Mayo Alliance Prognostic Model for Myelodysplastic Syndromes: Integration of Genetic and Clinical Information.

Science.gov (United States)

Tefferi, Ayalew; Gangat, Naseema; Mudireddy, Mythri; Lasho, Terra L; Finke, Christy; Begna, Kebede H; Elliott, Michelle A; Al-Kali, Aref; Litzow, Mark R; Hook, C Christopher; Wolanskyj, Alexandra P; Hogan, William J; Patnaik, Mrinal M; Pardanani, Animesh; Zblewski, Darci L; He, Rong; Viswanatha, David; Hanson, Curtis A; Ketterling, Rhett P; Tang, Jih-Luh; Chou, Wen-Chien; Lin, Chien-Chin; Tsai, Cheng-Hong; Tien, Hwei-Fang; Hou, Hsin-An

2018-06-01

To develop a new risk model for primary myelodysplastic syndromes (MDS) that integrates information on mutations, karyotype, and clinical variables. Patients with World Health Organization-defined primary MDS seen at Mayo Clinic (MC) from December 28, 1994, through December 19, 2017, constituted the core study group. The National Taiwan University Hospital (NTUH) provided the validation cohort. Model performance, compared with the revised International Prognostic Scoring System, was assessed by Akaike information criterion and area under the curve estimates. The study group consisted of 685 molecularly annotated patients from MC (357) and NTUH (328). Multivariate analysis of the MC cohort identified monosomal karyotype (hazard ratio [HR], 5.2; 95% CI, 3.1-8.6), "non-MK abnormalities other than single/double del(5q)" (HR, 1.8; 95% CI, 1.3-2.6), RUNX1 (HR, 2.0; 95% CI, 1.2-3.1) and ASXL1 (HR, 1.7; 95% CI, 1.2-2.3) mutations, absence of SF3B1 mutations (HR, 1.6; 95% CI, 1.1-2.4), age greater than 70 years (HR, 2.2; 95% CI, 1.6-3.1), hemoglobin level less than 8 g/dL in women or less than 9 g/dL in men (HR, 2.3; 95% CI, 1.7-3.1), platelet count less than 75 × 10 9 /L (HR, 1.5; 95% CI, 1.1-2.1), and 10% or more bone marrow blasts (HR, 1.7; 95% CI, 1.1-2.8) as predictors of inferior overall survival. Based on HR-weighted risk scores, a 4-tiered Mayo alliance prognostic model for MDS was devised: low (89 patients), intermediate-1 (104), intermediate-2 (95), and high (69); respective median survivals (5-year overall survival rates) were 85 (73%), 42 (34%), 22 (7%), and 9 months (0%). The Mayo alliance model was subsequently validated by using the external NTUH cohort and, compared with the revised International Prognostic Scoring System, displayed favorable Akaike information criterion (1865 vs 1943) and area under the curve (0.87 vs 0.76) values. We propose a simple and contemporary risk model for MDS that is based on a limited set of genetic and clinical variables

Integrated web-based viewing and secure remote access to a clinical data repository and diverse clinical systems.

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Duncan, R G; Saperia, D; Dulbandzhyan, R; Shabot, M M; Polaschek, J X; Jones, D T

2001-01-01

The advent of the World-Wide-Web protocols and client-server technology has made it easy to build low-cost, user-friendly, platform-independent graphical user interfaces to health information systems and to integrate the presentation of data from multiple systems. The authors describe a Web interface for a clinical data repository (CDR) that was moved from concept to production status in less than six months using a rapid prototyping approach, multi-disciplinary development team, and off-the-shelf hardware and software. The system has since been expanded to provide an integrated display of clinical data from nearly 20 disparate information systems.

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

Science.gov (United States)

Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

2018-03-01

The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

Factors associated with clinical inertia: an integrative review

Science.gov (United States)

Aujoulat, Isabelle; Jacquemin, Patricia; Rietzschel, Ernst; Scheen, André; Tréfois, Patrick; Wens, Johan; Darras, Elisabeth; Hermans, Michel P

2014-01-01

Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. PMID:24868181

The Federal Trade Commission, clinical integration, and the organization of physician practice.

Science.gov (United States)

Casalino, Lawrence P

2006-06-01

This article examines Federal Trade Commission (FTC) policy--in particular, the agency's controversial 1996 statements on clinical integration--toward joint negotiations for nonrisk contracts with health plans by physicians organized into independent practice associations (IPAs) and (with hospitals) into physician-hospital organizations (PHOs). The article concludes that the policy is consistent with anti-trust principles, consistent with current thinking on the use of organized processes to improve medical care quality, specific enough to provide guidance to physicians wanting to integrate clinically, and general enough to encourage ongoing innovations in physician organization. The FTC should consider stronger sanctions for IPAs and PHOs whose clinical integration is nothing more than a sham intended to provide cover for joint negotiations, should give the benefit of the doubt to organizations whose clinical integration appears to be reasonably consonant with the statements, and should clarify several ambiguities in the statements. Health plans should facilitate IPA and PHO efforts to improve care by rewarding quality and efficiency and by providing clinically integrated organizations with claims information on individual patients. Though creating clinically integrated organizations is difficult and expensive, physicians should recognize that clinical integration can help them both to gain some negotiating leverage with health plans and to improve the quality of care for their patients.

Stakeholder engagement: a key component of integrating genomic information into electronic health records.

Science.gov (United States)

Hartzler, Andrea; McCarty, Catherine A; Rasmussen, Luke V; Williams, Marc S; Brilliant, Murray; Bowton, Erica A; Clayton, Ellen Wright; Faucett, William A; Ferryman, Kadija; Field, Julie R; Fullerton, Stephanie M; Horowitz, Carol R; Koenig, Barbara A; McCormick, Jennifer B; Ralston, James D; Sanderson, Saskia C; Smith, Maureen E; Trinidad, Susan Brown

2013-10-01

Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine.

MedTime: a temporal information extraction system for clinical narratives.

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Lin, Yu-Kai; Chen, Hsinchun; Brown, Randall A

2013-12-01

Temporal information extraction from clinical narratives is of critical importance to many clinical applications. We participated in the EVENT/TIMEX3 track of the 2012 i2b2 clinical temporal relations challenge, and presented our temporal information extraction system, MedTime. MedTime comprises a cascade of rule-based and machine-learning pattern recognition procedures. It achieved a micro-averaged f-measure of 0.88 in both the recognitions of clinical events and temporal expressions. We proposed and evaluated three time normalization strategies to normalize relative time expressions in clinical texts. The accuracy was 0.68 in normalizing temporal expressions of dates, times, durations, and frequencies. This study demonstrates and evaluates the integration of rule-based and machine-learning-based approaches for high performance temporal information extraction from clinical narratives. Copyright © 2013 Elsevier Inc. All rights reserved.

From organizational integration to clinical integration: analysis of the path between one level of integration to another using official documents

Science.gov (United States)

Mandza, Matey; Gagnon, Dominique; Carrier, Sébastien; Belzile, Louise; Demers, Louis

2010-01-01

Purpose Services’ integration comprises organizational, normative, economic, informational and clinical dimensions. Since 2004, the province of Quebec has devoted significant efforts to unify the governance of the main health and social care organizations of its various territories. Notwithstanding the uniformity of the national plan’s prescription, the territorial integration modalities greatly vary across the province. Theory This research is based upon a conceptual model of integration that comprises six components: inter-organizational partnership, case management, standardized assessment, a single entry point, a standardized service planning tool and a shared clinical file. Methods We conducted an embedded case study in six contrasted sites in terms of their level of integration. All documents prescribing the implementation of integration were retrieved and analyzed. Results and conclusions The analyzed documents demonstrate a growing local appropriation of the current integrative reform. Interestingly however, no link seems to exist between the quality of local prescriptions and the level of integration achieved in each site. This finding leads us to hypothesize that the variable quality of the operational accompaniment offered to implement these prescriptions is a variable in play.

Addressing narcissistic personality features in the context of medical care: integrating diverse perspectives to inform clinical practice.

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Magidson, J F; Collado-Rodriguez, A; Madan, A; Perez-Camoirano, N A; Galloway, S K; Borckardt, J J; Campbell, W K; Miller, J D

2012-04-01

Narcissistic personality disorder (NPD) is characterized by an unrealistic need for admiration, lack of empathy toward others, and feelings of superiority. NPD presents a unique and significant challenge in clinical practice, particularly in medical settings with limited provider contact time, as health professionals treat individuals who often require excessive admiration and have competing treatment needs. This practice review highlights real case examples across three distinct medically oriented clinical settings (inpatient and outpatient behavioral medicine and a Level I trauma center) to demonstrate the difficult and compromising situations that providers face when treating patients with general medical conditions and comorbid narcissistic personality features. The main goal of this article is to discuss the various challenges and obstacles associated with these cases in medical settings and discuss some strategies that may prove successful. A second goal is to bridge diverse conceptualizations of narcissism/NPD through the discussion of theoretical and empirical perspectives that can inform understanding of the clinical examples. Despite differing perspectives regarding the underlying motivation of narcissistic behavior, this practice review highlights that these paradigms can be integrated when sharing the same ultimate goal: to improve delivery of care across medically oriented clinical settings for patients with narcissistic features.

Development of a clinical data warehouse from an intensive care clinical information system.

Science.gov (United States)

de Mul, Marleen; Alons, Peter; van der Velde, Peter; Konings, Ilse; Bakker, Jan; Hazelzet, Jan

2012-01-01

There are relatively few institutions that have developed clinical data warehouses, containing patient data from the point of care. Because of the various care practices, data types and definitions, and the perceived incompleteness of clinical information systems, the development of a clinical data warehouse is a challenge. In order to deal with managerial and clinical information needs, as well as educational and research aims that are important in the setting of a university hospital, Erasmus Medical Center Rotterdam, The Netherlands, developed a data warehouse incrementally. In this paper we report on the in-house development of an integral part of the data warehouse specifically for the intensive care units (ICU-DWH). It was modeled using Atos Origin Metadata Frame method. The paper describes the methodology, the development process and the content of the ICU-DWH, and discusses the need for (clinical) data warehouses in intensive care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[Development and clinical evaluation of an anesthesia information management system].

Science.gov (United States)

Feng, Jing-yi; Chen, Hua; Zhu, Sheng-mei

2010-09-21

To study the design, implementation and clinical evaluation of an anesthesia information management system. To record, process and store peri-operative patient data automatically, all kinds of bedside monitoring equipments are connected into the system based on information integrating technology; after a statistical analysis of those patient data by data mining technology, patient status can be evaluated automatically based on risk prediction standard and decision support system, and then anesthetist could perform reasonable and safe clinical processes; with clinical processes electronically recorded, standard record tables could be generated, and clinical workflow is optimized, as well. With the system, kinds of patient data could be collected, stored, analyzed and archived, kinds of anesthesia documents could be generated, and patient status could be evaluated to support clinic decision. The anesthesia information management system is useful for improving anesthesia quality, decreasing risk of patient and clinician, and aiding to provide clinical proof.

Multiscale integration of -omic, imaging, and clinical data in biomedical informatics.

Science.gov (United States)

Phan, John H; Quo, Chang F; Cheng, Chihwen; Wang, May Dongmei

2012-01-01

This paper reviews challenges and opportunities in multiscale data integration for biomedical informatics. Biomedical data can come from different biological origins, data acquisition technologies, and clinical applications. Integrating such data across multiple scales (e.g., molecular, cellular/tissue, and patient) can lead to more informed decisions for personalized, predictive, and preventive medicine. However, data heterogeneity, community standards in data acquisition, and computational complexity are big challenges for such decision making. This review describes genomic and proteomic (i.e., molecular), histopathological imaging (i.e., cellular/tissue), and clinical (i.e., patient) data; it includes case studies for single-scale (e.g., combining genomic or histopathological image data), multiscale (e.g., combining histopathological image and clinical data), and multiscale and multiplatform (e.g., the Human Protein Atlas and The Cancer Genome Atlas) data integration. Numerous opportunities exist in biomedical informatics research focusing on integration of multiscale and multiplatform data.

