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PubMedDate not supplied

MEDLINE: the options for health professionals.

The bibliographic database MEDLINE, produced by the National Library of Medicine (NLM), is a computerized index to the world's biomedical literature. The database can be searched back to 1966 and contains 6.8 million records. The various means of access are divided, for the purposes of this article, into three categories: logging onto a remote host computer by telephone and modem or by the Internet; subscribing to part or all of the database on compact disc (CD-ROM); and leasing the data on a transport medium such as magnetic tape or CDs for loading on a local host computer. Decisions about which method is preferable in a given situation depend on cost, availability of hardware and software, local expertise, and the size of the intended user population. Trends include increased access to the Internet by health professionals, increased network speed, links from MEDLINE records to full-text databases or online journals, and integration of MEDLINE into wider health information systems.

CD-ROM↗
PubMed2006

Improving oversight of the graduate medical education enterprise: one institution's strategies and tools.

Accreditation organizations, financial stakeholders, legal systems, and regulatory agencies have increased the need for accountability in educational processes and curricular outcomes of graduate medical education. This demand for greater programmatic monitoring has placed pressure on institutions with graduate medical education (GME) programs to develop greater oversight of these programs. Meeting these challenges requires development of new GME management strategies and tools for institutional GME administrators to scrutinize programs, while still allowing these programs the autonomy to develop and implement educational methods to meet their unique training needs. At the Medical University of South Carolina (MUSC), senior administrators in the college of medicine felt electronic information management was a critical strategy for success and thus proceeded to carefully select an electronic residency management system (ERMS) to provide functionality for both individual programs and the GME enterprise as a whole. Initial plans in 2002 for a phased deployment had to be changed to a much more rapid deployment due to regulatory issues. Extensive communication and cooperation among MUSC's GME leaders resulted in a successful deployment in 2003. Evaluation completion rates have substantially improved, duty hours are carefully monitored, patient safety has improved through more careful oversight of residents' procedural privileges, regulators have been pleased, and central GME administrative visibility of program performance has dramatically improved. The system is now being expanded to MUSC's medical school and other health professions colleges. The authors discuss lessons learned and opportunities and challenges ahead, which include improving tracking of development of procedural competency, establishing and monitoring program performance standards, and integrating the ERMS with GME reimbursement systems.

Academic Medical Centers↗
PubMed2005

Development of a data warehouse at an academic health system: knowing a place for the first time.

In 1998, the University of Michigan Health System embarked upon the design, development, and implementation of an enterprise-wide data warehouse, intending to use prioritized business questions to drive its design and implementation. Because of the decentralized nature of the academic health system and the development team's inability to identify and prioritize those institutional business questions, however, a bottom-up approach was used to develop the enterprise-wide data warehouse. Specific important data sets were identified for inclusion, and the technical team designed the system with an enterprise view and architecture rather than as a series of data marts. Using this incremental approach of adding data sets, institutional leaders were able to experience and then further define successful use of the integrated data made available to them. Even as requests for the use and expansion of the data warehouse outstrip the resources assigned for support, the data warehouse has become an integral component of the institution's information management strategy. The authors discuss the approach, process, current status, and successes and failures of the data warehouse.

Academic Medical Centers↗
PubMed2004

MITIS: a WWW-based medical system for managing and processing gynecological-obstetrical-radiological data.

In this paper a World Wide Web (WWW)-based medical system, called MITIS, is designed and developed for the management and processing of obstetrical, gynecological and radiological medical data. The system records all the necessary medical information in terms of patient data, examinations, and operations and provides the user-expert with advanced image processing tools for the manipulation, processing and storage of ultrasound and mammographic images. The system can be installed in a hospital's Local Area Network (LAN) where it can access picture archival and communication systems (PACS) servers (if available), or any other server within the radiology department, for image archiving and retrieval, based on the digital imaging and communication in medicine (DICOM) 3.0 protocol, over TCP/IP and also it is accessible to external physicians via the hospital's Internet connection. MITIS is composed as a set of independent WWW modules (ISAPI server extension dlls) and a Win32 application (COM+ server) for mammography image processing and evaluation.

Algorithms↗
PubMed1993

An X Window system for statlab results reporting.

We have developed a system that receives "stat" results encoded in Health Level Seven from the Laboratory Information System, prints a report in destination Intensive Care Units (ICUs), and captures the data for review in a custom spreadsheet format at color X-terminals located in ICUs. Available services include a reference nomogram plot of arterial blood gas data, printed summaries, automated access to the Clinical Information System and a Medline database, electronic mail, a simulated electronic calculator, and general news and information. Security mechanisms include an audit trail of user activities on the system. Noteworthy technical aspects and non-technical factors impacting success are discussed.

