Stats & facts. What makes an integrated system integrated?
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Data Collection↗
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Results for “Systems Integration”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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HL7: facilitating multiple approaches to systems integration.
System interfaces of the 1980s are being replaced by system integration of the 1990s. Standards such as Health Level 7 (HL7) are facilitating this integration process. The authors dispel several persistent misconceptions about the HL7 standard and illustrate two working approaches to HL7-based networking.
Computer Communication Networks↗
The impact of federal systems integration initiatives on services for mentally ill homeless persons.
Nearly everyone writing on homelessness over the past 15 years has called for comprehensive integrated systems of care to address the multiple and complex needs of people who become homeless, especially those with mental illness. What is often overlooked is that calls for systems integration are far from new. Although the names have changed over the years, the underlying concepts have not. The purposes of this paper are fourfold: (1) to clarify the distinction between services integration and systems integration; (2) to map the evolution of federal programs to demonstrate that most of these really have been focused on services integration rather than systems integration; (3) to assess the extent that data from these programs supports the idea of systems integration; and (4) to show how the current ACCESS demonstration for persons who are homeless and mentally ill is likely to provide answers that prior programs have not. Without these new data, systems integration, as one solution to the problems of homelessness, remains a theory without empirical evidence; albeit a theory with persuasive conceptual underpinnings.
Continuity of Patient Care↗
Pathways database system: an integrated system for biological pathways.
MOTIVATION: During the next phase of the Human Genome Project, research will focus on functional studies of attributing functions to genes, their regulatory elements, and other DNA sequences. To facilitate the use of genomic information in such studies, a new modeling perspective is needed to examine and study genome sequences in the context of many kinds of biological information. Pathways are the logical format for modeling and presenting such information in a manner that is familiar to biological researchers. RESULTS: In this paper we present an integrated system, called Pathways Database System, with a set of software tools for modeling, storing, analyzing, visualizing, and querying biological pathways data at different levels of genetic, molecular, biochemical and organismal detail. The novel features of the system include: (a) genomic information integrated with other biological data and presented from a pathway, rather than from the DNA sequence, perspective; (b) design for biologists who are possibly unfamiliar with genomics, but whose research is essential for annotating gene and genome sequences with biological functions; (c) database design, implementation and graphical tools which enable users to visualize pathways data in multiple abstraction levels, and to pose predetermined queries; and (d) an implementation that allows for web(XML)-based dissemination of query outputs (i.e. pathways data) to researchers in the community, giving them control on the use of pathways data. AVAILABILITY: Available on request from the authors.
Database Management Systems↗
Bioartificial liver process monitoring and control systems with integrated systems capability.
Monitoring and control of a bioartificial liver (BAL) support system have the potential to allow for maximization of device bioactivity and protection of both patient and device from untoward consequences of a complex hemoperfused fluidic process, such as coagulation, leakage, or decreased metabolic output. In this work, an integrated embedded systems controller and associated experimental platform were developed to allow for simultaneous monitoring and control of the physical environment of the BAL support system to ensure optimal and sustained hepatic metabolic function and to allow for simplified recording of experimental data. The user interface and core embedded system kernel were developed with rapid prototyping software tools and allowed for operation of easily modified user interface panels. BAL environment monitoring consisted of real-time recording of ambient and reactor temperatures, reactor inlet pressure, the presence of bubbles in the prereactor inlet tubing, and aqueous oxygen tension. Environmental parameters under direct real-time control included reactor inlet flow rate, ambient temperature, and adaptive control of flow rate in response to changes in either inlet pressure or outlet oxygen tension. Use of embedded system integration techniques will facilitate subsequent BAL studies that are dependent on scale-up of reactor size and number, fluidic complexity, and the degree of parallelism such as large animal studies and, ultimately, human clinical studies. In addition, further studies of the effects of flow rate, shear, oxygenation and metabolic substrate on real-time cellular respiration can be pursued with the use of real-time ruthenium oxymetry, as described in this article.
Animals↗
Organizing primary care for an integrated system.
During the past decade, many changes have occurred in the Canadian healthcare delivery system but few, if any, of these changes have specifically addressed the role of the family physician. This paper proposes a number of changes to the infrastructure that supports the role of family physicians, including family physician accountability for delivering twenty-four-hour, seven-days-per-week services to a defined population of patients. The infrastructure needed to support family physicians as the coordinators of care across the continuum of healthcare services includes family-medicine group practices or practice networks linked by electronic networks. Family medicine is the key to health-system integration. Systems to integrate family medicine with other primary healthcare providers and with secondary- and tertiary-care systems are proposed, as well as quality-improvement systems for family medicine.
Canada↗
Information system integration. Open systems and healthcare.
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Commerce↗
Smooth sailing on the purchasing stream. Purchasing tool helps health system integrate legacy systems and streamline order processes.
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Computer Communication Networks↗
Case report: Taiwan's experience in adopting IHE technical framework to integrate systems.
Though more and more hospitals adopt PACS in Taiwan, they all meet the same problem of system integration. The Integrating the Healthcare Enterprise (IHE) association proposes an integrated technical framework and process profiles to solve problems of heterogeneous system integration in medical environment for information sharing. Therefore, this paper reports the experience of a case hospital that successfully applied IHE framework to integrate its HIS, RIS and PACS in Taiwan. This paper indicates that using the IHE can help evaluate the integration ability of PACS vendors, enhance staff's ability, shorten the PACS implementation time, reduce the cost, and reserve system's expansibility. The case hospital was able to successfully implement it's PACS because of executive's full support, using the standard, and providing complete training to reduce user's resistance. This paper not only shares the experiences of IHE adoption of a case hospital but also summarizes key factors to implement PACS successfully. Again, this paper confirms that standard is helpful to integrate heterogeneous system.