Rule-based Information Integration

NARCIS (Netherlands)

de Keijzer, Ander; van Keulen, Maurice

2005-01-01

In this report, we show the process of information integration. We specifically discuss the language used for integration. We show that integration consists of two phases, the schema mapping phase and the data integration phase. We formally define transformation rules, conversion, evolution and

How information systems should support the information needs of general dentists in clinical settings: suggestions from a qualitative study

Directory of Open Access Journals (Sweden)

Wali Teena

2010-02-01

Full Text Available Abstract Background A major challenge in designing useful clinical information systems in dentistry is to incorporate clinical evidence based on dentists' information needs and then integrate the system seamlessly into the complex clinical workflow. However, little is known about the actual information needs of dentists during treatment sessions. The purpose of this study is to identify general dentists' information needs and the information sources they use to meet those needs in clinical settings so as to inform the design of dental information systems. Methods A semi-structured interview was conducted with a convenience sample of 18 general dentists in the Pittsburgh area during clinical hours. One hundred and five patient cases were reported by these dentists. Interview transcripts were coded and analyzed using thematic analysis with a constant comparative method to identify categories and themes regarding information needs and information source use patterns. Results Two top-level categories of information needs were identified: foreground and background information needs. To meet these needs, dentists used four types of information sources: clinical information/tasks, administrative tasks, patient education and professional development. Major themes of dentists' unmet information needs include: (1 timely access to information on various subjects; (2 better visual representations of dental problems; (3 access to patient-specific evidence-based information; and (4 accurate, complete and consistent documentation of patient records. Resource use patterns include: (1 dentists' information needs matched information source use; (2 little use of electronic sources took place during treatment; (3 source use depended on the nature and complexity of the dental problems; and (4 dentists routinely practiced cross-referencing to verify patient information. Conclusions Dentists have various information needs at the point of care. Among them, the needs

Integrating clinical communication with clinical reasoning and the broader medical curriculum.

Science.gov (United States)

Cary, Julie; Kurtz, Suzanne

2013-09-01

The objectives of this paper are to discuss the results of a workshop conducted at EACH 2012. Specifically, we will (1) examine the link between communication, clinical reasoning, and medical problem solving, (2) explore strategies for (a) integrating clinical reasoning, medical problem solving, and content from the broader curriculum into clinical communication teaching and (b) integrating communication into the broader curriculum, and (3) discuss benefits gained from such integration. Salient features from the workshop were recorded and will be presented here, as well as a case example to illustrate important connections between clinical communication and clinical reasoning. Potential links between clinical communication, clinical reasoning, and medical problem solving as well as strategies to integrate clinical communication teaching and the broader curricula in human and veterinary medicine are enumerated. Participants expressed enthusiasm and keen interest in integration of clinical communication teaching and clinical reasoning during this workshop, came to the idea of the interdependence of these skills easily, and embraced the rationale immediately. Valuing the importance of communication as clinical skill and embracing the interdependence between communication and thought processes related to clinical reasoning and medical problem solving will be beneficial in teaching programs. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Three-tiered integration of PACS and HIS toward next generation total hospital information system.

Science.gov (United States)

Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

1998-01-01

The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

Extending the theoretical framework for curriculum integration in pre-clinical medical education

DEFF Research Database (Denmark)

Vergel, John; Stentoft, Diana; Montoya, Juny

2017-01-01

students' knowledge integration. Therefore, we aimed to uncover how curriculum integration is manifested through context. METHODS: We collected data from the official curriculum and interviewed ten participants (including curriculum designers, facilitators, and students) in the bachelor's medical program......INTRODUCTION: Curriculum integration is widely discussed in medical education but remains ill defined. Although there is plenty of information on logistical aspects of curriculum integration, little attention has been paid to the contextual issues that emerge from its practice and may complicate...... at Aalborg University. We observed various learning activities focused on pre-clinical education. Inspired by grounded theory, we analyzed the information we gathered. RESULTS: The following theoretical constructs emerged after the inductive analysis: 1) curriculum integration complexity is embedded...

'Trial Exegesis': Methods for Synthesizing Clinical and Patient Reported Outcome (PRO Data in Trials to Inform Clinical Practice. A Systematic Review.

Directory of Open Access Journals (Sweden)

Angus G K McNair

Full Text Available The CONSORT extension for patient reported outcomes (PROs aims to improve reporting, but guidance on the optimal integration with clinical data is lacking. This study examines in detail the reporting of PROs and clinical data from randomized controlled trials (RCTs in gastro-intestinal cancer to inform design and reporting of combined PRO and clinical data from trials to improve the 'take home' message for clinicians to use in practice.The case study was undertaken in gastro-intestinal cancer trials. Well-conducted RCTs reporting PROs with validated instruments were identified and categorized into those combining PRO and clinical data in a single paper, or those separating data into linked primary and supplemental papers. Qualitative methods were developed to examine reporting of the critical interpretation of the trial results (trial exegesis in the papers in relation of the PRO and clinical outcomes and applied to each publication category. Results were used to inform recommendations for practice.From 1917 screened abstracts, 49 high quality RCTs were identified reported in 36 combined and 15 linked primary and supplemental papers. In-depth analysis of manuscript text identified three categories for understanding trial exegesis: where authors reported a "detailed", "general", or absent PRO rationale and integrated interpretation of clinical and PRO results. A total of 11 (30% and 6 (16% combined papers reported "detailed" PRO rationale and integrated interpretation of results although only 2 (14% and 1 (7% primary papers achieved the same standard respectively. Supplemental papers provide better information with 11 (73% and 3 (20% achieving "detailed" rationale and integrated interpretation of results. Supplemental papers, however, were published a median of 20 months after the primary RCT data in lower impact factor journals (median 16.8 versus 5.2.It is recommended that single papers, with detailed PRO rationale and integrated PRO and

HL7 and DICOM based integration of radiology departments with healthcare enterprise information systems.

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Blazona, Bojan; Koncar, Miroslav

2007-12-01

Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. However, this requirement represents one of the major challenges for the Information and Communication Technology (ICT) solutions, as systems today use diverse technologies, proprietary protocols and communication standards which are often not interoperable. One of the main producers of clinical information in healthcare settings represent Radiology Information Systems (RIS) that communicate using widely adopted DICOM (Digital Imaging and COmmunications in Medicine) standard, but in very few cases can efficiently integrate information of interest with other systems. In this context we identified HL7 standard as the world's leading medical ICT standard that is envisioned to provide the umbrella for medical data semantic interoperability, which amongst other things represents the cornerstone for the Croatia's National Integrated Healthcare Information System (IHCIS). The aim was to explore the ability to integrate and exchange RIS originated data with Hospital Information Systems based on HL7's CDA (Clinical Document Architecture) standard. We explored the ability of HL7 CDA specifications and methodology to address the need of RIS integration HL7 based healthcare information systems. We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers. The outcome of our pilot work proves our original assumption of HL7 standard being able to adopt radiology data into the integrated healthcare systems. Uniform DICOM to CDA translation scripts and business processes within IHCIS is desired and cost effective regarding to use of supporting IHCIS services aligned to SOA.

Data Entities and Information System Matrix for Integrated Agriculture Information System (IAIS)

Science.gov (United States)

Budi Santoso, Halim; Delima, Rosa

2018-03-01

Integrated Agriculture Information System is a system that is developed to process data, information, and knowledge in Agriculture sector. Integrated Agriculture Information System brings valuable information for farmers: (1) Fertilizer price; (2) Agriculture technique and practise; (3) Pest management; (4) Cultivation; (5) Irrigation; (6) Post harvest processing; (7) Innovation in agriculture processing. Integrated Agriculture Information System contains 9 subsystems. To bring an integrated information to the user and stakeholder, it needs an integrated database approach. Thus, researchers describes data entity and its matrix relate to subsystem in Integrated Agriculture Information System (IAIS). As a result, there are 47 data entities as entities in single and integrated database.

Integrated care information technology.

Science.gov (United States)

Rowe, Ian; Brimacombe, Phil

2003-02-21

Counties Manukau District Health Board (CMDHB) uses information technology (IT) to drive its Integrated Care strategy. IT enables the sharing of relevant health information between care providers. This information sharing is critical to closing the gaps between fragmented areas of the health system. The tragic case of James Whakaruru demonstrates how people have been falling through those gaps. The starting point of the Integrated Care strategic initiative was the transmission of electronic discharges and referral status messages from CMDHB's secondary provider, South Auckland Health (SAH), to GPs in the district. Successful pilots of a Well Child system and a diabetes disease management system embracing primary and secondary providers followed this. The improved information flowing from hospital to GPs now enables GPs to provide better management for their patients. The Well Child system pilot helped improve reported immunization rates in a high health need area from 40% to 90%. The diabetes system pilot helped reduce the proportion of patients with HbA1c rang:9 from 47% to 16%. IT has been implemented as an integral component of an overall Integrated Care strategic initiative. Within this context, Integrated Care IT has helped to achieve significant improvements in care outcomes, broken down barriers between health system silos, and contributed to the establishment of a system of care continuum that is better for patients.

A participatory assessment of IS integration needs in maternity clinics using activity theory.

Science.gov (United States)

Häkkinen, Heidi; Korpela, Mikko

2007-01-01

The design and development of information systems should focus on a wider context than merely one user group or organization. This is particularly the case with systems integration. A tentative description of the activity network, information needs, and user requirements should be acquired before any major changes are planned. Relatively rapid yet participatory methods are needed at this preliminary stage. In this article, we claim that activity theory offers a suitable framework for this. Subsequently, we present a qualitative study in which this approach was used, with focus on the practices of the information management within a maternity care activity network. The first aim was to elicit the most important integration needs in the existing information systems of Finnish maternity clinics. Secondly, we wanted to introduce a participatory approach to be utilized by the service-providing organizations themselves, rather than software companies or quality consultants. Data were collected in multi-professional group interviews. The results include information needs and communication problems as well as outlines for solutions in the systems integration of maternity clinics. Various tools of information management do not meet the concrete needs of health care work. Integration is needed on many levels, and it has to be adapted to the needs of numerous stakeholders. The applied activity-theoretical framework proved useful in describing such a multi-faceted system of information and its users. More research is needed on its wider applicability, particularly in situations where researchers are not active participants.

Towards a Unified Approach to Information Integration - A review paper on data/information fusion

Energy Technology Data Exchange (ETDEWEB)

Whitney, Paul D.; Posse, Christian; Lei, Xingye C.

2005-10-14

Information or data fusion of data from different sources are ubiquitous in many applications, from epidemiology, medical, biological, political, and intelligence to military applications. Data fusion involves integration of spectral, imaging, text, and many other sensor data. For example, in epidemiology, information is often obtained based on many studies conducted by different researchers at different regions with different protocols. In the medical field, the diagnosis of a disease is often based on imaging (MRI, X-Ray, CT), clinical examination, and lab results. In the biological field, information is obtained based on studies conducted on many different species. In military field, information is obtained based on data from radar sensors, text messages, chemical biological sensor, acoustic sensor, optical warning and many other sources. Many methodologies are used in the data integration process, from classical, Bayesian, to evidence based expert systems. The implementation of the data integration ranges from pure software design to a mixture of software and hardware. In this review we summarize the methodologies and implementations of data fusion process, and illustrate in more detail the methodologies involved in three examples. We propose a unified multi-stage and multi-path mapping approach to the data fusion process, and point out future prospects and challenges.

Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

Directory of Open Access Journals (Sweden)

Megan Doerr

2014-03-01

Full Text Available Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

CliniProteus: A flexible clinical trials information management system

Science.gov (United States)

Mathura, Venkatarajan S; Rangareddy, Mahendiranath; Gupta, Pankaj; Mullan, Michael

2007-01-01

Clinical trials involve multi-site heterogeneous data generation with complex data input-formats and forms. The data should be captured and queried in an integrated fashion to facilitate further analysis. Electronic case-report forms (eCRF) are gaining popularity since it allows capture of clinical information in a rapid manner. We have designed and developed an XML based flexible clinical trials data management framework in .NET environment that can be used for efficient design and deployment of eCRFs to efficiently collate data and analyze information from multi-site clinical trials. The main components of our system include an XML form designer, a Patient registration eForm, reusable eForms, multiple-visit data capture and consolidated reports. A unique id is used for tracking the trial, site of occurrence, the patient and the year of recruitment. Availability http://www.rfdn.org/bioinfo/CTMS/ctms.html. PMID:21670796

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C. S.; Friedman, C. P.; Douglas, G.; Miller, D. J.

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations. PMID:10566414

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C S; Friedman, C P; Douglas, G; Miller, D J

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations.

Probabilistic XML in Information Integration

NARCIS (Netherlands)

de Keijzer, Ander; Shim, J.; Casati, F.

2006-01-01

Information integration is a difficult research problem. In an ambient environment, where devices can connect and disconnect arbitrarily, the problem only increases, because data sources may become available at any time, but can also disappear. In such an environment, information integration needs

MD-CTS: An integrated terminology reference of clinical and translational medicine

Directory of Open Access Journals (Sweden)

Will Ray

2016-01-01

Full Text Available New vocabularies are rapidly evolving in the literature relative to the practice of clinical medicine and translational research. To provide integrated access to new terms, we developed a mobile and desktop online reference—Marshfield Dictionary of Clinical and Translational Science (MD-CTS. It is the first public resource that comprehensively integrates Wiktionary (word definition, BioPortal (ontology, Wiki (image reference, and Medline abstract (word usage information. MD-CTS is accessible at http://spellchecker.mfldclin.edu/. The website provides a broadened capacity for the wider clinical and translational science community to keep pace with newly emerging scientific vocabulary. An initial evaluation using 63 randomly selected biomedical words suggests that online references generally provided better coverage (73%-95% than paper-based dictionaries (57–71%.

Variability in Clinical Integration Achieved by Athletic Training Students across Different Clinical Sport Assignments

Science.gov (United States)

Dodge, Thomas M.; Mazerolle, Stephanie M.; Bowman, Thomas G.

2015-01-01

Context: Clinical integration impacts athletic training students' (ATSs) motivation and persistence. Research has yet to elucidate the manner in which different clinical placements can influence clinical integration. Objective: To examine differences in the levels of clinical integration achieved by ATSs across various clinical sport assignments.…

Designing healthcare information technology to catalyse change in clinical care

Directory of Open Access Journals (Sweden)

William Lester

2008-05-01

Full Text Available The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge_performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environmentwhere disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their realworld effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT tools for translating clinical information into clinical action.

The Need for Clinical Decision Support Integrated with the Electronic Health Record for the Clinical Application of Whole Genome Sequencing Information

Directory of Open Access Journals (Sweden)

Brandon M. Welch

2013-12-01

Full Text Available Whole genome sequencing (WGS is rapidly approaching widespread clinical application. Technology advancements over the past decade, since the first human genome was decoded, have made it feasible to use WGS for clinical care. Future advancements will likely drive down the price to the point wherein WGS is routinely available for care. However, were this to happen today, most of the genetic information available to guide clinical care would go unused due to the complexity of genetics, limited physician proficiency in genetics, and lack of genetics professionals in the clinical workforce. Furthermore, these limitations are unlikely to change in the future. As such, the use of clinical decision support (CDS to guide genome-guided clinical decision-making is imperative. In this manuscript, we describe the barriers to widespread clinical application of WGS information, describe how CDS can be an important tool for overcoming these barriers, and provide clinical examples of how genome-enabled CDS can be used in the clinical setting.

Integrated inventory information system

Digital Repository Service at National Institute of Oceanography (India)

Sarupria, J.S.; Kunte, P.D.

The nature of oceanographic data and the management of inventory level information are described in Integrated Inventory Information System (IIIS). It is shown how a ROSCOPO (report on observations/samples collected during oceanographic programme...

Clinical and Para Clinical Information Needs of Infertility Electronic Health Records in Iran: A Delphi Study.

Science.gov (United States)

Farzandipour, Mehrdad; Jeddi, Fateme Rangraz; Gilasi, Hamid Reza; Shirzadi, Diana

2017-09-01

infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method. Designing the questionnaire was done based on library studies and Gathering experts' views was done based on Delphi technique. 261 items from clinical and Para clinical information of infertile patients' electronic health records were subjected to an opinion poll by experts. During this process 223 items were accepted and 38 items have been rejected after two sessions of surveys by infertility experts. Para clinical information section consisted of 57 items that all of them have been accepted by the experts. Also, clinical information section consisted of 242 items from which 204 items were accepted and 38 items were rejected by the experts. existence of a structured electronic record system of infertile patients' information leads to the integration of patients' information, improvement of health care services and a decrease in treatment costs: all working to increase information safety. Furthermore, only essential and relevant information would be provided for the specialists and it will facilitate and direct the future infertility related studies due to the coherence, unity and relevance of the information.

Integration and timing of basic and clinical sciences education.

Science.gov (United States)

Bandiera, Glen; Boucher, Andree; Neville, Alan; Kuper, Ayelet; Hodges, Brian

2013-05-01

Medical education has traditionally been compartmentalized into basic and clinical sciences, with the latter being viewed as the skillful application of the former. Over time, the relevance of basic sciences has become defined by their role in supporting clinical problem solving rather than being, of themselves, a defining knowledge base of physicians. As part of the national Future of Medical Education in Canada (FMEC MD) project, a comprehensive empirical environmental scan identified the timing and integration of basic sciences as a key pressing issue for medical education. Using the literature review, key informant interviews, stakeholder meetings, and subsequent consultation forums from the FMEC project, this paper details the empirical basis for focusing on the role of basic science, the evidentiary foundations for current practices, and the implications for medical education. Despite a dearth of definitive relevant studies, opinions about how best to integrate the sciences remain strong. Resource allocation, political power, educational philosophy, and the shift from a knowledge-based to a problem-solving profession all influence the debate. There was little disagreement that both sciences are important, that many traditional models emphasized deep understanding of limited basic science disciplines at the expense of other relevant content such as social sciences, or that teaching the sciences contemporaneously rather than sequentially has theoretical and practical merit. Innovations in integrated curriculum design have occurred internationally. Less clear are the appropriate balance of the sciences, the best integration model, and solutions to the political and practical challenges of integrated curricula. New curricula tend to emphasize integration, development of more diverse physician competencies, and preparation of physicians to adapt to evolving technology and patients' expectations. Refocusing the basic/clinical dichotomy to a foundational

An Integrated Workflow For Secondary Use of Patient Data for Clinical Research.

Science.gov (United States)

Bouzillé, Guillaume; Sylvestre, Emmanuelle; Campillo-Gimenez, Boris; Renault, Eric; Ledieu, Thibault; Delamarre, Denis; Cuggia, Marc

2015-01-01

This work proposes an integrated workflow for secondary use of medical data to serve feasibility studies, and the prescreening and monitoring of research studies. All research issues are initially addressed by the Clinical Research Office through a research portal and subsequently redirected to relevant experts in the determined field of concentration. For secondary use of data, the workflow is then based on the clinical data warehouse of the hospital. A datamart with potentially eligible research candidates is constructed. Datamarts can either produce aggregated data, de-identified data, or identified data, according to the kind of study being treated. In conclusion, integrating the secondary use of data process into a general research workflow allows visibility of information technologies and improves the accessability of clinical data.

Integration of Hospital Information and Clinical Decision Support Systems to Enable the Reuse of Electronic Health Record Data.

Science.gov (United States)

Kopanitsa, Georgy

2017-05-18

The efficiency and acceptance of clinical decision support systems (CDSS) can increase if they reuse medical data captured during health care delivery. High heterogeneity of the existing legacy data formats has become the main barrier for the reuse of data. Thus, we need to apply data modeling mechanisms that provide standardization, transformation, accumulation and querying medical data to allow its reuse. In this paper, we focus on the interoperability issues of the hospital information systems (HIS) and CDSS data integration. Our study is based on the approach proposed by Marcos et al. where archetypes are used as a standardized mechanism for the interaction of a CDSS with an electronic health record (EHR). We build an integration tool to enable CDSSs collect data from various institutions without a need for modifications in the implementation. The approach implies development of a conceptual level as a set of archetypes representing concepts required by a CDSS. Treatment case data from Regional Clinical Hospital in Tomsk, Russia was extracted, transformed and loaded to the archetype database of a clinical decision support system. Test records' normalization has been performed by defining transformation and aggregation rules between the EHR data and the archetypes. These mapping rules were used to automatically generate openEHR compliant data. After the transformation, archetype data instances were loaded into the CDSS archetype based data storage. The performance times showed acceptable performance for the extraction stage with a mean of 17.428 s per year (3436 case records). The transformation times were also acceptable with 136.954 s per year (0.039 s per one instance). The accuracy evaluation showed the correctness and applicability of the method for the wide range of HISes. These operations were performed without interrupting the HIS workflow to prevent the HISes from disturbing the service provision to the users. The project results have proven that

Integrated Compliance Information System (ICIS)

Data.gov (United States)

U.S. Environmental Protection Agency — The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data...

Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

Science.gov (United States)

Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

1999-08-01

Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

Integration of radiology and hospital information systems (RIS, HIS) with PACS

International Nuclear Information System (INIS)

Mosser, H.; Urban, M.; Hruby, W.; Duerr, M.; Rueger, W.

1992-01-01

PACS development has now reached a stage where it can clearly be stated that the technology for storage, networking and display in a fully digital environment is available. This is reflected by an already large and rapidly increasing number of PACS installations in USA, Western Europe and Japan. Such installations consist of a great variety of information systems, more or less interconnected, like PACS, HIS, RIS and other departmental systems, differing in both hardware and software. Various data -even if they only concern one person- are stored in different systems distributed in the hospital. The integration of all digital systems into a functional unit is determined by the radiologist's need of quick access to all relevant information regardless where it is stored. The interconnection and functional integration of all digital systems in the hospital determine the clinical benefits of PACS. This paper describes the radiologist's requirements concerning this integration, and presents some realistic solutions such as the Siemens ISI (Information System Interface), and a mobile viewing station for the wards (visitBox). (author). 9 refs., 4 figs

Information Integration; The process of integration, evolution and versioning

NARCIS (Netherlands)

de Keijzer, Ander; van Keulen, Maurice

2005-01-01

At present, many information sources are available wherever you are. Most of the time, the information needed is spread across several of those information sources. Gathering this information is a tedious and time consuming job. Automating this process would assist the user in its task. Integration

Integration of Basic and Clinical Sciences: Faculty Perspectives at a U.S. Dental School.