Clinical Laboratory Information Systems↗
PubMed2001

Connecting to success: practice management on the Net.

Profound changes in the way dental practices manage data, patient records, and communication are beginning to unfold. Sooner than most of us can imagine, secured patient medical and dental records will reside on the Internet. Additionally, communication between health care providers and patients will become virtually 100% electronic. As the Application Service Provider (ASP) dental models mature, practices will transition from paper to "paperless" to "web-based" management and clinical systems. This article examines and explains these future frontiers.

Appointments and Schedules↗
PubMed1994

Integrated control of ectoparasites.

Integrated control of ectoparasites of veterinary importance is being implemented on a limited basis at present. However, several forces are accelerating a global shift to integrated pest management (IPM). These accelerating forces include the following: reduction in new chemical compounds registered for use on livestock and poultry universal development of resistance to pesticides heightened environmental sensitivities to exclusive dependence on pesticide-based control need for strategies which increase profits for the producer while decreasing costs to the consumer. Integrated pest control requires many technologies for incorporation into specific pest management systems. Individual components include new chemicals, formulations and delivery systems, biological control, mechanical control, immunological control, genetic control, and regulatory control. Computer simulation models based on a quantitative ecological database are invaluable in devising and monitoring IPM approaches to controlling ectoparasites which affect livestock and poultry. IPM strategies have been developed for pests of veterinary importance, but eventually these must be incorporated into total livestock production systems. For implementation, a number of major impediments to IPM must be overcome. These problems can best be solved through a vigorous technology transfer programme. In addition to face-to-face meetings between producers and extension agents, the implementation of IPM can be further encouraged at producer group meetings, through education of animal health professionals, by the publication of articles in producer magazines, and by radio and television broadcasts to the agricultural sector. Research focusing on the development of cost-effective and environmentally-compatible IPM systems is necessary for future progress.

Animals↗
PubMed1999

Interlibrary cooperation: from ILL to IAIMS and beyond.

A recent solicitation over the MEDLIB-L e-mail discussion list revealed over thirty diverse examples of hospital library-based interlibrary cooperative initiatives currently underway. Many are familiar and have been featured in the professional literature. Most go unreported and unrecognized however, comprising invisible resource-sharing infrastructures that hospital librarians painstakingly piece together in order to provide their clients with expanded service options. This paper, drawing from the MEDLIB-L survey as well as descriptions in the published literature, provides a broad overview of such recent interlibrary cooperative efforts. Examples include interlibrary loan networks, collective purchasing initiatives, holder-of-record or union catalog access agreements, arrangements to provide e-mail and Internet access, and consortia to share electronic resources. Examples were chosen based on the initiatives' diversity of participants, and represent a wide range of locations across the United States. Such initiatives focus on local, statewide, or regional collaboration, and several involve partnerships between academic medical center libraries and regional hospital libraries. An early example of a hospital-based interlibrary cooperative IAIMS effort is described, pointing to future possibilities involving the Internet and regional hospital system intranets.

Computer Communication Networks↗
PubMed1996

An integrated approach to senology education: combination of a hypermedia program with a multimedia archive.

The aim of this work was to demonstrate the computerized system on senology, which combines a hypermedia application to a multimedia didactical archive, integrated with a radiological information system. These applications have been developed on Macintosh computers using the softwares Supercard and 4th Dimension. The hypermedia application deals with basic principles of anatomy as well as the radiologic semeiology and pathology through different imaging techniques in order to illustrate basic principles. Thus, students can modify their learning pathways and the timing as they wish. Limitations are related to time consumption in preparing the programs and technical difficulties in expanding them. Multimedia archive allows to classify a large number of difficult and uncommon clinical cases, creating an easily updatable teaching file in digital format which considerably improves access to stored image data, also reducing loss of films and film degradation. From initial experiences we conclude that these systems are valid devices in information and up to date for physicians dedicated to the study of breast pathology.

Breast↗
PubMed1998

The BC health information standards council.

The establishment of a British Columbia (BC) Health Information Standards Council is one of the strategies that is helping to develop and implement BCs vision for health information management. This vision is of effectively and efficiently managed information that enables informed decision making to achieve the results desired in our health system. The Council focuses on the identification of standards and guidelines that will enable, facilitate and promote effective health information sharing. This focus has resulted in approved and mandated informatics standards for use across the health system in the areas of data, applications, technology, security, confidentiality and privacy.

British Columbia↗
PubMed2000

A neural network ActiveX based integrated image processing environment.