Diffusion of Innovation↗
Sepsis alert and diagnostic system: integrating clinical systems to enhance study coordinator efficiency.
Screening patients for clinical studies is time-consuming for researchers. Inefficiencies from human-based eligibility screening cause delay in scientific breakthroughs and are costly. We sought to determine the reliability of an automated computer-based real-time eligibility screening tool. A time-motion diary study was conducted in two university-based intensive care units using a cohort-controlled design. Time saved by automated eligibility screening and the positive and negative predictive values of the integrated eligibility screening system were compared with the gold standard of manual chart review. Sepsis Alert and Diagnostic System sensitivity and specificity were 82% and 95%, respectively. Positive and negative predictive values were 87.5% and 93%, respectively. During evaluation, Sepsis Alert and Diagnostic System saved a minimum of 137 minutes for the study coordinator. Sepsis Alert and Diagnostic System serves as a reliable tool for real-time eligibility screening in an intensive care unit setting. Time efficiencies through use of Sepsis Alert and Diagnostic System may translate into cost savings for funding agencies. The concept and methodology deployed in this study are applicable to any facility with electronic medical record capacity, as long as the data within that system are granular enough to support the specific query.
Baltimore↗
Developing information systems for integrated systems.
As the structure of healthcare delivery systems changes, an increasing number of healthcare executives are rethinking their organizations' approaches to the delivery of care. At the same time, many executives are re-engineering their organizations' information systems to provide the infrastructure necessary to support changing requirements. Healthcare executives can take a number of steps to ensure that their organizations' information systems help reduce costs and improve quality of patient care.
Community Health Planning↗
Managed care as a platform for cross-system integration.
Following the significant industrialization of private health care, managed care strategies for reducing costs are beginning to enter the public sector. Privatization of public mental health dollars is already a reality in some states and a growing possibility in many others. Changes in the financial management of behavioral health care are a source of concern for providers, advocates, and clients who desire services that are consistent with the core values of an integrated system of care. This article reviews the core values of the system of care for children and families, recent changes in the continuum of care for children with severe emotional disorders, and basic principles and strategies of managed care. It is proposed that system-of-care values and managed care principles are not mutually exclusive. In fact, a judicious combination of systems-of-care values and private sector management strategies may facilitate cross-system integration of services for children and youth. An example of a private, nonprofit corporation designed to manage public sector dollars across child welfare, juvenile justice, and mental health/alcohol and drug addiction systems is presented.
Adolescent↗
Information processing in the primate visual system: an integrated systems perspective.
The primate visual system contains dozens of distinct areas in the cerebral cortex and several major subcortical structures. These subdivisions are extensively interconnected in a distributed hierarchical network that contains several intertwined processing streams. A number of strategies are used for efficient information processing within this hierarchy. These include linear and nonlinear filtering, passage through information bottlenecks, and coordinated use of multiple types of information. In addition, dynamic regulation of information flow within and between visual areas may provide the computational flexibility needed for the visual system to perform a broad spectrum of tasks accurately and at high resolution.
Animals↗
Osseointegrated implants: five systems. Integral implant system.
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Dental Implantation, Endosseous↗
Successful systems integration strategies: the access program for persons who are homeless and mentally ill.
In 1993, the Access to Community Care and Effective Services and Supports (ACCESS) federal demonstration program was initiated. Using a quasi-experimental design, the 5-year demonstration program sought to assess the impact of integrated systems of care on outcomes for homeless persons with mental illness. The authors report on which integration strategies were chosen and how their implementation is quantified. Data collected primarily through annual site visits revealed that only two strategies were used by all nine systems. The systems integration strategies employed remained relatively stable over the 5 years. Successful implementation appears to be related to the strategies selected.
Delivery of Health Care, Integrated↗
Vertical systems integration.
Healthcare organizations are vertically integrating into systems for operational, economic, and quality incentives. These system transformations require that the nurse executive assume new roles, responsibilities, and skills. The authors review the trends in system integration and discuss implications for nurse administrators based on literature and structured interviews with nurse executives who have experience in integrated systems or who are engaged in integrated system planing and development.
Delivery of Health Care↗
The transformational model for professional practice: a system integration focus.
Healthcare organizations face the increasingly difficult challenge of providing services that are of high quality, reasonable cost, and easy accessibility for their constituents. Mergers and acquisitions are one strategy for accomplishing this, but in doing so it is critical to have a "road map" to create an integrated system, rather than merely a consortium of hospitals. The University of Pittsburgh Medical Center has successfully created an integrated healthcare system of 19 hospitals. The authors describe the professional practice model used as a framework for success in integrating patient care.
Decision Making↗
Monitoring the progress of system integration.
As providers of health care face the multiple challenges of today's health care environment, many believe that integrated delivery systems promise the structure needed to provide high-quality, cost-efficient care. They make structural and process changes with the expectation that those changes will improve system performance. But few systems actually measure progress in creating an integrated system. This article describes one health care system's strategy for introducing organizational measures to create an integrated system scorecard and focuses on the development, results, and use of the staff survey. The survey provides reliable indicators of system integration. Linking the survey results with network performance measures, in turn, provides managers with tools for judging whether system integration is associated with improved system performance.
Data Collection↗