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Six-year-old Thomas Carter never knew that his risk of permanent injury was worse because he lived in Morton, in rural West Texas. But when Thomas chose to play with matches and was accidentally burned over 40 percent of his body, statistically the chances were slim that he could be saved from death or permanent injury.
Telemedicine is advancing rapidly, and with it the diagnostic and treatment possibilities. X-ray and MRI images, tissue specimens and medical record data are being transmitted between distant cities even now. For rural hospitals, this means having around-the-clock access to radiology expertise--without having to compensate a full-time radiologist. And for off-site clinics, it means fewer trips out to have an image interpreted.
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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.
Sophisticated distributed applications are easier to develop and maintain when prototyped using personal computer (PC) technology. Baptist Medical System, the largest hospital system in Arkansas, is using PC technology to prototype and then develop mainframe-based applications that augment mission-critical, distributed systems.
At Kagoshima University Hospital, we have been developing the total hospital information system named THINK (total hospital information system of Kagoshima University), using a large-size computer system. In this system, the entry of data is done only once at the point of origin. The mutual use of data is done by various subsystems, and the user interface is uniformity. As a result of the speed, accuracy, and flexibility of the system's software, we have achieved efficient medical services and hospital management by a unified database; furthermore, we have improved medical care to patients and we can use this database for supporting not only medical education but also clinical research.
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A key factor in providing a total integrated healthcare system is clear collaboration with suppliers, says Tony Scott, while Jon Melling looks at systems procurement in the US.
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As middle managers, medical record practitioners will be involved in justification of auto ID technology to upper management. To prepare a good justification, one must have a thorough knowledge of the technology and its advantages and disadvantages. One must also be familiar with the payback period and the installation process. This article has attempted to introduce the reader to some emerging technologies in health care, and answer some of the questions that are key to justifying their acquisition. By most estimates, these technologies are finding their way into health care, however slowly, and hold much promise for improvement in productivity and accuracy in data collection.
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