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PubMed1976

A DATA MANAGER for the health information system Berlin.

The needs for permanently changing the logical and physical structure of a medical datebase during the development of a health information system have initiated the project of implementing a DATA MANAGER. The concept of the DATA MANAGER covers facilities for the development of the logical data structure model including documentation of the model and programming support for application programs accessing the health information system (HIS) database. The outstanding facilities of the INTERLISP system have been found to be appropriate for writing the DATA MANAGER. A first data structure model, on which the DATA MANAGER will operate, is roughly outlined.

Berlin↗
PubMed2003

Health information system for community-based multiple screening.

Disease screening is one of important activities in the domain of public health. However, traditional disease screening is based on solitary disease rather than multiple diseases. Although information accrued from multiple screening make contribution to health risk assessment as well as efficient management, data sources underpinning multiple screening are diversified and complicated including registration, primary data from questionnaire or biological measurement, referral system, confirmatory diagnosis, and case management. As our multiple screening integrates five types of cancers and four types of chronic disease at each out-reach and ambulatory setting, packages for attendants vary according to age, gender and risk factor (such as betel chewing, alcohol drink, smoking, family history, self-disease history, etc.). We took the initiative in design of health information system to support the complex processes of multiple screening. To enhance the efficiency of multiple screening and efficient disease management, health information system was therefore designed to support such a complicated infrastructure.

Adult↗
PubMed2005

[Founding and development of the Croatian Health Information System].

Information systems, either computer or paper based, are the key to business effectiveness and efficiency of healthcare organizations. The rationale of starting a large healthcare informatics project by the Ministry of Health and Welfare may be argued by two needs: (1) the need of medical data transformation into the information required for public health policy decision-making; and (2) measures in the field of health and pharmacoeconomics, i.e. systematic surveillance of healthcare costs that define the prospects for savings without lowering the level of service (estimated at 20%-30% of potential savings), along with the need of transparency and adoption of European Union directives and standards. Implementation of the proposed system results in two groups of fundamental functions: (1) the creation of a central public health information system which facilitates real-time tracking of primary healthcare cost generators, which in turn are used for creating health economics policy, and (2) to automatize the process of generating a consolidated national health budget including the Croatian Institute of Health Insurance and hospitals as well as consolidated financial reports for all those involved in the healthcare system. The model of the National Health Information System of the Republic of Croatia is described.

Croatia↗
PubMed1991

The European challenge in health information systems.

The challenge for Europe in the field of information and communication technologies applied to health care is that of "integration, modularity and security" of health information systems in order to obtain greater efficiency of health care, to assure quality of care and to promote industrial competitiveness.

Confidentiality↗
PubMedDate not supplied

[The role of a health information system as an aid in making regional public health decisions. Experience in Botswana (Southern Africa)].

Decision-making procedures within a health system vary according to the administrative and political organisation of each country. All health levels have, daily or irregularly, decisions to make. To provide reliable, objective and understandable information to decision makers is a difficult, expensive and sometimes misleading exercise. Basic data can be gathered through surveys or institutional routine. Through a concrete example within a Primary Health Care context, the possibilities and the advantages of the utilisation of routinely collected information, regionally processed, are described with the positive interactions within the whole health system. Validation, processing, relativization of the results and their use in supervision, epidemiological and performance surveillance are discussed, emphasizing the privileged aspect of Botswana.

Botswana↗
PubMed2005

Application of VPN technique in the construction of public health information system.

Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district (city), county, and town, as far as to the countryside level were described, and how to apply the three solutions, i.e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.

China↗
PubMedDate not supplied

Factors influencing health information system adoption in American hospitals.

OBJECTIVES: To study the number of health information systems (HISs), applicable to administrative, clinical, and executive decision support functionalities, adopted by acute care hospitals and to examine how hospital market, organizational, and financial factors influence HIS adoption. METHODS: A cross-sectional analysis was performed with 1441 hospitals selected from metropolitan statistical areas in the United States. Multiple data sources were merged. Six hypotheses were empirically tested by multiple regression analysis. RESULTS: HIS adoption was influenced by the hospital market, organizational, and financial factors. Larger, system-affiliated, and for-profit hospitals with more preferred provider organization contracts are more likely to adopt managerial information systems than their counterparts. Operating revenue is positively associated with HIS adoption. CONCLUSION: The study concludes that hospital organizational and financial factors influence on hospitals' strategic adoption of clinical, administrative, and managerial information systems.

