Text management in a healthcare information system

Virtually there. Natural language or textual data in the patient record plays a critical role in medicine. Read about the innovative system LDS Hospital has implemented to integrate textual data into the computerized patient record.     

The impact of the pervasive information age on healthcare organizations

New information technologies place data on integrated information systems, and provide access via pervasive computing technologies. Pervasive computing puts computing power in the hands of all employees, available wherever it is needed. Integrated systems offer seamless data and process integration over diverse information systems. In this paper we look at the impact of these technologies on healthcare organizations in the future.     

Development of a web-based multifacility healthcare surveillance information system

This article describes recent work to develop a Web-based statistical surveillance information system to monitor in real time the status of the U.S. Air Force's worldwide healthcare network. The intent is to incorporate statistical and related methods in order to identify unusual events and patterns of concern in large, highly distributed organizations. The work recently received an award from Vice President Gore for reinventing government.     

Legislative possibilities to reduce the impact of cancer

Ten proposals are made for legislation, using existing knowledge, to reduce the incidence of cancer. The proposals are framed so as to cause no damage to farmers' incomes or to taxation revenues. The basic philosophy behind these proposals, deriving from Charles Schultz, is that people will do more influenced by economic incentives than they will by coercion. The 10 proposals relate to: a soil bank for farmers; maximum tax yields; taxation related to advertising; package labeling to provide incentives to reduce risk; generalized industrial pollution, a “schmutz” index, and economic incentives; incentives to maintain long-term employee records; feeding of meat animals—Government grading; food additives and contaminants; radiation—energy production, medical, uv; and air pollution—gasoline prices. The paper concludes with a consideration of the so-called “safer” cigarette (and the need to reduce smoking as well as tars) and a search for the elusive “prevention” constituency.     

应用医院感染管理信息系统降低医院感染漏报率

目的 应用医院感染信息系统,降低医院感染漏报率.方法 通过医院感染信息系统对临床患者的高危因素及异常数值进行前瞻性监测,打印出异常报告,医院感染专职人员持报告到临床科室与医师沟通交流,督促及时上报并填写医院感染诊断.结果 2008年医院感染病例755例,漏报率4.79％,2011年医院感染病例602例,漏报率为1.47％,漏报率较前有明显降低,差异有统计学意义(P＜0.01).结论 应用医院感染信息系统,提高了医师上报医院感染病例的依从性;改变了临床科室对医院感染专职人员的认识;强化对日常医院感染知识的培训;降低了医院感染漏报率.     

The value of information technology in healthcare

Not only will healthcare investments in information technology (IT) continue, they are sure to increase. Just as other industries learned over time how to extract more value from IT investments, so too will the healthcare industry, and for the same reason: because they must. This article explores the types of business value IT has generated in other industries, what value it can generate in healthcare, and some of the barriers encountered in achieving that value. The article ends with management principles for IT investment.     

Barriers to incident reporting in a healthcare system

Background: Learning from mistakes is key to maintaining and improving the quality of care in the NHS. This study investigates the willingness of healthcare professionals to report the mistakes of others.

Methods: The questionnaire used in this research included nine short scenarios describing either a violation of a protocol, compliance with a protocol, or improvisation (where no protocol exists). By developing different versions of the questionnaire, each scenario was presented with a good, poor, or bad outcome for the patient. The participants (n=315) were doctors, nurses, and midwives from three English NHS trusts who volunteered to take part in the study and represented 53% of those originally contacted. Participants were asked to indicate how likely they were to report the incident described in each scenario to a senior member of staff.

Results: The findings of this study suggest that healthcare professionals, particularly doctors, are reluctant to report adverse events to a superior. The results show that healthcare professionals, as might be expected, are most likely to report an incident to a colleague when things go wrong (F(2,520) = 82.01, p<0.001). The reporting of incidents to a senior member of staff is also more likely, irrespective of outcome for the patient, when the incident involves the violation of a protocol (F(2,520) = 198.77, p<0.001. It appears that, although the reporting of an incident to a senior member of staff is generally not very likely, particularly among doctors, it is most likely when the incident represents the violation of a protocol with a bad outcome.

Conclusions: An alternative means of organisational learning that relies on the identification of system (latent) failures before, rather than after, an adverse event is proposed.

