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At least 19 recordsLinked to original sources
PubMed1995

The impact of IAIMS on the work of information experts. Integrated Advanced Information Management Systems.

Integrated Advanced Information Management Systems (IAIMS) programs differ but have certain characteristics in common. Technological and organizational integration are universal goals. As integration takes place, what happens to those implementing the vision? A survey of 125 staff members, or information experts, involved in information or informatics at an IAIMS-funded institution was conducted during the last year of the implementation phase. The purpose was to measure the impact of IAIMS on the jobs of those in the library and related service units, and the computing, telecommunications, and health informatics divisions. The researchers used newly developed scales measuring levels of integration (knowledge of and involvement with other departments), customer orientation (focus on the user), and informatedness (changes in the nature of work beyond automation of former routines). Ninety-four percent of respondents indicated that their jobs had changed a great deal; the changes were similar regardless of division. To further investigate the impact of IAIMS on librarians in particular, a separate skills survey was conducted. The IAIMS librarians indicated that technology and training skills are especially needed in the new, integrated environment.

Analysis of Variance↗
PubMedDate not supplied

Regional health information systems: applying the IAIMS model.

In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed in the context of regional health information systems developed. The challenges of aligning the various information agencies and agendas in support or a regional health information system are complex; however, the potential rewards for health care in quality, efficacy, and cost savings are enormous.

Delivery of Health Care↗
PubMed1985

Toxicology information systems: a historical perspective.

Toxicology information systems have evolved swiftly from early, library-based bibliographic tools to advanced packages utilizing sophisticated computer and telecommunication technologies. These systems have evolved concurrently with the rapid expansion of the science of toxicology itself. Bibliographic files such as TOXLINE represent first attempts to handle the toxicology literature through on-line retrieval. Subsequent approaches applied the use of computers to provide literature-derived data, as in TDB or RTECS, or to capture data directly in the laboratory. Societal concerns about hazardous substances, manifested in legislation and regulations, have been responsible for the creation of many computerized systems. Advanced, integrated information management systems are being explored as a method of accessing a large number of independently maintained toxicology databases. Changes in information technologies such as the trend toward microcomputers and novel high-density storage devices will affect the future of toxicology information systems as will impending developments in toxicology itself related to biotechnology, analytical methodology, and alternatives to whole animal testing.

History, 20th Century↗
PubMedDate not supplied

Demonstrating the effects of an IAIMS on health care quality and cost.

The importance of demonstrating the effect of integrating electronic medical records into clinical practice, and methods for conducting the studies necessary to do so, are presented as a model that may be applicable to other aspects of the Integrated Advanced Information Management System (IAIMS). Integrated electronic medical record (EMR) systems offer the prospect of both improving the quality of health care by reducing variation in processes and outcomes and lowering its costs. Because such systems are expensive and require time-consuming re-engineering of health care delivery, demonstrating effectiveness should be part of system development. The expected benefits should be demonstrated using the most rigorous study design that the local clinical environment can support. Results of useful studies include both processes and outcomes of care, the latter including both objective and subjective measures. Comprehensive testing of EMR innovations requires a multispecialty team of investigators, adequate funding, and a commitment of both informaticists and clinicians. Demonstrating the beneficial effects of integrated EMR systems will facilitate their incorporation into everyday clinical care.

Cost-Benefit Analysis↗
PubMedDate not supplied

IAIMS architecture.

An information system architecture defines the components of a system and the interfaces among the components. A good architecture is essential for creating an Integrated Advanced Information Management System (IAIMS) that works as an integrated whole yet is flexible enough to accommodate many users and roles, multiple applications, changing vendors, evolving user needs, and advancing technology. Modularity and layering promote flexibility by reducing the complexity of a system and by restricting the ways in which components may interact. Enterprise-wide mediation promotes integration by providing message routing, support for standards, dictionary-based code translation, a centralized conceptual data schema, business rule implementation, and consistent access to databases. Several IAIMS sites have adopted a client-server architecture, and some have adopted a three-tiered approach, separating user interface functions, application logic, and repositories.

Computer Systems↗
PubMed1994

Integrated Advanced Medical Information Systems (IAIMS): payoffs and problems.

IAIMS (Integrated Advanced Information Management Systems) is an initiative to improve the access to information needed to provide patient care, health-oriented education, biomedical research, and management of large medical center environments. This paper will review the goals, history, and accomplishments of the IAIMS initiative. Shortcomings and frustrations, lessons learned, and the future of such initiatives will also be discussed.

