Benefits realization at Mercy Memorial results in a changed organizational culture

May 1, 1989, marked the completion of the first phase of the installation of a new hospitalwide computer system at Mercy Memorial Hospital (MMH) in Monroe, Mich. This installation has involved more than the mere addition of new hardware and application training. MMH has undertaken an aggressive pursuit to achieve the quantitative and qualitative benefits that so often elude system installers. These are often the same benefits that serve to justify new systems expenditures. This is the last in a three-part series (see our Feb. and May 1989 issues).

Service, training key to information center's success

Three years ago, an Information Center was put in place at Riverside Methodist Hospitals. The PC-based system supports hundreds of users and communicates with a wide variety of ancillary departments. In addition, ongoing training and support helps ensure that users can maximize the benefits of the available technology.

Special communication. The Cooperative Human Tissue Network

This report is to make the general scientific community aware of availability of human tissues through this network. During the short period of its existence, this network has developed useful procedures for distributing human tumor tissue in a rapid, scientifically useful, cost-effective manner to investigators to whom this tissue would not otherwise be available. The growth in the number of specimens being distributed matches the previous experience of each of the member institutions in internal distribution activities. It is expected that the availability of tissue will lead to new research initiatives and grant applications. This Network has been established as a model which can in the future be expanded to meet the needs of the scientific community at large. The National Cancer Institute encourages investigators engaging in cancer research who have need of human tissues to submit their requests to the Cooperative Human Tissue Network.

Development of a statewide Maternal and Child Health Information Network

The Maternal and Child Health Information Network (MATCH) was a national demonstration project funded in 1983 by a Special Projects of Regional and National Significance (SPRANS) grant. The network's major objectives have been to correlate collected clinical service data items into usable information, to expand the database through linkage with other systems within the Ohio Department of Health, and to analyze the conjugated data in an effort to expand current knowledge of maternal and child health. The network is interactive between local funded agencies and the state Health Department. Both data entry and data retrieval are distributed at the end-user information centers. Training and support, major components of the project, are provided to each participant and user of the network. One advantage of MATCH is that it allows linkage of clinical service records with vital records as an outcome of prenatal care and/or a history for child health clients. This aspect of the system permits an expanded look at the population being served by funds designated for maternal and child health programs and the ultimate outcome of such services, and permits comparison with those not receiving preventive health services.

Data communications within a health authority

This paper describes the data communication network installed in four hospitals in the Hammersmith and Queeen Charlotte's Special Health Authority to support several hundred microcomputers, terminals and printers and several host systems, including the integrated computerized hospital information system which is currently under development. Broadband local area network and wide area network technologies have been employed to provide a flexible system, which is capable of being expanded to meet the increasing demand for data communications within the authority. The broadband networks are the first such installations in a health authority in Britain.

A local network for sharing resources and technical support: BACS/PHILNET

Within the framework of large regional and national networks, local libraries can benefit by working together. We report the establishment of an online health sciences library network to share resources and technical support in the greater St. Louis area. BACS/PHILNET has evolved beyond a local automated interlibrary loan network to pilot off-site integrated library and information management systems in hospitals.

HIS-PACS coupling: BAZIS/ZIS and Philips/MARCOM on speaking terms

Nowadays a growing number of experts in the PACS field agree on the necessity of having an integrated HIS-PACS combination available in modern hospitals in order to manage the enormous amounts of patient data, both textual, numerical and image information, in an effective way. Since 1986 BAZIS (the Development and Support Group of the Hospital Information System), Philips Medical Systems and the University Hospital of Utrecht (AZU) are partners in the so-called Dutch PACS Project in the development and evaluation of a fully integrated image information system. The first phase of the coupling (sub)project consists of establishing a communication link between the BAZIS/ZIS and the Philips/MARCOM system with the following restrictions: the only data sent concerns the inpatients of one ward; data will only flow one way, from BAZIS/ZIS to Philips/MARCOM. In the second phase two-way communication will be realized and more departments can be part of the experiment. In phase 3 a more general HIS-PACS interface will be developed, independent of the manufacturers of HIS and PACS. In this paper the technical solution chosen for the first phase coupling, the format of the messages being transferred, and the events which result in sending the messages, will be described. Also, reference is made to the demonstration of the working HIS-PACS link, given during the 6th EuroPACS meeting in Utrecht and Leiden on 25-26 April 1988.

EuroPACS: a catalyst for PACS in Europe

The EuroPACS organization and its intended role in PACS development in Europe is briefly described. EuroPACS was initiated at Braunlage FRG, August 1984. Its aim is to stimulate mutual contacts between various groups in Europe being active in the PACS field. Its main activities are: organization of EuroPACS conferences (once or twice per year), publication of a newsletter and organization of special sessions in larger congresses.

