OBJECTIVES: The purpose of this study was to design an integrated data management system based on the POCT1-A2, LIS2-A, LIS2-A2, and HL7 standard to ensure data interoperability between mobile equipment, such as point-of-care testing equipment and the existing hospital data system, its efficiency was also evaluated. METHODS: The method of this study was intended to design and realize a data management system which would provide a solution for the problems that occur when point-of-care testing equipment is introduced to existing hospital data, after classifying such problems into connectivity, integration, and interoperability. This study also checked if the data management system plays a sufficient role as a bridge between the point-of-care testing equipment and the hospital information system through connection persistence and reliability testing, as well as data integration and interoperability testing. RESULTS: In comparison with the existing system, the data management system facilitated integration by improving the result receiving time, improving the collection rate, and by enabling the integration of disparate types of data into a single system. And it was found out that we can solve the problems related to connectivity, integration and interoperability through generating the message in standardized types. CONCLUSIONS: It is expected that the proposed data management system, which is designed to improve the integration point-of-care testing equipment with existing systems, will establish a solid foundation on which better medical service may be provided by hospitals by improving the quality of patient service.
Clinical Laboratory Information Systems ; Database Management Systems ; Dietary Sucrose ; Hospital Information Systems ; Humans ; Information Systems ; Medical Order Entry Systems ; Point-of-Care Systems

OBJECTIVES: To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. METHODS: We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. RESULTS: The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. CONCLUSIONS: We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.
Commerce ; Computer Systems ; Decision Support Systems, Clinical ; Delivery of Health Care* ; Electronic Health Records ; Information Services ; Medical Informatics ; Medical Order Entry Systems ; Privacy ; Soaps ; Social Control, Formal

OBJECTIVES: Human factors engineering is a discipline that deals with computer and human systems and processes and provides a methodology for designing and evaluating systems as they interact with human beings. This review article reviews important current and past efforts in human factors engineering in health informatics in the context of the current trends in health informatics. METHODS: The methodology of human factors engineering and usability testing in particular were reviewed in this article. RESULTS: This methodology arises from the field of human factors engineering, which uses principles from cognitive science and applies them to implementations such as a computer-human interface and user-centered design. CONCLUSIONS: Patient safety and best practice of medicine requires a partnership between patients, clinicians and computer systems that serve to improve the quality and safety of patient care. People approach work and problems with their own knowledge base and set of past experiences and their ability to use systems properly and with low error rates are directly related to the usability as well as the utility of computer systems. Unusable systems have been responsible for medical error and patient harm and have even led to the death of patients and increased mortality rates. Electronic Health Record and Computerized Physician Order Entry systems like any medical device should come with a known safety profile that minimizes medical error and harm. This review article reviews important current and past efforts in human factors engineering in health informatics in the context of the current trends in health informatics.
Cognitive Science ; Computer Systems ; Electronic Health Records ; Humans ; Informatics ; Knowledge Bases ; Medical Errors ; Medical Order Entry Systems ; Patient Care ; Patient Safety ; Practice Guidelines as Topic

OBJECTIVES: This study demonstrates the feasibility of using expert system shells for rapid clinical decision support module development. METHODS: A readily available expert system shell was used to build a simple rule-based system for the crude diagnosis of vaginal discharge. Pictures and 'canned text explanations' are extensively used throughout the program to enhance its intuitiveness and educational dimension. All the steps involved in developing the system are documented. RESULTS: The system runs under Microsoft Windows and is available as a free download at http://healthcybermap.org/vagdisch.zip (the distribution archive includes both the program's executable and the commented knowledge base source as a text document). The limitations of the demonstration system, such as the lack of provisions for assessing uncertainty or various degrees of severity of a sign or symptom, are discussed in detail. Ways of improving the system, such as porting it to the Web and packaging it as an app for smartphones and tablets, are also presented. CONCLUSIONS: An easy-to-use expert system shell enables clinicians to rapidly become their own 'knowledge engineers' and develop concise evidence-based decision support modules of simple to moderate complexity, targeting clinical practitioners, medical and nursing students, as well as patients, their lay carers and the general public (where appropriate). In the spirit of the social Web, it is hoped that an online repository can be created to peer review, share and re-use knowledge base modules covering various clinical problems and algorithms, as a service to the clinical community.
Archives ; Caregivers ; Decision Making, Computer-Assisted ; Decision Support Systems, Clinical ; Expert Systems ; Humans ; Knowledge Bases ; Peer Review ; Product Packaging ; Software Design ; Students, Nursing ; Tablets ; Uncertainty ; Vaginal Discharge

With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.
Decision Support Systems, Clinical ; Diagnostic Imaging ; Follow-Up Studies ; Humans ; Medical Order Entry Systems

