Informed strategy. Information managers should play a key role in determining an organization's direction

Hospital chief executive officers need to set directions for their facilities' information systems, and information professionals need to play a more direct role in strategic planning, according to speakers at the Computers in Healthcare Conference last May. To implement effective information systems, chief information officers must be closely connected with the organization's capital budgeting and strategic budgeting process. A key strategic role for information systems managers is to educate organization personnel in the use of information technology. As demands placed on information systems increase, improving end users' skill level is the best way to take the pressure off. Information managers must create systems that respond to changes in healthcare, including the trend toward outpatient care. The information requirements for strategic planning include an external assessment and an internal assessment. Managers should strive to create information systems capable of answering strategic questions concerning patients, payers, practice patterns, and other key issues. Information systems also must provide data that allow managers to assess strategic decisions. They should also give top managers access to information that will help them identify and pursue broad new goals and directions.     

Using operational information and information systems to improve in-patient flow in hospitals

PURPOSE: To consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed. DESIGN/METHODOLOGY/APPROACH: The literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements. FINDINGS: The National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service. RESEARCH LIMITATIONS/IMPLICATIONS: The work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England. PRACTICAL IMPLICATIONS: Some bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology. ORIGINALITY/VALUE: There has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.     

Gesundheitsinformationssysteme aus rechtlicher Sicht

The increasing importance of laws concerning privacy is directly connected to the importance of modern information and communication technologies and is a result of newly awakened consciousness concerning chances and risks of disseminating information. These conflicts have to be resolved mostly by legal means.Many new applications of information technology in medicine especially in diagnostics and treatment and the potential for new developments in health care of the disabled and elderly will open up new ways for the information society. Computer sciences and the Internet have created new dangers for privacy and data security, as information is continuously gathered and stored in various systems and places. Many organizations depend more and more on information systems, especially in the fields of health care and related areas.The growing exchange of sensitive data between health care organizations and third party institutions is responsible for the growing fear about misuse and abuse of private information. On the other hand, information systems and data exchange no longer exist in a legal grey area as the process of legislation continues to closely follow developments in new information technologies.Due to the importance of health care information systems, the growing need for rules and laws in the modern information society is a challenge that has already been addressed.     

Implementing health information technology to improve the process of health care delivery: a case study.

Integration of health information is critical to the provision of effective, quality care in today's fragmented health care system. The increasing prevalence of chronic conditions and the demand for a comprehensive understanding of patient health on the part of providers are driving the need for the integration of health information through electronic health information systems. Two distinct health information systems currently utilized in the health care field include electronic medical records (EMR) and chronic disease management systems (CDMS). The integration of these systems is likely to enable the efficient management of health information and improve the quality of health care as it would provide real-time patient information in a coordinated manner. The lack of real-time information may result in delayed treatment, uninformed decisions, inefficient resource use, and medical errors. Despite their importance and widespread support, these systems have slow provider adoption rates. Our understanding of how health information technology may be used to improve health care is limited by the relative paucity of research on the adoption, integration, and implementation of these 2 types of systems. This paper documents the use of an EMR at Marshfield Clinic, a multidisciplinary group practice in the United States. We review the concomitant use of an EMR for clinical data capture and the implementation of a proprietary CDMS, InformaCare, for care management of chronic diseases. These 2 systems allow providers to deliver health care using evidence-based guidelines that meet the Institute of Medicine's aim of providing safe, efficient, patient-centered, and timely care.     

Health information systems

India's failure to develop a unified health information and monitoring system at the national level indicates the need develop systems at the grassroots level which can provide meaningful information to field workers and communities. The planning and administration of health services requires health information systems. The 7 sources of health information that presently exist in India (Decennial Population Census, Civil Registration system, Sample Registration system, Survey of Causes of Death, National Sample Survey, Family Welfare Statistics, and Management Information and Evaluation Systems) have traditionally collected poor quality data. National health programs have developed their own information systems. Since these systems act independently, it is difficult to derive a total picture of any one region -- much less the whole country. As a result, a true health profile of India does not exist. Some have suggested establishing a computerized information system, but such a proposal is simply unrealistic. Instead of attempting to develop a national information system, grassroots systems should be encouraged. These systems should have the primary aim of facilitating decision-making for field workers and community members. since it is the local members who will have the need for the information, they will be motivated to collect it. In the end, the usefulness of these information systems will be measured in their ability to create a better understanding of adverse health effects and to help in their prevention and control.     

What can information systems do for primary health care? An international perspective.