Hospital-physician bonding: the computer connection

Hospitals seeking ways to increase their utilization must not overlook the medical staff, who form the main channel for patient admissions and referrals. Since physicians generally admit patients where they feel the best care is offered--and where their practice of medicine is most facilitated--many hospitals wishing to attract and retain physicians have linked patient data to their offices via computer. By strengthening positive relationships and computerizing access to information, bonding with physicians has emerged as an effective alternative to traditional hospital marketing efforts.

A Virtual Notebook for biomedical work groups

During the past several years, Baylor College of Medicine has made a substantial commitment to the use of information technology in support of its corporate and academic programs. The concept of an Integrated Academic Information Management System (IAIMS) has proved central in our planning, and the IAIMS activities that we have undertaken with funding from the National Library of Medicine have proved to be important extensions of our technology development. Here we describe our Virtual Notebook system, a conceptual and technologic framework for task coordination and information management in biomedical work groups. When fully developed and deployed, the Virtual Notebook will improve the functioning of basic and clinical research groups in the college, and it currently serves as a model for the longer-term development of our entire information management environment.

University of Cincinnati Medical Center: integrating information

The University of Cincinnati Medical Center has combined five existing units into a new organization responsible for initiating an Integrated Academic Information Management System (IAIMS). This new organization, Medical Center Information and Communications, was reorganized into nine departments, which now provide a variety of information services. Ultimate goals for IAIMS include a patient-centered database, a decision-support system, and a knowledge network. The IAIMS prototype, currently under development for the University of Cincinnati Hospital's Internal Medicine Service, consists of components representative of the IAIMS model's ultimate goals. A major premise of this IAIMS effort is that it is patient-centered.

The knowledge workstation: an electronic environment for knowledge management

This paper focuses on the creation of the IAIMS workstation in the context of the outcomes of a year-long IAIMS strategic planning process at the Johns Hopkins Medical Institutions (JHMI). These outcomes include a long-term institutional vision for a functional knowledge management environment, a JHMI IAIMS model, a strategic plan, and two model prototypes. The functional requirements and specific implementation strategies for the IAIMS workstation, the prototype for managing the knowledge base of the published biomedical literature, are discussed in detail.

Information management through integration of distributed resources

Duke University Medical Center conducted a strategic planning process focused on information management needs beginning in 1983 and ending in 1985. That effort concluded that the institution was ready to establish an Integrated Academic Information Management System (IAIMS). A model was proposed in which information management was to be achieved through integrated distributed resources. The elements of the IAIMS model are ongoing policy development and planning; communications; an electronic library or resource inventory; coordination of the development or selection of the end-user function; user support; and ongoing evaluation. This model is being tested to determine its effectiveness in meeting the administrative, patient care, research, and educational needs of a basic science department and a clinical science department at Duke University.

Arizona network improves providers' competitiveness

In the September/October issue of Physician Executive, the Remote Practice Network (RPN) health care delivery system concept was introduced and explained. In this article, the concept is illustrated by a description of Arizona HealthSource (AHS), an RPN developed in Phoenix, Arizona. AHS's design, evolution, and operation demonstrate both the competitive pressures that force hospitals into taking new initiatives and the exciting alternative offered by an RPN. Arizona HealthSource serves the Phoenix, Ariz., region, a highly competitive health care marketplace. The organization was started by St. Joseph's Hospital and Medical Center in cooperation with Magliaro & McHaney, a consulting firm with offices in Atlanta, Ga., and La Jolla, Calif. AHS is currently managed under contract by Magliaro & McHaney, which develop the RPN concept and which designs, implements, markets, and manages health care delivery system.

Growth and change through information management

As health care executives create and mold visions for the future of their institutions, they are discovering that one critical factor is that the vast potential power of information technology be skillfully implemented and managed. Past methods of managing what was at one time called data processing will no longer serve well in this new era. At The Methodist Hospital, innovative management methods have allowed us to bridge the gap from the information systems and management methods of the past. An excellent set of new management techniques has been used to engage project teams in the management of change. Information systems projects have been used successfully as catalysts for dramatic institutional growth and constructive change.

From tangled webs to network integrity: computer security in hospital management. Part II

This article is the second of two on the subject of computer security in hospital management in the first part, the authors dramatized the need for not only information security awareness but also the need for implementation of security measures to protect valuable information. This second article provides an overview of the components of a good computer security plan, contains a brief explanation of some of the new network security technology available today, and gives the reader several sources that can provide further information on information security.

A computer network for the surveillance of communicable diseases: the French experiment

The description and first results of the French Communicable diseases Network are reported. The network, initiated in November 1984, currently includes the National Department of Health, the local health offices and various clinical, biological, and epidemiological partners. Surveillance of influenza, viral hepatitis, acute urethritis, measles, and mumps is based upon reports from sentinel general practitioners throughout France who are equipped with terminals and can communicate their data on a 24-hour basis. The network distributes electronic bulletins summarizing the surveillance data, the regional statistics concerning other diseases, and epidemiological and administrative news. Electronic mail is used for data validation and enhances communication between the parties of the network.