Clinical Information Systems

by Van De Velde, Rudi; Degoulet, Patrice

• ISBN13: 9780387955384
• ISBN10: 0387955380
• Format: Hardcover
• Copyright: 2003-05-01
• Publisher: Springer Verlag

Summary

The importance of hospital information systems (HISs) is unquestionable: they are the integration tool that facilitates the management of medical and administrative information, thereby improving the quality of health care. Clinical Information Systems: A Component-Based Approach explores the different components involved in the implementation of clinical information systems (CISs), which are the part of HISs that deals with the direct management of the patient. With its practical and reader-friendly approach, this book aims to guide healthcare professionals through the different steps of the conceptualization, design, development, deployment, refinement, maintenance, and evaluation of CISs. In addition to detailing the importance of HISs and CISs, the book addresses their extension in multisite environments: community health information systems (CHISs) or networks (CHINs), which are implemented in an effort to better serve the public. Clinical Information Systems: A Component-Based Approach guides healthcare professionals in implementing, managing, and accessing CISs in various healthcare settings. It addresses the needs of physicians, nurses, allied health professionals, and informaticians, requiring knowledge of the principles and implementation of integrated CISs aimed at improving the quality and delivery of health care. Featuring case studies and a Glossary, the book is ideal for the undergraduate and graduate levels, as well as for the practicing professional. Book jacket.

Author Biography

Rudi Van de Velde is professor of medical informatics at the University of Brussels and head of the Computing Department at the AZ-VUB University Hospital, Brussels, Belgium Patrice Degoulet is professor of medical informatics at the University of Paris and head of the Computing Department at Georges Pompidou University Hospital, Paris, France