Science.gov (United States)

van der Hoeven, Dharini; van der Hoeven, Ransome; Zhu, Liang; Busaidy, Kamal; Quock, Ryan L

2018-04-01

Although dental education has traditionally been organized into basic sciences education (first and second years) and clinical education (third and fourth years), there has been growing interest in ways to better integrate the two to more effectively educate students and prepare them for practice. Since 2012, The University of Texas School of Dentistry at Houston (UTSD) has made it a priority to improve integration of basic and clinical sciences, with a focus to this point on integrating the basic sciences. The aim of this study was to determine the perspectives of basic and clinical science faculty members regarding basic and clinical sciences integration and the degree of integration currently occurring. In October 2016, all 227 faculty members (15 basic scientists and 212 clinicians) were invited to participate in an online survey. Of the 212 clinicians, 84 completed the clinician educator survey (response rate 40%). All 15 basic scientists completed the basic science educator survey (response rate 100%). The majority of basic and clinical respondents affirmed the value of integration (93.3%, 97.6%, respectively) and reported regular integration in their teaching (80%, 86.9%). There were no significant differences between basic scientists and clinicians on perceived importance (p=0.457) and comfort with integration (p=0.240), but the basic scientists were more likely to integrate (p=0.039) and collaborate (p=0.021) than the clinicians. There were no significant differences between generalist and specialist clinicians on importance (p=0.474) and degree (p=0.972) of integration in teaching and intent to collaborate (p=0.864), but the specialists reported feeling more comfortable presenting basic science information (p=0.033). Protected faculty time for collaborative efforts and a repository of integrated basic science and clinical examples for use in teaching and faculty development were recommended to improve integration. Although questions might be raised about

Integrated information theory of consciousness: an updated account.

Science.gov (United States)

Tononi, G

2012-12-01

This article presents an updated account of integrated information theory of consciousness (liT) and some of its implications. /IT stems from thought experiments that lead to phenomenological axioms (existence, compositionality, information, integration, exclusion) and corresponding ontological postulates. The information axiom asserts that every experience is spec~fic - it is what it is by differing in its particular way from a large repertoire of alternatives. The integration axiom asserts that each experience is unified- it cannot be reduced to independent components. The exclusion axiom asserts that every experience is definite - it is limited to particular things and not others and flows at a particular speed and resolution. /IT formalizes these intuitions with postulates. The information postulate states that only "differences that make a difference" from the intrinsic perpective of a system matter: a mechanism generates cause-effect information if its present state has selective past causes and selective future effects within a system. The integration postulate states that only information that is irreducible matters: mechanisms generate integrated information only to the extent that the information they generate cannot be partitioned into that generated within independent components. The exclusion postulate states that only maxima of integrated information matter: a mechanism specifies only one maximally irreducible set of past causes and future effects - a concept. A complex is a set of elements specifying a maximally irreducible constellation of concepts, where the maximum is evaluated over elements and at the optimal spatiatemporal scale. Its concepts specify a maximally integrated conceptual information structure or quale, which is identical with an experience. Finally, changes in information integration upon exposure to the environment reflect a system's ability to match the causal structure of the world. After introducing an updated definition of

Regional Logistics Information Resources Integration Patterns and Countermeasures

Science.gov (United States)

Wu, Hui; Shangguan, Xu-ming

Effective integration of regional logistics information resources can provide collaborative services in information flow, business flow and logistics for regional logistics enterprises, which also can reduce operating costs and improve market responsiveness. First, this paper analyzes the realistic significance on the integration of regional logistics information. Second, this paper brings forward three feasible patterns on the integration of regional logistics information resources, These three models have their own strengths and the scope of application and implementation, which model is selected will depend on the specific business and the regional distribution of enterprises. Last, this paper discusses the related countermeasures on the integration of regional logistics information resources, because the integration of regional logistics information is a systems engineering, when the integration is advancing, the countermeasures should pay close attention to the current needs and long-term development of regional enterprises.

Social learning in a longitudinal integrated clinical placement.

Science.gov (United States)

Roberts, Chris; Daly, Michele; Held, Fabian; Lyle, David

2017-10-01

Recent research has demonstrated that longitudinal integrated placements (LICs) are an alternative mode of clinical education to traditional placements. Extended student engagement in community settings provide the advantages of educational continuity as well as increased service provision in underserved areas. Developing and maintaining LICs require a differing approach to student learning than that for traditional placements. There has been little theoretically informed empirical research that has offered explanations of which are the important factors that promote student learning in LICs and the relationships between those factors. We explored the relationship between student learning, student perceptions of preparedness for practice and student engagement, in the context of a rural LIC. We used a sequential qualitative design employing thematic, comparative and relational analysis of data from student interviews (n = 18) to understand possible processes and mechanisms of student learning in the LIC. Through the theoretical lens of social learning systems, we identified two major themes; connectivity and preparedness for practice. Connectivity described engagement and relationship building by students, across formal and informal learning experiences, interprofessional interactions, social interactions with colleagues, interaction with patients outside of the clinical setting, and the extent of integration in the wider community. Preparedness for practice, reflected students' perceptions of having sufficient depth in clinical skills, personal and professional development, cultural awareness and understanding of the health system, to work in that system. A comparative analysis compared the nature and variation of learning across students. In a relational analysis, there was a positive association between connectivity and preparedness for practice. Connectivity is a powerful enabler of students' agentic engagement, collaboration, and learning within an LIC. It

Integrated Information Management (IIM)

National Research Council Canada - National Science Library

McIlvain, Jason

2007-01-01

Information Technology is the core capability required to align our resources and increase our effectiveness on the battlefield by integrating and coordinating our preventative measures and responses...

Hospital-physician collaboration: landscape of economic integration and impact on clinical integration.

Science.gov (United States)

Burns, Lawton Robert; Muller, Ralph W

2008-09-01

Hospital-physician relationships (HPRs) are an important area of academic research, given their impact on hospitals' financial success. HPRs also are at the center of several federal policy proposals such as gain sharing, bundled payments, and pay-for-performance (P4P). This article analyzes the HPRs that focus on the economic integration of hospitals and physicians and the goals that HPRs are designed to achieve. It then reviews the literature on the impact of HPRs on cost, quality, and clinical integration. The goals of the two parties in HPRs overlap only partly, and their primary aim is not reducing cost or improving quality. The evidence base for the impact of many models of economic integration is either weak or nonexistent, with only a few models of economic integration having robust effects. The relationship between economic and clinical integration also is weak and inconsistent. There are several possible reasons for this weak linkage and many barriers to further integration between hospitals and physicians. Successful HPRs may require better financial conditions for physicians, internal changes to clinical operations, application of behavioral skills to the management of HPRs, changes in how providers are paid, and systemic changes encompassing several types of integration simultaneously.

Integrated Reporting Information System -

Data.gov (United States)

Department of Transportation — The Integrated Reporting Information System (IRIS) is a flexible and scalable web-based system that supports post operational analysis and evaluation of the National...

Integration of Information Technologies in Enterprise Application Development

Directory of Open Access Journals (Sweden)

Iulia SURUGIU

2012-05-01

Full Text Available Healthcare enterprises are disconnected. In the era of integrated information systems and Internet explosion, the necessity of information systems integration reside from business process evolution, on the one hand, and from information technology tendencies, on the other hand. In order to become more efficient and adaptive to change, healthcare organizations are tremendously preoccupied of business process automation, flexibility and complexity. The need of information systems integration arise from these goals, explaining, at the same time, the special interest in EAI. Extensible software integration architectures and business orientation of process modeling and information systems functionalities, the same as open-connectivity, accessibility and virtualization lead to most suitable integration solutions: SOA and BPM architectural styles in a cloud computing environment.

Integrating multimodal information for intraoperative assistance in neurosurgery

Directory of Open Access Journals (Sweden)

Eisenmann U.

2015-09-01

Full Text Available Computer-assisted planning of complex neurosurgical interventions benefits from a variety of specific functions and tools. However, commercial planning- and neuronavigation systems are rather restrictive concerning the availability of innovative methods such as novel imaging modalities, fiber tracking algorithms or electrical dipole mapping. In this respect there is a demand for modular neurosurgical planning systems offering flexible interfaces for easy enhancement. Furthermore all relevant planning information should be available within neuron-avigation. In this work we present a planning system providing these capabilities and its suitability and application in a clinical setting. Our Multimodal Planning System (MOPS 3D offers a variety of tools such as definition of trajectories for minimally invasive surgery, segmentation of ROIs, integration of functional information from atlas maps or magnetoencephalography. It also supplies plugin interfaces for future extensions. For intraoperative application MOPS is coupled with the neuronavigation system Brainlab Vector Vision Cranial/ENT (VVC. We evaluated MOPS in the Department of Neurosurgery at the University Hospital Heidelberg. Surgical planning and navigation was performed in 5 frequently occurring clinical cases. The time necessary for planning was between 5 and 15 minutes including data import, segmentation and planning tasks. The additional information intraoperatively provided by MOPS 3D was highly appreciated by the neurosurgeons and the performance was satisfactory.

An ontologically founded architecture for information systems in clinical and epidemiological research.

Science.gov (United States)

Uciteli, Alexandr; Groß, Silvia; Kireyev, Sergej; Herre, Heinrich

2011-08-09

This paper presents an ontologically founded basic architecture for information systems, which are intended to capture, represent, and maintain metadata for various domains of clinical and epidemiological research. Clinical trials exhibit an important basis for clinical research, and the accurate specification of metadata and their documentation and application in clinical and epidemiological study projects represents a significant expense in the project preparation and has a relevant impact on the value and quality of these studies.An ontological foundation of an information system provides a semantic framework for the precise specification of those entities which are presented in this system. This semantic framework should be grounded, according to our approach, on a suitable top-level ontology. Such an ontological foundation leads to a deeper understanding of the entities of the domain under consideration, and provides a common unifying semantic basis, which supports the integration of data and the interoperability between different information systems.The intended information systems will be applied to the field of clinical and epidemiological research and will provide, depending on the application context, a variety of functionalities. In the present paper, we focus on a basic architecture which might be common to all such information systems. The research, set forth in this paper, is included in a broader framework of clinical research and continues the work of the IMISE on these topics.

Integration of Information Technologies in Enterprise Application Development

OpenAIRE

Iulia SURUGIU

2012-01-01

Healthcare enterprises are disconnected. In the era of integrated information systems and Internet explosion, the necessity of information systems integration reside from business process evolution, on the one hand, and from information technology tendencies, on the other hand. In order to become more efficient and adaptive to change, healthcare organizations are tremendously preoccupied of business process automation, flexibility and complexity. The need of information systems integration ar...

The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data.

Science.gov (United States)

Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N

2010-01-01

Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions.

Theory-practice integration in selected clinical situations

Directory of Open Access Journals (Sweden)

M Davhana-Maselesele

2001-09-01

Full Text Available The current changes in health care systems challenge knowledgeable, mature and independent practitioners to integrate theoretical content with practice. The aim of this study was to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on rendering of family planning services to clients as a component of Community Nursing Science. Structured observation schedules were used to observe the theoretical content of the curriculum as well as the practical application of what has been taught in the clinical area. The findings of the study revealed that there was a need for an integrated holistic curriculum, which would address the needs of the community. It was concluded that a problem-based and community-based curriculum, intersectoral collaboration between college and hospital managements and student involvement in all processes of teaching and learning would improve the integration of theory and practice. There also appeared to be a need for tutors to be more involved in clinical teaching and accompaniment.

