Outreach activities of the National Library of Medicine: a five-year review.
Explore the source record for details and available documents.
Acquired Immunodeficiency Syndrome↗
SEARCH · PubMed Health
Results for “Integrated Advanced Information Management Systems”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
IAIMS: planning for change.
The success of IAIMSs and other information technology plans depends to a great extent on the fit between the planning process and the nature of the organization. Planning processes differ as a function of both plurality of goals and the degree to which technology or the external environment changes. If all members of an organization share a common goal and the organization is in a relatively stable environment, the classic "plan, prototype, implement, evaluate" process may be appropriate. Most health care organizations are not consistent with this model. The components of the organization may have different goals, and both the health care environment and roles for technology are changing rapidly. In these circumstances, planning takes on a different light. This paper outlines approaches to IAIMS planning in various environments and provides a framework for IAIMS planning in rapidly changing environments.
Integrated Advanced Information Management Systems↗
The future of the IAIMS in a managed care environment: a call for private action and public investment.
A national public and private "grand challenge" initiative should be undertaken to assure the American public that the telecommunications and computing revolutions improve health care, health education, and biomedical and health services research, and secure accountability for cost, quality, and access. The initiative should focus on meeting the needs of the patient and society at large. It needs to be a national vision, but it also ought to have regional focus. A plan for action would include a health-infrastructure strategy, a service strategy, an education strategy, a research and development strategy, and an international-linkages strategy. Without this type of initiative, health care will lack the basic building blocks it needs to more effectively deal with the transformational forces that have already been unleashed. These forces will strengthen or weaken health care in the next century depending on whether and how the nation--including the leadership in health care and the informatics community--responds to this challenge.
Academic Medical Centers↗
The IAIMS--an essential infrastructure for increasing the competitiveness of health care practices.
The eighth annual workshop of the IAIMS Consortium was devoted to exploring how information technology might provide the tools to allow health care practices to compete in the new health care environment while maintaining independence. The options that were discussed included: optimizing care of the patient in the local setting; reducing practice overhead by improving efficiency and effectiveness; and finding innovative strategies for providing health care and new products.
Economic Competition↗
A new information base: integrated and networked computers.
Explore the source record for details and available documents.
Computer Communication Networks↗
Implementation of organizational practices to protect information in health organizations.
In March of 1997, the National Research Council (NRC) of the National Academy of Sciences issued the report, "For the Record: Protecting Electronic Health Information." In its report, the Council recommended both technical and organizational practices to protect electronic health information. At the time the report was issued, Vanderbilt University Medical Center was deeply immersed in the development of organizational practices consistent with the Council's recommendations. We agreed that the recommended technical and organizational practices are important for protecting other information types in addition to health information, and that they suggest appropriate practices for non-electronic information, as well. In this paper, we focus on our process for developing and implementing the seven organizational practices recommended for immediate implementation.
Academic Medical Centers↗
Integrated Academic Information Management Systems (IAIMS). Part I. The IAIMS initiatives of NLM. Institutional planning for advanced information services.
Explore the source record for details and available documents.
Academic Medical Centers↗
Using information tools to improve hospital productivity.
Because of the new reimbursement incentives placed on healthcare institutions, the efficient and effective use of resources is being emphasized more than ever before. In this new environment, decisions must be made with skill and insight, supported by information tools that analyze and manage productivity. By integrating advanced information technology into hospitals' existing information systems, productivity can become a powerful tool to achieve and maintain a competitive advantage.
Efficiency↗
Telemedicine for access to quality care on medical practice and continuing medical education in a global arena.
Health care practices continue to evolve with technological advances integrating computer applications and patient information management into telemedicine systems. Telemedicine can be broadly defined as the use of information technology to provide patient care and share clinical information from one geographic location to another. Telemedicine can lower costs and increase access to health care, especially for those who live in remote or underserved areas. The mechanism of telemedicine raises some difficult legal and regulatory issues as well since technology provides remote diagnosis and treatment across state lines resulting in unclear definitions for liability coverage. Physician licensing becomes an issue because telemedicine facilitates consultations without respect to state or national borders. With the increased access to current information and resources, continuing medical education becomes more feasible with synchronous or asynchronous access to educational content. The challenge in implementation of these unique educational tools is the inclusion for standards of practice and appropriate regulatory mechanisms to cover the audiences.
