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At least 1,333 records · Page 74Linked to original sources
PubMed1998

[Acceptance of digital image distribution in a "filmless hospital"].

PURPOSE: Since October 1996 a hospital-wide digital image distribution has been added to the PACS of the central radiology department in the Barmherzigen Brüder hospital in Regensburg. In this way an almost film-less procedure has been realized in the hospital. An extensive questioning of the non-radiology physicians is intended to determine the strengths and weakness of the digital image distribution and the general acceptance of the system. MATERIALS AND METHODS: The installed system consists of the PACS of the radiology department and 50 image distribution work stations in all outpatient departments, wards, and operating theaters. RESULTS: 78.8% of the non-radiology physicians of the main departments participated in the study. The acceptance by the participants was highly positive; 90% of them experienced a facilitation of the routine work. CONCLUSIONS: The digital image distribution is also accepted by non-radiology physicians and makes a major contribution to the improvement of procedures in clinical routine.

Attitude of Health Personnel↗
PubMedDate not supplied

Consultation-liaison psychiatrists management of depression.

Prospective data on 1,360 consecutive inpatients referred to the consultation-liaison psychiatry service of 2 metropolitan general teaching hospitals and diagnoses as having a Depressive Illness Spectrum Disorder were collected by using the MICRO-CARES clinical database system. The distribution of DSM-III-R diagnoses was major depression (MD) 49%; dysthymia (DYS) 15%; organic or substance-induced mood disorder or depressive disorder not otherwise specified (ORG/NOS) 14%; and adjustment disorder with depressed mood (AD) 29%s. Antidepressants were prescribed in 59% of the MD cases, 40% of the DYS cases, 36% of the ORG/NOS cases, and 17% of the AD cases. In confirmed MD, antidepressants were prescribed in 69%, and significantly more often in those who were older, female, had a prior history of physical illness, had a neoplasm or a disorder of the nervous or musculoskeletal systems, had higher Axis IV scores, or were referred because of pain or terminal illness. The patients with confirmed MD prescribed antidepressants had a longer length of stay and were referred later than those not prescribed antidepressants. The results illustrate the importance of all the forms of depression in consultation-liaison psychiatry and the vigor with which all forms are treated.

Adult↗
PubMed1992

Indicators of hospital closure under PPS and Blue Cross/Blue Shield cost-based reimbursements.

Using an adaptation of discriminant analysis on a sample of 120 hospitals in the state of Alabama, this paper illuminates characteristics of hospitals closed due to financial failure under PPS and cost-based Blue Cross/Blue Shield reimbursement systems. The results show high debt levels, poor revenue and cost ratios, poor utilization management, and the inability to collect effectively on outstanding accounts in the year prior to hospital failure.

Alabama↗
PubMedDate not supplied

The DPACS project at the University of Trieste.

The DPACS project (Data and Picture Archiving and Communication System) was undertaken at the University of Trieste by the Institute of Radiology and the DEEI (Dipartimento di Elettrotecnica, Elettronica ed Informatica), in collaboration with the CRSTBS (Centro Ricerche e Studi Tecnologie Biomediche Sanitarie) of the Area Science Park and the Azienda Ospedaliera of Trieste. The main objective of this project is to create an open system for the management of clinical data and images and for the integration of health care services. The first phase is oriented toward finding an implementation strategy for the creation of a prototype DPACS system, to serve as a starting point for the realization of a distributed structure for the extension of the service, firstly to the entire structure of the Cattinara Hospital and subsequently to all the Public Health units in Trieste. After local testing, the service will finally be expanded to a wider geographical level. The intensive computerization of the Institute of Radiology furnished the most favourable environment for the verification of the prototype, as the service provided by the existing RIS (Radiology Information System) and PACS (Picture and Archiving Communication System) has long been consolidated. One of the main goals of the project, in particular, is to replace the old, by now obsolete, PACS with the DPACS services.

Humans↗
PubMedDate not supplied

[Supply of outpatient care in the Lazio region: geographic distribution and characteristics of outpatient clinics].

Outpatient care accounts every year for a large share of the National Health Fund spending, however characteristics of supply have not been thoroughly investigated. Objective of the study is the description of the outpatient care system of Lazio region and of the main characteristics of outpatient clinics, through indicators obtained using data from the Outpatient Care Information System (SIAS) for 1999. Outpatient clinics were classified into three categories: ASL managed clinics, private clinics and hospital trusts. Absolute and relative density of supply (respectively DAO and DRO) were used as indicators of clinics distribution in the regional area. Number of specialties, average procedure weight and volume of procedures performed were used as indicators of complexity. Absolute density of supply (DAO = n. of dispatch points/population) is generally high, and a large and statistically significant variability is observed (p < 0.001). The relative density (i.e. the correlation coefficient between DAO and population density) is positive overall (r = 0.43), but it is higher within the private sector (r = 0.62) independently from provider category. Statistically significant differences were observed among categories of providers in terms of average number of specialties (ASL managed: 9.9; private clinics: 1.7; hospital trusts: 16.1), average weight (ASL managed: 1.1; private clinics: 0.9; hospital trusts: 1.3) and average volume of procedures supplied (ASL managed: 35.000; private clinics: 59.000; hospital trusts: 282.000). The administrative SIAS database was a useful tool to define indicators aimed at describing characteristics of the outpatient care system, although these results must be confirmed with a higher and more homogeneous level of coverage.