With the development and utilization of computer techniques, Internet is playing an important role in information dissemination. There are abundant biomedical resources on the Internet. Accessing biomedical information is more dependent on the Internet than ever. It is important to explore new methods to describe and manage information resources. We have analyzed biomedical databases, search engines, web sites, and the metadata adopted by biomedical databases. The results show that biomedical information resources are characterized by electronic format, networking, dynamia, and dispersion. Describing a resource with metadata allows it to be understood by both humans and machines in ways that promote interoperability. Metadata interoperability has to be the underlying principle for networked information management. It directly impinges on information sharing, interchange, and accessibility across the boundaries of systems, languages, and geographic locations. We can use metadata to describe biomedical information and to integrate resources. It will benefit the people to access, select, and utilize biomedical information resources.
Computer Communication Networks ; organization & administration ; Database Management Systems ; organization & administration ; Information Storage and Retrieval ; methods ; Internet ; Medical Informatics Computing

In this paper, we introduce the grid technology into the design of the distributed PACS. First, we analyse the architecture and functions of OGSA-DAI, and then, introduce a model of the distributed PACS based on OGSA-DAI, and give a detailed analysis on its basic components and workflow. Finally, we make a conclusion on the distributed PACS based on grid technology.
Computer Communication Networks ; Computer Systems ; Database Management Systems ; Humans ; Information Storage and Retrieval ; methods ; Medical Informatics ; Radiology Information Systems ; Software ; Software Design ; Systems Integration

In order to improve the sharing of DICOM, a proposal is offered to introduce XML into DICOM on the SPIE 2005 and in this way, better readability and expansibility of DICOM files have been achieved. On this basis, the DICOM data structure is improved further by replacing the one-dimension linear data structure with multilayer tree-shaped data structure. And thus the nesting and dependence relationships between information object and data elements are much clearer and it is more convenient and easy to browse DICOM image files.
Database Management Systems ; Information Storage and Retrieval ; methods ; standards ; Medical Informatics ; methods ; Medical Records Systems, Computerized ; Programming Languages ; Radiology Information Systems ; Software ; User-Computer Interface

Background: Reporting rate of notifiable communicable diseases has been assumed to be low in Korea. To encourage timely reporting of notifiable communicable diseases and to improve the reporting process by the Infection Control Unit, a disease code-based electronic surveillance and in-house electronic reporting system was developed and implemented in February 2003. We evaluated the reporting rates of notifiable communicable diseases before and after the implementation of the electronic reporting- system. METHODS: The electronic reporting system, which was integrated to the computerized physician order entry system, was designed to monitor KCD-4 codes at the time of every order entry. Whenever the system recognized the predetermined codes of notifiable communicable diseases, it generated an alert box to recommend reporting: and then a physician could fill up an electronic report form, which was collected and faxed to the local public health authority by the Infection Control Unit. Reporting rate of notifiable communicable diseases in 2002, when the conventional paper-based reporting system was used, was assumed comparing the number of cases reported actually and that of cases identified to be reported by reviewing the medical records and electronic database. RESULTS: From March to July 2003, 181 cases with tuberculosis and 14 with other communicable diseases were reported whereas 106 and 9 cases were reported respectively for the same 5-month period in 2002. Reporting rate using the conventional reporting system in 2002 was assumed to be 61% and 39% respectively. Conclusions: Using a disease code-based electronic reporting system, reporting of notifiable communicable diseases could be improved compared with conventional paper-based reporting system.
Communicable Diseases* ; Disease Notification ; Infection Control ; Korea ; Medical Informatics Applications ; Medical Order Entry Systems ; Medical Records ; Public Health ; Tuberculosis

Wearable sensor systems which allow for remote or self-monitoring of health-related parameters are regarded as one means to alleviate the consequences of demographic change. This paper aims to summarize current research in wearable sensors as well as in sensor-enhanced health information systems. Wearable sensor technologies are already advanced in terms of their technical capabilities and are frequently used for cardio-vascular monitoring. Epidemiologic predictions suggest that neuropsychiatric diseases will have a growing impact on our health systems and thus should be addressed more intensively. Two current project examples demonstrate the benefit of wearable sensor technologies: long-term, objective measurement under daily-life, unsupervised conditions. Finally, up-to-date approaches for the implementation of sensor-enhanced health information systems are outlined. Wearable sensors are an integral part of future pervasive, ubiquitous and person-centered health care delivery. Future challenges include their integration into sensor-enhanced health information systems and sound evaluation studies involving measures of workload reduction and costs.
Delivery of Health Care ; Health Information Systems ; Medical Informatics ; Monitoring, Ambulatory