scholarly journals Using Timestamp Data to Assess the Impact of Voice Recognition on the Efficiency of Grossing Biopsies

2020 ◽  
Author(s):  
Jay J. Ye ◽  
Michael R. Tan ◽  
Chung H. Shum
Keyword(s):  
Health Care ◽  
Information System ◽  
Cost Saving ◽  
Biopsy Specimen ◽  
Multivariate Analyses ◽  
Voice Recognition ◽  
Clinical Information ◽  
Turnaround Time ◽  
Biopsy Specimens ◽  
The Impact

Context.— Studies on the adoption of voice recognition in health care have mostly focused on turnaround time and error rate, with less attention paid to the impact on the efficiency of the providers. Objective.— To study the impact of voice recognition on the efficiency of grossing biopsy specimens. Design.— Timestamps corresponding to barcode scanning for biopsy specimen bottles and cassettes were retrieved from the pathology information system database. The time elapsed between scanning a specimen bottle and the corresponding first cassette was the length of time spent on the gross processing of that specimen and is designated as the specimen time. For the first specimen of a case, the specimen time additionally included the time spent on dictating the clinical information. Therefore, the specimen times were divided into the following 2 categories: first-specimen time and subsequent-specimen time. The impact of voice recognition on specimen times was studied using both univariate and multivariate analyses. Results.— Specimen complexity, prosector variability, length of clinical information text, and the number of biopsies the prosector grossed that day were the major determinants of specimen times. Adopting voice recognition had a negligible impact on specimen times. Conclusions.— Adopting voice recognition in the gross room removes the need to hire transcriptionists without negatively impacting the efficiency of the prosectors, resulting in an overall cost saving. Using computer scripting to automatically enter clinical information (received through the electronic order interface) into report templates may potentially increase the grossing efficiency in the future.

scholarly journals Implementing an Integrated Large-Scale Clinical Information System for ISSSTE’s Hospital Network in Mexico

2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara
Keyword(s):  
Health Care ◽  
Information System ◽  
Health Care Services ◽  
Large Scale ◽  
Clinical Information System ◽  
Clinical Information ◽  
Public Hospitals ◽  
Care Services ◽  
Cost Reductions

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.

scholarly journals The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes

2017 ◽  
Vol 141 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Athena K. Petrides ◽  
Ida Bixho ◽  
Ellen M. Goonan ◽  
David W. Bates ◽  
Shimon Shaykevich ◽  
...  
Keyword(s):  
Information System ◽  
Electronic Health Record ◽  
Government Regulation ◽  
Turnaround Time ◽  
Health Record ◽  
Laboratory Information System ◽  
Before And After ◽  
Electronic Health ◽  
Ordered Data ◽  
The Impact

Context.— A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). Objective.— To determine the impact of an interfaced EHR-LIS on laboratory processes. Design.— We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. Results.— The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. Conclusions.— An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

Information Security Management in Picture Archiving and Communication Systems for the Healthcare Industry

2009 ◽  
pp. 682-690
Author(s):  
Carrison K.S. Tong ◽  
Eric T.T. Wong
Keyword(s):  
Health Care ◽  
Information System ◽  
Information Security ◽  
Clinical Information System ◽  
Security Management ◽  
Clinical Information ◽  
Information Security Management ◽  
Care Industry ◽  
Security Event ◽  
Picture Archiving And Communication

