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Results for “Integrated Advanced Information Management Systems”

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PubMed1994

HERMES: a health care workstation integration architecture.

An architecture is described that facilitates integration of existing databases and applications without modifying them. By means of this architecture, data from different sources dispersed in a network can be combined and directly used in existing applications or applications that have been developed specially for integration. This feature of combining data from different sources into one workstation is viewed as the enabling technology on which computer-based patient records can be built. The abstraction of computer-, network- and application-specific details is completely dealt with by the integration architecture. This integration architecture has been developed with extendibility and flexibility in mind, and allows for a growth-path towards application of the open system paradigm in medicine.

Computer Communication Networks↗

PubMed1998

A new twist in US health care data standards development: adoption of electronic health care transactions standards for administrative simplification.

To reduce the costs of common administrative transactions, health plans, payers and providers encouraged the US Congress to legislate administrative simplification of specific electronic health data transactions. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 created incentives for a public-private partnership to develop and implement standards for the uniformity of health care data used in electronic administrative health transactions and standards for the privacy and security of individually identifiable health information. The standards' requirements of HIPAA and how they have been met by the US government hold promise for accelerating the uniform adoption of standards developed by accredited standards developing organizations. The transactions designated by Congress, the process of choosing the standards in the Department of Health and Human Services, the principles that guided these choices, and the actual choices, are presented here. A successful partnership for administrative health data standards can pave the way for success in clinical health data standards and their application in computer-based patient record systems.

Computer Security↗

PubMed1999

AIDMAN--advanced informatics distributed medical access network.

We describe AIDMAN, a pilot project in which health clinics in remote areas of Greece are connected with mainland hospitals, to provide routine clinical service for both chronic health care and accident and emergency. Clinical practice is supported through the use of the Virtual Consultation Workstation that is being developed and evaluated specifically for the project and which is based on readily available commercial products and international standards. The communication infrastructure remains a major obstacle to any telemedicine project, and for this reason, satellite communication is used in the AIDMAN project to overcome the current lack of digital links and bandwidth. The proposed system will provide real time video, high definition image, shared applications and data over a link running at 128 kbps. In this paper we discuss the design of the AIDMAN system, the Virtual Consultation Workstation and the communication channel.

Computer Communication Networks↗

PubMed1993

NetMenu: experience in the implementation of an institutional menu of information sources.

NetMenu is a program, developed at Yale, which enables straightforward access to online information systems. NetMenu has been deployed in several diverse settings within our medical center. In the hospital, NetMenu is functioning as a front-end for our clinical workstation providing access to the hospital information system, the clinical laboratory computer, a drug database and several bibliographic databases. The medical libraries are utilizing NetMenu for both medical education workstations and for scholarly information workstations. This paper describes our initial experience in the implementation, support, and maintenance of NetMenu as an institutional menu of information sources.

Academic Medical Centers↗

PubMed1994

A software engineering approach for medical workstations development.

Multimedia medical workstations represent the natural tool for accessing the hospital information system environment. They are complex medical systems that have to gather, in a single framework, a large collection of components dealing with multimedia medical objects. To remain current with both medical practice and with advances in the computer science field, they have to allow the iterative addition of new functions to the set of existing ones. In this paper, after a survey of commonly required medical workstation functional components, we shall try to discuss how a software engineering approach can streamline the development of a medical workstation. Different software engineering tools needed to build the functional components of a workstation are described. Their integration in a single dedicated environment is considered through four perspectives: data, presentation, communication and control. Benefits and limitations of an object-oriented approach are discussed.

Computer Communication Networks↗

PubMed1995

Development of an integrated clinical database system for a regional mental health service.

The authors describe development of an automated system to provide caregivers in a regional mental health service in Calgary, Alberta, with access to information about persons with chronic mental illness served by the system. All participating organizations provided input about system design features and data elements. Issues of confidentiality of records were addressed. A working model demonstrated to caregivers was rated as useful and understandable by more than 90 percent of respondents.

Adolescent↗

PubMedDate not supplied

The evolution of the IAIMS: lessons for the next decade.

The Integrated Academic (Advanced) Information Management System (IAIMS) initiative emerged in the early 1980s to respond to trends in biomedical information, transfer and access, and to identify the implications for health sciences libraries. Three recurrent themes have emerged as being essential to the creation of IAIMs: changing the paradigm; redirecting expenditures to build reuseable infrastructure; and working across cultural boundaries. An IAIMS penetrates an organization in four stages: from creating awareness; through development of foundation infrastructure; through integration as an extra effort; to integration as a byproduct of organizational structure and information architecture. Extension of the IAIMS to support a regional area is a natural fifth stage that reapplies the processes of the first four stages and re-uses the infrastructure that has been built within the cooperating organizations. Area IAIMSs have the potential to transform biomedicine by enabling new paradigms for manpower development and publication of information.

