Standards to Support Information Systems Integration in Anatomic Pathology

2009 ◽  
Vol 133 (11) ◽  
pp. 1841-1849 ◽  
Author(s):  
Christel Daniel ◽  
Marcial García Rojo ◽  
Karima Bourquard ◽  
Dominique Henin ◽  
Thomas Schrader ◽  
...  
Keyword(s):  
Information Systems ◽  
Information Exchange ◽  
Tissue Bank ◽  
Clinical Information ◽  
Diagnostic Process ◽  
Anatomic Pathology ◽  
Research Activities ◽  
Healthcare Enterprise ◽  
Integrating The Healthcare Enterprise ◽  
Technical Framework

Abstract Context.—Integrating anatomic pathology information— text and images—into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). Objective.—To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. Design.—We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. Results.—The IHE anatomic pathology technical framework describes a first integration profile, “Anatomic Pathology Workflow,” dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. Conclusion.—The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

scholarly journals Clinical Information Systems – Seen through the Ethics Lens

2020 ◽  
Vol 29 (01) ◽  
pp. 104-114
Author(s):  
Ursula H. Hübner ◽  
Nicole Egbert ◽  
Georg Schulte
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Information Exchange ◽  
Ethics Education ◽  
Health Information Exchange ◽  
Evaluation Studies ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Smart Systems

Objective: The more people there are who use clinical information systems (CIS) beyond their traditional intramural confines, the more promising the benefits are, and the more daunting the risks will be. This review thus explores the areas of ethical debates prompted by CIS conceptualized as smart systems reaching out to patients and citizens. Furthermore, it investigates the ethical competencies and education needed to use these systems appropriately. Methods: A literature review covering ethics topics in combination with clinical and health information systems, clinical decision support, health information exchange, and various mobile devices and media was performed searching the MEDLINE database for articles from 2016 to 2019 with a focus on 2018 and 2019. A second search combined these keywords with education. Results: By far, most of the discourses were dominated by privacy, confidentiality, and informed consent issues. Intertwined with confidentiality and clear boundaries, the provider-patient relationship has gained much attention. The opacity of algorithms and the lack of explicability of the results pose a further challenge. The necessity of sociotechnical ethics education was underpinned in many studies including advocating education for providers and patients alike. However, only a few publications expanded on ethical competencies. In the publications found, empirical research designs were employed to capture the stakeholders’ attitudes, but not to evaluate specific implementations. Conclusion: Despite the broad discourses, ethical values have not yet found their firm place in empirically rigorous health technology evaluation studies. Similarly, sociotechnical ethics competencies obviously need detailed specifications. These two gaps set the stage for further research at the junction of clinical information systems and ethics.

scholarly journals Self-enrolment antenatal health promotion data as an adjunct to maternal clinical information systems in the Western Cape Province of South Africa

2018 ◽  
Vol 3 (Suppl 2) ◽  
pp. e000565 ◽  
Author(s):  
Alexa Heekes ◽  
Nicki Tiffin ◽  
Pierre Dane ◽  
Themba Mutemaringa ◽  
Mariette Smith ◽  
...  
Keyword(s):  
South Africa ◽  
Health Promotion ◽  
Information Systems ◽  
Pregnant Women ◽  
Information Exchange ◽  
Clinical Information ◽  
Clinical Information Systems ◽  
Western Cape ◽  
Public Health Services ◽  
Western Cape Province

Information systems designed to support health promotion in pregnancy, such as the MomConnect programme, are potential sources of clinical information which can be used to identify pregnancies prospectively and early on. In this paper we demonstrate the feasibility and value of linking records collected through the MomConnect programme, to an emergent province-wide health information exchange in the Western Cape Province of South Africa, which already enumerates pregnancies from a range of other clinical data sources. MomConnect registrations were linked to pregnant women known to the public health services using the limited identifiers collected by MomConnect. Three-quarters of MomConnect registrations could be linked to existing pregnant women, decreasing over time as recording of the national identifier decreased. The MomConnect records were usually the first evidence of pregnancy in pregnancies which were subsequently confirmed by other sources. Those at lower risk of adverse pregnancy outcomes were more likely to register. In some cases, MomConnect was the only evidence of pregnancy for a patient. In addition, the MomConnect records provided gestational age information and new and more recently updated contact numbers to the existing contact registry. The pilot integration of the data in the Western Cape Province of South Africa demonstrates how a client-facing system can augment clinical information systems, especially in contexts where electronic medical records are not widely available.

scholarly journals The Clinical Information Systems Response to the COVID-19 Pandemic

2021 ◽  
Vol 30 (01) ◽  
pp. 105-125
Author(s):  
J. Jeffery Reeves ◽  
Natalie M. Pageler ◽  
Elizabeth C. Wick ◽  
Genevieve B. Melton ◽  
Yu-Heng Gamaliel Tan ◽  
...  
Keyword(s):  
Information Systems ◽  
Information Exchange ◽  
Large Scale ◽  
Predictive Analytics ◽  
Clinical Care ◽  
Clinical Information ◽  
Machine Learning Algorithms ◽  
Screening Tools ◽  
Contact Tracing ◽  
Clinical Information Systems