Radiation information and informed consent for clinical trials

Energy Technology Data Exchange (ETDEWEB)

Caon, Martin [School of Nursing and Midwifery, Flinders University, Adelaide (Australia)], E-mail: martin.caon@flinders.edu.au

2008-09-01

Examples of the statements about the radiation from medical imaging in the information for participants provided to the Human Research Ethics Committee (HREC) for approval are presented and discussed. There is considerable scope for improvement in the information about radiation that is presented to potential participants in clinical trials. Many radiation statements seem only intended to allay fear and anxiety about radiation rather than providing accurate information. This situation cannot be said to be conducive to allowing the participant to give informed consent to their involvement in a clinical trial in which ionising radiation is used. As many clinical trials are international and conducted at many sites (sometimes over 100), we would expect the same statements to have been seen by members of HRECs in many countries. Few HRECs include a member who is an expert in radiation. Hence, to ensure that the information is sound, those sections of the participant information that refer to radiation should be written or reviewed by a specialist in radiation protection such as a medical physicist, a health physicist or a radiation safety officer. (opinion)

Radiation information and informed consent for clinical trials

International Nuclear Information System (INIS)

Caon, Martin

2008-01-01

Examples of the statements about the radiation from medical imaging in the information for participants provided to the Human Research Ethics Committee (HREC) for approval are presented and discussed. There is considerable scope for improvement in the information about radiation that is presented to potential participants in clinical trials. Many radiation statements seem only intended to allay fear and anxiety about radiation rather than providing accurate information. This situation cannot be said to be conducive to allowing the participant to give informed consent to their involvement in a clinical trial in which ionising radiation is used. As many clinical trials are international and conducted at many sites (sometimes over 100), we would expect the same statements to have been seen by members of HRECs in many countries. Few HRECs include a member who is an expert in radiation. Hence, to ensure that the information is sound, those sections of the participant information that refer to radiation should be written or reviewed by a specialist in radiation protection such as a medical physicist, a health physicist or a radiation safety officer. (opinion)

Efficacy of integrating information literacy education into a women's health course on information literacy for RN-BSN students.

Science.gov (United States)

Ku, Ya-Lie; Sheu, Sheila; Kuo, Shih-Ming

2007-03-01

Information literacy, essential to evidences-based nursing, can promote nurses' capability for life-long learning. Nursing education should strive to employ information literacy education in nursing curricula to improve information literacy abilities among nursing students. This study explored the effectiveness of information literacy education by comparing information literacy skills among a group of RN-BSN (Registered Nurse to Bachelors of Science in Nursing) students who received information literacy education with a group that did not. This quasi-experimental study was conducted during a women's health issues course taught between March and June 2004. Content was presented to the 32 RN-BSN students enrolled in this course, which also taught skills on searching and screening, integrating, analyzing, applying, and presenting information. At the beginning and end of the program, 75 RN-BSN student self-evaluated on a 10 point Likert scale their attained skills in searching and screening, integrating, analyzing, applying, and presenting information. Results identified no significant differences between the experimental (n = 32) and control groups (n = 43) in terms of age, marital status, job title, work unit, years of work experience, and information literacy skills as measured at the beginning of the semester. At the end of the semester during which content was taught, the information literacy of the experimental group in all categories, with the exception of information presentation, was significantly improved as compared to that of the control group. Results were especially significant in terms of integrating, analyzing, and applying skill categories. It is hoped that in the future nursing students will apply enhanced information literacy to address and resolve patients' health problems in clinical settings.

Clinical decision support for whole genome sequence information leveraging a service-oriented architecture: a prototype.

Science.gov (United States)

Welch, Brandon M; Rodriguez-Loya, Salvador; Eilbeck, Karen; Kawamoto, Kensaku

2014-01-01

Whole genome sequence (WGS) information could soon be routinely available to clinicians to support the personalized care of their patients. At such time, clinical decision support (CDS) integrated into the clinical workflow will likely be necessary to support genome-guided clinical care. Nevertheless, developing CDS capabilities for WGS information presents many unique challenges that need to be overcome for such approaches to be effective. In this manuscript, we describe the development of a prototype CDS system that is capable of providing genome-guided CDS at the point of care and within the clinical workflow. To demonstrate the functionality of this prototype, we implemented a clinical scenario of a hypothetical patient at high risk for Lynch Syndrome based on his genomic information. We demonstrate that this system can effectively use service-oriented architecture principles and standards-based components to deliver point of care CDS for WGS information in real-time.

Factors shaping effective utilization of health information technology in urban safety-net clinics.

Science.gov (United States)

George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard

2013-09-01

Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

Efficient Algorithms for Searching the Minimum Information Partition in Integrated Information Theory

Science.gov (United States)

Kitazono, Jun; Kanai, Ryota; Oizumi, Masafumi

2018-03-01

The ability to integrate information in the brain is considered to be an essential property for cognition and consciousness. Integrated Information Theory (IIT) hypothesizes that the amount of integrated information ($\\Phi$) in the brain is related to the level of consciousness. IIT proposes that to quantify information integration in a system as a whole, integrated information should be measured across the partition of the system at which information loss caused by partitioning is minimized, called the Minimum Information Partition (MIP). The computational cost for exhaustively searching for the MIP grows exponentially with system size, making it difficult to apply IIT to real neural data. It has been previously shown that if a measure of $\\Phi$ satisfies a mathematical property, submodularity, the MIP can be found in a polynomial order by an optimization algorithm. However, although the first version of $\\Phi$ is submodular, the later versions are not. In this study, we empirically explore to what extent the algorithm can be applied to the non-submodular measures of $\\Phi$ by evaluating the accuracy of the algorithm in simulated data and real neural data. We find that the algorithm identifies the MIP in a nearly perfect manner even for the non-submodular measures. Our results show that the algorithm allows us to measure $\\Phi$ in large systems within a practical amount of time.

Benefits and problems in implementation for integrated medical information system

International Nuclear Information System (INIS)

Park, Chang Seo; Kim, Kee Deog; Park, Hyok; Jeong, Ho Gul

2005-01-01

Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of tissues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the health care enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, health care provider and information system vendors, in an expert, efficient, and cost-effective manner. The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

Integrating research, clinical care, and education in academic health science centers.

Science.gov (United States)

King, Gillian; Thomson, Nicole; Rothstein, Mitchell; Kingsnorth, Shauna; Parker, Kathryn

2016-10-10

Purpose One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to achieve the vision of evidence-informed decision making (EIDM) and optimal client care. The paper aims to discuss this issue. Design/methodology/approach This paper synthesizes literature on organizational learning and collaboration, evidence-informed organizational decision making, and learning-based organizations to derive insights concerning the nature of effective workplace learning in AHSCs. Findings An evidence-informed model of collaborative workplace learning is proposed to aid the alignment of research, clinical, and educational functions in AHSCs. The model articulates relationships among AHSC academic functions and sub-functions, cross-functional activities, and collaborative learning processes, emphasizing the importance of cross-functional activities in enhancing collaborative learning processes and optimizing EIDM and client care. Cross-functional activities involving clinicians, researchers, and educators are hypothesized to be a primary vehicle for integration, supported by a learning-oriented workplace culture. These activities are distinct from interprofessional teams, which are clinical in nature. Four collaborative learning processes are specified that are enhanced in cross-functional activities or teamwork: co-constructing meaning, co-learning, co-producing knowledge, and co-using knowledge. Practical implications The model provides an aspirational vision and insight into the importance of cross-functional activities in enhancing workplace learning. The paper discusses the conceptual and empirical basis to the model, its contributions and limitations, and implications for AHSCs. Originality/value The model's potential utility for health care is discussed, with implications for organizational culture and the promotion of cross-functional activities.

Implementation of an anonymisation tool for clinical trials using a clinical trial processor integrated with an existing trial patient data information system

NARCIS (Netherlands)

Aryanto, Kadek Y. E.; Broekema, Andre; Oudkerk, Matthijs; van Ooijen, Peter M. A.

To present an adapted Clinical Trial Processor (CTP) test set-up for receiving, anonymising and saving Digital Imaging and Communications in Medicine (DICOM) data using external input from the original database of an existing clinical study information system to guide the anonymisation process. Two

Theoretical information reuse and integration

CERN Document Server

Rubin, Stuart

2016-01-01

Information Reuse and Integration addresses the efficient extension and creation of knowledge through the exploitation of Kolmogorov complexity in the extraction and application of domain symmetry. Knowledge, which seems to be novel, can more often than not be recast as the image of a sequence of transformations, which yield symmetric knowledge. When the size of those transformations and/or the length of that sequence of transforms exceeds the size of the image, then that image is said to be novel or random. It may also be that the new knowledge is random in that no such sequence of transforms, which produces it exists, or is at least known. The nine chapters comprising this volume incorporate symmetry, reuse, and integration as overt operational procedures or as operations built into the formal representations of data and operators employed. Either way, the aforementioned theoretical underpinnings of information reuse and integration are supported.

Autonomous Preference-Aware Information Services Integration for High Response in Integrated Faded Information Field Systems

Science.gov (United States)

Lu, Xiaodong; Mori, Kinji

The market and users' requirements have been rapidly changing and diversified. Under these heterogeneous and dynamic situations, not only the system structure itself, but also the accessible information services would be changed constantly. To cope with the continuously changing conditions of service provision and utilization, Faded Information Field (FIF) has been proposed, which is a agent-based distributed information service system architecture. In the case of a mono-service request, the system is designed to improve users' access time and preserve load balancing through the information structure. However, with interdependent requests of multi-service increasing, adaptability and timeliness have to be assured by the system. In this paper, the relationship that exists among the correlated services and the users' preferences for separate and integrated services is clarified. Based on these factors, the autonomous preference-aware information services integration technology to provide one-stop service for users multi-service requests is proposed. As compared to the conventional system, we show that proposed technology is able to reduce the total access time.

An integrated organisation-wide data quality management and information governance framework: theoretical underpinnings.

Science.gov (United States)

Liaw, Siaw-Teng; Pearce, Christopher; Liyanage, Harshana; Liaw, Gladys S S; de Lusignan, Simon

2014-01-01

Increasing investment in eHealth aims to improve cost effectiveness and safety of care. Data extraction and aggregation can create new data products to improve professional practice and provide feedback to improve the quality of source data. A previous systematic review concluded that locally relevant clinical indicators and use of clinical record systems could support clinical governance. We aimed to extend and update the review with a theoretical framework. We searched PubMed, Medline, Web of Science, ABI Inform (Proquest) and Business Source Premier (EBSCO) using the terms curation, information ecosystem, data quality management (DQM), data governance, information governance (IG) and data stewardship. We focused on and analysed the scope of DQM and IG processes, theoretical frameworks, and determinants of the processing, quality assurance, presentation and sharing of data across the enterprise. There are good theoretical reasons for integrated governance, but there is variable alignment of DQM, IG and health system objectives across the health enterprise. Ethical constraints exist that require health information ecosystems to process data in ways that are aligned with improving health and system efficiency and ensuring patient safety. Despite an increasingly 'big-data' environment, DQM and IG in health services are still fragmented across the data production cycle. We extend current work on DQM and IG with a theoretical framework for integrated IG across the data cycle. The dimensions of this theory-based framework would require testing with qualitative and quantitative studies to examine the applicability and utility, along with an evaluation of its impact on data quality across the health enterprise.

Grounded theory for radiotherapy practitioners: Informing clinical practice

International Nuclear Information System (INIS)

Walsh, N.A.

2010-01-01

Radiotherapy practitioners may be best placed to undertake qualitative research within the context of cancer, due to specialist knowledge of radiation treatment and sensitivity to radiotherapy patient's needs. The grounded theory approach to data collection and analysis is a unique method of identifying a theory directly based on data collected within a clinical context. Research for radiotherapy practitioners is integral to role expansion within the government's directive for evidence-based practice. Due to the paucity of information on qualitative research undertaken by radiotherapy radiographers, this article aims to assess the potential impact of qualitative research on radiotherapy patient and service outcomes.

Evaluation of services of the integrative health clinic in Hong Kong.

Science.gov (United States)

Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S

2008-10-01

(i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

Environment, safety, and health information technology systems integration.

Energy Technology Data Exchange (ETDEWEB)

Hendrickson, David A.; Bayer, Gregory W.

2006-02-01

The ES&H Information Systems department, motivated by the numerous isolated information technology systems under its control, undertook a significant integration effort. This effort was planned and executed over the course of several years and parts of it still continue today. The effect was to help move the ES&H Information Systems department toward integration with the corporate Information Solutions and Services center.

Integration of Basic and Clinical Science in the Psychiatry Clerkship.

