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PubMed1999

Knowledge acquisition environment for the design of a decision support system: application in blood transfusion.

Blood transfusion is a medical domain where decision support systems (DSSs) could be very helpful to the physicians but must easily and continuously be maintained. We have developed a knowledge acquisition tool that allows the construction and the maintenance of such a system by the domain expert. The methodology used could be applied to another highly evolutive medical domain. In this paper, we detail our knowledge acquisition tool, its use and the final DSS obtained, which is fully integrated into our hospital information network.

Artificial Intelligence↗

PubMedDate not supplied

Positron emission tomography: a first-hand experience.

In July 1999, the University of Kansas Hospital installed a positron emission tomography (PET) scanner and added PET to the imaging technologies it offers patients and physicians. The new service is managed by the nuclear medicine section in the department of radiology. Plans are being implemented now to install a cyclotron in March 2000. Prior to installation of the scanner, a radiation area survey was performed in the space being considered for the PET unit. We also needed to address other critical considerations, including the manufacturer's requirements for construction of the scanner room, special electrical needs, and how the system would connect to our existing information network. It is important to work closely with your chief financial officer and chief operations officer from the beginning of the purchasing process so that these administrators have up-to-date, supportive information about PET and the progress of the installation. We made use of a variety of promotional techniques to market the new service, including broadcast e-mail, an open house for potential referring physicians, postings on the nuclear medicine Web site and communication through the local media. We also worked with the major insurance providers that utilize our hospital to educate them about PET and its benefits. In addition, we trained our own billing staff about procedures that optimize reimbursement for PET. In March 2000, University of Kansas Hospital will install the first cyclotron in the state, enabling us to generate the drugs used for PET scanning and potentially to add targets for research PET radiopharmaceuticals.

Computer Communication Networks↗

PubMed1992

The CD-ROM experience at Loma Linda: the issues of training, logistics, and creative financing.

Since the end of 1987, the Medical Center and University libraries at Loma Linda have progressed from stand-alone CD-ROM-based workstations for access to MEDLINE to networked CD-ROM access to a variety of databases. T.O.M.M.I. (Total Online Medical Material Integration) is a CD-ROM-based wide area network linking the Loma Linda University Medical Center, Loma Linda University, and other entities in Loma Linda, California. T.O.M.M.I., a microcomputer-based system, represents the implementation of IAIMS at Loma Linda. In addition to discussing the issue of "downsizing" campus-wide information networks, this article focuses on the issues of training, handling of logistical problems, and the use of creative financing.

CD-ROM↗

PubMed2004

Should dentistry be part of the National Health Information Infrastructure?

BACKGROUND: The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely. METHODS: The author reviews the NHII and its goals and structure through published reports and background literature. The author evaluates the advantages and disadvantages of the NHII regarding their implications for the dental care system. RESULTS: The NHII proposes to implement computer-based patient records, or CPRs, for most Americans by 2014, connect personal health information with other clinical and public health information, and enable different types of care providers to access CPRs. Advantages of the NHII include transparency of health information across health care providers, potentially increased involvement of patients in their care, better clinical decision making through connecting patient-specific information with the best clinical evidence, increased efficiency, enhanced bioterrorism defense and potential cost savings. Challenges in the implementation of the NHII in dentistry include limited use of CPRs, required investments in information technology, limited availability and adoption of standards, and perceived threats to privacy and confidentiality. CONCLUSIONS: The implementation of the NHII is making rapid strides. Dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met. Practice Implications. The NHII has far-reaching implications on dental practice by making it easier to access relevant patient information and by helping to improve clinical decision making.

Artificial Intelligence↗

PubMed2005

Complex networks and simple models in biology.

The analysis of molecular networks, such as transcriptional, metabolic and protein interaction networks, has progressed substantially because of the power of models from statistical physics. Increasingly, the data are becoming so detailed--though not always complete or correct--that the simple models are reaching the limits of their usefulness. Here, we will discuss how network information can be described and to some extent quantified. In particular statistics offers a range of tools, such as model selection, which have not yet been widely applied in the analysis of biological networks. We will also outline a number of present challenges posed by biological network data in systems biology, and the extent to which these can be addressed by new developments in statistics, physics and applied mathematics.

Animals↗

PubMed1985

AIDS--a health education approach in West Glamorgan.

An education programme on AIDS has been established in West Glamorgan. It was designed to provide an information network amongst health authority staff which would reach as wide an audience as possible. The programme has been organised on a direct contact approach because of the limitations of other methods of disseminating information to large groups of people. The initial success of the programme has led to its extension among other interested groups in West Glamorgan such as the prison population, drug groups, and members of the gay community. The programme is to continue and be updated on a regular basis.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Medical information system, health records, and knowledge banks.

