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PubMed2004

Not so fast! The dark side of computers in health care.

There are now computers in numerous health care devices, from thermometers to ventilators, and there are pitfalls to avoid in our increasing dependence on computers. To be useful, information must be delivered in the right context. Computer systems must be protected from worms, viruses, and other harmful code, and they must prevent unauthorized access to data. The source of all underlying decision algorithms must be known and appropriate for the population being served. And there must be contingency plans to mitigate losses caused by system unavailability.

Computer Security↗
PubMed2004

The 100 most wired 2004.

Even as they speed ahead in their quest to improve quality and operations, the top IT hospitals are shifting gears away from a fascination with whiz-bang technology to the nitty-gritty work that ensures success. In the foldout, you'll find the 100 Most Wired, Innovator Award winners, Most Wired-Small and Rural, Most Wireless and Most Improved.

Benchmarking↗
PubMedDate not supplied

Attitudes of nurses toward computerization: a replication.

To assess the attitudes of nurses toward computerization, Stronge and Brodt's questionnaire, Assessment of Nurses' Attitudes Toward Computerization was used to survey head nurses, staff registered nurses, and licensed practical nurses in a 500-bed hospital. Nurses' attitudes were generally favorable toward computers and there were no significant differences in attitudes by nurses' job title, level of education, age, or years of nursing experience. Previous experience with computers was the only variable significantly related to total mean score with those nurses who had previously used computers having significantly (p less than 0.001) more favorable attitudes toward computers than those who reported no previous computer use. A factor analysis was obtained; five factors emerged. Although the factors are similar to the categories identified by Stronge and Brodt, results of the factor analysis suggest response bias.

Adult↗
PubMed2004

Improving governance and reducing risk in electronic patient record systems: ensuring appropriate competencies for support and end-user staff.

As clinical health information systems, particularly Electronic Patient Records, become widely used, so it is important to address the Governance and Risk Reduction policies needed to ensure their safe and effective use. Greater emphasis needs to be placed on ensuring that all staff involved have relevant, recognized competencies. This paper describes two initiatives--one for health informatics staff, and one for end-user health professionals--ensure and assess such competencies

Computer Literacy↗
PubMed2004

Assessing the impact of change in the organization of a technical support system for a health information systems (HIS).

OBJECTIVE: Evaluate the impact of the implementation of a new model of Help Desk and technical support in HIS users of the hospital. We carried an anonymous survey on a random sample of 150 users of the new system. The administrative staff (A), doctors (D) and nurses (N) were analysed by strata. We assessed the accessibility both to phone calls and through the institutional intranet; the understanding of the problems; the time taken to fully answer requests; and the degree of satisfaction concerning the change. The results showed that 94%, gained access through the intranet and that it was very satisfactory for the medical group (D80% vs A34% vs N8.7%). The different kinds of users were satisfied with the response time, above all the administrative stratum (A42% vs D38% vs N14%). All of them commented on their satisfaction with the change, above all, the doctors (D68% vs A46% vs N22%), who before this new implementation had expressed dissatisfaction with the old system. CONCLUSIONS: operational changes in the Help Desk contributed to improve how the service was perceived by its users; nevertheless both doctors and nurses required even faster response time.

Computer Communication Networks↗
PubMed2002

Overview on security standards for Healthcare information systems.

The intense need for Healthcare information exchange has revealed a lack of interoperability of systems and applications. Security controls, usually based on proprietary methods and techniques, aggravate the current situation. However, timely development of HIS security standards may improve the interoperability and enable the integration of systems. This chapter provides an overview of the standardisation work that is being done by official standardisation organisations in Europe and world-wide.

Computer Security↗
PubMed2002

Demonstration results for the standard ENV 12924.

Within the working programme of CEN/TC251 (Health Informatics), a standard for Security Categorisation and Protection for Healthcare Information Systems has been developed. This document was formally adopted in 1997 by CEN as pre-standard CEN ENV 12924. A demonstration and implementation effort, which was to be effected in principle at one location, was planned and executed as part of the MEDSEC project. The standard CEN ENV 12924 contains a security categorisation model for information systems in Healthcare, distinguishing six categories, plus some refinements. For each category it specifies the required protection measures. The project task consisted of demonstrating and implementing the standard (as far as possible within a limited period) in a real life situation, and providing feedback on these results to the CEN organisation. To this end, the categorisation scheme, as specified in the standard, was applied to a large part of the information (sub)-systems in the Leiden University Medical Centre. A set of ten sub-systems was then selected for a more detailed investigation. The actual protection status for each sub-system was evaluated on the basis of the recommended protection profiles specified in the standard. For each of the relevant recommendations in the standard, its status was recorded, and remarks were added on its relevance, feasibility, etc. These detailed data have been gathered in separate reports for each sub-system. These reports evidently are confidential, in view of protection of the hospital's information security. A similar, though more limited exercise has been done at Magdeburg University Hospital (UHM), in order to be able to allow for possible differences in local situations. A thorough comparison of results for different hospitals was beyond the scope of the project, however. From the overall picture we have tried to draw conclusions on the quality, completeness and applicability of the standard, as well as on the actual level of protection of the systems. As a by-product of the investigation, for all systems out of the small group, implementation plans have been specified to bring the protection in the various (sub)-systems on a higher level, where necessary. Subsequently, these plans have been realised to a large extent. To facilitate the bookkeeping of the results, we have used the SIDERO model, resulting from the SEISMED project. This model has been enhanced, for this purpose, with the recommendations from this standard. A brief description of this database model has been included in Appendix B. As an overall conclusion, we may state that the standard has proven to be a very useful instrument, providing a good basis for a security review of the types of Healthcare information systems which are encountered in a hospital environment. Some suggestions have been presented, for amending recommendations that were found too unpractical or too heavy in the circumstances considered. Also, we suggest to add one category to the set of six which is being used now. Furthermore, the use of a 'bookkeeping tool' (like e.g. SIDERO) is strongly recommended.

Computer Security↗