Cross-Sectional Studies↗
PubMed2003

Survivable authentication for health information systems.

Possible solutions to establish a survivable authentication framework in a health information system including the one based on one-time passwords (OTPs) are discussed. A new convenient method to generate OTPs is proposed.

Algorithms↗
PubMed2003

Security, safety and quality in Health Information Systems.

The issues of Safety and Security are closely intertwined in Health information Systems. The paper explores the development of interest in these issues and looks to the next steps in the development of Safety standards. These efforts are compatible with the wider activities aimed at avoiding "adverse incidents" in the delivery of Healthcare.

Computer Security↗
PubMed1997

Evaluating large scale health information systems: from practice towards theory.

With the introduction of large scale health information systems which are incrementally developed from legacy systems, evaluators are faced with difficult methodological and practical problems. Some of the problems involved in multidisciplinary multi-method evaluations care discussed. It is argued that the development of a framework for evaluation is necessary in order to successfully plan an evaluation, understand the implications of the results and make future predictions based upon them. Some suggestions for arriving at such a framework are put forward.

Evaluation Studies as Topic↗
PubMed2004

The near-term future for child health information systems.

The developmental process in children offers an opportunity to influence their health and well-being as adults. The information infrastructure of the future needs to support the multiple partners responsible for providing elements of the health protection and health care of children. In this partnership, public health plays simultaneously a supportive role and a leadership role. Five tasks need to guide near-term information systems thinking with respect to establishing a basis for building electronic linkages among various child health programs. First, the nation's vital records system must be reengineered to ensure that this key information asset can be integrated into other child health information systems. Second, through an appropriate governance structure, the key stakeholders in child health should endorse standards and requirements that define a longitudinal health record for children. Third, public health agencies should develop a thorough business case/value proposition that drives mutually developed and mutually endorsed requirements for the integration of presently fragmented systems. Fourth, public health should take the lead in ensuring that parents have convenient access to information that can support the coordination of their child's care and development. And fifth, provider groups and public health agencies should join research networks to study how information supports positive changes to children's health.

Child↗
PubMed2006

[Health Information Systems: from closed systems to social citizenship. A challenge for the reduction of inequalities in local management].

The traditional concept of health information systems (HIS) poses numerous problems when attempting to support local management orientated to the reduction of health inequalities. How does one design a local HIS, and what would its characteristics be? We view HIS as open and complex systems of which we ourselves are a part. The hypothesis is that a HIS that provides support to local management must be conceived as a set of processes including data, information, knowledge, communication, and action (DIKCA). Data constitute a complex structure with five components. Information is a set of processed data; meanwhile knowledge output involves a subject's understanding and grasp of the phenomenon. Communication links the previous concepts to action. Strategic and communicative actions should be priorities in local management. This proposal aims at management support by the HIS to eliminate health inequalities and build an inclusive society.

Health Services Accessibility↗
PubMedDate not supplied

The development of a computerized health information system to facilitate program planning/evaluation and enhanced First Nations control of community health services.

The Ontario Region of the Medical Services Branch, Health Canada, comprises approximately 63,000 First Nations people living on reserve in 126 First Nations communities. As of January 1997, 39% of these communities have either assumed control of the delivery of health services or are in transfer negotiations with the federal government. Another 17% have entered into an Integrated Community Based Health Services Agreement with the federal government, which could culminate in a full transfer agreement. In order to provide First Nations with timely access to health information for case management, program planning and evaluation, and the development of their own program priorities at the community level, Medical Services Branch, Ontario Region, has worked in partnership with First Nations to develop a comprehensive, computerized Health Information System (HIS). With direct access to a reliable epidemiological database, First Nations will be able to re-profile available resources in response to their own identified community health priorities.