A medical decision system with the capability to answer questions in an interactive mode to assist clinical decisions is described. The system consists of four modules: (a) clinical case history bank, (b) pooled clinical experience bank, (c) clinical knowledge band, and (d) biomedical research bank. At the human/machine interface, an encoder transforms input natural language into codes and retransforms output into natural language. If properly authorized, the physician can request his patient's files, ask for clinical experience in similar cases, ask for related textbook knowledge, or browse among related research findings or speculations. All four modules have been tested as prototypes. Multidisciplinary cooperation is needed for the implementation of a national medical information network and for the reorientation of clinical and academic medicine.

Computers↗

PubMed2005

Evolutionary aspects of whole-genome biology.

A decade of access to whole-genome sequences has been increasingly revealing about the informational network relating all living organisms. Although at one point there was concern that extensive horizontal gene transfer might hopelessly muddle phylogenies, it has not proved a severe hindrance. The melding of sequence and structural information is being used to great advantage, and the prospect exists that some of the earliest aspects of life on Earth can be reconstructed, including the invention of biosynthetic and metabolic pathways. Still, some fundamental phylogenetic problems remain, including determining the root--if there is one--of the historical relationship between Archaea, Bacteria and Eukarya.

Biological Evolution↗

PubMed1998

Hormone replacement therapy: determinants of women's decisions.

Hormone replacement therapy: determinants of women's decisions. The purpose of this qualitative study was to explore the decision-making process used by menopausal women initiating or remaining on hormone replacement therapy (HRT), stopping HRT, or never starting HRT. Eight focus groups, composed of women reflecting these categories, were conducted. Four major themes or spheres of influence emerged as important in the women's decision-making process: the woman's internal influence--the interface between her perceptions and feelings including the symptoms of menopause, the benefits realized by HRT usage, and the experiences of negative side effects; interpersonal relationships, including the patient-physician relationship, family, friends and information networks; external influences, such as ageism and sexism; and consequences resulting from whichever treatment decision was chosen. A new concept was elucidated called "weighted influence" to underscore the dynamic interplay among the spheres. As information about HRT continues to grow and change, an understanding and application of these spheres of influence can assist physicians in engaging in a dialogue with their patients that allows individual evaluation and application of this new information.

Adult↗

PubMed1997

Service system performance and integration: a baseline profile of the ACCESS demonstration sites. Access to Community Care and Effective Services and Supports.

OBJECTIVE: Networks of agencies at the 18 demonstration sites in the Access to Community Care and Effective Services and Supports (ACCESS) program for homeless persons with serious mental illness were surveyed to profile baseline levels of systems performance and integration as part of a longitudinal evaluation of systems change and client outcomes. METHODS: Interviews were conducted with a representative from each of 875 agencies in the 18 service networks. Information was obtained about the perceived performance of the service system and the extent of systems integration as measured by client referrals, funds exchanges, and information sharing between agencies. Measures consisted of two multi-item scales assessing the accessibility and coordination of services for the target population in each community and four indexes of interagency relationships. RESULTS: Services at baseline for homeless mentally ill persons at the program sites were rated as relatively inaccessible, and the coordination of services between agencies was rated as even more problematic. Interagency ties were largely based on client referrals and information exchanges, with very few instances of funding transfers in the form of contracts or grants. On average, at baseline agencies that had received an ACCESS grant were better connected to their local service network than were other agencies. CONCLUSIONS: Consistent with the premise of the ACCESS demonstration, services for persons who are homeless and mentally ill in urban America are fragmented and not very accessible. The longitudinal design of the evaluation will allow for an assessment of efforts to improve services and systems integration and of the effects of these improvements on client outcomes.

Adult↗

PubMed2005

SIGNe: A Geographic Information System on the Web for End-Stage Renal Disease.

A Web-based Geographic Information System (Web-GIS), the SIGNe (Système d'Information Géographique pour la Néphrologie), was designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease (ESRD). This Web-GIS was coupled to a data warehouse and embedded in an n-tier architecture designed as the Multi-Source Information System (MSIS). It allows to access views of ESRD concerning the epidemiology of the demand and the supply of care. It also provides maps matching the offer of care to the demand. It is presented with insights on the design and underlying technologies. It is dedicated to professionals and to public health care decision-makers in the domain of ESRD.

Geographic Information Systems↗

PubMed1997

[Information communication to travelers, the French and Belgian experiences].

Providing relevant and up-to-date information to professionals and the general public is possible through many existing as well as developing means of communication including telephone and faxing, databases, answering machines and internet. Professionals may use information networks in order to harmonize advice given to their patients or clients. An exchange may also be established among all types of travel medicine professionals for keeping up with the latest relevant news and information or for sharing new ideas. Because travellers are now more proactive on their health than ever before, basic information designed for the general public is also becoming necessary. Examples of the various uses of communications in France and in Belgium are considered below.

Belgium↗

PubMed2003

[EMI net--electronic medical record sharing in local community for home care medicine].

An electronic medical information network (EMI net) includes patient records from more than 40 facilities in Matsudo City and it is now used especially to improve the communication between doctors and nurses who visit patients' home. This fact suggests the importance of a medical information sharing system in a local area for home care medicine. An infrastructure connecting facilities to share the database of the patient records is essential for home care medicine performed by a multidisciplinary team beyond one medical facility.

