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The effect of information systems architecture on health care data quality.

A rapidly increasing number of health care provider institutions is dealing with data architecture design issues that directly affect the quality of data within their heterogeneous information systems. These problems result from a failure to recognize that they are actually managing a loosely distributed yet integrated database among their many information system platforms. Understanding the issues surrounding data integration, the application available interface standards, and the tools available for implementation is critical to operating a successful distributed health care information systems environment today.

Architecture↗

A computer-based patient record: Emory's approach.

The replacement of the paper medical record at Emory will be gradual over the next several years. We foresee milestone events after which portions of the patient record are no longer retained in paper form. As these milestones are identified, the HIM professionals at the three institutions will begin the formidable task of managing the transition to a paperless system. Evaluation of business processes and the skill sets needed by staff members can be accomplished and a plan for each phase of transition developed.

Academic Medical Centers↗

Confidentiality on the information highway: balancing the needs of individual patients and society.

State and federal agencies, professional associations and business coalitions are actively promoting the development of regional or statewide health database organizations (HDOs). One of the key missions of HDOs is the public release of aggregated healthcare data and analyses to facilitate improved patient care. In 1992 and 1993 a committee appointed by the National Academy of Sciences' Institute of Medicine studied the implications of HDO formation in a landmark report. The committee's recommendations on how to assure accuracy and completeness of data, minimize potential harm from released data and guarantee appropriate protections for individually identifiable data are summarized and interpreted in the following article.

Computer Communication Networks↗

Computerized patient records: backbone to an emerging information infrastructure.

The potential reform of our health care system has initiated market changes that include mergers, acquisitions, and consolidations. This shift in the market has created demand for immediate access to clinical information. The author predicts that the computer-based patient record system will become the clinical information source of the future, providing staff with the ability to capture, store, and communicate medical information instantaneously.

Attitude to Computers↗

Accessing the Internet. Guidelines for beginners and mental health resources for experts. I. Just for beginners. The information highway's on-ramp.

People have very different levels of comfort and experience in traveling the information superhighway. In the following column, Part I will provide an overview for beginners from two experts with the Boston Computer Society, the oldest and largest computer user organization in the world. Part II provides information to those with previous Internet experience who want to access specialized mental health information resources. It is written by an expert in this area who has served as a member of the Information System Committee of the American Psychiatric Association.

Computer Communication Networks↗

Accessing the Internet. Guidelines for beginners and mental health resources for experts. II. The next step. How to access mental health resources on the Internet and on BBS.

People have very different levels of comfort and experience in traveling the information superhighway. In the following column, Part I will provide an overview for beginners from two experts with the Boston Computer Society, the oldest and largest computer user organization in the world. Part II provides information to those with previous Internet experience who want to access specialized mental health information resources. It is written by an expert in this area who has served as a member of the Information System Committee of the American Psychiatric Association.

Computer Communication Networks↗

Impact of enterprisewide data.

The article provides an overview of initiatives relating to enterprisewide data collection. It discusses the meaning behind the term enterprisewide data and describes how health care entities are working to make the goal of enterprisewide data a reality by evaluating and employing such technologies as electronic data interchange, automated medical payment systems, and computerized patient records. It concludes with a discussion of data standardization in the health care industry and some issues that must be addressed by a health care entity as it strives to create an enterprisewide data system.

Abstracting and Indexing↗

The new informatics of national healthcare reform.

The President's Health Security Act has succeeded in attracting America's attention. Several of its initiatives have been well-publicized and hotly debated in Congress. The act also includes a number of implications for healthcare informatics, and devotes an entire chapter to this subject, although this area has not received as much publicity. Every behavioral healthcare provider's information system would be significantly affected by enactment of the Health Security Act. Selected forms and data elements for the management and delivery of behavioral healthcare services would need to be standardized. Organizations of behavioral healthcare providers, managed care companies and purchasers would increasingly share selected patient and subscriber information in aggregated form, for a variety of purposes. As a result, tougher laws to protect patient data privacy will likely be forthcoming. The following article gives an overview of the informatics needs of the soon-to-be reformed American healthcare system, into which behavioral healthcare will be integrated. As part of the larger system, behavioral healthcare services and information systems will need to comply with the same guidelines and requirements, outlined below, as other healthcare providers. Preparation to meet the information demands of the evolving healthcare system will require adaptation of existing computerized information systems, utilization of new technology, consultation with the system's major shareholders and attention to continuous quality improvement processes.

Computer Communication Networks↗