     

A new frontier in healthcare risk management: Working to reduce avoidable patient suffering

This article presents a new avenue for healthcare risk managers to drive improvement for patients and healthcare organizations alike: working to reduce avoidable patient suffering. It briefly describes the problem of patient suffering, differentiates between avoidable and unavoidable suffering, and suggests that common risk management tools can be used to tackle the problem. It also highlights a success story from one large health system.     

手卫生干预对降低重症监护室医院感染率的影响

目的对某院重症监护室（ICU）医务人员手卫生进行干预,了解其对医院感染率的影响。方法对某院ICU医务人员手卫生进行干预,并建立有效的监督管理机制,比较干预前（2012年1-12月）和干预后（干预后第1阶段：2013年1-6月;干预后第2阶段：2013年7-12月）医务人员手卫生依从率和医院感染率。结果共调查4 066例患者,干预前医务人员手卫生依从率为50.03%,干预后第1、2阶段手卫生依从率分别为61.80%和64.57%,上升趋势具有统计学意义（rs=1.00, P<0.001）。干预前,ICU医院感染率为5.48%,干预后第1、2阶段分别为3.86%和3.30%,医院感染率的下降趋势具有统计学意义（rs=-1.00,P<0.001）。ICU导管相关血流感染率、导尿管相关尿路感染率和呼吸机相关性肺炎感染率下降趋势均具有统计学意义（rs=-1.00,均P<0.001）。手卫生依从率与ICU医院感染率、导管相关血流感染率、导尿管相关尿路感染率、呼吸机相关性肺炎感染率间存在负相关（均P<0.05）。结论提高手卫生依从性,可有效降低ICU病房医院感染发生率。     

Application of statistical inference techniques in health information management

We have demonstrated that objective comparisons can be made using accepted statistical techniques. We have also shown that you can apply tests which don't meet the basic assumptions and still obtain valid results, in most cases. This robustness of statistics tests is particularly helpful with the type of data and analysis that health information management professionals typically deal with, where exactness of the results is not crucial. You can perform a quick analysis using simple statistical tools and obtain a P value that is fairly close to what it would be if you selected the tests more stringently. The examples of inferential statistics in this article demonstrate how to select tests based on characteristics of the data and how to interpret the results. The kinds of statistical analysis that can be performed in health information management are numerous. Below are some other ideas on how to use inferential statistics in HIM practice. 1. Set up an ordinal scale to evaluate coding accuracy to evaluate coders: Score 1 means the correct code was assigned for the principal diagnosis and only minor errors in coding among secondary diagnoses. Score 2 means the correct code was assigned for the principal diagnosis, but there are omissions or major errors among secondary diagnoses. Score 3 means a minor error in coding the principal diagnosis and only minor errors in secondary diagnoses. Score 4 means a minor error in coding the principal diagnosis and major errors or omissions in secondary diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS)     

The use of XML in healthcare information management

Extensible Markup Language (XML) is an emerging Internet standard that is gaining momentum in many industries, including healthcare. This article examines the origins of XML, its components, and some potential uses for XML in the healthcare industry. It then discusses a specific initiative to use XML as the basis for an industry-standard scheduling protocol.     

Five constants of information technology adoption in healthcare

The healthcare industry has developed a dependence on information technology (IT) for maintaining and improving both clinical and business operations. Whether IT is used for office automation or for reducing medical errors, there are five constants that routinely influence the successful integration of IT in healthcare. These constants are the proper use and maintenance of the IT budget, the role of supportive leadership, the use of project management, the process of implementation, and the significance of end user involvement. These constants challenge healthcare organizations to efficiently and effectively use their financial and human resources when adopting new IT. These constants also shape how the healthcare industry approaches the adoption and utilization of new IT. A collective understanding of these constants and their interrelationships will enable healthcare organizations to better integrate new IT and achieve organizational goals of developing a solid technological infrastructure to truly enhance the delivery of quality healthcare.     

韩国医疗保障体系简介

介绍了韩国社会医疗保险系统发展现状及韩国实现社会医疗保险全民覆盖的过程,重点描述了韩国从多个社会医疗保险基金发展为统一的社会医疗保险制度过程,分析了韩国社会医疗保险改革与韩国卫生体制改革没有同步实施而出现的私立医疗机构占垄断地位、缺乏首诊和转诊制度、患者个人自付比例过高等严重问题.希望对我国目前正在推进的社会医疗保险体系有所启示,防止我国在社会医疗保险和卫生体制综合改革过程中出现类似的错误.