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PubMedDate not supplied

The complexity of developing a nursing information system: a Brazilian experience.

Information systems development is a complex process involving technical, organizational, social, and environmental issues. The active participation of nurses in information systems development is important but not easily accomplished, especially in settings in which the nurses are not familiar with the technology. Participatory design, which focuses on community participation, is an approach to information systems development that is not often used. This article explains this approach and describes the experience of using the participatory-design approach in designing a nursing information system project in a Brazilian teaching hospital. Traditional systems- development approaches are not sensitive to individuals' needs or political and organizational dimensions. The focus of the article is on the basic topics discussed with nurses and the relevance of those topics to the design of nursing information systems. A nursing classification system is a basic component of an information system and a relevant instrument for the creation of formalized nursing knowledge. However, we should not neglect other approaches that can contribute to a better understanding of nursing work situations and the development of nursing knowledge.

Brazil↗
PubMed1975

An environmental and energy information system.

The Environmental Information System Office (EISO) at Oak Ridge National Laboratory (ORNL) provides information support for researchers and administrators involved with energy and environmental policy and progress. Multiple EISO activities for various governmental agencies have resulted in establishment of compatible data bases concerned with energy environmental information, methods for effectively developing these, development and computer display of numerical daya summaries, and reports evaluating published information. Direction is provided by continuing dialogue between users and information system staff.

Environmental Pollution↗
PubMed2003

Usefulness and effects on costs and staff management of a nursing resource management information system.

While administrative information systems can assist nurse managers to improve cost containment and resource management of their units, such effects cannot be known without rigorous evaluations. This article presents evaluation results of CLASSICA, an information system designed to provide decision support for nurse managers in financial management, resource allocation, and activity planning. CLASSICA demonstrated a 41% reduction in expenditures for overtime and extra hours during the evaluation period as compared with a 1.8% reduction in control units that did not use the system. Nurse managers reported a substantial improvement in management information and stated that they had gained control over costs. The system helped them analyse the relationships between patient activity, staffing and costs of nursing care. Nurse managers also reported high satisfaction with the system, the information and decision support provided, and its ease of use. These results suggest that CLASSICA is a decision support system that can successfully assist nurse managers in effectively managing their units.

Decision Support Systems, Management↗
PubMed1995

[A construction of a PACS and reporting system linked with the hospital information system in Gunma University Hospital].

A PACS (Picture Archiving and Communication System) and reporting system were introduced into Gunma University Hospital. These systems were linked with Hospital Information System (HIS), enabling us to refer to images, such as those of CR, CT, MRI and scintigraphy, at wards and conference rooms within a reasonable times. Bone scintigraphy and a report on it are illustrated as an example. A standardized protocol for the interface between PACS and the imaging format must be established without delay for the progress of PACS.

Computer Communication Networks↗
PubMed1994

Differentiating between marketing-driven and technology-driven vendors of medical information systems.

Buyers of medical information systems such as laboratory information systems need to recognize that the vendors of such systems may pursue corporate strategies emphasizing expenditures on marketing and client services, expenditures on technology and research and development (R&D), or a more balanced approach. The strategic goals and objectives of a vendor of an information system should align closely with those of a potential hospital client. A restless hospital client seeking cutting-edge technology will probably be dissatisfied with a system vendor who emphasizes slow ongoing incremental system development. Objective criteria for distinguishing between a marketing-driven vendor and a technology-driven vendor of medical information systems, and their variants, are presented based on the ratio of marketing expenditures to sales revenue compared with the ratio of research and development expenditures to sales revenue of the company. More subjective narrative criteria are also offered for making such distinctions.

Hospitals↗
PubMed2003

A framework for evaluation of medical information systems.

The evaluation of information systems, especially in the health care field, is a complex task. While in the general information system science field there have been several attempts to build frameworks and models to understand better the evaluation of information systems, in health care such models have been non-existent. Unfortunately general frameworks cannot be exactly applied for the evaluation of medical information systems, because they do not recognise the specific nature of the medicine. This article represents an attempt at formulating conceptual models to understand the evaluation of the different impacts of medical information systems.

Decision Support Systems, Clinical↗
PubMed1995

Creating temporal abstractions in three clinical information systems.

