scholarly journals Steps towards Interoperability in Healthcare Environment

2016 ◽  
pp. 1-23 ◽  
Author(s):  
Hugo Peixoto ◽  
Andréa Domingues ◽  
Bruno Fernandes
Keyword(s):  
Information Systems ◽  
Open Source ◽  
Continuous Improvement ◽  
Intelligent Agents ◽  
Clinical Studies ◽  
Clinical Decision ◽  
Clinical Situation ◽  
Health Record ◽  
Alert System ◽  
Preventive Actions

Information should be accessible everywhere and at any time to help with clinical decision and be available for clinical studies through data computationally interpretable. This work is based on a set of studies performed at Centro Hospitalar do Tâmega e Sousa. An Electronic Semantic Health Record was formalized and implemented which was delivered through a platform named Agency for the Integration, Diffusion and Archive, which is supported by intelligent agents. Furthermore, to strengthen the relation between the patient and the hospital, an appointment alert system was developed, which allowed the reduction of non-programmed misses and a decrease of costs. Finally to promote user's confidence on Information Systems, an open-source tool was developed that enables the scheduling of preventive actions. These tools allowed continuous improvement of systems and are currently well accepted inside the healthcare unit, proving in real clinical situation the effectiveness and usability of the model.

scholarly journals Steps towards Interoperability in Healthcare Environment

2020 ◽  
pp. 482-499
Author(s):  
Hugo Peixoto ◽  
Andréa Domingues ◽  
Bruno Fernandes
Keyword(s):  
Information Systems ◽  
Open Source ◽  
Continuous Improvement ◽  
Intelligent Agents ◽  
Clinical Studies ◽  
Clinical Decision ◽  
Clinical Situation ◽  
Health Record ◽  
Alert System ◽  
Preventive Actions

Information should be accessible everywhere and at any time to help with clinical decision and be available for clinical studies through data computationally interpretable. This work is based on a set of studies performed at Centro Hospitalar do Tâmega e Sousa. An Electronic Semantic Health Record was formalized and implemented which was delivered through a platform named Agency for the Integration, Diffusion and Archive, which is supported by intelligent agents. Furthermore, to strengthen the relation between the patient and the hospital, an appointment alert system was developed, which allowed the reduction of non-programmed misses and a decrease of costs. Finally to promote user's confidence on Information Systems, an open-source tool was developed that enables the scheduling of preventive actions. These tools allowed continuous improvement of systems and are currently well accepted inside the healthcare unit, proving in real clinical situation the effectiveness and usability of the model.

scholarly journals ScheduleIT–Open-Source Preventive Actions Management Plataform in Healthcare Information Systems

2012 ◽  
Vol 5 ◽  
pp. 734-742 ◽  
Author(s):  
Hugo Peixoto ◽  
Jœlio Duarte ◽  
António Abelha ◽  
Manuel Santos ◽  
José Machado
Keyword(s):  
Information Systems ◽  
Open Source ◽  
Healthcare Information ◽  
Healthcare Information Systems ◽  
Preventive Actions

Integrating Legacy Laboratory Information Systems into a Client-Server World: The University of Minnesota Clinical Workstation (CWS) Project

1995 ◽  
Vol 34 (03) ◽  
pp. 289-296 ◽  
Author(s):  
B. H. Sielaff ◽  
D. P. Connelly ◽  
K. E. Willard
Keyword(s):  
Information Systems ◽  
Clinical Decision ◽  
Database Management System ◽  
University Of Minnesota ◽  
Client Server ◽  
Clinical Workstation ◽  
Future Hospital ◽  
The Cost ◽  
The University ◽  
Laboratory Information Systems

Abstract:The development of an innovative clinical decision-support project such as the University of Minnesota’s Clinical Workstation initiative mandates the use of modern client-server network architectures. Preexisting conventional laboratory information systems (LIS) cannot be quickly replaced with client-server equivalents because of the cost and relative unavailability of such systems. Thus, embedding strategies that effectively integrate legacy information systems are needed. Our strategy led to the adoption of a multi-layered connection architecture that provides a data feed from our existing LIS to a new network-based relational database management system. By careful design, we maximize the use of open standards in our layered connection structure to provide data, requisition, or event messaging in several formats. Each layer is optimized to provide needed services to existing hospital clients and is well positioned to support future hospital network clients.