Science.gov (United States)

Wilkins, Kirsten M; Moore, David; Rohrbaugh, Robert M; Briscoe, Gregory W

2017-06-01

Integration of basic and clinical science is a key component of medical education reform, yet best practices have not been identified. The authors compared two methods of basic and clinical science integration in the psychiatry clerkship. Two interventions aimed at integrating basic and clinical science were implemented and compared in a dementia conference: flipped curriculum and coteaching by clinician and physician-scientist. The authors surveyed students following each intervention. Likert-scale responses were compared. Participants in both groups responded favorably to the integration format and would recommend integration be implemented elsewhere in the curriculum. Survey response rates differed significantly between the groups and student engagement with the flipped curriculum video was limited. Flipped curriculum and co-teaching by clinician and physician-scientist are two methods of integrating basic and clinical science in the psychiatry clerkship. Student learning preferences may influence engagement with a particular teaching format.

Information Integration Technology Demonstration (IITD)

National Research Council Canada - National Science Library

Loe, Richard

2001-01-01

The objectives of the Information Integration Technology Demonstration (IITD) were to investigate, design a software architecture and demonstrate a capability to display intelligence data from multiple disciplines...

Identification of Breast Cancer Using Integrated Information from MRI and Mammography.

Directory of Open Access Journals (Sweden)

Shih-Neng Yang

Full Text Available Integration of information from corresponding regions between the breast MRI and an X-ray mammogram could benefit the detection of breast cancer in clinical diagnosis. We aimed to provide a framework of registration from breast MRI to mammography and to evaluate the diagnosis using the combined information.43 patients with 46 lesions underwent both MRI and mammography scans, and the interval between the two examinations was around one month. The distribution of malignant to benign lesions was 31/46 based on histological results. Maximum intensity projection and thin-plate spline methods were applied for image registration for MRI to mammography. The diagnosis using integrated information was evaluated using results of histology as the reference. The assessment of annotations and statistical analysis were performed by the two radiologists.For the cranio-caudal view, the mean post-registration error between MRI and mammography was 2.2±1.9 mm. For the medio-lateral oblique view, the proposed approach performed even better with a mean error of 3.0±2.4 mm. In the diagnosis using MRI assessment with information of mammography, the sensitivity was 91.9±2.3% (29/31, 28/31, specificity 70.0±4.7% (11/15, 10/15, accuracy 84.8±3.1% (40/46, 38/46, positive predictive value 86.4±2.1% (29/33, 28/33 and negative predictive value 80.8±5.4% (11/13, 10/13.MRI with the aid of mammography shows potential improvements of sensitivity, specificity, accuracy, PPV and NPV in clinical breast cancer diagnosis compared to the use of MRI alone.

An integrated organisation-wide data quality management and information governance framework: theoretical underpinnings

Directory of Open Access Journals (Sweden)

Siaw-Teng Liaw

2014-10-01

Full Text Available Introduction Increasing investment in eHealth aims to improve cost effectiveness and safety of care. Data extraction and aggregation can create new data products to improve professional practice and provide feedback to improve the quality of source data. A previous systematic review concluded that locally relevant clinical indicators and use of clinical record systems could support clinical governance. We aimed to extend and update the review with a theoretical framework.Methods We searched PubMed, Medline, Web of Science, ABI Inform (Proquest and Business Source Premier (EBSCO using the terms curation, information ecosystem, data quality management (DQM, data governance, information governance (IG and data stewardship. We focused on and analysed the scope of DQM and IG processes, theoretical frameworks, and determinants of the processing, quality assurance, presentation and sharing of data across the enterprise.Findings There are good theoretical reasons for integrated governance, but there is variable alignment of DQM, IG and health system objectives across the health enterprise. Ethical constraints exist that require health information ecosystems to process data in ways that are aligned with improving health and system efficiency and ensuring patient safety. Despite an increasingly ‘big-data’ environment, DQM and IG in health services are still fragmented across the data production cycle. We extend current work on DQM and IG with a theoretical framework for integrated IG across the data cycle.Conclusions The dimensions of this theory-based framework would require testing with qualitative and quantitative studies to examine the applicability and utility, along with an evaluation of its impact on data quality across the health enterprise.

Building trust and diversity in patient-centered oncology clinical trials: An integrated model.

Science.gov (United States)

Hurd, Thelma C; Kaplan, Charles D; Cook, Elise D; Chilton, Janice A; Lytton, Jay S; Hawk, Ernest T; Jones, Lovell A

2017-04-01

Trust is the cornerstone of clinical trial recruitment and retention. Efforts to decrease barriers and increase clinical trial participation among diverse populations have yielded modest results. There is an urgent need to better understand the complex interactions between trust and clinical trial participation. The process of trust-building has been a focus of intense research in the business community. Yet, little has been published about trust in oncology clinical trials or the process of building trust in clinical trials. Both clinical trials and business share common dimensions. Business strategies for building trust may be transferable to the clinical trial setting. This study was conducted to understand and utilize contemporary thinking about building trust to develop an Integrated Model of Trust that incorporates both clinical and business perspectives. A key word-directed literature search of the PubMed, Medline, Cochrane, and Google Search databases for entries dated between 1 January 1985 and 1 September 2015 was conducted to obtain information from which to develop an Integrated Model of Trust. Successful trial participation requires both participants and clinical trial team members to build distinctly different types of interpersonal trust to effect recruitment and retention. They are built under conditions of significant emotional stress and time constraints among people who do not know each other and have never worked together before. Swift Trust and Traditional Trust are sequentially built during the clinical trial process. Swift trust operates during the recruitment and very early active treatment phases of the clinical trial process. Traditional trust is built over time and operates during the active treatment and surveillance stages of clinical trials. The Psychological Contract frames the participants' and clinical trial team members' interpersonal trust relationship. The "terms" of interpersonal trust are negotiated through the psychological

Pursuing Improvement in Clinical Reasoning: The Integrated Clinical Education Theory.

Science.gov (United States)

Jessee, Mary Ann

2018-01-01

The link between clinical education and development of clinical reasoning is not well supported by one theoretical perspective. Learning to reason during clinical education may be best achieved in a supportive sociocultural context of nursing practice that maximizes reasoning opportunities and facilitates discourse and meaningful feedback. Prelicensure clinical education seldom incorporates these critical components and thus may fail to directly promote clinical reasoning skill. Theoretical frameworks supporting the development of clinical reasoning during clinical education were evaluated. Analysis of strengths and gaps in each framework's support of clinical reasoning development was conducted. Commensurability of philosophical underpinnings was confirmed, and complex relationships among key concepts were elucidated. Six key concepts and three tenets comprise an explanatory predictive theory-the integrated clinical education theory (ICET). ICET provides critical theoretical support for inquiry and action to promote clinical education that improves development of clinical reasoning skill. [J Nurs Educ. 2018;57(1):7-13.]. Copyright 2018, SLACK Incorporated.

Integrated Risk Information System (IRIS)

Data.gov (United States)

U.S. Environmental Protection Agency — EPA?s Integrated Risk Information System (IRIS) is a compilation of electronic reports on specific substances found in the environment and their potential to cause...

An open, component-based information infrastructure for integrated health information networks.

Science.gov (United States)

Tsiknakis, Manolis; Katehakis, Dimitrios G; Orphanoudakis, Stelios C

2002-12-18

A fundamental requirement for achieving continuity of care is the seamless sharing of multimedia clinical information. Different technological approaches can be adopted for enabling the communication and sharing of health record segments. In the context of the emerging global information society, the creation of and access to the integrated electronic health record (I-EHR) of a citizen has been assigned high priority in many countries. This requirement is complementary to an overall requirement for the creation of a health information infrastructure (HII) to support the provision of a variety of health telematics and e-health services. In developing a regional or national HII, the components or building blocks that make up the overall information system ought to be defined and an appropriate component architecture specified. This paper discusses current international priorities and trends in developing the HII. It presents technological challenges and alternative approaches towards the creation of an I-EHR, being the aggregation of health data created during all interactions of an individual with the healthcare system. It also presents results from an ongoing Research and Development (R&D) effort towards the implementation of the HII in HYGEIAnet, the regional health information network of Crete, Greece, using a component-based software engineering approach. Critical design decisions and related trade-offs, involved in the process of component specification and development, are also discussed and the current state of development of an I-EHR service is presented. Finally, Human Computer Interaction (HCI) and security issues, which are important for the deployment and use of any I-EHR service, are considered.

A secure and efficient password-based user authentication scheme using smart cards for the integrated EPR information system.

Science.gov (United States)

Lee, Tian-Fu; Chang, I-Pin; Lin, Tsung-Hung; Wang, Ching-Cheng

2013-06-01

The integrated EPR information system supports convenient and rapid e-medicine services. A secure and efficient authentication scheme for the integrated EPR information system provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Wu et al. proposed an efficient password-based user authentication scheme using smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various malicious attacks. However, their scheme is still vulnerable to lost smart card and stolen verifier attacks. This investigation discusses these weaknesses and proposes a secure and efficient authentication scheme for the integrated EPR information system as alternative. Compared with related approaches, the proposed scheme not only retains a lower computational cost and does not require verifier tables for storing users' secrets, but also solves the security problems in previous schemes and withstands possible attacks.

Medical knowledge packages and their integration into health-care information systems and the World Wide Web.

Science.gov (United States)

Adlassnig, Klaus-Peter; Rappelsberger, Andrea

2008-01-01

Software-based medical knowledge packages (MKPs) are packages of highly structured medical knowledge that can be integrated into various health-care information systems or the World Wide Web. They have been established to provide different forms of clinical decision support such as textual interpretation of combinations of laboratory rest results, generating diagnostic hypotheses as well as confirmed and excluded diagnoses to support differential diagnosis in internal medicine, or for early identification and automatic monitoring of hospital-acquired infections. Technically, an MKP may consist of a number of inter-connected Arden Medical Logic Modules. Several MKPs have been integrated thus far into hospital, laboratory, and departmental information systems. This has resulted in useful and widely accepted software-based clinical decision support for the benefit of the patient, the physician, and the organization funding the health care system.

HBV DNA Integration: Molecular Mechanisms and Clinical Implications

Science.gov (United States)

Tu, Thomas; Budzinska, Magdalena A.; Shackel, Nicholas A.; Urban, Stephan

2017-01-01

Chronic infection with the Hepatitis B Virus (HBV) is a major cause of liver-related morbidity and mortality. One peculiar observation in cells infected with HBV (or with closely‑related animal hepadnaviruses) is the presence of viral DNA integration in the host cell genome, despite this form being a replicative dead-end for the virus. The frequent finding of somatic integration of viral DNA suggests an evolutionary benefit for the virus; however, the mechanism of integration, its functions, and the clinical implications remain unknown. Here we review the current body of knowledge of HBV DNA integration, with particular focus on the molecular mechanisms and its clinical implications (including the possible consequences of replication-independent antigen expression and its possible role in hepatocellular carcinoma). HBV DNA integration is likely to influence HBV replication, persistence, and pathogenesis, and so deserves greater attention in future studies. PMID:28394272

Integration issues of information engineering based I-CASE tools

OpenAIRE

Kurbel, Karl; Schnieder, Thomas

1994-01-01

Problems and requirements regarding integration of methods and tools across phases of the software-development life cycle are discussed. Information engineering (IE) methodology and I-CASE (integrated CASE) tools supporting IE claim to have an integrated view across major stages of enterprise-wide information-system development: information strategy planning, business area analysis, system design, and construction. In the main part of this paper, two comprehensive I-CASE tools, ADW (Applicati...

Evidence-based integrative medicine in clinical veterinary oncology.

Science.gov (United States)

Raditic, Donna M; Bartges, Joseph W

2014-09-01

Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology. Published by Elsevier Inc.

