Promises of things to come. Object technology products will benefit from certification, collaboration and HL7.
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Certification↗
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.
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Integrating PACS power.
While the technology side of PACS is strong, it's the way you implement your PACS--and especially the way you integrate your PACS with your hospital and radiology information system--that makes all the difference.
Hospital Information Systems↗
The bridge between administrative and clinical information system.
On one side, physicians are asked to record administrative information, such as activity measurement, case-mix of their specialty, billing, for statistical, legal or reimbursement purposes; and on the other side, they need to gather detailed information about their own patients in terms of clinical evolution, for the day-to-day care of the patients or for clinical research purposes. Many other actors are also involved with these processes, both on the administrative side, such as registration officers, administrators and on the clinical side, nurses and other care providers. Applications have been developed within hospital information systems for capturing and disseminating information according to these specific actors and dedicated purposes. But more and more appears the need to integrate these data for insuring the coherence of information and avoiding redundancy of data capture. How to conciliate these objectives? We describe the Geneva's approach for integrating the administrative and the clinical systems.
Data Collection↗
Integration of medical applications: the 'mediator service' of the SynEx platform.
Interoperability is a key issue and a long-term domain of research for distributed healthcare information systems. The SynEx European project provides open and standard integration platform for both new and legacy medical applications. It aims to provide access to hospital information services, patient records, and to medical knowledge, in a seamless way, hiding the distribution aspects and the heterogeneity of the underlying systems. In this study, we describe the SynEx 'mediator service', a software engineering component, that is used to facilitate the development of mediators between any pair of SynEx components and to manage the corresponding interchange messages. Both a C++ library and a Java package of a generic mediator model are provided with several ready-to-use specialisations for well-defined use. The use of the XML technology as a powerful data interchange format and as an efficient data structure converter is proposed and discussed.
Computer Communication Networks↗
The "mediator service", a component to ease the integration of medical applications in the SynEx framework.
Interoperability is a key issue and a long-term domain of research for distributed healthcare information systems. The European project SynEx provides an open and standard integration platform for both new and legacy medical applications. It allows the collaboration of distributed and heterogeneous healthcare records and services. It aims to provide access to Hospital Information Services, to remote sources of medical data and to medical knowledge, in a seamless way, hiding the distribution aspects and the heterogeneity of systems. In this project, the Medical Informatics Department of the Broussais University Hospital is responsible for the development of the "Mediator Service". It is a software component of the SynEx platform which is used as a "glue" mechanism to provide a flexible way to facilitate the interchange between any pair of systems, with different nomenclatures and data structures. The Mediator Service uses a generic model of mediators to create, through specialization, specific mediators for practical cases. Based on this model, it offers a C++ library to be used as the tool case by the programmers, to reduce the development effort. The use of XML as a powerful data interchange format and as a data structure descriptor is proposed and evaluated.
Computer Communication Networks↗
The CEN healthcare information systems architecture standard and the DHE middleware. A practical support to the integration and evolution of healthcare systems.
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Computer Communication Networks↗
Health care professional workstation: software system construction using DSSA scenario-based engineering process.
This paper describes a new method for the evolutionary determination of user requirements and system specifications called scenario-based engineering process (SEP). Health care professional workstations are critical components of large scale health care system architectures. We suggest that domain-specific software architectures (DSSAs) be used to specify standard interfaces and protocols for reusable software components throughout those architectures, including workstations. We encourage the use of engineering principles and abstraction mechanisms. Engineering principles are flexible guidelines, adaptable to particular situations. Abstraction mechanisms are simplifications for management of complexity. We recommend object-oriented design principles, graphical structural specifications, and formal components' behavioral specifications. We give an ambulatory care scenario and associated models to demonstrate SEP. The scenario uses health care terminology and gives patients' and health care providers' system views. Our goal is to have a threefold benefit. (i) Scenario view abstractions provide consistent interdisciplinary communications. (ii) Hierarchical object-oriented structures provide useful abstractions for reuse, understandability, and long term evolution. (iii) SEP and health care DSSA integration into computer aided software engineering (CASE) environments. These environments should support rapid construction and certification of individualized systems, from reuse libraries.
Computer Systems↗
Integration of data driven decision support into the HELIOS environment.
The development of large-scale, clinically accepted decision support systems (DSS) calls for powerful and commonly available methods and tools for knowledge acquisition, system realisation, and knowledge base maintenance. The paper addresses problems associated with the integration of knowledge-based systems within the clinical setting with special reference to (i) data driven decision support, (ii) the Arden Syntax as a knowledge representation format and, (iii) the HELIOS software engineering environment. Architecture of a DSS based on Arden Syntax and its integration in the HELIOS environment are presented. Realisation of the DSS is discussed in relation to client-server architecture and object-oriented databases, which are essential concepts of the HELIOS environment. Sharability and reusability of the knowledge, together with commonality of used software tools are also discussed.
Database Management Systems↗
Integration of digital angiography and gamma-camera diagnostic modalities to a generalized hospital information system.
Within the framework of the NIKA project for the development of a "Generalized System for Processing and Management of Medical Images", we have integrated a Digital Subtraction Angiography (DSA) station and a gamma-camera diagnostic modality to the newly developed generalized hospital-wide information system. The integration consists of acquiring, digitizing, converting and filing the information from the above diagnostic modalities to the hospital's Picture Archiving and Communication System (PACS). The PACS, which is installed in the Onasio Cardiosurgery Centre of Athens, Greece, is responsible for archival, cataloging, retrieval and viewing of the large volume of patient examination data accumulated during his/her stay in the Centre. The ultimate goal is for all patient data, from all different examinations, to be viewed on dedicated client workstations. Information from different modalities can then be simultaneously presented to the attending physician, for a complete picture of the patient history and condition.