The reform of health information systems has been made a priority by health managers, public health specialists and technocrats. While each of these groups has promised major benefits from improvements in information systems, insufficient attention has been paid to the limitations placed upon the theoretical possibilities of information technology by the characteristics of the health system of which the information system is but a part. Managers anticipate improved efficiency and rational allocation of resources, but rational decision making does not automatically follow from improvements in information. Epidemiologists and public health specialists seek more effective and equitable health systems but methodological problems and the expense of many conventional epidemiological approaches continue to limit the usefulness of disease surveillance, programme monitoring and evaluation. Both managers and epidemiologists are confronted with the conflicts which arise in seeking to create locally sensitive information systems within centralised health systems. Technocrats see microcomputers as essential for information systems to be truly effective and as a means of liberating health workers from the drudgery of form filling. However, the rate of organisational evolution in the health system has not kept pace with the rapid development of information technology. There are good prospects for considerable health gain to be wrought from reforms in health information systems but to realise these it is necessary that this process be 'action-led' rather than, as is conventional, 'data-led'. The latter approach sees data as the end in itself; the 'action-led' approach, in contrast, regards information as needs to interventions with a focus on how information will influence decisions. For improvements in information to result in improved health, strategies must be adopted which will ensure that information routinely informs decisions and is seen as a means to the end of improving health.     

山东省社区卫生服务信息系统需求与对策研究

目的了解山东省社区卫生服务信息系统建设需求情况,为优化山东省社区卫生信息系统提供依据。方法采用多阶段分层系统抽样的方法进行有关社区卫生服务信息化建设需求情况的问卷调查。结果社区卫生服务中心(站)对社区卫生服务信息系统使用需求高,对实现社区卫生服务信息系统管理的迫切程度和硬件设备更新、升级的迫切程度呈现为欠发达地区明显高于发达地区和中等发达地区,对公共卫生、医疗、医保、药品以及财务监管社区卫生服务信息系统功能模块需要完善的迫切程度呈现为公共卫生模块需要完善的迫切程度最高。结论不同地区社区卫生服务信息系统需求程度不同,社区卫生服务机构应根据信息系统建设规划要求和需求程度,优化社区卫生服务信息系统,提高社区卫生服务信息系统的建设和使用水平。     

Health information imperatives for Third World countries

The role of health information in the health delivery services of a nation is stressed with examples from the advanced nations. Factors responsible for the poor state of health information systems in the Third World and the effects on health delivery services are identified. probable factors that may Lead to the development of health information systems in the Third World in the future are posited. Recommendations for the establishment of health information systems based on funding, staffing, functions and networking are made.     

Information systems for health sector monitoring in Papua New Guinea

This paper describes (i). how a national health information System was designed, tested and implemented in Papua New Guinea, (ii). how the system was integrated with other management information systems, and (iii). how information has been used to support decision-making. It concludes that central coordination of systems design is essential to make sure that information systems are aligned with government priorities and can deliver the information required by managers. While there is often scope for improving the performance of existing information systems, too much emphasis can be placed on revising data collection procedures and creating the perfect information system. Data analysis, even from imperfect systems, can stimulate greater interest in information, which can improve the quality and completeness of reporting and encourage a more methodical approach to planning and monitoring services. Our experience suggests that senior decision-makers and political leaders can play an important role in creating a culture of information use. By demanding health information, using it to formulate policy, and disseminating it through the channels open to them, they can exert greater influence in negotiations with donors and other government departments, encourage a more rational approach to decision-making that will improve the operation of health services, and stimulate greater use of information at lower levels of the health system. The ability of information systems to deliver these benefits is critical to their sustainability.     

Integrating child health information systems

The Health Resources and Services Administration and All Kids Count (a national technical assistance center fostering development of integrated child health information systems) have been working together to foster development of integrated child health information systems.Activities have included: identification of key elements for successful integration of systems; development of principles and core functions for the systems; a survey of state and local integration efforts; and a conference to develop a common vision for child health information systems to meet medical care and public health needs.We provide 1 state (Utah) as an example that is well on the way to development of integrated child health information systems.     

Information for management--the extent of information management in the acute care hospital sector

The article explores the contributions of information and information technology to health care management by means of a study into current information use in a small acute care hospital and the preparations for new general practitioner purchasing systems. The findings highlight the interdependency between manual and computer systems and key departments in the hospital. With increased emphasis on primary health care, there is a greater need for information sharing between the hospital and general practitioners. Provision of information itself becomes a factor in determining service quality. Information systems are therefore emerging as an element in gaining competitive advantage in hospitals in the United Kingdom.     