Knowledge and information management for integrated water resource management

Science.gov (United States)

Watershed information systems that integrate data and analytical tools are critical enabling technologies to support Integrated Water Resource Management (IWRM) by converting data into information, and information into knowledge. Many factors bring people to the table to participate in an IWRM fra...

Web-based integrated public healthcare information system of Korea: development and performance.

Science.gov (United States)

Ryu, Seewon; Park, Minsu; Lee, Jaegook; Kim, Sung-Soo; Han, Bum Soo; Mo, Kyoung Chun; Lee, Hyung Seok

2013-12-01

The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.

Integrated Information Systems Across the Weather-Climate Continuum

Science.gov (United States)

Pulwarty, R. S.; Higgins, W.; Nierenberg, C.; Trtanj, J.

2015-12-01

The increasing demand for well-organized (integrated) end-to-end research-based information has been highlighted in several National Academy studies, in IPCC Reports (such as the SREX and Fifth Assessment) and by public and private constituents. Such information constitutes a significant component of the "environmental intelligence" needed to address myriad societal needs for early warning and resilience across the weather-climate continuum. The next generation of climate research in service to the nation requires an even more visible, authoritative and robust commitment to scientific integration in support of adaptive information systems that address emergent risks and inform longer-term resilience strategies. A proven mechanism for resourcing such requirements is to demonstrate vision, purpose, support, connection to constituencies, and prototypes of desired capabilities. In this presentation we will discuss efforts at NOAA, and elsewhere, that: Improve information on how changes in extremes in key phenomena such as drought, floods, and heat stress impact management decisions for resource planning and disaster risk reduction Develop regional integrated information systems to address these emergent challenges, that integrate observations, monitoring and prediction, impacts assessments and scenarios, preparedness and adaptation, and coordination and capacity-building. Such systems, as illustrated through efforts such as NIDIS, have strengthened the integration across the foundational research enterprise (through for instance, RISAs, Modeling Analysis Predictions and Projections) by increasing agility for responding to emergent risks. The recently- initiated Climate Services Information System, in support of the WMO Global Framework for Climate Services draws on the above models and will be introduced during the presentation.

EFFICIENCY INDICATORS INFORMATION MANAGEMENT IN INTEGRATED SECURITY SYSTEMS

Directory of Open Access Journals (Sweden)

N. S. Rodionova

2014-01-01

Full Text Available Summary. Introduction of information technology to improve the efficiency of security activity leads to the need to consider a number of negative factors associated with in consequence of the use of these technologies as a key element of modern security systems. One of the most notable factor is the exposure to information processes in protection systems security threats. This largely relates to integrated security systems (ISS is the system of protection with the highest level of informatization security functions. Significant damage to protected objects that they could potentially incur as a result of abnormal operation ISS, puts a very actual problem of assessing factors that reduce the efficiency of the ISS to justify the ways and methods to improve it. Because of the nature of threats and blocking distortion of information in the ISS of interest are: the volume undistorted ISF working environment, as a characteristic of data integrity; time access to information as a feature of its availability. This in turn leads to the need to use these parameters as the performance characteristics of information processes in the ISS - the completeness and timeliness of information processing. The article proposes performance indicators of information processes in integrated security systems in terms of optimal control procedures to protect information from unauthorized access. Set the considered parameters allows to conduct comprehensive security analysis of integrated security systems, and to provide recommendations to improve the management of information security procedures in them.

Risk Informed Structural Systems Integrity Management

DEFF Research Database (Denmark)

Nielsen, Michael Havbro Faber

2017-01-01

The present paper is predominantly a conceptual contribution with an appraisal of major developments in risk informed structural integrity management for offshore installations together with a discussion of their merits and the challenges which still lie ahead. Starting point is taken in a selected...... overview of research and development contributions which have formed the basis for Risk Based Inspection Planning (RBI) as we know it today. Thereafter an outline of the methodical basis for risk informed structural systems integrity management, i.e. the Bayesian decision analysis is provided in summary....... The main focus is here directed on RBI for offshore facilities subject to fatigue damages. New ideas and methodical frameworks in the area of robustness and resilience modeling of structural systems are then introduced, and it is outlined how these may adequately be utilized to enhance Structural Integrity...

CSIR's new integrated electronic library information-system

CSIR Research Space (South Africa)

Michie, A

1995-08-01

Full Text Available The CSIR has developed a CDROM-based electronic library information system which provides the ability to reproduce and search for published information and colour brochures on the computer screen. The system integrates this information with online...

Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness.

Science.gov (United States)

Koch, Sven H; Weir, Charlene; Haar, Maral; Staggers, Nancy; Agutter, Jim; Görges, Matthias; Westenskow, Dwayne

2012-01-01

Fatal errors can occur in intensive care units (ICUs). Researchers claim that information integration at the bedside may improve nurses' situation awareness (SA) of patients and decrease errors. However, it is unclear which information should be integrated and in what form. Our research uses the theory of SA to analyze the type of tasks, and their associated information gaps. We aimed to provide recommendations for integrated, consolidated information displays to improve nurses' SA. Systematic observations methods were used to follow 19 ICU nurses for 38 hours in 3 clinical practice settings. Storyboard methods and concept mapping helped to categorize the observed tasks, the associated information needs, and the information gaps of the most frequent tasks by SA level. Consensus and discussion of the research team was used to propose recommendations to improve information displays at the bedside based on information deficits. Nurses performed 46 different tasks at a rate of 23.4 tasks per hour. The information needed to perform the most common tasks was often inaccessible, difficult to see at a distance or located on multiple monitoring devices. Current devices at the ICU bedside do not adequately support a nurse's information-gathering activities. Medication management was the most frequent category of tasks. Information gaps were present at all levels of SA and across most of the tasks. Using a theoretical model to understand information gaps can aid in designing functional requirements. Integrated information that enhances nurses' Situation Awareness may decrease errors and improve patient safety in the future.

Information Security Management - Part Of The Integrated Management System

Science.gov (United States)

Manea, Constantin Adrian

2015-07-01

The international management standards allow their integrated approach, thereby combining aspects of particular importance to the activity of any organization, from the quality management systems or the environmental management of the information security systems or the business continuity management systems. Although there is no national or international regulation, nor a defined standard for the Integrated Management System, the need to implement an integrated system occurs within the organization, which feels the opportunity to integrate the management components into a cohesive system, in agreement with the purpose and mission publicly stated. The issues relating to information security in the organization, from the perspective of the management system, raise serious questions to any organization in the current context of electronic information, reason for which we consider not only appropriate but necessary to promote and implement an Integrated Management System Quality - Environment - Health and Operational Security - Information Security

Ontology Based Resolution of Semantic Conflicts in Information Integration

Institute of Scientific and Technical Information of China (English)

LU Han; LI Qing-zhong

2004-01-01

Semantic conflict is the conflict caused by using different ways in heterogeneous systems to express the same entity in reality.This prevents information integration from accomplishing semantic coherence.Since ontology helps to solve semantic problems, this area has become a hot topic in information integration.In this paper, we introduce semantic conflict into information integration of heterogeneous applications.We discuss the origins and categories of the conflict, and present an ontology-based schema mapping approach to eliminate semantic conflicts.

A Meta Schema for Evidence Information in Clinical Practice Guidelines as a Basis for Decision-Making

OpenAIRE

Kaiser, Katharina; Martini, Patrick; Miksch, Silvia; Öztürk, Alime

2007-01-01

Clinical practice guidelines are an important instrument to aid physicians during medical diagnosis and treatment. Currently, different guideline developing organizations try to define and integrate evidence information into such guidelines. However, the coding schemas and taxonomies used for the evidence information differ widely, which makes the use cumbersome and demanding. We explored these various schemas and developed a meta schema for the evidence information, which covers the most imp...

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

Science.gov (United States)

McLean, Gillian

2015-12-01

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. © The Author(s) 2015.

Detecting clinically relevant new information in clinical notes across specialties and settings.

Science.gov (United States)

Zhang, Rui; Pakhomov, Serguei V S; Arsoniadis, Elliot G; Lee, Janet T; Wang, Yan; Melton, Genevieve B

2017-07-05

Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient. A corpus of 591 progress notes over 40 inpatient admissions was annotated for new information longitudinally by physicians to generate a reference standard. Note redundancy between various specialties was evaluated on 71,021 outpatient notes and 64,695 inpatient notes from 500 solid organ transplant patients (April 2015 through August 2015). Our best method achieved at best performance of 0.87 recall, 0.62 precision, and 0.72 F-measure. Addition of semantic similarity metrics compared to baseline improved recall but otherwise resulted in similar performance. While outpatient and inpatient notes had relatively similar levels of high redundancy (61% and 68%, respectively), redundancy differed by author specialty with mean redundancy of 75%, 66%, 57%, and 55% observed in pediatric, internal medicine, psychiatry and surgical notes, respectively. Automated techniques with statistical language models for detecting redundant versus clinically relevant new information in clinical notes do not improve with the addition of semantic similarity measures. While levels of redundancy seem relatively similar in the inpatient and ambulatory settings in the Fairview Health Services, clinical note redundancy appears to vary significantly with different medical specialties.

Evaluation of the clinical process in a critical care information system using the Lean method: a case study

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Yusof Maryati Mohd

2012-12-01

Full Text Available Abstract Background There are numerous applications for Health Information Systems (HIS that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS, known as IntelliVue Clinical Information Portfolio (ICIP, and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

Information Integration Architecture Development

OpenAIRE

Faulkner, Stéphane; Kolp, Manuel; Nguyen, Duy Thai; Coyette, Adrien; Do, Thanh Tung; 16th International Conference on Software Engineering and Knowledge Engineering

2004-01-01

Multi-Agent Systems (MAS) architectures are gaining popularity for building open, distributed, and evolving software required by systems such as information integration applications. Unfortunately, despite considerable work in software architecture during the last decade, few research efforts have aimed at truly defining patterns and languages for designing such multiagent architectures. We propose a modern approach based on organizational structures and architectural description lan...

Some insights for a relationship marketing model integrating SERVQUAL and customer loyalty in dental clinics

OpenAIRE

Vargas Perez, Ana Maria; Grijalvo Martin, Maria Mercedes; Mercado Idoeta, Carmelo

2012-01-01

The demand of new services, the emergence of new business models, insufficient innovation, underestimation of customer loyalty and reluctance to adopt new management are evidence of the deficiencies and the lack of research about the relations between patients and dental clinics. In this article we propose the structure of a model of Relationship Marketing (RM) in the dental clinic that integrates information from SERVQUAL, Customer Loyalty (CL) and activities of RM and combines the vision of...

The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology.

Science.gov (United States)

Ouagne, David; Hussain, Sajjad; Sadou, Eric; Jaulent, Marie-Christine; Daniel, Christel

2012-01-01

A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses.

The Dilution Effect and Information Integration in Perceptual Decision Making.

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Hotaling, Jared M; Cohen, Andrew L; Shiffrin, Richard M; Busemeyer, Jerome R

2015-01-01

In cognitive science there is a seeming paradox: On the one hand, studies of human judgment and decision making have repeatedly shown that people systematically violate optimal behavior when integrating information from multiple sources. On the other hand, optimal models, often Bayesian, have been successful at accounting for information integration in fields such as categorization, memory, and perception. This apparent conflict could be due, in part, to different materials and designs that lead to differences in the nature of processing. Stimuli that require controlled integration of information, such as the quantitative or linguistic information (commonly found in judgment studies), may lead to suboptimal performance. In contrast, perceptual stimuli may lend themselves to automatic processing, resulting in integration that is closer to optimal. We tested this hypothesis with an experiment in which participants categorized faces based on resemblance to a family patriarch. The amount of evidence contained in the top and bottom halves of each test face was independently manipulated. These data allow us to investigate a canonical example of sub-optimal information integration from the judgment and decision making literature, the dilution effect. Splitting the top and bottom halves of a face, a manipulation meant to encourage controlled integration of information, produced farther from optimal behavior and larger dilution effects. The Multi-component Information Accumulation model, a hybrid optimal/averaging model of information integration, successfully accounts for key accuracy, response time, and dilution effects.