Forecasting↗

PubMed1994

Major issues in user interface design for health professional workstations: summary and recommendations.

Lack of good user interfaces has been a major impediment to the acceptance and routine use of health-care professional workstations. Health-care providers, and the environment in which they practice, place strenuous demands on the interface. User interfaces must be designed with greater consideration of the requirements, cognitive capabilities, and limitations of the end-user. The challenge of gaining better acceptance and achieving widespread use of clinical information systems will be accentuated as the variety and complexity of multi-media presentation increases. Better understanding of issues related to cognitive processes involved in human-computer interactions is needed in order to design interfaces that are more intuitive and more acceptable to health-care professionals. Critical areas which deserve immediate attention include: improvement of pen-based technology, development of knowledge-based techniques that support contextual presentation, and development of new strategies and metrics to evaluate user interfaces. Only with deliberate attention to the user interface, can we improve the ways in which information technology contributes to the efficiency and effectiveness of health-care providers.

Cognition↗

PubMed1998

Active X based standards for healthcare integration.

With cost pressures brought to the forefront by the growth of managed care, the integration of healthcare information systems is more important than ever. Providers of healthcare information are under increasing pressure to provide timely information to end users in a cost effective manner. Organizations have had to decide between the strong functionality that a multi-vendor 'best of breed' architecture provides and the strong integration provided by a single-vendor solution. As connectivity between systems increased, these interfaces were migrated to work across serial and eventually, network, connections. In addition, the content of the information became standardized through efforts like HL7 and ANSI X12 and Edifact. Although content-based standards go a long way towards facilitating interoperability, there is also quite a bit of work required to connect two systems even when they both adhere to the standard. A key to accomplishing this goal is increasing the connectivity between disparate systems in the healthcare environment. Microsoft is working with healthcare organizations and independent software vendors to bring Microsoft's powerful enterprise object technology, ActiveX, to the healthcare industry. Whilst object orientation has been heralded as the 'next big thing' in computer applications development, Microsoft believe that, in fact, component software is the technology which will provide the greatest benefit to end users.

Certification↗

PubMed1999

[RIS modality interfaces. From proprietary solutions to DICOM worklist management].

Radiologic information systems (RIS) and picture archiving and communication systems (PACS) are becoming increasingly widespread. This leads to new demands on the integration of the individual, formerly independent information systems (RIS, modalities, PACS). Possible ways of integrating individual systems are introduced. Besides the detailed description of different realizations of system communication, its role in the PACS at the university hospital in Freiburg is explained. The integration of different information systems still requires the use of proprietary interfaces. An appropriate integration generally has been realized in Freiburg. In the near future DICOM basic worklist management will standardize system integration and render an interdepartmental workflow concept possible. Even though an available communication standard exists, not all problems in the RIS-modality interface are solved. Different data models in the various RI systems and modalities demand certain degrees of freedom in the standard. Thus a satisfactory workflow cannot be guaranteed even when all involved systems conform with the standard.

Germany↗

PubMed1994

Medical data and knowledge management by integrated medical workstations: summary and recommendations.

The health care professional workstation will function as an interface between the user and the patient data as well as an interface pertinent medical knowledge. Appropriate knowledge focus will require the workstation to recognize the concepts and structure of patient data, and understand the scope and access methods of knowledge sources. Issues are organized around five major themes: (i) structure, (ii) reliability and validation, (iii) views, (iv) location, and (v) ethical and legal. Conventional database representations can effectively address data structure and format variations that will inevitably persist in local data stores. The reliability of data and the validation of knowledge are critical issues that may determine the ultimate utility of clinical workstations. Alternative views of patient information and knowledge sources represent the true power of an intelligent data portal, represented by a well-designed clinical workstation. Both data and knowledge are optimally represented in decentralized information networks, although the confidentiality and ownership of this information must be respected. Evolutionary progress toward consistent representations of knowledge and patient data will be facilitated by the establishment of self-documentation standards for the developers of data encoding systems and knowledge sources, perhaps extended from the preliminary model afforded by the Unified Medical Language System (UMLS).

Computer Security↗

PubMed2001

Knowledge integration: insight through the E-portal.

Data become information when they can be summarized and organized into logical patterns; information becomes knowledge when it can be manipulated for actionable decision making; knowledge becomes insight when contextually relevant and temporarily appropriate. This article describes how information technology can now be used to provide clinicians with access to both insight and information that is context- and event-sensitive. Collaboration between the American College of Physicians, medical knowledge experts, Oregon Health Sciences University (OHSU), and shared medical systems for framework and infrastructure combine to create the ideal environment of complementary and synergistic competencies. This article describes the research that is under way at OHSU to determine how to deploy medical knowledge derived from these sources and integrate it into the clinical workflow; it also examines a vision of how medical knowledge can be integrated in the future.

