This report describes a hospital-wide clinical computing system that permits physicians, nurses, medical students, and other health workers to retrieve data from the clinical laboratories; to look up reports from the departments of radiology and pathology; to look up demographic data and outpatient visits; to look up prescriptions filled in the outpatient pharmacy; to perform bibliographic retrieval of the MEDLINE data base; to read, write, retract, edit, and forward electronic mail; and to request delivery of a patient’s chart.

Clinical computing in a teaching hospital.

Integration and beyond: linking information from disparate sources and into workflow.

A particular political issue today concerns ways of improving national healthcare systems without incurring further costs. An extensive study by the Institute of Medicine (IOM) in the United States formally reported that computer-based patient records are absolutely necessary to help contain the cost explosion in health care. The information obtained from experts, the studies conducted, and the conclusions that went into the IOM's report have now been collected in this volume. A large portion of the volume discusses the state-of-the-art in existing computer-based systems as well as the essential needs which must be addressed by future computer-based patients' records. A final section in the book discusses implementation strategies for changing to the electronic system and practical issues. The book asks who will bear the final cost? how and when will health-care providers who use the system be trained? This volume contains the sort of information which hospital administrators, hospital systems designers, third-party payer groups, and medical technology providers will need in any sucessful transition to hospital systems which use a computer-based patient record.

/pdf/aspects-of-the-computer-based-patient-record-zo5jaj2mui.pdf

Aspects of the computer-based patient record

Happy birthday DIOGENE: a hospital information system born 20 years ago

After reading this chapter, you should know the answers to these questions: 


Why are standards important in biomedical informatics?


What data standards are necessary to be able to exchange data seamlessly among systems?


What organizations are active in standards development?


What aspects of biomedical information management are supported today by standards?


What is the process for creating consensus standards?


What factors and organizations influence the creation of standards?

Standards in Biomedical Informatics

Local area networks and the hospital

A demonstration implementation of a distributed data processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system changes have been required. The LACN uses a fiber-optic communications medium and provides extensive communications protocol support within the network, based on the ISO/OSI Model. The architecture is reconfigurable and expandable. This paper describes system architectural issues, the applications environment and the local area network.

Implementation of a Prototype Generalized Network Technology for Hospitals

The architecture, technologies, and methods used to achieve functional integration of IBM MVS/CICS/PCS, MUMPS, and UNIX based clinical information systems along with PC's and workstations are described Network equipment, protocols, and application integration software are discussed Interconnecting departmental networks of PC's, workstations, and minicomputers is also addressed

Integrating Heterogeneous Systems Using Local Network Technologies and Remote Procedure Call Protocols

A local area communications network has been implemented at the University of California, San Francisco Hospital to integrate major components of the hospital's information system. This microprocessor-based network technology was developed by The Applied Physics Laboratory of the Johns Hopkins University. The first year's experience has demonstrated the basic feasibility of this technology in simplifying the integration of diverse hardware and software systems. Four minicomputer-based UCSF systems now use the network to synchronize key patient identification and registration information among the systems. Clinical uses of the network will begin during the second year of the project.

S. A. Kahn

Papers

Local area networks and the hospital

Implementation of a Prototype Generalized Network Technology for Hospitals

Integrating Heterogeneous Systems Using Local Network Technologies and Remote Procedure Call Protocols

A Hospital Local Area Communication Network—The First Year's Experience