Modern clinical information system developers recognize the need to associate temporal information with clinical data. However, specific clinical systems capture different temporal features using a variety of data modeling techniques. Two commonly used methods to represent temporal information are point-based events and interval-based durations. We recently implemented a rule-based expert system for drug dose monitoring on three clinical information systems. The expert system requires both static drug dosing information (drug name, amount, route, frequency) and temporal dosing information (duration of therapy, renewals, restarts). Our design goal was to use the same expert system code on all three information systems by defining a common database schema to hide differences in the original systems' data models. Although we have been successful in mapping clinical data from these three source systems into a unified temporal data representation, we describe how differences in handling time within the three clinical systems made this goal difficult to achieve.

Clinical Pharmacy Information Systems↗
PubMed1991

Use of database management software in a management information system.

If information is to play a useful role in the decision making process, an organization must design a system for capturing, organizing and presenting information from daily activities to its managers. Use of relational database management software to design a custom application as part of a management information system is both practical and cost effective. Designing a database management application is very challenging but well worth the effort, asserts the author of this case study.

Data Display↗
PubMed2006

To decay is system: the challenges of keeping a health information system alive.

Health information system (HIS) architecture and socio-technical approaches for system deployment have been topics of systematic research for decades. Sustainable operation in gradually changing environments, however, has not yet received sufficient attention. Even HIS that have gone life to the satisfaction of their developers and end-users may degrade gracefully or fail catastrophically if not continuously and thoroughly kept in sync with their environment. Critical environmental changes may owe their origins to the complexity of health care and its delivery. Seemingly minor environmental changes can result in significant failures on the part of the information system and may adversely affect the quality of health care delivered. Such minor degradation or near failure may go unnoticed for a while and then hit unexpectedly. Five origins of decay will be analyzed. Methods of systematic observation and containment of such decaying processes will tentatively be presented. Some origins of system decay exist in the immediate hospital or regional setting of usage. Indicators to identify processes of decay will be suggested and methods to preemptively reduce the risk of decay will be presented. Other origins span national health care systems or beyond. Not all such risks can hence be controlled locally. Software Oversight Committees may be an instrument to monitor those risks that cannot be controlled through routine local management.

Computer Systems↗
PubMed1993

The Problem-Oriented Medical Synopsis: a patient-centered clinical information system.

A clinical information system consists of four major components: the clinical database, decision support, data analysis (including outcomes), and the development system. We have created such a system using generally available database methodology. The clinical database, for record-keeping, is called the Problem-Oriented Medical Synopsis, and is quite an old system, originating in 1966. We describe the suitability of a problem-oriented model of clinical records management to the relational model of database design, and describe our experience with the database as a departmental information system for patient care and outcomes research. Hybrid, or partially problem-oriented, databases represent an acceptable approach to clinical record-keeping.

Clinical Medicine↗
PubMed1998

Professional and organizational impact of using patient care information systems.

Evaluation of information systems has often been limited to success factors in relation to system implementation (on time and on budget), training and use of the system. Little attention has been paid to the longer-term effect of using these systems and the resulting issues for health care professionals and organizations. This paper reports on a multiple case study of community hospitals, which examined the impact of using Patient Care Information Systems. An analytic framework incorporated Donabedian's 3 aspects of quality care: structure, process and outcome. These were examined at three levels of impact; direct substitution, proceduralization and new capabilities. Many of the anticipated benefits in the study did not occur because changes occurring in structure (generally taks done by pharmacists and laboratory technologists) did not automatically influence process changes (such as decision making of physicians and nurses) or patient outcomes. Four themes illustrate important professional and organizational issues with implications for worklife of professionals, management and career training. They include the effects of increased efficiency and productivity; "visible" accountability; changing roles and responsibilities; and learning to use new technology versus using new information.

British Columbia↗
PubMed2003

Use of online resources while using a clinical information system.

BACKGROUND: Clinical information system (CIS) use is likely to evoke information needs, yet information resources use during CIS use has not been studied. METHODS: We used CIS log files and a survey to characterize clinicians' use of resources and infobuttons (context-sensitive links from a CIS to specific resources) while using a CIS. RESULTS: We examined 38,763 uses of resources and infobuttons by 2,607 users to identify specific sources and contexts (CIS functions) in which they used them. Laboratory results review was the most frequent context and Micromedex was the most popular resource. Differences in resource use were related to context and user type. The survey confirmed that resources and infobuttons were perceived as useful for patient-specific questions while using a CIS. CONCLUSIONS: Understanding context- and user-type-specific information needs can guide the development of infobuttons for use in a CIS.

Clinical Laboratory Techniques↗
PubMed2005

The Legume Information System (LIS): an integrated information resource for comparative legume biology.

