diseases in these cohort areas. Nutritional practices are one of our main interests, and repeated surveys by different methods are planned. Although all death certificates are collected through the health centres, disease registration committees were established in each district to register incident cases of both cancer and certain cardiovascular diseases. Representative population-based prospective studies in Japan are briefly reviewed and introduced.

Adult↗