The Dilution Effect and Information Integration in Perceptual Decision Making.

Directory of Open Access Journals (Sweden)

Jared M Hotaling

Full Text Available In cognitive science there is a seeming paradox: On the one hand, studies of human judgment and decision making have repeatedly shown that people systematically violate optimal behavior when integrating information from multiple sources. On the other hand, optimal models, often Bayesian, have been successful at accounting for information integration in fields such as categorization, memory, and perception. This apparent conflict could be due, in part, to different materials and designs that lead to differences in the nature of processing. Stimuli that require controlled integration of information, such as the quantitative or linguistic information (commonly found in judgment studies, may lead to suboptimal performance. In contrast, perceptual stimuli may lend themselves to automatic processing, resulting in integration that is closer to optimal. We tested this hypothesis with an experiment in which participants categorized faces based on resemblance to a family patriarch. The amount of evidence contained in the top and bottom halves of each test face was independently manipulated. These data allow us to investigate a canonical example of sub-optimal information integration from the judgment and decision making literature, the dilution effect. Splitting the top and bottom halves of a face, a manipulation meant to encourage controlled integration of information, produced farther from optimal behavior and larger dilution effects. The Multi-component Information Accumulation model, a hybrid optimal/averaging model of information integration, successfully accounts for key accuracy, response time, and dilution effects.

An integrated healthcare enterprise information portal and healthcare information system framework.

Science.gov (United States)

Hsieh, S L; Lai, Feipei; Cheng, P H; Chen, J L; Lee, H H; Tsai, W N; Weng, Y C; Hsieh, S H; Hsu, K P; Ko, L F; Yang, T H; Chen, C H

2006-01-01

The paper presents an integrated, distributed Healthcare Enterprise Information Portal (HEIP) and Hospital Information Systems (HIS) framework over wireless/wired infrastructure at National Taiwan University Hospital (NTUH). A single sign-on solution for the hospital customer relationship management (CRM) in HEIP has been established. The outcomes of the newly developed Outpatient Information Systems (OIS) in HIS are discussed. The future HEIP blueprints with CRM oriented features: e-Learning, Remote Consultation and Diagnosis (RCD), as well as on-Line Vaccination Services are addressed. Finally, the integrated HEIP and HIS architectures based on the middleware technologies are proposed along with the feasible approaches. The preliminary performance of multi-media, time-based data exchanges over the wireless HEIP side is collected to evaluate the efficiency of the architecture.

Sharing clinical information across care settings: the birth of an integrated assessment system

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Henrard Jean-Claude

2009-04-01

Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

Sharing clinical information across care settings: the birth of an integrated assessment system

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Gray, Leonard C; Berg, Katherine; Fries, Brant E; Henrard, Jean-Claude; Hirdes, John P; Steel, Knight; Morris, John N

2009-01-01

Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training. PMID:19402891

Clinical results of HIS, RIS, PACS integration using data integration CASE tools

Science.gov (United States)

Taira, Ricky K.; Chan, Hing-Ming; Breant, Claudine M.; Huang, Lu J.; Valentino, Daniel J.

1995-05-01

Current infrastructure research in PACS is dominated by the development of communication networks (local area networks, teleradiology, ATM networks, etc.), multimedia display workstations, and hierarchical image storage architectures. However, limited work has been performed on developing flexible, expansible, and intelligent information processing architectures for the vast decentralized image and text data repositories prevalent in healthcare environments. Patient information is often distributed among multiple data management systems. Current large-scale efforts to integrate medical information and knowledge sources have been costly with limited retrieval functionality. Software integration strategies to unify distributed data and knowledge sources is still lacking commercially. Systems heterogeneity (i.e., differences in hardware platforms, communication protocols, database management software, nomenclature, etc.) is at the heart of the problem and is unlikely to be standardized in the near future. In this paper, we demonstrate the use of newly available CASE (computer- aided software engineering) tools to rapidly integrate HIS, RIS, and PACS information systems. The advantages of these tools include fast development time (low-level code is generated from graphical specifications), and easy system maintenance (excellent documentation, easy to perform changes, and centralized code repository in an object-oriented database). The CASE tools are used to develop and manage the `middle-ware' in our client- mediator-serve architecture for systems integration. Our architecture is scalable and can accommodate heterogeneous database and communication protocols.

Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.

Science.gov (United States)

Veinot, Tiffany C; Senteio, Charles R; Hanauer, David; Lowery, Julie C

2018-06-01

To describe a new, comprehensive process model of clinical information interaction in primary care (Clinical Information Interaction Model, or CIIM) based on a systematic synthesis of published research. We used the "best fit" framework synthesis approach. Searches were performed in PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Library and Information Science Abstracts, Library, Information Science and Technology Abstracts, and Engineering Village. Two authors reviewed articles according to inclusion and exclusion criteria. Data abstraction and content analysis of 443 published papers were used to create a model in which every element was supported by empirical research. The CIIM documents how primary care clinicians interact with information as they make point-of-care clinical decisions. The model highlights 3 major process components: (1) context, (2) activity (usual and contingent), and (3) influence. Usual activities include information processing, source-user interaction, information evaluation, selection of information, information use, clinical reasoning, and clinical decisions. Clinician characteristics, patient behaviors, and other professionals influence the process. The CIIM depicts the complete process of information interaction, enabling a grasp of relationships previously difficult to discern. The CIIM suggests potentially helpful functionality for clinical decision support systems (CDSSs) to support primary care, including a greater focus on information processing and use. The CIIM also documents the role of influence in clinical information interaction; influencers may affect the success of CDSS implementations. The CIIM offers a new framework for achieving CDSS workflow integration and new directions for CDSS design that can support the work of diverse primary care clinicians.

INTEGRATED INFORMATION SYSTEM ARCHITECTURE PROVIDING BEHAVIORAL FEATURE

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Vladimir N. Shvedenko

2016-11-01

Full Text Available The paper deals with creation of integrated information system architecture capable of supporting management decisions using behavioral features. The paper considers the architecture of information decision support system for production system management. The behavioral feature is given to an information system, and it ensures extraction, processing of information, management decision-making with both automated and automatic modes of decision-making subsystem being permitted. Practical implementation of information system with behavior is based on service-oriented architecture: there is a set of independent services in the information system that provides data of its subsystems or data processing by separate application under the chosen variant of the problematic situation settlement. For creation of integrated information system with behavior we propose architecture including the following subsystems: data bus, subsystem for interaction with the integrated applications based on metadata, business process management subsystem, subsystem for the current state analysis of the enterprise and management decision-making, behavior training subsystem. For each problematic situation a separate logical layer service is created in Unified Service Bus handling problematic situations. This architecture reduces system information complexity due to the fact that with a constant amount of system elements the number of links decreases, since each layer provides communication center of responsibility for the resource with the services of corresponding applications. If a similar problematic situation occurs, its resolution is automatically removed from problem situation metamodel repository and business process metamodel of its settlement. In the business process performance commands are generated to the corresponding centers of responsibility to settle a problematic situation.

A Quality-Driven Methodology for Information Systems Integration

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Iyad Zikra

2017-10-01

Full Text Available Information systems integration is an essential instrument for organizations to attain advantage in today’s growing and fast changing business and technology landscapes. Integration solutions generate added value by combining the functionality and services of heterogeneous and diverse systems. Existing integration environments tend to rely heavily on technical, platform-dependent skills. Consequently, the solutions that they enable are not optimally aligned with the envisioned business goals of the organization. Furthermore, the gap between the goals and the solutions complicates the task of evaluating the quality of integration solutions. To address these challenges, we propose a quality-driven, model-driven methodology for designing and developing integration solutions. The methodology spans organizational and systems design details, providing a holistic view of the integration solution and its underlying business goals. A multi-view meta-model provides the basis for the integration design. Quality factors that affect various aspects of the integration solution guide and inform the progress of the methodology. An example business case is presented to demonstrate the application of the methodology.

Integrated risk information system (IRIS)

Energy Technology Data Exchange (ETDEWEB)

Tuxen, L. [Environmental Protection Agency, Washington, DC (United States)

1990-12-31

The Integrated Risk Information System (IRIS) is an electronic information system developed by the US Environmental Protection Agency (EPA) containing information related to health risk assessment. IRIS is the Agency`s primary vehicle for communication of chronic health hazard information that represents Agency consensus following comprehensive review by intra-Agency work groups. The original purpose for developing IRIS was to provide guidance to EPA personnel in making risk management decisions. This original purpose for developing IRIS was to guidance to EPA personnel in making risk management decisions. This role has expanded and evolved with wider access and use of the system. IRIS contains chemical-specific information in summary format for approximately 500 chemicals. IRIS is available to the general public on the National Library of Medicine`s Toxicology Data Network (TOXNET) and on diskettes through the National Technical Information Service (NTIS).

Information Systems Integration and Enterprise Application Integration (EAI) Adoption: A Case from Financial Services

Science.gov (United States)

Lam, Wing

2007-01-01

Increasingly, organizations find that they need to integrate large number of information systems in order to support enterprise-wide business initiatives such as e-business, supply chain management and customer relationship management. To date, organizations have largely tended to address information systems (IS) integration in an ad-hoc manner.…

Clinical data integration model. Core interoperability ontology for research using primary care data.

Science.gov (United States)

Ethier, J-F; Curcin, V; Barton, A; McGilchrist, M M; Bastiaens, H; Andreasson, A; Rossiter, J; Zhao, L; Arvanitis, T N; Taweel, A; Delaney, B C; Burgun, A

2015-01-01

This article is part of the Focus Theme of METHODS of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". Primary care data is the single richest source of routine health care data. However its use, both in research and clinical work, often requires data from multiple clinical sites, clinical trials databases and registries. Data integration and interoperability are therefore of utmost importance. TRANSFoRm's general approach relies on a unified interoperability framework, described in a previous paper. We developed a core ontology for an interoperability framework based on data mediation. This article presents how such an ontology, the Clinical Data Integration Model (CDIM), can be designed to support, in conjunction with appropriate terminologies, biomedical data federation within TRANSFoRm, an EU FP7 project that aims to develop the digital infrastructure for a learning healthcare system in European Primary Care. TRANSFoRm utilizes a unified structural / terminological interoperability framework, based on the local-as-view mediation paradigm. Such an approach mandates the global information model to describe the domain of interest independently of the data sources to be explored. Following a requirement analysis process, no ontology focusing on primary care research was identified and, thus we designed a realist ontology based on Basic Formal Ontology to support our framework in collaboration with various terminologies used in primary care. The resulting ontology has 549 classes and 82 object properties and is used to support data integration for TRANSFoRm's use cases. Concepts identified by researchers were successfully expressed in queries using CDIM and pertinent terminologies. As an example, we illustrate how, in TRANSFoRm, the Query Formulation Workbench can capture eligibility criteria in a computable representation, which is based on CDIM. A unified mediation approach to semantic interoperability provides a

An information integration theory of consciousness

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Tononi Giulio

2004-11-01

Full Text Available Abstract Background Consciousness poses two main problems. The first is understanding the conditions that determine to what extent a system has conscious experience. For instance, why is our consciousness generated by certain parts of our brain, such as the thalamocortical system, and not by other parts, such as the cerebellum? And why are we conscious during wakefulness and much less so during dreamless sleep? The second problem is understanding the conditions that determine what kind of consciousness a system has. For example, why do specific parts of the brain contribute specific qualities to our conscious experience, such as vision and audition? