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At least 73 records · Page 4Linked to original sources
PubMed1992

[Development of an integrated system of family medicine--pathologic anatomy service to start epidemiologic studies on tumors occurring in an area of southern Italy. First results].

In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, and only one of them (Ragusa) provides data for Southern Italy. Usually, PBRs are based on data collection from Pathologists and medical records. Our integrated system differentiates from traditional PBRs because the information comes from the General Practitioners (GPs) and is completed with the diagnosis provided by the Pathologists (Ps). During two years we have registered 1,057 new cancers on a middle period population of 212,644. GPs and Ps signed 395 and 879 incident cases, respectively. GPs alone provided 16.8%, Ps alone 62.6%, and either source 20.6% of total cases. After excluding non melanotic skin cancers and bladder carcinoma, the GPs-Ps integrated system counted 828 new cases in two years. These incidence data are the first in our region (Puglia). The 178 cases signed by GPs alone should have been lost if the informations of our PBR had been based only on local Ps' records. Moreover, 94 of GPs cases (11% of total cancers registered) were subjects who moved outside the area for diagnosis and treatment. Even if this article evaluates the effect of under-registration attributable to Ps or GPs, the cancer incidence data and the active involvement of GPs indicate that they could be usefully involved in the registration of cancer data.

Epidemiologic Methods↗
PubMed1996

Supporting the "clinic without walls" with an event-directed messaging system integrated into an electronic medical record.

To facilitate the communication of ideas, orders and treatment plans among providers practicing in a multidisciplinary ambulatory care setting, we have created an event-directed messaging system integrated into our larger Ambulatory Care Information System (ACIS). ACIS has been operational since 1992 and currently supports an average of 350 patient visits per day. The new messaging system permits a provider to send a message to the next provider who will be caring for a patient. The messages can be sent to any provider offering care in the future, or they can be directed to future visits with a particular clinical service. In contrast to traditional electronic mail systems, messages are not directed to specific providers or groups of provider. Messages are instead directed to a specific clinical event, namely a patient's visit to an appropriate clinic. Messages are displayed when a patient returns for a designated visit, both as part of a pre-printed progress note upon which a provider documents the visit and as part of a hypertext-based general information display in an electronic medical record. The messaging system helps providers ensure that subsequent providers caring for their patients will be alerted to pertinent aspects of a patient's care. It also similarly helps providers quickly gain familiarity with those issues prior providers had felt were important to highlight or did not want to risk being overlooked.

Ambulatory Care Information Systems↗
PubMed1997

System integrational and migrational concepts and methods within healthcare.

In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems.

Computer Communication Networks↗
PubMed1996

Using hub technology to facilitate information system integration in a health-care enterprise.

The deployment and maintenance of multiple point-to-point interfaces between a clinical information system, such as a laboratory information system, and other systems within a healthcare enterprise is expensive and time consuming. Moreover, the demand for such interfaces is increasing as hospitals consolidate and clinical laboratories participate in the development of regional laboratory networks and create host-to-host links with laboratory outreach clients. An interface engine, also called a hub, is an evolving technology that could replace multiple point-to-point interfaces from a laboratory information system with a single interface to the hub, preferably HL7 based. The hub then routes and translates laboratory information to other systems within the enterprise. Changes in application systems in an enterprise where a centralized interface engine has been implemented then amount to thorough analysis, an update of the enterprise's data dictionary, purchase of a single new vendor-supported interface, and table-based parameter changes on the hub. Two other features of an interface engine, support for structured query language and information store-and-forward, will facilitate the development of clinical data repositories and provide flexibility when interacting with other host systems. This article describes the advantages and disadvantages of an interface engine and lists some problems not solved by the technology. Finally, early developmental experience with an interface engine at the University of Michigan Medical Center and the benefits of the project on system integration efforts are described, not the least of which has been the enthusiastic adoption of the HL7 standard for all future interface projects.

Delivery of Health Care↗
PubMed1995

Technology assessment at the Institute for Clinical Systems Integration and HealthPartners.