Ambulatory Care↗
PubMed1991

A study pre and post unit dose conversion in a pediatric hospital.

Two pediatric medical wards were studied pre and post unit dose conversion using some of the methods described by Schnell et al. The proportion of nurses' time spent on medication related activities decreased from 23.7% pre to 21.6% post unit dose conversion. Nurses' attitudes to the roles of pharmacists and nurses did not change overall and there were significant improvements in their perceptions of the drug distribution system. Observed medication incident rates decreased from 10.3% to 2.9% when wrong time errors were excluded. Medication room audits showed less opportunity for error post-conversion. Work sampling of pharmacists' activities showed no significant change in the amount of time spent on distribution activities. Medication costs decreased by 4% under unit dose drug distribution.

Attitude of Health Personnel↗
PubMed1990

Design considerations for integrated hospital information systems.

This article describes the main characteristics of the integrated hospital information system (HIS) environment, discusses design objectives, and analyzes four design issues--system architecture, conceptual data base design, application portfolio, and plans for development and implementation. The main objective is to provide managers and system designers with a guiding blueprint for HIS design based on state-of-the-practice technological capabilities and current experience with integrated HIS. Clearly, the capabilities of present information technology provide more feasible ways to implement integrated HIS in a distributed environment. This approach answers hospital information needs by shifting some of the processing and data to the end-user level, yet allows management to retain control of the central portion of the data base while facilitating data sharing among various organizational units.

Computer Communication Networks↗
PubMed1986

Local network and distributed processing issues in the Johns Hopkins Hospital.

The Johns Hopkins Hospital has initiated an ambitious program to apply modern technologies to the development of a new, comprehensive clinical information system. One component of this system is a networking technology for supporting the integration of diverse and functionally distinct information systems. This paper discusses the selection of the networking technology implemented at JHH, issues and problems, networking concepts, protocols, and reliability.

Computer Communication Networks↗
PubMed1993

Computerized relational database for monitoring clozapine therapy.

The use of a computerized relational database to satisfy the patient-monitoring requirements of clozapine's manufacturer at an Oregon state psychiatric facility is described. The pharmacy department designed a computerized system to efficiently manage the patient-monitoring requirements of clozapine's manufacturer. A relational database program allows information in database files to be readily retrieved and organized into standardized or customized reports. These reports provide white blood cell (WBC) counts to the drug's manufacturer, patient discharge information to other clozapine providers, psychiatric test results to treating physicians, financial data to hospital administration, and other key data related to the facility's clozapine treatment system. The computerized system minimized the additional workload required to dispense clozapine, decreased the cost of clozapine by $234,441 compared with the cost under the closed distribution system, and provided for comprehensive clinical monitoring. Between May 1991 and October 1992, 168 clozapine recipients were monitored; pharmacists notified physicians about 86 patients not meeting WBC-count criteria. The use of a computerized relational database enabled a state psychiatric hospital to efficiently manage the burden of monitoring clozapine recipients.

Clinical Pharmacy Information Systems↗
PubMed2006

[Probable cause of death after reclassification of ill-defined causes on hospital admissions forms in the Unified National Health System, Rio de Janeiro, Brazil].

This article describes the clinical and socio-demographic characteristics of deaths from ill-defined causes in the State of Rio de Janeiro, Brazil, in 1998, and reclassifies the groups of probable causes based on data from death certificates in the Mortality Information System and the Hospital Information System of the Unified National Health System (SIH-SUS) for 1997-98. Reclassification required a random sample of defined causes from the SIH-SUS. The technique used was probabilistic relationship of records. As compared to deaths with defined causes, in those with ill-defined causes the individuals were predominantly non-white, had less schooling, had died in Greater Metropolitan Rio de Janeiro, were less likely to have been hospitalized in the SUS, and were more likely to have died at home and without medical care. It was possible to reclassify 20% of deaths with ill-defined causes. Reclassification had a minor impact on proportional mortality, due to the size of this group (10% of the deaths). However, if the results could be applied to all deaths with ill-defined causes, the impact might be greater on proportional mortality.

Adolescent↗
PubMed1995

The rural and global medical informatics consortium and network for radiology services.

Telemedicine systems that provide health delivery services to rural clinics and hospitals are being demonstrated in clinical settings. This paper summarizes the research and consortia projects at the University of Arizona Medical Center. The paper describes the Rural and Global Picture Archiving and Communications (PACS) environment developed under a National Science Foundation grant. The Rural and Global PACS environment includes many workstations, database, and networking components and is treated as a large distributed system. These components are described in this paper. The multimedia services for radiology provided by the Rural and Global PACS are described and their performance is measured. Finally, the current research work using the Open Software Foundation's distributed computing environment (OSF DCE) services is described. An OSF DCE testbed for the Rural and Global PACS is described and the rationale of using OSF DCE in the project is presented.

Arizona↗
PubMed1998

Enterprise-scale image distribution with a Web PACS.

The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A fifth AMICAS receives teleradiology studies via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. AMICAS has been installed at MGH since March of 1997. During that time, it has been a reliable component of the evolving digital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care.

Computer Communication Networks↗