Table of Contents

Series Preface	vii
Preface	ix
Introduction: The Evolution of Health Information Systems	1	(14)
Functional Perspective	1	(3)
Hospital Information Systems	1	(1)
Community Health Information Systems	2	(1)
Clinical Information Systems	3	(1)
Technology Perspective	4	(3)
Object-Oriented and Component-Based Computing	4	(1)
Middleware	5	(2)
Mobile Communications	7	(1)
Architectural Perspective	7	(4)
Mainframe Architectures	7	(1)
Departmental Systems	8	(1)
Distributed Systems and the Client/Server Era	8	(2)
Network-Centric Architectures and Web Services	10	(1)
Toward Component-Based Clinical Information Systems	11	(1)
Summary and Conclusions	12	(2)
References	14	(1)
Frameworks: A Collection of Business Objects	15	(22)
A New Vision	15	(1)
Software Components	16	(2)
Software Objects	18	(1)
Business Rules	19	(1)
Architectural Requirements	20	(1)
Architectural Design	21	(3)
Architecture Layers	21	(3)
Dynamics of the Architecture	24	(1)
Enterprise Infostructure Model	24	(6)
Patient Component	25	(1)
Activity Component	26	(1)
Resource Management Component	26	(1)
Health Record Component	27	(1)
Authorization Component	28	(1)
Knowledge Management Component	28	(2)
Application Domain	30	(2)
Technical Infrastructure	32	(1)
Summary and Conclusions	33	(1)
References	34	(3)
Frameworks: A Collaboration of Objects	37	(18)
Dimensions in Communications	38	(1)
Infrastructure Level	38	(1)
Applicative Level	38	(1)
Communication Standards	39	(6)
Communication at the Syntax Level	40	(4)
Communication at the Semantic Level	44	(1)
Communication at the Pragmatic Level	45	(1)
Collaboration Between Objects	45	(5)
Collaboration via the WWW	45	(1)
Request Brokers	46	(2)
Downloadable Components	48	(1)
OMG CORBAmed Approach	48	(1)
CCOW	49	(1)
Scenarios in Distributed Environments	50	(1)
Summary and Conclusions	51	(1)
References	52	(3)
The Patient Component	55	(10)
Conceptual Specifications	55	(1)
Functional Specifications	56	(3)
Patient Retrieval	56	(1)
Patient Identification and Registration	57	(1)
Patient Admission and Discharge	58	(1)
Patient Tracking and Transfer Functions	59	(1)
Patient Health Data Cards	59	(4)
Rationale for Using Health Data Cards	59	(1)
Card Technologies	60	(1)
Examples of Health Data Card Applications	61	(2)
Summary and Conclusions	63	(1)
References	63	(2)
The Activity Component	65	(24)
Conceptual Specifications	66	(6)
Activities and Tasks	66	(1)
Classification of Healthcare Tasks	67	(2)
The Life Cycle of an Activity	69	(3)
Provider Order Entry Systems	72	(4)
Benefits	72	(1)
Requirements	73	(3)
POE and Computer-Based Decision Support	76	(7)
Critiquing Systems	77	(1)
Consulting Systems	77	(1)
Reminder Systems	77	(1)
Event Engine	78	(3)
Rules	81	(1)
Computer-Based Guidelines	82	(1)
Framework for Automating Medical Processes: The Workflow Engine	83	(2)
Summary and Conclusions	85	(1)
References	86	(3)
The Health Record Component	89	(34)
Scope of Health Records	89	(1)
Strategies in Evolving Toward Electronic Health Records	90	(3)
From Healthcare Provider to Patient-Centered Electronic Records	90	(1)
Barriers to the Development of Electronic Health Records	91	(1)
Requirements for the Implementation of EHR Systems	92	(1)
Conceptual Specifications	93	(18)
Time and Events	94	(2)
Classes of Clinical Data: The User Point of View	96	(4)
Health Records Structures	100	(7)
Health Record Component Architecture	107	(4)
Health Record Management	111	(6)
User Interface Component	111	(1)
Strategies of Clinical Data Entry at the Point of Care	112	(4)
Presentation for Reading and Interpretation	116	(1)
Summary and Conclusions	117	(1)
References	118	(5)
The Knowledge Component	123	(30)
Conceptual Specifications	124	(9)
Types of Knowledge	124	(1)
Knowledge Representation Formalisms	125	(5)
Inferences and Problem-Solving Techniques	130	(3)
Ontologies and Terminology Servers	133	(2)
Architectural Frameworks	135	(1)
Clinical Decision Support Systems	136	(3)
Historical Background	136	(1)
Scope of Intervention	136	(2)
Mode of Intervention	138	(1)
Computer-Encoded Guidelines	139	(5)
Knowledge Sharing and Reuse	139	(1)
Toward the Standardization of Electronic Guidelines	140	(4)
Knowledge-Based System Integration	144	(4)
Integration with Daily Clinical Practice	144	(1)
Integration with Clinical Protocols	145	(1)
Integration with Patient Record Management Systems	146	(2)
Summary and Conclusions	148	(1)
References	149	(4)
The Resource Management Component	153	(20)
Conceptual Specifications	154	(2)
Nature and Types of Resources	154	(1)
Scheduling Systems	154	(2)
Functional Specifications	156	(13)
Objectives of a Scheduling System	157	(1)
Requirements of a Scheduling System	158	(6)
Scheduling Templates	164	(2)
Choosing the Optimum Appointment Schedule	166	(3)
Architecture of the Resource Component	169	(2)
Activity Thesaurus	169	(1)
Workflow Engine	169	(1)
Scheduling Engine	169	(1)
Interface Engine	170	(1)
Summary and Conclusions	171	(1)
References	172	(1)
The Security Component	173	(18)
Conceptual Specifications	174	(5)
Security Principles	174	(3)
Security Modeling	177	(2)
Establishment of a Healthcare Security Policy	179	(1)
Security Issues When Accessing Health Data	179	(2)
Identification, Authentication, and Authorization	179	(1)
Single Sign-On	180	(1)
Automatic Time-Out	181	(1)
Security Issues During the Communication of Health Data	181	(7)
Typology of Exchanges	181	(1)
Potential Threats and Dangers	181	(1)
Message Securing	182	(3)
Public Key Repository Infrastructures	185	(1)
General Security Mechanisms	186	(2)
Summary and Conclusions	188	(1)
References	189	(2)
Imaging Management and Integration	191	(26)
Conceptual Specifications	192	(8)
Image Standards	192	(1)
Image Modalities	192	(4)
Image Representation	196	(1)
Compression Techniques	197	(3)
Image Communication System	200	(4)
Enterprise Networking	200	(1)
HIS/PACS Interfaces	201	(3)
Image Archive	204	(2)
Image Database	204	(1)
Image Indexing Subsystem	205	(1)
Workflow Manager	206	(1)
Digital Imaging Workstations	207	(5)
System Requirements	207	(2)
Functional Requirements	209	(3)
3D Imaging in Clinical Use	212	(1)
Summary and Conclusions	213	(2)
References	215	(2)
AZ-VUB Clinical Information System	217	(14)
Rudi Van de Velde
Rony Lanssiers
Goedele Antonissen
Vital Claeys
Background	217	(1)
Technological Environment	217	(4)
Business Tier	218	(2)
Client Tier	220	(1)
Information System Components	221	(4)
Authorization Component	221	(1)
Patient Component	222	(1)
Activity Component	222	(1)
Medical Component	222	(1)
Knowledge and Terminology Component	223	(1)
Resource Component	224	(1)
Workflow Management	224	(1)
Deployment Architecture	225	(1)
Mobile Computing	226	(1)
Internet Portal	226	(1)
Results	226	(1)
Discussion and Conclusions	227	(2)
References	229	(2)
HEGP Clinical Information System	231	(12)
Patrice Degoulet
Lise Marin
Marion Lavril
Christel Le Bozec
Elisabeth Delbecke
Francoise Aime
Jean-Jacques Meaux
Lionel Rose
Background	231	(1)
Component-Based Architecture	232	(5)
Component Selection Process	232	(1)
Generic Components	233	(1)
Healthcare Components	234	(1)
Departmental Legacy Applications	235	(1)
The Information System Portal	235	(1)
Information Workflow	236	(1)
Results	237	(2)
Discussion and Conclusions	239	(2)
References	241	(2)
HCUG Clinical Information System	243	(10)
Antoine Geissbuhler
Jean-Raoul Scherrer
Background	243	(1)
Underlying Concepts	243	(3)
Knowledge Management for Point-of-Care Decision Support	243	(2)
Multiple Views of a Coherent Representation	245	(1)
Encapsulation of Legacy Systems	245	(1)
Progressive Integration of Heterogeneous Clinical Applications	245	(1)
Distributed Expertise	245	(1)
Architectural and Technical Choices	246	(1)
Main Components	247	(2)
Access Control Components	247	(1)
Terminology and Knowledge-Based Components	248	(1)
Document Processing Components	248	(1)
Encapsulation of Legacy and Commercial Systems	248	(1)
Clinical Applications	249	(2)
Results	251	(1)
Discussion and Conclusions	251	(1)
References	252	(1)
VUMC Clinical Information System	253	(12)
William W. Stead
Randall A. Bates
Jeff Byrd
Dario Giuse
Randolph A. Miller
Edward K. Shultz
Background	253	(1)
VUMC Information Management Architecture	254	(8)
Enterprise Information Architecture	255	(6)
Application Component Architecture	261	(1)
Results	262	(1)
Discussion and Conclusions	263	(1)
References	264	(1)
Postface	265	(4)
Managing Complexity	265	(1)
Challenge of Software Engineering	266	(1)
Experience from Case Studies	266	(1)
Organizational and Human Aspects	267	(2)
Glossary	269	(12)
Index	281