Summary Objective: The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19. Methods: PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced. Results: CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes. Conclusion: Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.

scholarly journals Managing Complexity. From Documentation to Knowledge Integration and Informed Decision Findings from the Clinical Information Systems Perspective for 2018

2019 ◽  
Vol 28 (01) ◽  
pp. 095-100 ◽  
Author(s):  
Werner O. Hackl ◽  
Alexander Hoerbst ◽  
Keyword(s):  
Information Systems ◽  
Knowledge Integration ◽  
Process Management ◽  
Clinical Information ◽  
Informed Decision ◽  
Knowledge Generation ◽  
Clinical Information Systems ◽  
Research Activities ◽  
Selection Of

Objective: To summarize recent research and to propose a selection of best papers published in 2018 in the field of Clinical Information Systems (CIS). Method: Each year a systematic process is carried out to retrieve articles for the CIS section of the IMIA Yearbook of Medical Informatics and to select a set of pest papers for the section. The same query as in the last five years was used. The retrieved articles were categorized in a multi-pass review carried out by the two section editors. The final selection of candidate papers was then peer-reviewed by Yearbook editors and external reviewers. Based on the review results the best papers were then chosen at the selection meeting with the IMIA Yearbook editorial board. Text mining, and term co-occurrence mapping techniques were again used to get an overview of the content of the retrieved articles. Results: The query was carried out in mid-January 2019, yielding a consolidated, deduplicated result set of 2,264 articles which had been published in 957 different journals. This year, we nominated twelve papers as candidates and three of them were finally selected as best papers in the CIS section. Again, the content analysis of the articles revealed the broad spectrum of topics which is covered by CIS research. Conclusions: We could observe ongoing trends from our 2017 analysis. The patient increasingly moves in the focus of the research activities and trans-institutional aggregation of data is still an important field of work. The move to use patient and other clinical data directly for the patient and to support data driven process management, the move away from clinical documentation to patient-focused knowledge generation and support of informed decision, is gaining momentum by the application of new or already known but, due to technological advances, now applicable methodological approaches.

scholarly journals Trends in Clinical Information Systems Research in 2019

2020 ◽  
Vol 29 (01) ◽  
pp. 121-128
Author(s):  
W. O. Hackl ◽  
A. Hoerbst ◽  
Keyword(s):  
Information Systems ◽  
Clinical Information ◽  
Clinical Information Systems ◽  
Ethical Perspective ◽  
Editorial Committee ◽  
Systems Research ◽  
Research Activities ◽  
Information Systems Research ◽  
Mapping Techniques ◽  
Selection Of

Objective: To give an overview of recent research and to propose a selection of best papers published in 2019 in the field of Clinical Information Systems (CIS). Method: Each year, we apply a systematic process to retrieve articles for the CIS section of the IMIA Yearbook of Medical Informatics. For six years now, we use the same query to find relevant publications in the CIS field. Each year we retrieve more than 2,000 papers. As CIS section editors, we categorize the retrieved articles in a multi-pass review to distill a pre-selection of 15 candidate best papers. Then, Yearbook editors and external reviewers assess the selected candidate best papers. Based on the review results, the IMIA Yearbook Editorial Committee chooses the best papers during the selection meeting. We used text mining, and term co-occurrence mapping techniques to get an overview of the content of the retrieved articles. Results: We carried out the query in mid-January 2020 and retrieved a de-duplicated result set of 2,407 articles from 1,023 different journals. This year, we nominated 14 papers as candidate best papers, and three of them were finally selected as best papers in the CIS section. As in previous years, the content analysis of the articles revealed the broad spectrum of topics covered by CIS research. Conclusions: We could observe ongoing trends, as seen in the last years. Patient benefit research is in the focus of many research activities, and trans-institutional aggregation of data remains a relevant field of work. Powerful machine-learning-based approaches, that use readily available data now often outperform human-based procedures. However, the ethical perspective of this development often comes too short in the considerations. We thus assume that ethical aspects will and should deliver much food for thought for future CIS research.

Modeling Interoperable Information Systems with 3LGM² and IHE

2015 ◽  
Vol 54 (05) ◽  
pp. 398-405 ◽  
Author(s):  
M. Schaaf ◽  
F. Jahn ◽  
R. Brandner ◽  
A. Winter ◽  
S. Stäubert
Keyword(s):  
Information Systems ◽  
Enterprise Architecture ◽  
Reference Model ◽  
State Enterprise ◽  
Strategic Information ◽  
Current State ◽  
Healthcare Enterprise ◽  
Integrating The Healthcare Enterprise ◽  
Master Model ◽  
Information Manager

SummaryBackground: Strategic planning of information systems (IS) in healthcare requires descriptions of the current and the future IS state. Enterprise architecture planning (EAP) tools like the 3LGM² tool help to build up and to analyze IS models. A model of the planned architecture can be derived from an analysis of current state IS models. Building an inter-operable IS, i. e. an IS consisting of interoperable components, can be considered a relevant strategic information management goal for many IS in healthcare. Integrating the healthcare enterprise (IHE) is an initiative which targets interoperability by using established standards.Objectives: To link IHE concepts to 3LGM² concepts within the 3LGM² tool. To describe how an information manager can be supported in handling the complex IHE world and planning interoperable IS using 3LGM² models. To describe how developers or maintainers of IHE profiles can be supported by the representation of IHE concepts in 3LGM².Methods: Conceptualization and concept mapping methods are used to assign IHE concepts such as domains, integration profiles actors and transactions to the concepts of the three-layer graph-based meta-model (3LGM²).Results: IHE concepts were successfully linked to 3LGM² concepts. An IHE-master-model, i. e. an abstract model for IHE concepts, was modeled with the help of 3LGM² tool. Two IHE domains were modeled in detail (ITI, QRPH). We describe two use cases for the representation of IHE concepts and IHE domains as 3LGM² models. Information managers can use the IHE-master-model as reference model for modeling interoperable IS based on IHE profiles during EAP activities. IHE developers are supported in analyzing consistency of IHE concepts with the help of the IHE-master-model and functions of the 3LGM² toolConclusion: The complex relations between IHE concepts can be modeled by using the EAP method 3LGM². 3LGM² tool offers visualization and analysis features which are now available for the IHE-master-model. Thus information managers and IHE developers can use or develop IHE profiles systematically. In order to improve the usability and handling of the IHE-master-model and its usage as a reference model, some further refinements have to be done. Evaluating the use of the IHE-master-model by information managers and IHE developers is subject to further research.

Testing Conformance and Interoperability of eHealth Applications

2010 ◽  
Vol 49 (03) ◽  
pp. 281-289 ◽  
Author(s):  
T. Namli ◽  
A. Dogac
Keyword(s):  
Case Studies ◽  
Information Exchange ◽  
Test Scenario ◽  
Testing Environment ◽  
Testing Framework ◽  
Testing Tools ◽  
Healthcare Enterprise ◽  
Integrating The Healthcare Enterprise ◽  
Interoperability Testing ◽  
Test Framework

Summary Objective: To explain the common conformance and interoperability testing requirements of eHealth applications through two case studies; one using a prominent eHealth messaging standard, namely HL7 v3 [1], and the other using Integrating the Healthcare Enterprise (IHE) [2] Profiles and to describe how these testing requirements can be addressed through an automated, modular and scenario-based testing framework, namely Test BATN. Methods: Summarizing the conformance testing requirements of HL7 v3 messages. Illustrating the interoperability testing requirements of IHE Profiles through a scenario based on the IHE XDS, IHE XDS-MS and IHE PIX profiles. Explaining how these requirements can be handled through a dynamic and configurable test framework addressing all the layers in the interoperability stack within a single test scenario. Results: Conformance and interoperability testing are necessary to maintain correct information exchange as the correctness of the exchanged data is essential in the healthcare domain. There are many standards used in eHealth that the applications need to conform. Additionally, there are profiling initiatives such as IHE and Continua Health Alliance which publish integration profiles addressing a specific clinical need or a use case and describe how to combine or use the existing standards to provide interoperability. However, as the results of our case studies demonstrate, there are many commonalities in the conformance and interoperability testing requirements of these standards and profiles and therefore an integrated testing environment is needed. Conclusion: Our main conclusion is that rather than having individual testing tools for each standard or initiative, a generic and modular test framework exploiting the commonalities in the testing processes and fostering reusability of modular, pluggable testing components will improve the efficiency of testing. Through the TestBATN framework, we describe how this modularity can be achieved by providing common interfaces facilitating the development of adaptors which allows different testing components to be plugged into the system.

Information Systems Strategy and Administration

2019 ◽  
pp. 126-131
Author(s):  
Jeffrey G. Frieling ◽  
Karl E. Misulis ◽  
Mark E. Frisse
Keyword(s):  
Information Systems ◽  
Strategic Planning ◽  
Strategic Plan ◽  
Clinical Information ◽  
Organizational Strategy ◽  
Clinical Information Systems ◽  
Effective Governance ◽  
Information Systems Strategy ◽  
Healthcare Enterprise

Clinical information systems are vital tools to execute on organizational strategy. Clinical information systems support clinical activities that reflect the values and priorities of an organization. An information system’s strategic plan must therefore align with the strategy and operations of the larger organization. Governance of information systems requires coordinated work by experienced professionals. Effective governance and administration are essential. Strategic planning is performed at many levels; those of principal concern here are those of the healthcare enterprise and the information systems division. Strategic planning extends beyond the enterprise. The strategic plan and goals of the clinical information systems should be reviewed periodically.

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