Like other information systems in banking and commercial companies, information security is also an important issue in the health care industry. It is a common problem to have security incidences in an information system. Such security incidences include physical attacks, viruses, intrusions, and hacking. For instance, in the USA, more than 10 million security incidences occurred in the year 2003. The total loss was over $2 billion. In the health care industry, damages caused by security incidences could not be measured only by monetary cost. The trouble with inaccurate information in health care systems is that it is possible that someone might believe it and do something that might damage the patient. In a security event in which an unauthorized modification to the drug regime system at Arrowe Park Hospital proved to be a deliberate modification, the perpetrator received a jail sentence under the Computer Misuse Act of 1990. In another security event (The Institute of Physics and Engineering in Medicine, 2003), six patients received severe overdoses of radiation while being treated for cancer on a computerized medical linear accelerator between June 1985 and January 1987. Owing to the misuse of untested software in the control, the patients received radiation doses of about 25,000 rads while the normal therapeutic dose is 200 rads. Some of the patients reported immediate symptoms of burning and electric shock. Two died shortly afterward and others suffered scarring and permanent disability. BS7799 is an information security management standard developed by the British Standards Institution (BSI) for an information security management system (ISMS). The first part of BS7799, which is the code of practice for information security, was later adopted by the International Organization for Standardization (ISO) as ISO17799. The ISO 27002 standard is the rename of the existing ISO 17799 standard. It basically outlines hundreds of potential controls and control mechanisms, which may be implemented. The second part of BS7799 states the specification for ISMS which was replaced by The ISO 27001 standard published in October 2005. The Picture Archiving and Communication System (PACS; Huang, 2004) is a clinical information system tailored for the management of radiological and other medical images for patient care in hospitals and clinics. It was the first time in the world to implement both standards to a clinical information system for the improvement of data security.

scholarly journals Information systems in the new world: an emerging national approach

2005 ◽  
Vol 29 (3) ◽  
pp. 292 ◽  
Author(s):  
Heather Grain
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Information System ◽  
Decision Support ◽  
Decision Support Systems ◽  
Support Systems ◽  
Clinical Information ◽  
Advisory Council ◽  
Infrastructure Development ◽  
Health Administrator

AUSTRALIA IS ONE OF MANY countries around the world wanting to take advantage of clinical decision support systems to reduce misadventure, improve quality of care and enhance health outcomes. Policy and infrastructure developments that could remove many of the barriers to the implementation of these systems are being considered by the Australian Health Ministers? Advisory Council (AHMAC) over the next few months. These initiatives include processes for national identification of health care recipients; common approaches to consent to information sharing and access control in the electronic health care environment; secure messaging infrastructure; a national medicines directory and agreement on national terminology.1 These considerations are taking place in a context of jurisdictional cost sharing, with mutual benefits being sought. Detailed business cases have been developed, and supporting policy and practical pathways forward are actively sought. This joint policy and infrastructure development approach will seek to build consistent, shared formats and risk management, as well as shared financial responsibility. This approach is seen as more likely to lead to system change and implementation, where previously almost every advancement has succeeded in identifying more obstacles. The kind of objectives outlined above are a major underpinning of HealthConnect and state-based health information system initiatives across the country. These initiatives are extremely expensive, require significant infrastructure investment to achieve the benefits they promise, and none can be successfully implemented solely by information technology or information system professionals. It is vital that health care managers at all levels and domains of health care appreciate the success factors when making decisions about the introduction and management of these systems. The information world itself is changing for us all. These changes don?t just affect the information managers or the information technology (IT) enthusiasts found in many clinical areas of our health care organisations. As in other areas of our lives, IT has invasive effects on the clinical workplace, administration and government offices. Managers in health care are often frustrated by what is seen as a failure of IT to deliver on its promise of better decision support systems, sharing of clinical information between organisations and faster access to patient information and clinical knowledge. Nevertheless, these systems are already changing the method of collecting and using clinical information in the workplace, and are having an impact on the skills needed by all health professionals, including the health administrator.

The number of biopsy specimens can influence the non-lifting sign in colorectal laterally spreading tumors

2021 ◽  
Vol 59 (04) ◽  
pp. 321-325
Author(s):  
Yang Liu ◽  
Ning Wei ◽  
Rui Hua Shi
Keyword(s):  
Tumor Size ◽  
Multivariate Analyses ◽  
Tumor Location ◽  
Gender History ◽  
Related Factors ◽  
Factors Affecting ◽  
Biopsy Specimens ◽  
History Of ◽  
The Impact ◽  
Lifting Sign