The Technology Assessment Committee of the Institute for Clinical Systems Integration (ICSI) draws upon the resources of many different groups and in turn, keeps the groups informed about new medical treatments, devices, and procedures. This new Minneapolis-based technology assessment committee uses a collaborative effort to serve the information needs of many employer groups, patients, providers, and health care organizations in the area. This committee serves as the principal mechanism by which new medical and surgical procedures, devices, and treatments, as well as new applications of old but unproved or doubtful applications of existing technologies are reviewed for medical appropriateness at ICSI (a nonprofit quality improvement organization) and at HealthPartners (a combined staff and group model HMO in Minnesota).

Academies and Institutes↗
PubMed1998

[A chromosomal integration system for development of polyvalent vaccine strains].

We have developed a potential bivalent vaccine stain through the chromosomal integration system in which the gene that codes for the B subunit of cholera toxin was integrated into the chromosome of an attenuated strain of Salmonella typhimurium. This system involves two steps: construction of a hisOG deletion mutation into the chromosome of S. typhimurium strain SL3261: and replacement of the hisOG deletion by the complete hisOG region and the segment of heterologous DNA which codes for the B subunit of cholera toxin. The recombinant strain SL3261 (named TT201) was obtained. Southern hybrid confirmed that the CTB gene was integrated into the chromosome of TT201. Western blot analysis demonstrated that the CTB gene was expressed stably in TT201. When administered orally to mice, the recombinant strain elicited a serum antibody response to CTB. The strain TT201 is a potentially bivalent vaccine candidate.

Animals↗
PubMed1990

Genomic integration system based on pBR322 sequences for the cyanobacterium Synechococcus sp. PCC7942: transfer of genes encoding plastocyanin and ferredoxin.

Synechococcus sp. PCC7942 recipient strains were constructed for the chromosomal integration of DNA fragments cloned in any pBR322-derived vector, which carries the ampicillin resistance (ApR) marker. The construction was based on the incorporation of specific recombination targets, the so-called 'integration platforms', into the chromosomal metF gene. These platforms consist of an incomplete bla gene (ApS) and the pBR322 ori separated from each other by a gene encoding an antibiotic (streptomycin or kanamycin) resistance (SmR or KmR). Recombination between a pBR322-derived donor plasmid and such a chromosomal platform results with high frequency in restoration of the bla gene and replacement of the chromosomal marker (SmR or KmR) by the insert of the donor plasmid. The integration into the platform depends on recombination between pBR322 ori and bla sequences only and is therefore independent of the DNA insert to be transferred. The desired recombinants are found by selection for a functional bla gene (ApR) and subsequent screening for absence of the chromosomal antibiotic marker. Gene transfer with this integration system was found to occur efficiently and reliably. Furthermore, the presence of the pBR322 ori in the platform allowed for 'plasmid rescue' of integrated sequences. The system was applied successfully for the transfer of the gene encoding plastocyanin (petE1) from Anabaena sp. PCC7937 and for the integration of an extra copy of the gene encoding ferredoxin I (petF1) from Synechococcus sp. PCC7942 itself.

Blotting, Northern↗
PubMed1998

Growth rate of integrated systems shows huge rise in last two years.

The number of integrated health systems is increasing rapidly across the country as hospitals realize these are the key to their survival. Just how influential are these systems? Here are a few facts: The number of highly integrated health systems rose to 228 in 1997, a 20.6% increase from 1996. Integrated hospitals reported an average occupancy rate of 52.2%. Hospitals that are not integrated reported an average occupancy rate of 48.1%.

Catchment Area, Health↗
PubMedDate not supplied

An integrated system for the automation of the clinical chemistry laboratory.

A user programmable microcomputer-based integrated system for automatic analysis in the clinical chemistry laboratory is presented. Friendly user-instrument interaction helps the operator when defining tests and analytical conditions or entering sample data and test requests. Quality control data are retained for the automatic production of various statistical lists and graphs. Routine operator intervention is limited to reagent preparation, sample loading onto the autosampler plate, definition of the tests to be performed on each of the samples and data validation before the generation of reports. Finally, connection with an existing laboratory management system is provided by means of a standard serial interface.

Automation↗
PubMed1996

An integrated system for measuring static and dynamic accommodation with a Canon Autoref R-1 refractometer.

An integrated system is described which we have found useful for efficiently collecting and analyzing both static and dynamic accommodation data using the Canon Autoref R-1 refractometer. The system consists of hardware modifications and software designed to both facilitate the measurement of accommodation and to process the resulting data. Several features of the Canon R-1, which may not be evident to some users, are also described. A program written in Microsoft C/C++ running under DOS, and designed for use on a PC, is available from the authors upon request.

Accommodation, Ocular↗
PubMed1997

An integrated system using immunomagnetic separation, polymerase chain reaction, and colorimetric detection for diagnosis of Plasmodium falciparum.

An integrated system for sample preparation and DNA detection of the malaria parasite using immunomagnetic separation in combination with the polymerase chain reaction (PCR) and colorimetric analysis is described. A cocktail of three monoclonal antibodies towards merozoite surface antigen-1 was used for magnetic capture of parasites from microliter amounts of whole blood. A sensitivity down to a parasitemia of 10(-6)% was achieved using cultured parasites as a model. The integrated approach was evaluated in a field study. A total of 410 blood samples from patients attending malaria clinics in Trat province and Kanchanaburi province in Thailand were analyzed. The samples were processed by immunomagnetic separation and transferred to central laboratory for PCR-based detection. Microscopic examinations on blood smears were done in parallel; 53% were positive using the DNA-based assay, while only 32% were positive using conventional microscopic analysis. This field study suggests a possible model for large-scale testing of malaria with an increased sensitivity compared with conventional methods.

Animals↗
PubMed1998

Integrating learning into integrated delivery systems.

Integrated delivery systems that promote learning and flexibility will be better prepared to face the challenges imposed by a complex and competitive environment. The integration of learning into these systems requires a shared vision, facilitative leadership, and highly functioning communication channels within an organic structure. Strategies that promote positive attitudes toward change are necessary for learning as is the provision of resources, training, incentives, and rewards that support learning, and feedback on how new administrative and clinical practices advance the mission and goals of the system.

Communication↗
PubMed1995

The importance of primary care providers in integrated systems.

Primary care physicians are essential to the success of an integrated healthcare delivery system. Because the current supply of primary care physicians does not meet the demand, healthcare systems are competing aggressively to offer primary care physicians attractive incentives to join their systems. Adequate financial incentives are essential, but equally important are incentives related to the types of affiliation established between a system and a physician. This article explains the role of primary care physicians in an integrated healthcare system, presents two examples of how healthcare systems have recruited and deployed primary care physicians, and describes key factors in achieving productive, long-term primary care affiliations.

Health Maintenance Organizations↗
PubMed1998

Design, construction and six years' experience of an integrated system for automated handling of discrete blood samples.

The present paper describes the design of an integrated system to aid in the taking and measurement of manual blood samples during nuclear medical examinations requiring blood sampling. In contrast to previously published systems, the present system is not used in the actual sampling of the blood, but aims to aid in all other aspects of handling and measurement. It consists of two main parts. One part is a distributed software system running on the scanner host computer used to register sample times, to display information pertaining to the ongoing examination and to collect data from a number of well crystals. The other main part consists of an industrial robot used to perform the actual weighing, centrifugation, pipetting and measurement of the samples. The system has been operational for 6 years, during which time it has had an "up-time" in excess of 95% and has handled and measured the blood samples from more than 5000 examinations, each comprising an average of 15 blood samples. The throughput of the system is 50 whole blood samples or 21 plasma samples per hour. In addition it has to a large extent removed the "human factor" from the process, thereby increasing the reliability of the data.

Automation↗
PubMed1992

What are the essentials of system integration?

In summary, the Luke article is a solid starting point for understanding the relationships between existing hospital systems, developing regional systems, and ultimate benefits to patients, their employers, and their communities. We clearly have a long way to go though, and the attention should turn to some of the key functional features of integrated systems.

Comprehensive Health Care↗
PubMedDate not supplied

Graduating to an integrated system: Yale University Medical School and Yale-New Haven Hospital coordinate security.

UNLABELLED: The authors, security directors at Yale University Medical School and Yale-New Haven Hospital respectively, discuss their decision to coordinate their efforts to procure compatible new security systems that would integrate such components as alarms, CCTV, and access control within and between the two campuses. The goal: improve safety and make alarm monitoring easier and more efficient by centralizing operations. THE RESULTS: an increase in security, a decline in security incidents, and a reduction in costs.

Academic Medical Centers↗