Clinical Competence↗
Managing the gap: balancing advances in technology with advances in management practice.
Expenditure on information systems is widely anticipated to lead to improved management of health care resources. Despite large investments in hardware and software, these expectations are difficult to realise. Part of the difficulty lies in the manner in which information systems are applied to, rather than integrated within, organisations. This paper considers some of the the personal and organisational issues that need to be addressed to 'manage the gap' in balancing advances in information technology with advances in management practice. The issues identified are consistent with the concept of a learning organisation dealing with environmental change.
Case Management↗
Clinical performance improvement: measuring costs and benefits.
Market shifts in health care reimbursement have made the improvement of clinical performance a key strategic goal for health care delivery systems, including hospitals, physician groups, and integrated delivery systems. This process requires a clinical management infrastructure, advanced clinical information technology, engaged physicians, and alterations to the strategic plan for the delivery system. Because the change to a clinical efficiency orientation takes several years for organizations to achieve, adoption of this approach must begin before markets become fully mature for managed care and most practicing physicians are aware of the change. This article outlines how to evaluate the costs and benefits of improving clinical performance and how to determine when an organization should begin making this change. It advises delivery systems executives to raise the priority of clinical performance improvement and to measure both the near-term and long-term impact of this approach on revenue, cost, quality, and market share.
Cost Control↗
Future of PACS: advanced integration with RIS and workflow management.
Explore the source record for details and available documents.
Humans↗
Nursing resource definition in DRGs. RIMS/Nursing Acuity Project Group.
The use of traditional nurse-specific patient classification/acuity systems for staffing are obsolete as they do not interact with other elements of hospital information systems (HIS). In the face of rapidly advancing managed care penetration the challenge for nursing has become the capability to measure and manage cost, quality, and outcomes by integrating nursing resource information into the standard HIS spawned by DRGs. Earlier efforts to quantify nursing relative intensity measures and correlate them with DRGs were not successful. New health care software technology (as well as combined financial and clinical department support) can now provide integrated clinical information and financial information by DRG for each patient's clinical record. Expert clinician medical-surgical and ICU nursing panels were empowered to evaluate and arrive at group consensus placing designated DRGs in clusters according to their average nursing care resource requirements. The method was tested and validated.
Activities of Daily Living↗
Information technology can enhance quality in regional health delivery.
OBJECTIVES: a) The use of information technology (IT) based solutions for quality health delivery in regional health information networks and the study of the enabling factors for their use in a regional health care network from key classes of users such as the medical personnel and the citizens. b) Identification of potential technologies for usage from all citizens and health providers in a regional environment, in all aspects of everyday life. c) Presentation of a generic user model for reference when developing and assessing IT based health delivery solutions. METHODS: After defining the major questions to be addressed, an overview of tele-health and tele-medicine technologies and solutions currently available shall be presented. Further, a generic user model applied to the use of IT based regional health delivery solutions both for the daily life and home care, and for research and clinical routine purposes are presented. Enabling technologies for integration of different IT modules, medical data processing and management procedures and the wireless application protocol (WAP) technology is discussed. RESULTS: Different levels of user applications are presented such as mobile telephony driven health information monitoring and systems integrating electronic health care records with multimedia medical information management and processing modules. CONCLUSIONS: Although IT solutions are advanced and continue to evolve, still the user acceptance and user friendliness issues are unresolved. Mobile telecommunication solutions however may hold the key for wide scale implementation of IT solutions in regional health information networks and increased quality of health services.
Decision Support Systems, Clinical↗
Developing an integrated model for outcomes management.