Computer Systems↗
PubMedDate not supplied

Aspects of IAIMS implementation that require further research.

The Integrated Advanced Information Management System (IAIMS) program promotes an integrated approach to information management within a medical center. Since the IAIMS program was conceived, many of the initial IAIMS technologic needs have been quite widely achieved or are planned for implementation in many medical centers. At the same time, the IAIMS frontier is being steadily pushed to new issues that need to be addressed to achieve the full power of the IAIMS vision. The paper discusses 1) levels of integration where IAIMS has been successfully pursued to date and 2) challenging areas in which research is required to approach the full potential of the IAIMS in the future.

Integrated Advanced Information Management Systems↗
PubMed1996

Integrating health sciences librarians into biomedicine.

Vanderbilt University Medical Center (VUMC) developed a model training program to prepare current and future health sciences librarians for roles that are integrated into the diverse fabric of the health care professions. As a complement to the traditional and theoretical aspects of a librarian's education, this mixture of supplemental coursework and intensive practical training emphasizes active management of information, problem-solving skills, learning in context, and direct participation in research, while providing the opportunity for advanced academic pursuits. The practical training will take place under the auspices of an established Integrated Advanced Information Management Systems (IAIMS) library that is fully integrated with the Health Center Information Management Unit and Academic Biomedical Informatics Unit. During the planning phase, investigators are analyzing the model's aims and requirements, concentrating on (a) refining the current understanding of the roles health sciences librarians occupy; (b) developing educational strategies that prepare librarians to fulfill expanded roles; and (c) planning for an evaluation process that will support iterative revision and refinement of the model.

Certification↗
PubMed1995

Managing information in the academic medical center: building an integrated information environment.

The strategic importance of integrated information systems and resources for academic medical centers should not be underestimated. Ten years ago, the National Library of Medicine in collaboration with the Association of Academic Medical Centers initiated the Integrated Advanced Information Management System (IAIMS) program to assist academic medical centers in defining a process for addressing deficiencies in their information environments. The authors give a brief history of the IAIMS program, and they describe both the characteristics of an integrated information environment and the technical and organizational structures necessary to create such an environment. Strategies some institutions have used to implement integrated information systems are also outlined. Finally, the authors discuss the role of librarians in integrated information system design.

Academic Medical Centers↗
PubMed1994

The Annette and Irwin Eskind Biomedical Library at Vanderbilt.

Opened in March 1994, the new library at Vanderbilt was planned to be at the intellectual and geographical heart of the medical center. Constructed of white precast blocks with a glass curtain wall, the building cost $12.5 million. Under an integrated advanced information management system (IAIMS) initiative, the building includes a center for biomedical informatics, which serves as the nerve center of the information enterprise at the medical center. Floor by floor descriptions are provided, including such design details as placing workstations directly inside the first floor entrance, a measure thought to contribute to increased use of the medical center network. User reaction to the building was highly positive in the first month of operation.

Facility Design and Construction↗
PubMedDate not supplied

The Vanderbilt University fast track to IAIMS: transition from planning to implementation.

Vanderbilt University Medical Center is implementing an Integrated Advanced Information Management System (IAIMS) using a fast-track approach. The elapsed time between start-up and completion of implementation will be 7.5 years. The Start-Up and Planning phases of the project are complete. The Implementation phase asks one question: How does an organization create an environment that redirects and coordinates a variety of individual activities so that they come together to provide an IAIMS? Four answers to this question are being tested. First, design resources to be "scalable"--i.e., capable of supporting enterprise-wide use. Second, provide information technology planning activities as ongoing core functions that direct local efforts. Third, design core infrastructure resources to be both reusable and expandable at the local level. Fourth, use milestones to measure progress toward selected endpoints to permit early refinement of plans and strategies.

Academic Medical Centers↗
PubMed1994

Defining clinical 'workstation'.

Interest in the physician's workstation has increased, yet often seems to focus on technological issues. At Boston's Beth Israel Hospital, the Center for Clinical Computing includes heavily used clinical workstations. Their evolution over the past 20 years suggests design criteria: the workstation must be patient-centered, the interface must be uniform, and data acquisition must be addressed at a system level. However, it is clinical function that really defines a workstation. The workstation should do the following: display patient information rapidly and flexibly; assist with administrative tasks; facilitate communication; and provide four important types of decision support: access to literature, access to databases, clinical calculation, and 'synthetic vision,' or different views of patient data. The solutions to our healthcare problems are not in 'workboxes' we can buy, but in creative approaches we can imagine. We need a patient-centered infrastructure and a reduced workload for the clinician-perhaps a 'worklesstation'.