Abstract Background Although the problem of whether to perform a biopsy before endoscopic treatment for colorectal laterally spreading tumor (LST) troubles clinicians, about 50 % of lesions still undergo a preceding biopsy. We aimed to explore factors affecting the non-lifting sign in LST and examine the influence of “biopsy-related factors”, such as the number of biopsy specimens and the interval after biopsy on non-lifting sign in cases with a history of biopsy. Methods Clinical data of 159 LSTs regarding age, gender, history of biopsy, tumor location, tumor size, the depth of submucosal invasion, tumor configuration, histologic type, location with respect to the fold, and result of non-lifting sign testing were investigated retrospectively. For patients with a history of biopsy, the period after biopsy and the number of biopsy specimens also were analyzed. Results Among 159 cases of LST, 112 were positive and 47 were negative for lifting signs. Biopsy history (p = 0.008), tumor size (p = 0.010), and location with respect to the fold (p = 0.022) were identified as factors affecting the non-lifting sign in multivariate analyses. In 75 LST cases with a history of biopsy, only the number of biopsies (p = 0.003) was identified as a factor affecting the non-lifting sign in multivariate analyses. Conclusions For LST, lesions with larger size, being across the fold, and biopsy history were predictive factors for non-lifting signs. Reducing the number of biopsies would reduce the occurrence of non-lifting signs when biopsy is necessary. The impact of the interval after the biopsy on the non-lifting sign will require further study.

scholarly journals P407 Is the rapid infliximab infusion a safe and cost-saving strategy in paediatric inflammatory bowel disease?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S375-S375
Author(s):  
G Pujol Muncunill ◽  
J Martínez-Osorio ◽  
F Bossacoma-Busquets ◽  
L Álvarez-Carnero ◽  
J Arrojo-Juárez ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Cost Saving ◽  
Bowel Disease ◽  
Family Satisfaction ◽  
Standard Protocol ◽  
Health Care Resources ◽  
Infusion Reactions ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Rapid infliximab (IFX) infusion administered over 60 min is a safe strategy in selected Inflammatory Bowel Disease (IBD) adult patients. Some paediatric studies found similar results among children but data are still scarce. The aim of our study is to evaluate the safety of rapid IFX infusion strategy in our cohort of Paediatric IBD (PIBD) patients and analyze the impact of this strategy on health care resources. Methods Paediatric IBD patients under IFX treatment using standard protocol (2-h IFX infusion), and who had received at least 4 previous standard infusions, with no dose change in the last 2 doses, and without infusion reactions were switched to receive a 1-h IFX infusions. Demographic and clinical data were collected from medical records, and patient and family satisfaction was recorded by a telephone survey. The optimisation of health care resources was also analyzed. Results A total of 46 PIBD patients were under IFX treatment during the study period (February 2018-February 2019) of whom 26 met inclusion criteria and were switched to rapid IFX infusions (14 Crohn’s disease (CD), 12 ulcerative colitis; 17 males). The mean age at switch was 15.3 years (IQR 5.3–17.9) with a mean time of IFX use of 30 months (IQR: 4–78). Sixteen patients were receiving concomitant immunomodulators. A total of 154 rapid IFX infusions were administered with a mean dose of IFX of 5.4 mg/kg (IQR 4–10) and an average frequency of 6.7 weeks (IQR 4–8). No patient received premedication at any time and no infusion reactions were seen during the study period. Family and patient satisfaction (22/26) was higher in rapid IFX infusion strategy than in standard protocol (9.1/10 vs. 7.6/10). During the study period, 154 h of hospitalisation were saved. Conclusion Rapid IFX infusion strategy in selected PIBD patients is safe and well accepted by patients and their families. In addition, it is a cost-saving strategy, minimising the loss of work and teaching hours by the caregivers and patients, and allows optimisation of the hospital resources. These results have led us to establish rapid IFX infusion in selected patients (with stable previous doses and no infusion reactions) as the standard protocol in our centre.

The Impact of a Clinical Information System in an Intensive Care Unit

2007 ◽  
Vol 22 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Abele Donati ◽  
Vincenzo Gabbanelli ◽  
Simona Pantanetti ◽  
Paola Carletti ◽  
Tiziana Principi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Information System ◽  
Intensive Care ◽  
Clinical Information System ◽  
Clinical Information ◽  
The Impact

scholarly journals Data-Driven Personalization of a Physiotherapy Care Pathway: Case Study of Posture Scanning

10.2196/18508 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e18508
Author(s):  
Olli Korhonen ◽  
Karin Väyrynen ◽  
Tino Krautwald ◽  
Glenn Bilby ◽  
Hedwig Anna Theresia Broers ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Information System ◽  
Health Care Professionals ◽  
Digital Data ◽  
Digital Tools ◽  
Data Driven ◽  
Care Process ◽  
The Impact

Background Advanced sensor, measurement, and analytics technologies are enabling entirely new ways to deliver health care. The increased availability of digital data can be used for data-driven personalization of care. Data-driven personalization can complement expert-driven personalization by providing support for decision making or even by automating some parts of decision making in relation to the care process. Objective The aim of this study was to analyze how digital data acquired from posture scanning can enhance physiotherapy services and enable more personalized delivery of physiotherapy. Methods A case study was conducted with a company that designed a posture scan recording system (PSRS), which is an information system that can digitally record, measure, and report human movement for use in physiotherapy. Data were collected through interviews with different stakeholders, such as health care professionals, health care users, and the information system provider, and were analyzed thematically. Results Based on the results of our thematic analysis, we propose three different types of support that posture scanning data can provide to enhance and enable more personalized delivery of physiotherapy: 1) modeling the condition, in which the posture scanning data are used to detect and understand the health care user’s condition and the root cause of the possible pain; 2) visualization for shared understanding, in which the posture scanning data are used to provide information to the health care user and involve them in more collaborative decision-making regarding their care; and 3) evaluating the impact of the intervention, in which the posture scanning data are used to evaluate the care progress and impact of the intervention. Conclusions The adoption of digital tools in physiotherapy has remained low. Physiotherapy has also lacked digital tools and means to inform and involve the health care user in their care in a person-centered manner. In this study, we gathered insights from different stakeholders to provide understanding of how the availability of digital posture scanning data can enhance and enable personalized physiotherapy services.

scholarly journals Lost in Transportation: Calcium Oxalate Crystals in Kidney Biopsy Specimens Fixed in Michel Medium May Disappear

2019 ◽  
Vol 144 (4) ◽  
pp. 485-489
Author(s):  
Clarissa A. Cassol ◽  
Juarez R. Braga ◽  
Ramon Hartage ◽  
Anjali A. Satoskar ◽  
Tibor Nadasdy ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Biopsy Specimen ◽  
Kidney Biopsy ◽  
Fixation Time ◽  
Biopsy Specimens ◽  
Frozen Tissue ◽  
Fresh Frozen ◽  
The Impact ◽  
Oxalate Nephropathy ◽  
Formalin Fixed

Context.— Calcium oxalate (CaOx) deposits in a kidney biopsy specimen can be seen in acute or chronic kidney injury and in oxalate nephropathy. Although no established cutoff criteria to diagnose oxalate nephropathy versus incidental CaOx deposition in the kidney exist, these conditions require different treatment. We noticed a significant decrease in the number of CaOx deposits in the kidney biopsy cores that were fixed in Michel transport medium (MTM) as compared to their counterparts fixed in formalin. Objective.— To investigate the impact of different fixatives on the number of CaOx deposits in kidney biopsy specimens. Design.— Retrospective search for kidney biopsies with diagnosis of CaOx deposition was performed in our Renal Pathology Database between January 1, 2015 and October 15, 2018. Results.— Seventy-six biopsies with an increased number of CaOx deposits were identified. CaOx deposits were counted on slides from the frozen tissue (MTM fixed or fresh frozen) and from the formalin-fixed cores. The density of CaOx deposits was significantly higher in formalin-fixed cores (13.6 ± 10.0/cm) than in MTM-fixed cores (3.2 ± 5.1/cm; P < .001). CaOx density in the kidney biopsy specimens decreased progressively with increased fixation time in MTM. No significant differences in the CaOx density between formalin-fixed and fresh frozen tissue were observed. Conclusions.— Our data demonstrate that fixation in MTM may result in a significant reduction in the number of CaOx deposits in a kidney biopsy specimen. This may make the diagnosis difficult, especially in small biopsy specimens with limited tissue in the formalin-fixed paraffin block.

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