Effectivness of Health Information System Applications: Clinical Information and Diagnosis-Treatment Systems in Turkey

2017 ◽  
Vol 5 (1) ◽  
pp. 122
Author(s):  
Assist. Prof. Dr. Demokaan DEMİREL
Keyword(s):  
Decision Making ◽  
Information System ◽  
Information Systems ◽  
Management Information System ◽  
Health Sector ◽  
Health Information System ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Management Information

The distinctive quality of the new social structure is that information becomes the only factor of production. In today's organizations, public administrators are directly responsible for applying information to administrative processes. In addition to his managerial responsibilities, a knowledge based organization requires every employee to take responsibility for achieving efficiency. This has increased the importance of information systems in the decision-making process. Information systems consist of computer and communication technology, data base management and model management and include activity processing system, management information system, decision support systems, senior management information system, expert systems and office automation systems. Information systems in the health sector aim at the management and provision of preventive and curative health services. The use of information systems in healthcare has the benefits of increasing service quality, shortening treatment processes, maximizing efficiency of the time, labour and medical devices. The use of information systems for clinical decision making and reducing medical errors in the healthcare industry dates back to the 1960s. Clinical information systems involve processing, storing and re-accessing information that supports patient care in a hospital. Clinical information systems are systems that are directly or indirectly related to patient care. These systems include electronic health/patient records, clinical decision support systems, nurse information systems, patient tracking systems, tele-medicine, case mix and smart card applications. Diagnosis-treatment systems are information-based systems used in the diagnosis and treatment of diseases. It consists of laboratory information systems, picture archiving and communication system, pharmacy information system, radiology information system, nuclear medicine information system. This study aims to evaluate the effectiveness of health information system applications in Turkey. The first part of the study focuses on the concept of information systems and the types of information systems in organization structures. In the second part, clinical information systems and applications for diagnosis-treatment systems in Turkey are examined. Finally, the study evaluates applications in the health sector qualitatively from the new organizational structure, which is formed by information systems.

Malignant hyperthermia susceptibility: utilization of genetic results in an electronic medical record to increase safety

2020 ◽  
Vol 21 (17) ◽  
pp. 1207-1215
Author(s):  
Jordan F Baye ◽  
Natasha J Petry ◽  
Shauna L Jacobson ◽  
Michelle M Moore ◽  
Bethany Tucker ◽  
...  
Keyword(s):  
Decision Support ◽  
Malignant Hyperthermia ◽  
Clinical Decision Support ◽  
Perioperative Complications ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Malignant Hyperthermia Susceptibility ◽  
Alert System ◽  
Genotyping Platform

Aim: This manuscript describes implementation of clinical decision support for providers concerned with perioperative complications of malignant hyperthermia susceptibility. Materials & methods: Clinical decision support for malignant hyperthermia susceptibility was implemented in 2018 based around our pre-emptive genotyping platform. We completed a brief descriptive review of patients who underwent pre-emptive testing, focused particularly on RYR1 and CACNA1S genes. Results: To date, we have completed pre-emptive genetic testing on more than 10,000 patients; 13 patients having been identified as a carrier of a pathogenic or likely pathogenic variant of RYR1 or CACNA1S. Conclusion: An alert system for malignant hyperthermia susceptibility – as an extension of our pre-emptive genomics platform – was implemented successfully. Implementation strategies and lessons learned are discussed herein.

scholarly journals Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record

2021 ◽  
Vol 147 ◽  
pp. 104349
Author(s):  
Thomas McGinn ◽  
David A. Feldstein ◽  
Isabel Barata ◽  
Emily Heineman ◽  
Joshua Ross ◽  
...  
Keyword(s):  
Child Abuse ◽  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Health Record ◽  
Electronic Health

scholarly journals Facilitating Genetics Aware Clinical Decision Support: Putting the eMERGE Infrastructure into Practice

ACI Open ◽  
2021 ◽  
Vol 05 (02) ◽  
pp. e54-e58
Author(s):  
Casey Overby Taylor ◽  
Luke V. Rasmussen ◽  
Laura J. Rasmussen-Torvik ◽  
Cynthia A. Prows ◽  
David A. Dorr ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Medical Records ◽  
Clinical Decision Support ◽  
Medical Records ◽  
Case Reports ◽  
Clinical Decision ◽  
Phase Iii ◽  
Health Record ◽  
It Infrastructure ◽  
Emerge Network

AbstractThis editorial provides context for a series of published case reports in ACI Open by summarizing activities and outputs of joint electronic health record integration and pharmacogenomics workgroups in the NIH-funded electronic Medical Records and Genomics (eMERGE) Network. A case report is a useful tool to describe the range of capabilities that an IT infrastructure or a particular technology must support. The activities we describe have informed infrastructure requirements used during eMERGE phase III, provided a venue to share experiences and ask questions among other eMERGE sites, summarized potential hazards that might be encountered for specific clinical decision support (CDS) implementation scenarios, and provided a simple framework that captured progress toward implementing CDS at eMERGE sites in a consistent format.

scholarly journals Reduced Length of Stay Using Clinical Decision Support Tool (ASAP) for Empiric Antibiotic Selection

2020 ◽  
Vol 41 (S1) ◽  
pp. s368-s368
Author(s):  
Mary Acree ◽  
Kamaljit Singh ◽  
Urmila Ravichandran ◽  
Jennifer Grant ◽  
Gary Fleming ◽  
...  
Keyword(s):  
Decision Support ◽  
Length Of Stay ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Health Record ◽  
Antibiotic Selection ◽  
Support Tool ◽  
Empiric Antibiotic

Background: Empiric antibiotic selection is challenging and requires knowledge of the local antibiogram, national guidelines and patient-specific factors, such as drug allergy and recent antibiotic exposure. Clinical decision support for empiric antibiotic selection has the potential to improve adherence to guidelines and improve patient outcomes. Methods: At NorthShore University HealthSystem, a 4-hospital, 789 bed system, an automated point-of-care decision support tool referred to as Antimicrobial Stewardship Assistance Program (ASAP) was created for empiric antibiotic selection for 4 infectious syndromes: pneumonia, skin and soft-tissue infections, urinary tract infection, and intra-abdominal infection. The tool input data from the electronic health record, which can be modified by any user. Using an algorithm created with electronic health record data, antibiogram data, and national guidelines, the tool produces an antibiotic recommendation that can be ordered via a link to order entry. If the tool identifies a patient with a high likelihood for a multidrug-resistant infection, a consultation by an infectious diseases specialist is recommended. Utilization of the tool and associated outcomes were evaluated from July 2018 to May 2019. Results: The ASAP tool was executed by 140 unique, noninfectious diseases providers 790 times. The tool was utilized most often for pneumonia (194 tool uses), followed by urinary tract infection (166 tool uses). The most common provider type to use the tool was an internal medicine hospitalist. The tool increased adherence to the recommended antibiotic regimen for each condition. Antibiotic appropriateness was assessed by an infectious diseases physician. Antibiotics were considered appropriate when they were similar to the antibiotic regimen recommended by the ASAP. Inappropriate antibiotics were classified as broad or narrow. When antibiotic coverage was appropriate, hospital length of stay was statistically significantly shorter (4.8 days vs 6.8 days for broad antibiotics vs 7.4 days for narrow antibiotics; P < .01). No significant differences were identified in mortality or readmission. Conclusions: A clinical decision support tool in the electronic health record can improve adherence to recommended empiric antibiotic therapy. Use of appropriate antibiotics recommended by such a tool can reduce hospital length of stay.Funding: NoneDisclosures: None

Assessing HIPAA Compliance of Open Source Electronic Health Record Applications

2021 ◽  
Vol 15 (2) ◽  
pp. 181-195
Author(s):  
Hossain Shahriar ◽  
Hisham M. Haddad ◽  
Maryam Farhadi
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Medical Decision ◽  
Patient Treatment ◽  
Health Record ◽  
Technical Requirements ◽  
Patient Health ◽  
Treatment Plans ◽  
Electronic Health ◽  
Quality In Healthcare

Electronic health record (EHR) applications are digital versions of paper-based patient health information. EHR applications are increasingly being adopted in many countries. They have resulted in improved quality in healthcare, convenient access to histories of patient medication and clinic visits, easier follow up of patient treatment plans, and precise medical decision-making process. The goal of this paper is to identify HIPAA technical requirements, evaluate two open source EHR applications (OpenEMR and OpenClinic) for security vulnerabilities using two open-source scanner tools (RIPS and PHP VulnHunter), and map the identified vulnerabilities to HIPAA technical requirements.

scholarly journals Developing Clinical Decision Support within a Commercial Electronic Health Record System to Improve Antimicrobial Prescribing in the Neonatal ICU

2014 ◽  
Vol 05 (02) ◽  
pp. 368-387 ◽  
Author(s):  
K. Cato ◽  
B. Sheehan ◽  
S. Patel ◽  
J. Duchon ◽  
P. DeLaMora ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Antimicrobial Prescribing ◽  
Neonatal Icu ◽  
Electronic Health

SummaryObjective: To develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool.Methods: Following sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool.Results: The CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%).Discussion: During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved.Conclusion: To improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges.Citation: Hum RS, Cato K, Sheehan B, Patel S, Duchon J, DeLaMora P, Ferng YH, Graham P, Vawdrey DK, Perlman J, Larson E, Saiman L. Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU. Appl Clin Inf 2014; 5: 368–387 http://dx.doi.org/10.4338/ACI-2013-09-RA-0069

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