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Results for “Systems Integration”

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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↗

PubMed2001

A model for data integration systems of biomedical data applied to online genetic databases.

We present a general model for data integration systems using a mediated schema to represent commonalities in the underlying sources. These sources are mapped to the mediated schema using source descriptions. Users can pose queries against the mediated schema, allowing the system to generate automatically a query plan that enumerates and ranks all possible ways in which the query could be answered. We apply this approach to the domain of online genetic databases, demonstrating the system s ability to answer relevant queries across multiple sources.

Databases, Genetic↗

PubMedDate not supplied

Desperately seeking synergy: the journey to systems integration of women's health services.

Providing women's health services can be a profitable enterprise. With 70% of health care purchases being made by women for themselves and their families, focusing on women as health care consumers strengthens the entire system. However, shrinking reimbursement and market pressures are creating an atmosphere of financial instability in health care. Is system integration the answer? The four presenters-each an executive champion for the women's service line in their systems-agree that integration can potentially reduce costs, improve quality of care, and increase patient and stakeholder satisfaction. Benefits can only be realized, however, if clinicians are engaged as partners early in the process, the organization is prepared to respond quickly to market changes, and competitive forces and culture differences across the system are acknowledged and addressed. "Women's Services" must also continually demonstrate its value to the system and find creative ways to differentiate itself in the marketplace.

Cost-Benefit Analysis↗

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↗

PubMed1981

A national blood transfusion system integrating a central computer service with hospital-based minicomputer routines.

The factors that should be considered in designing an integrated blood transfusion system are outlined. The system work performed by the Committee of Collaborative EDP Assistance in the Swedish Blood Transfusion Service is reviewed to illustrate these points. The system that has been developed is described.

Blood Donors↗

PubMed1996

Object-oriented analysis and design of an ECG storage and retrieval system integrated with an HIS.

For a hospital information system, object-oriented methodology plays an increasingly important role, especially for the management of digitized data, e.g., the electrocardiogram, electroencephalogram, electromyogram, spirogram, X-ray, CT and histopathological images, which are not yet computerized in most hospitals. As a first step in an object-oriented approach to hospital information management and storing medical data in an object-oriented database, we connected electrocardiographs to a hospital network and established the integration of ECG storage and retrieval systems with a hospital information system. In this paper, the object-oriented analysis and design of the ECG storage and retrieval systems is reported.

Computers↗

PubMed2002

An integrated system for feature evaluation of 3D images of a tissue specimen.

In this article we have proposed an integrated system for measurement of important features from 3D tissue images. We propose a segmentation technique, where we combine several methods to achieve a good degree of automation. Important histological and cytological three-dimensional features and strategies to measure them are described.

Algorithms↗

PubMed1994

An integrated system for multidisciplinary assessments in stroke rehabilitation.

BACKGROUND AND PURPOSE: There is increasing emphasis on the use of integrated systems for timely, accurate, and efficient data collection for a range of service, audit, quality, and research applications. The present study evaluates the acceptability and the quality of data collected on a ward-based system over a 6-month period. METHODS: A multidisciplinary system specific for stroke rehabilitation was used. Members of each discipline were required to enter demographic, medical, nursing, therapy, and psychosocial data as appropriate to their specialty. A users' survey was undertaken at the beginning and at the end of the study. The quality and completeness of data entry were assessed by a "snapshot" of the database at the end of the study period. Primary users (n = 13) included physicians, nurses, and therapists. RESULTS: The user survey at the end of the evaluation showed a significant increase in confidence in using the system. Although the frequency of use had increased, the time spent in data entry had decreased significantly. The increase in work load, estimated at 15 to 60 minutes per week, was considered to be balanced by the benefits in patient care, audit, and research. There were 67 medical and 1046 other assessments on 67 patients entered into the system. Seven patients (11%) had incomplete medical records. Nursing and therapy assessments had been entered for all patients at admission and on discharge, with more than 95% of all possible assessments monitoring recovery being recorded accurately compared with conventional records. CONCLUSIONS: The study showed that it was possible to introduce a computerized multidisciplinary assessment system on rehabilitation wards as a part of day-to-day work without the need for significant extra resources.

Cerebrovascular Disorders↗

PubMed1983

Integrated systems: from library to campus and beyond.

Integrated library systems have not yet been created, although they have been emphasized for nearly two decades. Now and in the future, the task is even more complex because the principal issue is access to information itself, wherever it is located and in whatever form it may exist. The goal becomes more feasible because of changes in library practices achieved with technological innovation. Although individual elements of a campus-wide information system may already exist, the details for implementation are yet to be articulated.

Information Systems↗

PubMed1999

Mechanosensitivity as an integrative system in heart: an audit.