The Legume Information System (LIS) (http://www.comparative-legumes.org), developed by the National Center for Genome Resources in cooperation with the USDA Agricultural Research Service (ARS), is a comparative legume resource that integrates genetic and molecular data from multiple legume species enabling cross-species genomic and transcript comparisons. The LIS virtual plant interface allows simplified and intuitive navigation of transcript data from Medicago truncatula, Lotus japonicus, Glycine max and Arabidopsis thaliana. Transcript libraries are represented as images of plant organs in different developmental stages, which are selected to query the analyzed and annotated data. Complex queries can be accomplished by adding modifiers, keywords and sequence names. The LIS also contains annotated genomic data featuring transcript alignments to validate gene predictions as well as motif and similarity analyses. The genomic browser supports comparative analysis via novel dynamic functional annotation comparisons. CMap, developed as part of the GMOD project (http://www.gmod.org/cmap/index.shtml), has been incorporated to support comparative analyses of community linkage and physical map data. LIS is being expanded to incorporate gene expression and biochemical pathways which will be seamlessly integrated forming a knowledge discovery framework.

Arabidopsis↗
PubMed1990

Validating nursing theory for use within a computerized nursing information system.

Computerized nursing information systems (CNISs) exemplify the application of computer science to nursing knowledge. For nursing knowledge to be a basis for CNIS development, variable relationships must be clearly defined, thus allowing transformation of data into knowledge. Nursing theories define variable relationships; these definitions, however, often are not specific enough on which to base data-based nursing information systems. This article describes how a nursing process model was derived from Self-Care Deficit Nursing Theory, the process model validated, and data relationships established within the model prior to its use as a structure for a CNIS.

Computer Simulation↗
PubMed1996

User and system interface issues in the purchase of imaging and information systems.

We introduce a set of worksheets to facilitate standardized comparisons among scheduling systems, hospital information systems, radiology information systems, and picture archiving and communication systems vendors. For each system category, we provide worksheets to evaluate the features, performance, installation requirements and costs of the included components. These worksheets will help to assure that critical user and systems interface issues are not overlooked and aid potential purchasers to make informed and objective purchasing decisions.

Computer Systems↗
PubMed2006

3LGM2-modeling to support management of health information systems.

OBJECTIVE: Both regional health information systems (rHIS) and hospital information systems (HIS) need systematic information management. Due to their complexity information management needs a thorough description or model of the managed information system. METHODS: The three layer graph-based meta-model (3LGM(2)) and the 3LGM(2) tool provide means for effectively describing and modeling HIS by hospital functions, application systems and physical data processing components. The 3LGM(2) tool has been used to model parts of the information system of the health care system of the German federal state Saxony and of the Leipzig University Medical Centre. RESULTS: Experiences showed, that 3LGM(2) is suitable for supporting information management even in rHIS. We explain some benefits for information management in regional as well as local settings. CONCLUSIONS: Acceptance of the 3LGM(2) depends strictly on its integration in management structures on the institutional, regional, and even national or European level.

Germany↗
PubMed1995

A soft systems approach to designing an information system model to be used as a tool support in the prevention and control of sexually transmitted diseases in a health jurisdiction of Mexico.

The purpose of this work is to present the preliminary results of research in progress on the design of an information system model that is capable of supporting prevention and control activities related to sexually transmitted diseases (STD) in a Mexican health jurisdiction. The project is being developed in the following five phases: 1) informetric indicators on the prevention and control of STD; 2) information flow models representing the access and use of information by the actors involved in the activities; 3) system analysis; 4) system design; and 5) implementation. Bibliometric/scientometric techniques have been applied to conduct the first phase of the project. A soft systems approach is to be conducted throughout phases 2-5. Austin and Kendall and Kendall criteria are to be used for system analysis, design, and implementation. Expected products and benefits include: a) a bibliographic database on the prevention and control of STD in Mexico; b) science policy indicators to improve decision making; c) an information system model/prototype; and d) the development of the soft systems methodology, as applied to improving information-problem-situations in a health system.

Databases, Bibliographic↗
PubMed2005

[Research and development of a clinical laboratory information system].

A clinical laboratory information system consists of two parts--the information system and the management system. Its development is based on scientific and rational lab-workflow, consulting the international standard HL7 Protocol, and combined with barcode technique and instrument communication. The information system mainly manages the data which come from the whole lab testing process while the management system is dominating the lab office work and management decisions.

Clinical Laboratory Information Systems↗