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Use of microcomputer programs for management engineering in hospitals reduces the chore of operational planning at very low cost. This article describes some management information systems available for microcomputers and provides an example run-through to show how one such system can be used to schedule patients for surgery.
Presents Path.Finder, a locally managed health care information system built in response to the need for better communication of current research evidence and clinical practice guidelines. Concludes that this system will improve patient care by providing up-to-date, clinically useful information which is relevant locally. The technology and the information management system have been developed in parallel.
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The use of human subjects for medical research in most industrialized nations requires the scientific and ethical scrutiny of research proposals by a governing institutional review board (IRB) or its equivalent. As part of their primary charge to protect human subjects, IRBs are responsible for the regulatory oversight of not only the research protocol itself but also the research conduct of the investigators and, if applicable, the funding sponsor. This article will discuss the regulatory requirements for an accurate account of IRB protocols and investigators and present an overview of the general flow of information for an IRB protocol. The current and potential uses of information management systems by IRBs will also be reviewed and accompanied by a discussion of the potential advantages and disadvantages of various computerized information systems for management of clinical research.
OBJECTIVE: To present an organized and practical approach to the validation of laboratory information systems. SOURCES: Personal experience, published papers, technical manuals, and Food and Drug Administration guidelines. DATA: Validation of the laboratory information system is the continuing process of proving the system fit for its intended use, initially and over time. It consists in defining, collecting, maintaining, and independently reviewing evidence that the system will perform consistently according to specification. Validation is tedious, difficult, and costly, but it must be done to assure that the system is fit for use and is working according to specification. In addition to professional and licensing bodies, laboratories making blood products fall under the regulatory requirements of the Food and Drug Administration. The buyer of a system is responsible for verifying that the developer has complied with all regulations and that the software products are validated to an appropriate degree, that the hardware is certified to perform its designated functions, that an appropriate period of acceptance testing has been done and documented, and that the system in use performs to specification and is under control. CONCLUSION: System validation demonstrates to all concerned, inside and outside the laboratory, that the laboratory information system manages information well, with the expected accuracy and reliability, file integrity, auditability, and management control.
With an urgent need for effective management of petroleum-contaminated sites, a GIS-aided simulation (GISSIM) system is presented in this study. The GISSIM contains two components: an advanced 3D numerical model and a geographical information system (GIS), which are integrated within a general framework. The modeling component undertakes simulation for the fate of contaminants in subsurface unsaturated and saturated zones. The GIS component is used in three areas throughout the system development and implementation process: (i) managing spatial and non-spatial databases; (ii) linking inputs, model, and outputs; and (iii) providing an interface between the GISSIM and its users. The developed system is applied to a North American case study. Concentrations of benzene, toluene, and xylenes in groundwater under a petroleum-contaminated site are dynamically simulated. Reasonable outputs have been obtained and presented graphically. They provide quantitative and scientific bases for further assessment of site-contamination impacts and risks, as well as decisions on practical remediation actions.
The Dermatology Management and Information System (DERM/MIS) was created by the Task Force on Biomedical Communications of the American Academy of Dermatology. The concept of such a System was conceived as part of the National Program for Dermatology and has been actively pursued since. The purpose of this report is to review the current status of DERM/OMS (Dermatology Office Management System); DERM/LIT (Dermatology Literature); DERM/RX (Dermatology treatment); DERM/DDX (Dermatology Differential Diagnosis); DERM/PATH (Dermatopathology). Other components of the DERM/MIS system are currently being planned. Predictions indicate that by the end of this decade a substantial percent of dermatologic offices will have access to some form of computerized programs. The DERM/MIS system has been designed specifically to meet the needs of the practicing dermatologist in the office setting.
Health care automation companies: card transaction processing/EFT/EDI-capable banks; claims auditing/analysis; claims processors/clearinghouses; coding products/services; computer hardware; computer networking/LAN/WAN; consultants; data processing/outsourcing; digital dictation/transcription; document imaging/optical disk storage; executive information systems; health information networks; hospital/health care information systems; interface engines; laboratory information systems; managed care information systems; patient identification/credit cards; pharmacy information systems; POS terminals; radiology information systems; software--claims related/computer-based patient records/home health care/materials management/supply ordering/physician practice management/translation/utilization review/outcomes; telecommunications products/services; telemedicine/teleradiology; value-added networks.