Community Health Services↗
PubMed1993

Graduate education in health information systems: having all your eggs in one basket.

Until recently, the technological evolution of information systems (IS) within the health care field has been relatively slow and sporadic in comparison to IS development in other industries. With the growing proliferation of powerful computers and personal workstations among health professionals, the advancement of IS technologies in the health care field has great potential. Hence, there is increasing pressure to integrate IS curricula into graduate level health administration education. This article combines earlier IS curricula from both the management and health care perspectives into an integrated framework for the development of a graduate education program in health information systems (HIS). The framework divides the HIS field into three modules: (1) HIS technologies and applications; (2) HIS theories and methodologies; and (3) HIS administration and impacts. This framework is also applied to the structuring of a master's level course for training generalists in HIS with a strong emphasis on the planning and management of hospital information systems.

British Columbia↗
PubMed2001

[Integrated health information system based on Resident Assessment Instruments].

The paper explores the meaning of Resident Assessment Instruments. It gives a summary of existing RAI instruments and derived applications. It argues how all of these form the basis for an integrated health information system for "chain care" (home care, home for the elderly care, nursing home care, mental health care and acute care). The primary application of RAI systems is the assessment of client care needs, followed by an analysis of the required and administered care with the objective to make an optimal individual care plan. On the basis of RAI, however, applications have been derived for reimbursement systems, quality improvement programs, accreditation, benchmarking, best practice comparison and care eligibility systems. These applications have become possible by the development on the basis of the Minimum Data Set of RAI of outcome measures (item scores, scales and indices), case-mix classifications and quality indicators. To illustrate the possibilities of outcome measures of RAI we present a table and a figure with data of six Dutch nursing homes which shows how social engagement is related to ADL and cognition. We argue that RAI/MDS assessment instruments comprise an integrated health information system because they have consistent terminology, common core items, and a common conceptual basis in a clinical approach that emphasizes the identification of functional problems.

Aged↗
PubMed2001

Securing interoperability between chip card based medical information systems and health networks.

Health information systems supporting shared care are going to be distributed and interoperable. Dealing with sensitive personal medical information, such information systems have to provide appropriate security services, allowing only authorised users restricted access rights to the patients' data according to the 'need to know' principle. Especially in healthcare, chip card based information systems occur in the shape of patient data cards providing informational self determination and mobility of the users as well as quality, integrity, accountability, and availability of the data stored on the card, thus improving the shared care of patients. The DIABCARD project aims at the implementation and evaluation of a chip card based medical information system (CCMIS) for facilitating communication and co-operation between health professionals in different organisations or departments caring the same patient with diabetes as an example. In co-operation with the EC-funded TrustHealth(2) project, communication and application security services needed are provided like strong authentication as well as the derived services such as authorisation, access control, accountability, confidentiality, etc. The solution is based on Health Professional Cards and Trusted Third Party services. In addition to the secure handling of the patient's chip card and data in DIABCARD workstations, the secure communication between these workstations and related departmental systems has been implemented. Based on the results of this feasibility study, an enhanced security services specification for the DIABCARD example of a CCMIS is provided which will be implemented in the framework of a health network being established in the German federal state Bavaria. Beside the preferred solution of a combination of Patient Identification Card and Patient Data Card, lower level alternatives using card-verifiable certificates are explained in some details. Finally, a few legal issues, future trends like the XML standard set and their implications for the solution presented as well as for distributed health information systems in general are shortly discussed.

Computer Security↗
PubMed2005

Implementing interoperable secure health information systems.

Ensuring the privacy and confidentiality of individuals has made security an indispensable component of health information systems. Delivery of healthcare services beyond the enterprise level to the regional, national or cross-border area places new challenges for security implementation. We review the current status and uptake of security measures in healthcare settings across European countries and examine in more detail some of the leading eHealth applications. Drawing on the findings of this analysis, we propose a generic model for streamlining the security implementation process on any level -local, regional, national or cross-border. Finally, we address the future prospects and requirements for advancing secure delivery of healthcare services across European borders.

Computer Security↗