Angiography, Digital Subtraction↗
Data as textbook.
Hospital information systems have been collecting patient-related data systematically for years. This article describes a course developed at the Yale University School of Nursing that uses hospital data as "textbook" to teach graduate nursing students to navigate a large hospital data set, enabling a multitude of nursing questions to be addressed. The approach used in this course is easily transferrable to the practice setting as demonstrated by the authors. Through understanding patient-level data, their aggregate patterns, and overall database construction, nurses can expand their contributions to clinical practice and management.
Curriculum↗
The Andover Working Group--accelerating the implementation of standards.
The Andover Working Group was formed with the objective to accelerate and broadly deliver standards-based solutions for healthcare which feature plug and play interoperability across the continuum of care. In this paper, organization and processes used by the Andover Working Group are discussed. A description of how multilateral message profiles, combined with object-oriented component middleware supporting application developments, systems integration and systems operation remove many of the barriers to deployment of systems of standards based applications is also given.
Diffusion of Innovation↗
Clinical-HINTS: integrated intelligent ICU patient monitoring and information management system.
Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft Windows as an embryo intelligent agent. Current generic reasoning skills include perception and reactive cognition of patient status but exclude therapeutic action. The system monitors the patient by communicating with the available sources of data and uses generic reasoning skills to generate intelligent alarms, or HINTS, on various levels of interpretation of an observed dysfunction, even in the presence of complex disorders. The system's communication and information management capabilities are used to acquire physiological data, and to store them along with their interpretations and any interventions for the dynamic recognition of interrelated pathophysiological states or clinical events.
Artificial Intelligence↗
The CIO and the medical informaticist: alliance for progress.
To achieve the full potential of information technology, health care institutions must overcome organizational and political barriers that often overshadow scientific and technical barriers. The time has come for an alliance between the Chief Information Officer (CIO) and medical informatics specialists, or informaticists. Organizations that successfully accomplish this alliance will position themselves to take advantage of the enormous potential of information technology to manage today's cost-quality pressures. This article first reviews some of the recent developments in the way health care organizations manage information technology. It then describes the traditional, perhaps the natural state of affairs, in which there may be tension and conflict between medical informaticists and line managers of information systems (IS). Finally, the article makes a case for closer collaboration and cooperation between these groups, and provides a case study that illustrates one example of such an alliance.
Academic Medical Centers↗
MedIDok--an Intranet tool for XML-based data modelling in medicine.
Integration of administrative, clinical and scientific documentation in medicine is a challenge because of the complexity and dynamics of the underlying data models. At least 50 items per procedure are necessary for clinically adequate documents. Extensive fine tuning is required to achieve acceptance by physicians, thus rapid prototyping is important. The results of this modelling process should be provided independently of specific implementations for reasons of portability. To address these needs we developed MedIDok (Medical Intranet-based Documentation), a set of intranet tools to generate and maintain specific documentation systems (generated programs, no manual coding) and the associated data models. The data structures are provided in XML format and therefore can be reused with other software architectures. The feasibility of non-redundant Intranet systems for both clinical and scientific information management is assessed covering the following domains at a major university hospital: hip ultrasound, endoscopic cholecystectomy, ESWL (extracorporeal shock wave lithotripsy) and implantable cardiac defibrillators. With the programs generated by MedIDok so far more than 10,000 patient contacts have been documented.
Computer Communication Networks↗
The holistic architectural approach to integrating the healthcare record in the overall information system.
The integration and evolution of existing systems represents one of the most urgent problems facing those responsible for healthcare information systems so that the needs of the whole organisation are addressed. The management of the healthcare record represents one of the major requirements in the overall process, however it is also necessary to ensure that the healthcare record and other healthcare information is integrated within the context of an overall healthcare information system. The CEN ENV 12967-1 'Healthcare Information Systems Architecture' standard defines a holistic architectural approach where the various, organisational, clinical, administrative and managerial requirements co-exist and cooperate, relying on a common heritage of information and services. This paper reviews the middleware-based approach adopted by CEN ENV 12967-1 and the specialisation necessary for the healthcare record based on CEN ENV 12265 'Electronic Healthcare Record Architecture'.
Computer Systems↗
The Virtual Hospital: an IAIMS integrating continuing education into the work flow.
Researchers at the University of Iowa are developing an integrated academic information management system (IAIMS) for use on the World Wide Web. The focus is on integrating continuing medical education (CME) into the clinicians' daily work and incorporating consumer health information into patients' life styles. Phase I of the project consists of loosely integrating patients' data, printed library information, and digital library information. Phase II consists of more tightly integrating the three types of information, and Phase III consists of awarding CME credits for reviewing educational, material at the point of patient care, when it has the most potential for improving outcomes. This IAIMS serves a statewide population. Its design and evolution have been heavily influenced by user-centered evaluation.
Attitude to Computers↗
Facilitation of health care delivery through enhanced communications.
To realize the advantages of advanced computing technology in medicine we will have to blend computing and communications facilities into a seamless entity that can support ubiquitous computing for medical use. Work-group computing applications, high speed networks linking a multiplicity of servers, and mobile computing platforms can provide the next generation of devices and services for the physician. Ultimately, the biggest challenge for communications and computing in medicine will be found in the requirement for standards in semantics and syntax in the highest levels of the OSI model. We present here our view of the functional requirements for physician communications and computing to meet standard medical practice in Western societies.
Communication↗
Outreach to Oregon physicians and hospitals: 5000 by 2000.
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Computer Communication Networks↗