Computer Communication Networks↗
PubMed1994

CPMCnet: an integrated information and internet resource.

The Network and Computer Systems department of the Health Sciences Library developed CPMCnet, an UNIX-based information and Internet server at Columbia-Presbyterian Medical Center. The project linked Gopher and World-Wide Web protocols as well as clients into an integrated application, providing the advantages of both. Development and use of CPMCnet has opened new channels of communication among information providers and end-users.

Academic Medical Centers↗
PubMed1994

The role of standards in creating a health information infrastructure.

In the belief that the existence of a variety of standards is an absolute necessity for health care professional workstations to work, this paper provides a detailed overview of the standards efforts of a number of groups. According to the International Standards Organization (ISO) Reference Model, workstations require a full level of standards from the physical level through and beyond the applications level. Rapidly changing technology challenges acceptance of standards at the lower levels. Current recommendations include fiberoptic media using certain protocols. Other standards in these lower levels also have support. At the applications level, data messaging standards are being developed by six groups. The consensus standards body for the United States is coordinating the efforts of these groups in order to produce a harmonized effort, and is coordinating the effort with Europe for an international effort. Work on the development of the full set of standards necessary for workstation implementations is lagging. Accelerating the process is mandatory if we are to achieve the necessary seamless interoperability required by workstations for ubiquitous intelligent communications between the workstations and the sources of data.

Database Management Systems↗
PubMed1994

Functional requirements as an integral part of the design and development process: summary and recommendations.

The Health Care Professional Workstation (HCPW) provides a portal to the health care system as a whole. Through this portal the health care professional must be able to carry out a wide variety of tasks in an integrated fashion. Traditional health care information systems have not been designed to support this kind of use, so the functional requirements development process must be capable of leading to an architecture and components for a system that will support such use. A variety of approaches may be employed to develop functional requirements, which may be used singly or in combination. Recommendations for this activity center on domain delineation, evaluation efforts to establish the most effective approaches, detailed functional requirement development, evaluation of the developed functional requirements, creation of shared resources, and education and training in the use of the tools and methodologies.

Database Management Systems↗
PubMed1994

Sharing and communicating health care information: summary and recommendations.

Sharing and communicating information is a fundamental task in modern medicine. The health care system of the western world is based on teamwork of professionals who participate in the care of patients. Exchange of information (not just data) requires the communicating parties to agree on a communication channel, an exchange protocol, and a common language. The language includes an alphabet, words, phrases, and symbols that express and assign meaning, understood by all. The most common forms of communication are the spoken word and the paper-based patient record. Computers and communication systems improve the sharing of health care information by overcoming the limitations imposed by the dimensions of time and location. However, natural language is still too complex and too ambiguous for current computing devices to handle the complex interactions between health care professional and patients. A simpler 'language' is needed that uses domain specific vocabularies (and/or codes), well-defined exchange protocols for data, information, knowledge, and, in the future, perhaps even wisdom. This simpler 'language' is expected to handle most of the routine information exchange but not eliminate natural language. It is essential that health care information systems preserve and incorporate natural language expressions and integrate them with structured vocabularies. Today, agreeing on standard data exchange protocols and domain specific vocabularies and codes is our greatest challenge. However, standards alone are not sufficient. Acceptance of the standards by the health care professionals, verifications in clinical environments, and implementation agreements by the medical informatics industry are essential. The group on 'Sharing and Communication of Health Care Information' addressed the issues raised above and unanimously recommends a number of steps that will improve the sharing of information. In addition, specific recommendations are offered to governments, health care institutions, and to developers of health care information systems.

Communication↗
PubMed1995

Reorganization of the information technology program at a United States medical school: is there a lesson for academic medical informatics in Japan?

Reorganization of the information technology program at Baylor College of Medicine commenced with the goal of obtaining a client-focused organization instead of a classically departmental structure. Legacy organizations independently established by request or serendipity had gaps and overlaps in services and could no longer respond to new issues, such as integration of several hospitals, resource sharing of health care delivery, administration of a shared library, and an academic informatics program. The renewal of the information technology program has led to departments of Telecommunications, Enterprise Services, Client Services, and Medical Informatics, and has also allowed cross-departmental projects led by a technology architect. In contrast with that of Baylor, the approach of the Yamaguchi University School of Medicine in Japan may be construed as economic efficiency at the cost of client services. Effective client services by friendly and efficient staff groups is the most important factor for an academic information technology program, if the goal is to reorganize in anticipation of future challenges to the medical center.

Computer Systems↗