The paper outlines an integrated image processing environment that uses neural networks ActiveX technology for object recognition and classification. The image processing environment which is Windows based, encapsulates a Multiple-Document Interface (MDI) and is menu driven. Object (shape) parameter extraction is focused on features that are invariant in terms of translation, rotation and scale transformations. The neural network models that can be incorporated as ActiveX components into the environment allow both clustering and classification of objects from the analysed image. Mapping neural networks perform an input sensitivity analysis on the extracted feature measurements and thus facilitate the removal of irrelevant features and improvements in the degree of generalisation. The program has been used to evaluate the dimensions of the hydrocephalus in a study for calculating the Evans index and the angle of the frontal horns of the ventricular system modifications.

Humans↗
PubMed2001

Republican Scientific-Medical Library, The Republic of Armenia: progress and programs.

In 1990, the Republican Scientific-Medical Library (RSML) of the Ministry of Health of Armenia in collaboration with the Fund for Armenian Relief created a vision of a national library network supported by information technology. This vision incorporated four goals: (1) to develop a national resource collection of biomedical literature accessible to all health professionals, (2) to develop a national network for access to bibliographic information, (3) to develop a systematic mechanism for sharing resources, and (4) to develop a national network of health sciences libraries. During the last decade, the RSML has achieved significant progress toward all four goals and has realized its vision of becoming a fully functional national library. The RSML now provides access to the literature of the health sciences including access to the Armenian medical literature, provides education and training to health professionals and health sciences librarians, and manages a national network of libraries of the major health care institutions in Armenia. The RSML is now able to provide rapid access to the biomedical literature and train health professionals and health sciences librarians in Armenia in information system use. This paper describes the evolution of the RSML and how it was accomplished.

Armenia↗
PubMed1991

Medical Facts File: a self service database of reference information.

The Dahlgren Memorial Library, Georgetown University Medical Center, will demonstrate Medical Facts File, a newly developed in-house database of general medical information. The file content emerged from the library's experience with commonly asked reference questions and the need to develop a database as an online source for users seeking quick answers to medical queries. Medical Facts File joins a growing family of over 18 databases which comprise Georgetown's IAIMS Knowledge Network. Use scenarios will demonstrate how an online search is initiated, either directly or as a prompt from one of the other online databases. The design of Medical Facts File at the Dahlgren Memorial Library began in late 1989 with a publishing section on instructions for authors planning to submit manuscripts to a variety of prominent medical journals. Since then, seven sections have been identified for the database. Three sections are highlighted for presentation, although work on the project is on-going. Medical Facts File is an easy-to-use, time saving system that facilitates tedious searching through a multitude of library sources. It provides users with a self-service, information look-up system.

Databases, Factual↗
PubMed1995

Integrated clinical database in a health maintenance organization.

This paper describes the development and implementation of the first phase of a comprehensive clinical information system in the Kaiser Permanente Northwest Region. This system integrates information from disparate departmental systems into a single clinical database. By using periodic batch downloads of patient data from departmental systems into the clinical database, rather than requiring real-time updates, we have been able to implement this system with relative ease and speed. It contains patient demographics, lab, outpatient pharmacy, radiology, pathology, dictated consults, admission histories and physicals, discharge summaries, and other dictated reports for over 380,000 Health Plan Members. The system is fast, intuitive, reliable, and user-friendly. In March 1994, there were approximately 1,600 active users. These individuals accounted for approximately 410,000 transactions in the month, with an average daily transaction volume of 11,450. Quantifiable cost-savings, in terms of decreased chart pulls and decreased phone calls for information, have offset the cost of development and implementation to some extent. Less quantifiable improvements in the quality of care and the associated cost-savings may eclipse the quantifiable benefits. This system lays the foundation for our clinical information system efforts.

Health Maintenance Organizations↗
PubMedDate not supplied

The "big bang" implementation: not for the faint of heart.

Replacing a hospital's obsolete mainframe computer system with a modern integrated clinical and administrative information system presents multiple challenges. When the new system is activated in one weekend, in "big bang" fashion, the challenges are magnified. Careful planning is essential to ensure that all hospital staff are fully prepared for this transition, knowing this conversion will involve system downtime, procedural changes, and the resulting stress that naturally accompanies change. Implementation concerns include staff preparation and training, process changes, continuity of patient care, and technical and administrative support. This article outlines how the University of Missouri Health Care addressed these operational concerns during this dramatic information system conversion.

Communication↗
PubMed1999

IAIMS and JCAHO: implications for hospital librarians. Integrated Academic Information Management Systems. Joint Commission on Accreditation of Healthcare Organizations.

The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relationship of the two frameworks, provide a view of their commonalities, and establish the advantages of both for hospital librarianship as a profession.

Humans↗