Education, Medical, Continuing↗

PubMedDate not supplied

Digital image management and communication in medicine.

With the rapid development of digital imaging modalities in medicine, there is an increasing need for an efficient management and archival of medical images in digital form. Picture Archiving and Communication Systems (PACS) are becoming an essential component of medical imaging equipment, allowing for medical images to be accessed and stored directly in digital form. This paper describes a hospital-wide PACS currently under development at the University Hospital of Geneva, based on an open architecture, regrouping equipment from different vendors in a distributed topology. The image archival is organized in multiple locations geographically distributed in the hospital. The PACS database is fully integrated with the concurrent Radiology Information System (RIS) and Hospital Information System (HIS). A standard image storage format called the PAPYRUS format was developed for the storage of medical images from a variety of imaging modalities. To provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS was developed.

Computer Communication Networks↗

PubMed1994

Clinical workstations: identifying clinical requirements and understanding clinical information.

A preliminary exploration of the problem of defining and meeting users' needs, this paper draws the bulk of its content from experiences in the PEN&PAD project in the UK. This program has been researching and developing prototype clinical workstations for direct use in patient care by health care professionals, chiefly doctors. Focusing more on general issues rather than the specific functional requirements embodied in the PEN&PAD prototypes, the paper begins with a brief summary of the goals of PEN&PAD and then outlines the three main axes of the work: user-centred design, medical concept and medical record models, and user interfaces and architectures. The remainder of the paper then concentrates on the first of these topics--working with users to define functional requirements.

Computer Systems↗

PubMed1999

[Modern network technologies for data communication in the hospital].

Modern network technologies provide the basic infrastructure for information and communication systems in the hospital today. The goal to build up a universal network infrastructure which meets the broadly varied requirements. Analysis of data communication in the hospital and the evaluation of established network technologies, as well as new developments, leads to the switching concept as the suitable solution. Two technologies play the major role in building enterprise networks: the Ethernet family, based on frame switching, and ATM, based on cell switching. Orientation on established standards is the key to free system choice and grants interoperability between systems from different manufacturers. However, the network design must meet the application and system architecture of the information technology in order to achieve successful mapping of the involved communication profiles. This means scaling of the bandwidth as needed, suitable segmenting of the network and resilient links. In a further step, policy-based networking takes advantages of prioritizing critical applications and therefore reduces interdependencies across the network.

Computer Systems↗

PubMed1994

Workstation network system which enables international exchange of characters and images at the University of Tokyo Hospital.

The circumstances when physicians want to exchange information are analyzed and the necessary requirements for workstations are discussed. Although there are many requirements, it will not be necessary to incorporate every requirement onto a single workstation. In the international setting, the capability of handling non-alphabetic characters is also important. The requirements for image display should be classified for those physicians who make their diagnosis primarily on the basis of images and those who use images as additional diagnostic information. On the basis of these discussions, the system of the University of Tokyo Hospital, which is now being implemented, is described. The system will be a network of approximately 300 workstations with one mainframe computer.

Computer Communication Networks↗

PubMed1997

Remote connection to the Kyushu University Medical Center LAN using digital and analog telephone lines.

SOHO (Small Office/Home Office) has recently become popular, as it makes working at home possible. Computers or Local Area Networks(LAN) connected to the office network from home are necessary for the implementation of this concept. Kyushu University has begun a service connecting home computers to the campus LAN for researchers, staff and students of the Faculty of Medicine. We have two different telephone connection methods. One connects the campus LAN and the home computer LAN using routers through the Integrated Services Digital Network (ISDN). The other connects computers at home to the workstation in the university, using modems and the PPP (Point to Point Protocol) through a public telephone analog line. This paper outlines our university SOHO connection system and discusses the merits and demerits of using telephone line connections.

Academic Medical Centers↗

PubMed1993

Full-text document storage and retrieval in a clinical information system.

The overall design of the CIS at CPMC is heavily influenced by the decision support component. The type of automated decision support being implemented dictates the need for highly structured or coded data. The value of decision support systems has been well documented. The current reliance on free-text documents is natural and a rewarding first step to a more valuable mix of coded and free text. While the health care provider might find the textual comments of the various reports extremely useful, the capability of an automated system to vigilantly review every data element for trends and anomalies is becoming invaluable in today's ever more complex health care delivery environment. Other approaches such as optical imaging systems would facilitate human decision support, but do not supply data in a format that can be processed by automated decision support systems. The developers of the CIS at CPMC believe that data are most valuable when available for both human and automated decision support.

Clinical Medicine↗