In the complexity of integrated delivery systems, the triad of clinicians, financial analysts, and information management personnel can partner to form an effective force in driving outcomes management efforts. Health care systems can take the opportunity to rethink outcomes management strategies with an emphasis on monitoring cost and quality simultaneously. Advanced practice nurses, with a wide breadth of knowledge obtained through higher education, are positioned to be active, effective team members at all points in the outcomes management process.
Delivery of Health Care, Integrated↗
Internet based ECG medical information system.
Physiological monitoring of humans for medical applications is well established and ready to be adapted to the Internet. This paper describes the implementation of a Medical Information System (MIS-ECG system) incorporating an Internet based ECG acquisition device. Traditionally clinical monitoring of ECG is largely a labour intensive process with data being typically stored on paper. Until recently, ECG monitoring applications have also been constrained somewhat by the size of the equipment required. Today's technology enables large and fixed hospital monitoring systems to be replaced by small portable devices. With an increasing emphasis on health management a truly integrated information system for the acquisition, analysis, patient particulars and archiving is now a realistic possibility. This paper describes recent Internet and technological advances and presents the design and testing of the MIS-ECG system that utilises those advances.
Database Management Systems↗
Integrating CD-ROM Medline with electronic mail: first step in implementing new strategy for online reference library.
Simultaneous ACCESS to and DISSEMINATION of electronically available PROFESSIONAL KNOWLEDGE, in a productive, Cost-of-Ownership effective, and affordable manner are now achievable. Emerging MANAGEMENT-OF-INFORMATION and SYSTEMS-INTEGRATION disciplines are essential contributing factors to devising and implementing NEW STRATEGIES for ONLINE REFERENCE LIBRARIES. Bringing integrated information closer to the ultimate user and RESHAPING the electronic databases and full-text management systems MARKETPLACE are the most significant outcomes. Key technology attributes are advancements in CD-ROM, Networking, and office automation. We have proven this concept by developing an INTERFACE between MEDLINE from COMPACT CAMBRIDGE and ALL-IN-1 from DIGITAL EQUIPMENT CORPORATION. Saved search results are automatically routed to the individual's ALL-IN-1 account where further DOCUMENT MANAGEMENT and electronic mail functions may be performed. A 486Ware system from Logicraft and a five-members VAX-Cluster (respectively), are linked in a DECNet environment that is the foundation of Children's Integrated Hospital Information System. In phase one of the project up to 8 SIMULTANEOUS USERS may access the 8 RECENT YEARS, from any one of 1500 ACCESS POINTS (local and remote), and utilize any one of 150 NETWORKED PRINTERS. Opportunities are now within reach to expand the electronic library services while utilizing progressive methods and taking advantage of the best available technologies.
Boston↗
START: an advanced radiation therapy information system.
START is an advanced radiation therapy information system (RTIS) which connects direct information technology present in the devices with indirect information technology for clinical, administrative, information management integrated with the hospital information system (HIS). The following objectives are pursued: to support decision making in treatment planning and functional and information integration with the rest of the hospital; to enhance organizational efficiency of a Radiation Therapy Department; to facilitate the statistical evaluation of clinical data and managerial performance assessment; to ensure the safety and confidentiality of used data. For its development a working method based on the involvement of all operators of the Radiation Therapy Department, was applied. Its introduction in the work activity was gradual, trying to reuse and integrate the existing information applications. The START information flow identifies four major phases: admission, visit of admission, planning, therapy. The system main functionalities available to the radiotherapist are: clinical history/medical report linking function; folder function; planning function; tracking function; electronic mail and banner function; statistical function; management function. Functions available to the radiotherapy technician are: the room daily list function; management function: to the nurse the following functions are available: patient directing function; management function. START is a departmental client (pc-windows)-server (unix) developed on an integrated database of all information of interest (clinical, organizational and administrative) coherent with the standard and with a modular architecture which can evolve with additional functionalities in subsequent times. For a more thorough evaluation of its impact on the daily activity of a radiation therapy facility, a prolonged clinical validation is in progress.
Medical Records Systems, Computerized↗