Community Networks↗

PubMed2003

[EMI net--electronic medical record sharing in local community for home care medicine].

An electronic medical information network (EMI net) includes patient records from more than 40 facilities in Matsudo City and it is now used especially to improve the communication between doctors and nurses who visit patients' homes. This fact suggests the importance of a medical information sharing system in a local area for home care medicine. An infrastructure connecting facilities to share the database of the patient records is essential for home care medicine performed by a multidisciplinary team beyond one medical facility.

Community Networks↗

PubMed2005

Design of an integrated system for Milwaukee children with developmental disabilities.

Currently, data on children with developmental delays are collected on an as-needed basis and in general are created and maintained locally. In this paper, a comprehensive, user-friendly integrated system design for children age birth to three years with disabilities in Milwaukee County is proposed. After the prototype system is developed and tested as a "proof-of-concept" the product system will be migrated into the Wisconsin Public Health Information Network (WI-PHIN) as a Program Area Module (PAM).

Child, Preschool↗

PubMed2005

A Web-based GIS for health care decision-support.

This Web-based application allows to access views of End-Stage Renal Disease (ESRD) concerning the epidemiology of the demand and the supply of care. It is a Web-based Geographic Information System (Web-GIS), the SIGNe (Système d'Information Géographique pour la Néphrologie), designed for the Renal Epidemiology and Information Network (REIN) dedicated to ESRD. It is a visualisation and decision-support tool. This Web-GIS was coupled to a data warehouse and embedded in an n-tier architecture designed as the Multi-Source Information System (MSIS). It provides maps matching the offer of care to the demand. It is presented with insights on the design and underlying technologies. It is dedicated to professionals and to public health care decision-makers.

Catchment Area, Health↗

PubMed1999

The G8-global healthcare applications project (GHAP) - recommendations for the way into the information society

The Global Healthcare Applications Project has sought to demonstrate the potential of telematics in the field of medicine and healthcare and to promote joint approaches to issues such as the setting of standards. This has been done through 10 sub-projects covering a range of applications and issues: 1. Towards a global public health information network - Coordinator: Germany (Ulrich Laaser, ulaaser@mail.uni-bielefeld.de; URL: http://health.ibs.uni-bielefeld. de/i-jphe/database/documents/abstract/laaser-g7.htm(C45-60_laaser-g7. pdf) 2. Improving prevention, early detection, diagnosis and treatment of cancer. - Coordinator: France (Gerard Brugal, gerard. brugal@imag.fr; URL: http://pathconsult.imag.fr/G7/G7_index.html) 3. Improving prevention, diagnosis and treatment of major cardiovascular diseases. - Coordinator: Italy (Attilio Maseri, amaseri@rm.unicatt.it; URL: http://www.g7cardio.org) 4. International concerted action for collaboration in telemedicine. - Coordinator: Canada (Andre Lacroix, lacroixa@ere.umontreal.ca; URL: http:// www.g7sp4.org) 5. Enabling mechanisms for a global healthcare network, including Internet connectivity. - Coordinator: UK (Ray Rogers, r.rogers@mcmail.com; URL: http://www.ehto.be/sp5) 6. International harmonisation of the use of data cards in healthcare: Internet Connectivity Coordinator: USA (Elliot R. Siegel, siegel@nlm.nih.gov; URL: http://www.nlm.nih.gov/) - Smart Cards and information exchange security in health care Joint Coordinators: France, European Commission, Italy and Germany (Jacques Sauret, jacques.sauret@sante.gouv.fr and G8-HC@sesam-vitale.fr; URL: http:/www.sesam-vitale.fr/Projects/Netlink-G7-En/) 7. Evidence and effectiveness. - Coordinator: Canada (Andrew Penn, andrew. penn@ualberta.ca; URL: http://www.medlib.com/spi/web.htm) 8. Multilingual anatomical digital database. - Coordinator: USA (Michael J. Ackermann; URL: http://www.nlm.nih.gov) 9. Medical image reference centre. - Coordinator: Japan (Eturo Kashiwagi,EK-WEY@mhw. go.jp; URL: http://www.medirec.ncc.go.jp) 10. Special Interactive TV and Multimedia Programmes for Professionals and Public in Dentistry and International Online Academy for Dentistry and Oral Medicine. - Coordinator: Germany (Alexander Ammann, ammann@quinline.com; URL: http://quinline.globaldent.com) - Further information: http://www. bmgesundheit.de

Journal Article↗

PubMed1994

An SDI program for distributing funding opportunities using electronic mail.

As the competition for funding increases, the need to make researchers aware of all available funding is becoming more acute. The solution presented here is a Selective Dissemination of Information (SDI) service which electronically mails funding information that matches a researcher's keywords. The keywords are part of extensive faculty profiles that make up a Faculty Expertise database. The funding information comes from the Sponsored Programs Information Network (SPIN) database. The software enables researchers to learn about appropriate funding opportunities without spending time actively searching for them.

Databases, Factual↗