The importance of modern information systems to manage healthcare delivery at the macro level--particularly through purchasing--is increasingly being recognised. There is also increasing investment in electronic patient record systems to aid care delivery. Both are intended to benefit the individual, yet neither gives full consideration to the human aspects and values--largely because of the under development of appropriate terms and structures. It is important to identify and structure the human facets as the determinants and principal components of healthcare delivery systems, to improve the information structure of these components, and then to use them as the building blocks of macro-management systems, so as to fuel the whole dynamic with one set of person-based values.
Over the past four years, Provenant Health Partners (PHP), Denver, has been developing and implementing a management information system to meet the organization's current needs. The system consists of the following information networks: Internal management; Electronic claims processing; Purchasing; Physician communications; Clinic communications; Physician practices; Other hospitals,offnaged health. In the past, PHP used the system primarily for traditional management and control purposes. Recently, however, the organization has extended the use of its data outputs to include internal and external marketing purposes as well. Clinical, service, and management quality data are now tracked and shared with internal and external constituents. PHP is also working to develop a health information system for the future. Such a system will include all the components of the current management information system, but will also facilitate effective health management of populations enrolled in the organization's integrated delivery network.
The following case study illustrates the use of case-mix information in the budget process. Using case-mix data from a management information system such as PBCS, hospital managers can obtain the assistance of those who influence the delivery of care to develop a sound statistical budget upon which to allocate available resources. Such a budget should be based on honest goals which can be used to evaluate actual accomplishments.
A decade ago, a handful of managed care information systems occupied a relatively minor niche in the healthcare information system industry. Today, dozens of small software development firms are experiencing explosive expansion and are being courted by larger vendors for partnership or acquisition. When selecting an information system capable of meeting the demands of managed care providers, financial managers should consider carefully the types of systems that are available, their price ranges, their modules, and the type of vendor selling the systems.
It is demonstrated that hospitals are information-dependent and that there is need for integration of information generated and gathered through their subsystems. This paper discusses recommendations of the Matheson Report for an integrated information management system which would link these subsystems. The library's statement of mission, means for self-assessment, and analysis of information needs and uses are explored. Future directions with examples of new roles for the library are outlined.
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With the implementation of Management Information Systems (MISs) in human service delivery settings, came the expectation that managers would make data-based decisions. There is substantial evidence, however, that this has not occurred. The present authors describe a systematic approach to correcting this deficiency. The approach involves a behavioral definition of management information use, the identification of disruptions in the behaviors comprising information use, and an intervention designed to reduce disruptions and promote use. Conclusions about the effectiveness of this approach gained from its implementation in a community mental health center are described.
The emerging generation of office automation systems combines new and existing software and procedures. While managers may be able to select from a broad array of software tools, they may also be required to use certain others. This article discusses organization design as the context for office automation; mature computer-based systems as one application of organization design variables; and emerging office automation systems as another application of those variables. The article concludes that Management Information System models developed for mature systems may be helpful where the use of software application is required for the individual worker; diffusion of innovation models recently developed for computing systems may be helpful where the type of software is optional for the individual worker.
Although some believe that electronic management information systems in the health care setting are of questionable value, I cannot support that position. There are undoubtedly health care institutions with management information systems (MISs) that are of dubious value, just as there are institutions in which the MIS is of enormous value. The question of the value of an MIS to an institution has more to do with an understanding of what an MIS is, what the institution's information needs are, and what the MIS can and should be doing for an organization, than it does with any inherent benefits that the system displays in and of itself exclusive of its environment. The views that follow address the process of evaluation that should take place to assess these issues and maximize the effectiveness of an information system in an organization. Figure 1 is a graphic representation of the evaluation process.
Management information systems--essential for strategic planning and management in today's complex healthcare environment--must be designed in concert with goals and strategies developed at the executive or corporate level. Healthcare organizations need management information to support four major functions: strategic planning and marketing, resource allocation, performance assessment, and evaluation of products and services. Computer systems fall into three general categories--administrative, clinical, and decision support (management information systems). Management information systems are the least advanced of the three. The need for strategic planning and managerial control in the face of complexity and competition, however, will result in rapid advances. The chief executive officer must be responsible for the following areas to ensure the effective use of information systems: strategic planning, information systems planning, user-driven focus, systems integration, and monitoring of results. Many larger healthcare organizations have established the position of chief information officer (CIO) to assist in these tasks. The CIO coordinates information systems, telecommunications, management engineering, and office automation.