Information technology and today's health care management

With the move to CPR, health information managers will be challenged to reengineer the ways they manage processes within the medical record department. A lot of age-old health information problems (i.e., missing documents, lost test results, and missing records) can be solved and productivity improved with imaging. The digitized records will allow simultaneous access to readily available, legible, and usable information for patient care, research, audits, and correspondence. However, the transition from a manual to computerized record presents many challenges. Health information managers will have to monitor the changeover carefully, anticipating the needs for new information and developing the necessary mechanisms to produce it, as well as implementing new technologies as they emerge. Conditions are right for an advance in health care information systems. Pressures and changes in structure in the health care industry require better management tools. Acceptance of HIS as a management tool is growing rapidly among the health care provider community. The technology to realize the CPR and advanced decision support systems is available. All the pieces are there--they just need to come together. As the health care organization's view of and need for information systems change, medical record professionals must draw on their knowledge and experience and make the transition from managers of record systems to managers of health care information systems.     

基于“军卫一号”的信息系统集成的研究

在我国大多数医院信息系统的研制还不能遵循HL7标准的条件下，以医院某个比较成熟的大系统做为标准实现各子系统集成，是一种符合中国国情的切实可行的集成方式。     

Harmonizing health information systems with information systems in other social and economic sectors

Efforts to strengthen health information systems in low- and middle-income countries should include forging links with systems in other social and economic sectors. Governments are seeking comprehensive socioeconomic data on the basis of which to implement strategies for poverty reduction and to monitor achievement of the Millennium Development Goals. The health sector is looking to take action on the social factors that determine health outcomes. But there are duplications and inconsistencies between sectors in the collection, reporting, storage and analysis of socioeconomic data. National offices of statistics give higher priority to collection and analysis of economic than to social statistics. The Report of the Commission for Africa has estimated that an additional US$ 60 million a year is needed to improve systems to collect and analyse statistics in Africa. Some donors recognize that such systems have been weakened by numerous international demands for indicators, and have pledged support for national initiatives to strengthen statistical systems, as well as sectoral information systems such as those in health and education. Many governments are working to coordinate information systems to monitor and evaluate poverty reduction strategies. There is therefore an opportunity for the health sector to collaborate with other sectors to lever international resources to rationalize definition and measurement of indicators common to several sectors; streamline the content, frequency and timing of household surveys; and harmonize national and subnational databases that store socioeconomic data. Without long-term commitment to improve training and build career structures for statisticians and information technicians working in the health and other sectors, improvements in information and statistical systems cannot be sustained.     

谈医疗器械管理系统的构建

目前国内医院信息管理系统中医疗器械信息化、数字化程度相对较低，影响了医院信息化整体发展。本文阐述了医疗器械管理系统的构建，完善医院信息管理系统，推进医院信息化整体发展。     

简易公共卫生地理信息系统的建立

目的：提出一个建立简易公共卫生地理信息系统的解决方法。方法：利用常规计算机软硬件及Epi Info2000／2002流行病学统计分析软件可以建立一套简易公共卫生地理信息系统。结果：使用该方法建立的简易公共卫生地理信息系统基本满足应用要求，并可节约大量经费。结论：尽可能地利用现有资源和免费资源，开源节流是基层卫生信息工作的有效方法。     

Health based geographical information systems: their potential examined in the light of existing data sources

There is much potential for the use of geographical information systems (GIS) within the management and analysis of health and health care data. This paper addresses the problems of using routine data in the creation of geographical information systems for health. The numerous sources of British official routine health information however vary greatly in their geographical coverage and geographical detail. Particular attention therefore focuses upon the extent to which existing data sets can readily be used within GIS. Recommendations for changes in the data collection process are forwarded to improve the potential for GIS use. The overall utility of geographical health information systems within health service planning is illustrated using the example of community based activities.     

矿山事故一体化应急决策指挥通信体系发展趋势

以矿山事故一体化通信体系和指挥信息决策共性研究为需求, 从矿山事故应急救援一体化指挥通信系统与平台、信息需求及信息生成、信息传递模型、信息传递策略方法等四方面来综述国内外矿山事故一体化应急决策指挥通信体系研究概况, 并从单一系统、综合系统、平台、体系的角度预测矿山事故应急指挥通信体系的整体发展趋势; 拟通过分析, 为我国矿山应急救援指挥通信平台建设提供借鉴。     

Adopting an information management approach to the design and implementation of information systems.

As the NHS adopts an information management approach to coordinated handling of total information resources, methods of systems analysis and design require assessment to ensure that they are appropriate. Mandatory use of Structured Systems Analysis and Design Methodology (SSADM) may be encouraging a damagingly narrow view of information systems. Research is described in which an holistic view of information systems is applied, allowing the needs of information users to play a stronger role in determining how information will be supplied to them. The techniques may also assist the training activities associated with implementing new systems.     

医院信息系统的技术集成

当前国内医院存在不同信息系统各自孤立的问题,致使信息难以交换。介绍了医院信息系统集成的必要性以及面临的困难,并简要阐述了系统集成的关键要素。