This review examines a manifold of apparently loosely linked observations and mechanisms, from membrane to man, and assembles them to support the notion that mechanoelectric transduction is an integrative regulatory system in the heart. For this, the assemblage has to satisfy, at least to some extent, criteria that apply to other integrative regulatory systems such as the endocrine and nervous systems. The integrative effectors in the endocrine system are chemical linkages, circulating hormones: in the nervous system the linkage is a network of cables, nerve conduction and neurotransmitters. Mechanical integration is would be effected through mechanical machinery, cardiac contractile and hydraulic function with attendant stress and strain transmitted via "tensegrity". This can, through the cytoskeleton, begin with membrane integrins and transmit intracellularly for example via F actins to reach the rest of the membranous integrins. Further transmission to the organ is via cell-to-cell adhesion complexes and the extracellular matrix. This tensegrity facilitates integration of force and strain changes from area to area. In consequence, and analogous to the neurendocrine system, mechanoelectric transduction should, and does (1) operate at the molecular or membrane level--this would be via mechanotransducers affecting transmembrane ionic flow; (2) operate in the cell--to influence electrophysiology; (3) have a multicellular expression--e.g. mechanical distortion of one cell can raise intracellular calcium of an adjacent cell; (4) express in the intact organ--e.g. an increase in venous return hydraulically distends the sinoatrial node, steepening its pacemaker potential, thus increasing heart rate. It should also (5) demonstrate elements of a feedback system--"mechanoelectric feedback", and (6) interact with other systems--the cytoskeleton incorporates cell signalling complexes intersecting with other signal cascades. Finally, (7) it can malfunction to produce clinical abnormality--it contributes electrophysiologically to lethal cardiac arrhythmia. This anatomical and functional behaviour of mechanoelectric transduction could sanction the prospect of viewing it as analogous to the other integrative physiological systems.

Actins↗

PubMedDate not supplied

Divesting losers: chipping away at integrated delivery systems.

Integrated health systems are rapidly divesting earlier acquisitions to beef up their bottom lines. Take an in-depth look at what the future may hold as the health systems battle to reorganize and reap greater profits.

Decision Making, Organizational↗

PubMed1999

Rapid decoherence in integrable systems: a border effect.

We show that rapid decoherence, usually associated with chaotic dynamics, is not necessarily a hallmark of nonintegrability: border effects in integrable systems may produce similarly drastic decoherence rates. These can be found when the subsystem under observation possesses an energy limitation as, e.g., in the N-atom Jaynes-Cummings model. We show for this model that special initial coherent wave packets exhibit entropy production rates strikingly similar to the chaotic case. Also, a (de)localization phenomenon is found to be a function of the proximity to the phase-space border.

Journal Article↗

PubMed1992

Comparison of integrated systemic and emotionally focused approaches to couples therapy.

This study compared couples receiving two marital therapy approaches and a control group over a 10-week treatment period. Integrated systemic therapy (IST) and an emotionally focused approach (EFT) were both found to be superior to the control and to be equally effective in alleviating marital distress, facilitating conflict resolution and goal attainment, and reducing target complaints at termination. IST couples, however, showed greater maintenance of gains from termination to 4-month follow-up on marital satisfaction and goal attainment. Clients' perceptions of how change occurred and issues related to the use of a team of observers in IST are discussed.

Adult↗

PubMed1987

Integrating systems theory and attachment theory: the use of radio communication to modify attachments in a patient with psychogenic vomiting.

A case is presented that shows the usefulness of integrating systems theory and attachment theory in the formulation and treatment of a clinical problem. The 5 year old son of East Indian immigrants presented with persistent psychogenic vomiting associated with pathological family attachments. It was evident that the precarious family equilibrium was stabilized by the child's psychogenic vomiting. The therapeutic team suggested to the family that their problems might be more satisfactorily resolved if the mother and child maintained their link by two-way radio. Three weeks later the vomiting had ceased, the child no longer felt that he needed the radio and both parents had established new patterns of relating to their child, whose attendance and peer socialization at school showed marked improvement. To some extent the rapid resolution of the problems was facilitated by the cultural strengths of the family.

Acculturation↗

PubMed1997

Identification and sequence analysis of the region encoding the site-specific integration system from Leuconostoc oenos (OEnococcus oeni) temperate bacteriophage phi 10MC.

Malolactic fermentation conducted by Leuconostoc oenos is an essential step in winemaking. L. oenos bacteriophages are thought to be responsible for fermentation failures, yet they have received little attention. The integration system of bacteriophage phi 10MC in the LOF111 L. oenos strain chromosome was studied and a 1,456 bp phage DNA fragment was cloned and sequenced. An open reading frame (int) showing homology with several temperate bacteriophage integrases was located upstream of the phage attachment site (attP). This organisation is comparable to other phage site-specific recombination systems. The same bacterial attachment site (attB) located in at tRNA(leu) gene was found in all 15 L. oenos strains studied and was involved in phi 10MC integration in the bacterial chromosome.

Amino Acid Sequence↗