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[Development and utilization of the integral system of computer monitoring in anesthesiology in clinical obstetrics and gynecology].

An original computer monitoring system for preoperative monitoring was developed at the department of anesthesiology and intensive care of the Research Center for Obstetrics and Gynecology of the Russian Academy of Medical Sciences. The system includes a bedside monitor Athena (S&W + Artema, Denmark) and two special monitors ABM-100 (Datex, Finland) and NCCOM (Bomed, USA). The potentialities of the system are discussed; physiological parameters were monitored and estimated in the real time mode. Variants of graphic interface of the system are presented, including an original multisystem integral nomogram. Utilization of the system demonstrated the advantages of objective physiological information recorded by the system, a high informative values of integral estimated parameters in the real time mode. The use of the multisystem integral nomogram helps the anesthesiologist rapidly and unambiguously to interpret the clinical situation and essentially accelerates the decision-making on further treatment strategy. The work with the system does not require any special knowledge and skills, the system is simple and easy in use.

Anesthesia, Obstetrical↗
PubMed2000

Demystifying the hospital information system/radiology information system integration process.

Most organizations planning to implement picture archiving and communications systems (PACS) are aware of the need to integrate the hospital information system (HIS) and radiology information system (RIS) with the PACS, yet few are acutely aware of the challenges associated with this requirement. This report highlights the results of collaborative efforts between Children's Hospital Medical Center-Cincinnati (CHMC) applications specialists with expertise in the HIS and CHMC information system, radiology staff familiar with the enterprise and radiology workflow and data flow requirements; and General Electric integration engineers familiar with the SMS HIS and RIS, and GE PACS. CHMC received Board approval, including full funding of the entire PACS project, in October 1998. An aggressive time frame for installation was established, as CHMC's PACS leadership committed to the selection, design, and implementation of PACS and computed radiography (CR) within 18 to 20 months. CHMC selected GE (Milwaukee, WI) as its PACS vendor in July 1999, and began its implementation in November 1999. We will present the four-stage integration process undertaken at CHMC: (1) planning the integration effort, (2) designing the Interface, (3) building the interface, and (4) testing the Interface.

Computer Systems↗
PubMed1981

[Response of pituitary and adrenal elements in a state of cardiorespiratory system integration].

Morpho-functional equivalents of reaction of the hypophyseal and adrenal elements have been studied in 7 test and 10 control dogs biometrically, histologically, histoenzymatically and electron microscopically under the condition of integration in the cardio-respiratory systems. The condition has been modelled by individually chosen physical loading (running in the treadmill) up to the IV stage of the organism's adaptation according to the author's technique. The integration state is developing instead of the starting desintegration state (the beginning of the work) and is characterized by an economical and effective functioning of the cardio-respiratory system elements. At the integration of the cardio-respiratory apparatus, the hypophysial-adrenal system is activating. The principle of the zonal reaction in the adrenals and that of the selective activity of the adenohypophysis is clearly followed, that is demonstrated in the predominant activation of the bundle zone elements, chromophobic and basophilic adenocytes where certain signs of the secretory excretion predominate. In cells of the glomerular zone the signs of synthetic processes prevail over those of the secretory excretion. In cells of the medullary substance the signs of the preceding forced secretory excretion are clearly seen. A suggestion is made that it is expedient to elaborate training regimes according to the loading determining integration of the organism's cardio-respiratory systems.

11-Hydroxycorticosteroids↗
PubMed2000

Clear goals, solid evidence, integrated systems, realistic roles.

To maximize the effectiveness of home care in improving or maintaining the health of Canadians, home-care programs must have clear goals, be founded firmly on evidence of effectiveness, form part of an integrated healthcare system and be grounded in constitutional and political reality. Goals should be client-centred and distinguish between curative, supportive and preventive care. Curative and supportive home care can be cost-effective if substitution for more costly institutional services can be achieved, but the cost-effectiveness of preventive home care and comprehensive care for the elderly has not been clearly demonstrated. Integrated delivery systems are a prerequisite for effective substitution of care at home for institutional care. Federal financing dedicated to a home-care program is unnecessary and is a political and constitutional non-starter. Federal leadership for a national home-care approach would be welcome. Canada Health Act protection for access to medically necessary home care is attractive, but such protection for pharmaceuticals is a higher need. Federal support for research and demonstration of new models of care is valuable.

Canada↗
PubMed1998

System integration: a necessity.

Healthcare organizations are undergoing tremendous change in an attempt to become more flexible and adaptive. To be successful in any such transformation, organizations must build processes and systems that allow them to move with change and create a culture that allows individuals to thrive amid change. The authors describe how a community teaching hospital has attempted this through its partnership in a vertically integrated delivery system, its reorganization to product line management, its adoption of a shared governance structure, and its commitment to building a culture with strong relationships. Many of these processes and systems are in their infancy, but an examination of the journey will inform other organizations as they respond to change.

Delivery of Health Care, Integrated↗
PubMed1995

Capitation revisited: integrated systems learn how to manage care and risk.

Caught in the middle of HMO price wars, integrated delivery systems are tightening their belts and demanding a greater share of what they save from delivering good outcomes more efficiently. Quality isn't endangered yet, leaders agree, but could be unless employers start to incorporate outcomes measures into their choice of health plans.

Capitation Fee↗
PubMed1998

Clinical process improvement as a means of facilitating health care system integration.

BACKGROUND: In recent years many health care providers, physicians, hospitals, and managed care organizations have undergone significant reorganization in both delivery and financing systems. This has created new organizations called integrated or organized delivery systems. Sentara Health System (Norfolk, Va), one of these new integrated entities, developed a unified strategy for clinical process improvement for the entire organization. This system-wide approach had unanticipated problems and benefits. METHODS: The Sentara Health System created a team responsible for coordinating clinical process improvement activities across its hospitals and ambulatory physician sites. A steering committee directed this team to improve the organization and delivery of care for specific high-cost, high-volume, or problem-prone disease for physicians to manage. A standardized approach aimed at coordinating care across sites was the cornerstone of these activities. RESULTS: Significant improvements in patient outcomes and a concomitant decrease in costs of care were accomplished for multiple diseases and procedures. These projects uncovered unanticipated barriers to implementing improvement projects in a complex health care system which make implementing these activities far more difficult than for an individual hospital with its medical staff. CONCLUSION: Coordinating clinical improvement activities across multiple hospitals and other sites of care in a complex integrated delivery system serves important purposes in addition to improving patient care. These projects were an important cultural change agent to transform the individual components of the system into one that is capable of delivering care continuously across multiple sites. Standardization of care practices, policies, and procedures is considerably enhanced by coordinating these activities across the entire system.

Cerebrovascular Disorders↗
PubMed1998

Home telecare system integrated with periodic health reminder and medical record & multimedia health information.

The necessity of home telecare system is growing due to increase in desire for health promotion owing to increase in chronic diseases, aged population and medical expenses. Already, we computerized patient's data and offer periodic health reminder to patients for health promotion by using Life-time Health Monitoring Program (LHMP). Our study connected LHMP to the Web on internet by CGI as an electronic medical record; enabling reference to patient's medical records anywhere. The study also made possible video teleconsultation and constructed multimedia database to provide health-related information to the patients. On these bases, a flow chart was developed using the home telecare to practice manage patients with chronic diseases, old patients, and the handicapped. Further standardization in data, establishment of law bases for home telecare system, development of rules for medical fees and active utilization of biomedical telemetry will be needed to extend home telecare system.

Home Care Services↗
PubMed1998

Designing health care information systems for integrated delivery systems: where we are and where we need to be.

A critical step in evolving an integrated delivery system (IDS) is planning, designing, and technologically realizing an efficient, appropriate, and effective infrastructure for developing an integrated network of information systems. The key to meeting this objective philosophically, logically, and physically in the face of rapid advances in computing technology and communication trends is often poorly understood by health providers and managers. The article discusses the concept of a total quality management information system model and illustrates how this sort of thinking can be applied to guide the critical steps that must be undertaken to plan, design, and develop a networked infrastructure of health care information systems that can facilitate information exchange and sharing among multiple health care providers within an IDS.

Canada↗
PubMed2001

An integrated system for high throughput TaqMan based SNP genotyping.

UNLABELLED: We have developed an integrated laboratory information system that allows the flexible handling of pedigree, phenotype and genotype information. Specifically, it includes client applications for an integrated data import from TaqMan typing files, Mendel checking, data export, handling of pedigree and phenotype information and analysis features. AVAILABILITY: The SQL source code, sources and binaries of the client applications (NT and Windows95/98 platforms) and additional documentation are available at http://www.mucosa.de/.

Clinical Laboratory Information Systems↗
PubMed2001

Integrated system for high-throughput protein identification using a microfabricated device coupled to capillary electrophoresis/nanoelectrospray mass spectrometry.

An integrated microsystem providing rapid analyses of trace-level tryptic digests for proteomics application is presented. This modular microsystem includes an autosampler and a microfabricated device comprising a sample introduction port and an array of separation channels together with a low dead-volume facilitating the interface to nanoelectrospray mass spectrometry. Sequential injection and separation of peptide standards and tryptic digests was achieved with a throughput of up to 30 samples per hour with less than 3% sample carryover. Replicate injections of peptide mixtures indicated that reproducibility of migration time was typically better than 2.3% relative standard deviation (RSD) whereas RSD values of 3.7-11.8% were observed on peak height. Mass spectral detection of submicromolar protein digests (< 7 femtomoles/injection) was achieved using a quadrupole/time of flight instrument in less than 2 min/per sample with peak widths of 1.8-7.0 s. The analytical potential of this integrated device for the identification of gel isolated proteins from Neisseria meningitidis immunotype L3 has been demonstrated using both peptide mass-fingerprint database searching and on-line tandem mass spectrometry.

Amino Acid Sequence↗
PubMed2000

An integrated system of telemedicine for minimally invasive surgery.

We have developed a telemedicine project called Telesurgex, which is an integrated information system designed for several hospitals as well as the Minimally Invasive Surgery Centre. The project researches and develops telemedicine systems (both hardware and software) and their contents, ensuring that they are really useful and not just a videoconference with medical topics. Another aim of the project is the improvement of teleteaching systems as applied to medicine, mainly teleteaching of minimally invasive surgical techniques.

Computer Communication Networks↗