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PubMed2004

Principles and core functions of integrated child health information systems.

Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

Child↗
PubMed2006

Education and training of health information systems--a literature review.

This review concerned the content of education and training in health information systems targeted for healthcare professionals. The publications selected for the review were explored as to their educational content, theoretical approaches, available options, learning outcomes and the respective impact on organisational learning. A total of 1772 abstracts were screened and up to 423 abstracts studied in more detail. Two reviewers independently assessed the extracted data and decided to include 21 articles for the final review. The studies were analysed in relation to health informatics competence level, previous knowledge of information system usage, learning environment, teaching methods, pedagogical approaches, goals of training and assessment of learning. The review revealed that any level of competence in health informatics contributes to the learning process. The review suggested that more attention should be paid to setting up goals for training and measuring the preferable competence level of learning. It also clearly indicated the need for further research on teaching health informatics to healthcare professionals.

Curriculum↗
PubMed1999

Evaluating computerized health information systems: hardware, software and human ware: experiences from the Northern Province, South Africa.

Despite enormous investment world-wide in computerized health information systems their overall benefits and costs have rarely been fully assessed. A major new initiative in South Africa provides the opportunity to evaluate the introduction of information technology from a global perspective and assess its impact on public health. The Northern Province is implementing a comprehensive integrated hospital information system (HIS) in all of its 42 hospitals. These include two mental health institutions, eight regional hospitals (two acting as a tertiary complex with teaching responsibilities) and 32 district hospitals. The overall goal of the HIS is to improve the efficiency and effectiveness of health (and welfare) services through the creation and use of information, for clinical, administrative and monitoring purposes. This multi-site implementation is being undertaken as a single project at a cost of R130 million (which represents 2.5 per cent of the health and welfare budget on an annual basis). The implementation process commenced on 1 September 1998 with the introduction of the system into Mankweng Hospital as the pilot site and is to be completed in the year 2001. An evaluation programme has been designed to maximize the likelihood of success of the implementation phase (formative evaluation) as well as providing an overall assessment of its benefits and costs (summative evaluation). The evaluation was designed as a form of health technology assessment; the system will have to prove its worth (in terms of cost-effectiveness) relative to other interventions. This is more extensive than the traditional form of technical assessment of hardware and software functionality, and moves into assessing the day-to-day utility of the system, the clinical and managerial environment in which it is situated (humanware), and ultimately its effects on the quality of patient care and public health. In keeping with new South African legislation the evaluation process sought to involve as many stakeholders as possible at the same time as creating a methodologically rigorous study that lived within realistic resource limits. The design chosen for the summative assessment was a randomized controlled trial (RCT) in which 24 district hospitals will receive the HIS either early or late. This is the first attempt to carry out an RCT evaluation of a multi-site implementation of an HIS in the world. Within this design the evaluation will utilize a range of qualitative and quantitative techniques over varying time scales, each addressing specific aims of the evaluation programme. In addition, it will attempt to provide an overview of the general impact on people and organizations of introducing high-technology solutions into a relatively unprepared environment. The study should help to stimulate an evaluation culture in the health and welfare services in the Northern Province as well as building the capacity to undertake such evaluations in the future.

Computers↗
PubMed1998

Results of European projects improving security of distributed health information systems.

The challenge for improvement of quality and efficiency of health care systems causes the development and promotion of "Shared Care" in all developed countries. Distribution, decentralisation, and specialisation of health care must be joint with an extended communication and co-operation between the different care providers. Fulfilling the shared care paradigm, care supporting health information systems has to be distributed, interoperable, and scaleable too. Communication and co-operation across organisational, regional, and even national boundaries is bearing high threats and risks regarding security and privacy of medical and personal information of both patients and health professionals. Involved in several security projects funded by the European Union, the Medical Informatics Department and the regional Clinical Cancer Registry at the University of Magdeburg are piloting a secure regional distributed medical record system for cancer diseases. Requirements, solutions, and experiences are presented and discussed.

Computer Communication Networks↗
PubMed1981

Evaluating primary ambulatory care with a health information system.

This paper describes one method by which data from a computer based health information system are used to screen the ambulatory care experiences of family practice residents. The steps in the evaluation process are discussed. Data collection techniques and definition of the reference population against which comparisons among the residents are made are also explained. The evaluation process is based on initial observations to answer progressively more specific questions about the resident-patient encounters. This approach is acceptable to faculty for several reasons: (1) data are timely and require minimal extra effort for collection, (2) resident discrepancies are easily identified, (3) data summaries are concise and easy to interpret, (4) cost effectiveness of resident performance can be evaluated, and (5) data are organized around a patient and the encounters he or she has had with all residents providing care.

Adolescent↗
PubMed2004

Key elements for successful integrated health information systems: lessons from the States.

The Genetic Services Branch, Maternal and Child Health Bureau of the Health Services and Resources Administration has provided funding to state health departments to integrate their newborn dried blood-spot screening programs with other early child health information systems since 1999. In 2001, All Kids Count conducted site visits to these grantees to identify and describe best practices in planning, developing, and implementing their integration projects. The site visits were organized around 9 key elements considered critical to the success of an information systems integration project: leadership, project governance, project management, stakeholder involvement, organizational and technical strategy, technical support and coordination, financial support and management, policy support and evaluation. Best practices for each of the key elements and 5 lessons learned were documented in Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Sourcebook for Planning and Development. The lessons learned are overarching conclusions that agencies should consider when planning and implementing integrated information systems. This article briefly describes the key elements, their best practices as implemented by states, and the lessons learned.

Child↗
PubMed2005

Health information systems - past, present, future.

In 1984, Peter Reichertz gave a lecture on the past, present and future of hospital information systems. In the meantime, there has been a tremendous progress in medicine as well as in informatics. One important benefit of this progress is that our life expectancy is nowadays significantly higher than it would have been even some few decades ago. This progress, leading to aging societies, is of influence to the organization of health care and to the future development of its information systems. Twenty years later, referring to Peter Reichertz' lecture, but now considering health information systems (HIS), two questions are discussed: which were lines of development in health information systems from the past until today? What are consequences for health information systems in the future? The following lines of development for HIS were considered as important: (1) the shift from paper-based to computer-based processing and storage, as well as the increase of data in health care settings; (2) the shift from institution-centered departmental and, later, hospital information systems towards regional and global HIS; (3) the inclusion of patients and health consumers as HIS users, besides health care professionals and administrators; (4) the use of HIS data not only for patient care and administrative purposes, but also for health care planning as well as clinical and epidemiological research; (5) the shift from focusing mainly on technical HIS problems to those of change management as well as of strategic information management; (6) the shift from mainly alpha-numeric data in HIS to images and now also to data on the molecular level; (7) the steady increase of new technologies to be included, now starting to include ubiquitous computing environments and sensor-based technologies for health monitoring. As consequences for HIS in the future, first the need for institutional and (inter-) national HIS-strategies is seen, second the need to explore new (transinstitutional) HIS architectural styles, third the need for education in health informatics and/or biomedical informatics, including appropriate knowledge and skills on HIS. As these new HIS are urgently needed for reorganizing health care in an aging society, as last consequence the need for research around HIS is seen. Research should include the development and investigation of appropriate transinstitutional information system architectures, of adequate methods for strategic information management, of methods for modeling and evaluating HIS, the development and investigation of comprehensive electronic patient records, providing appropriate access for health care professionals as well as for patients, in the broad sense as described here, e.g. including home care and health monitoring facilities. Comparing the world in 1984 and in 2004, we have to recognize that we imperceptibly, stepwise arrived at a new world. HIS have become one of the most challenging and promising fields of research, education and practice for medical informatics, with significant benefits to medicine and health care in general.

Computer Systems↗
PubMed1995

The development of integrated public health information systems: a statement by the Joint Council of Governmental Public Health Agencies.

To truly enjoy the benefits of the information age, public health agencies at each level of government must work together to plan and implement integrated information systems that meet the needs of our dynamic profession. The Joint Council of Governmental Public Health Agencies, comprised of state and local health officials, has worked to identify the solutions to public health's information needs. Investments in integrated systems that support service delivery to clients will improve program management and enhance accountability for public funds. The ability to produce good, client-centered data will be essential as the nation's health and welfare systems change.

Data Collection↗
PubMedDate not supplied

European strategies for training in health information systems.

The Committee of Ministers of the Council of Europe recently adopted a recommendation on training strategies for health information systems. The main elements were: specific adaptation of training both to the wider health care setting and to the individual work situation; training provided on a multidisciplinary basis; involvement of local health care, educational, research and commercial establishments; setting up of a network of reference centres to facilitate rapid exchange and harmonisation at national and European levels.

Curriculum↗
PubMed1998

The potential for Ontario region's health information system to facilitate case management, program planning, and evaluation and to promote enhanced First Nations' control of health services.

The Ontario Region of Medical Services Branch, Health Canada, comprises approximately 63,000 First Nations people living on-reserve in four geographical areas: Sioux Lookout, Moose Factory, Thunder Bay, and Southern Ontario. As of April 1996, 35% of the 126 First Nations communities in Ontario Region have either assumed control of the delivery of health services or are in the process of transfer negotiations with the federal government. Another 14% have entered into Integrated Community-based Health Services Agreements with the federal government, which is an intermediate step that could culminate in a complete transfer agreement. In order to provide First Nations with an epidemiological database for effective program planning and evaluation, Medical Services Branch, Ontario Region, has worked in partnership with First Nations during the past two and one-half years to develop a comprehensive, computerized Health Information System (HIS). HIS will provide First Nations with a significant degree of autonomy from the Medical Services Branch structure, with regard to access to health information for case management, program planning and evaluation, and the establishment of their own program priorities at the community level. With access to the HIS, First Nations will eventually be able to re-profile available resource in response to their own identified community health priorities.

Case Management↗
PubMed2001

A MeSH based intelligent search intermediary for Consumer Health Information Systems.

GIN Austria (Gesundheitsinformationsnetz Austria) offers patients and consumers reliable medical knowledge about diseases, wellness and disease management in an easy understandable way and enables them to quick and incessant access to informations about the Austrian health system and Austrian health organizations. To achieve full customer (patients, citizens) satisfaction to find relevant information we propose a concept of a vector-model oriented IR-Tool based on the controlled vocabulary of the MeSH Thesaurus (german version). By this approach users who are often not used to scientific terms and expressions are supported to build up their own query with MeSH Main Headings. In a second step broader and narrower Main Headings are added to the query vector by the system. For this calculation an adapted version of the Floyd-Warshall algorithm for directed, azyclic graphs is used. The tool is part of the GIN Search Modul, which will ease gathering health information from different heterogenous internet datasources.

Austria↗
PubMed1999

[Rapid development of a uniform computerized health information system in the Zenica-Doboj Canton].

It is very expensive and long-termed process to establish a complex information system, and it requires to include large number of people and processing of large number of information. As I believe that health economics and management are the key factors for maintaining health system, I think that it is now essential to create information system which will, above all, ensure accurate and prompt information to the health managers. Therefore, I suggest building of a cheaper variant of the information system which could be upgrated, and which will involve, on this stage, small number of health workers. Computerized part of this information system would be built in several levels. At each of these levels data for the needs of health statistics, economic-financial activities, and management would be processed. Communication within information system, on this stage, would be enabled through telephone lines and modems. The system would work "off line". The change of data would be carried out periodically.

Bosnia and Herzegovina↗
PubMed2007

Educational challenge of health information systems' interoperability.

OBJECTIVES: As health care develops from an organization-centered via service-centered (disease management) towards a person-centered system (favored homecare, patient monitoring, body area networks), information systems involved have to be semantically interoperable, process-related, decision-supportive, context-sensitive, user-oriented, and trustworthy. METHODS: The aforementioned paradigm shift requires highly flexible solutions based on knowledge concepts, provided by a service-oriented and model-driven approach. RESULTS: Information systems' design, implementation and maintenance have to be realized based on formal grammar. This is true for all considered aspects and views of the system and its components, using metalanguages and reflecting all domains touched. CONCLUSIONS: For meeting the challenge, involvement of, and close collaboration between, experts from different domains as well as knowledge and tooling regarding formal modeling and model interchange are required.

Artificial Intelligence↗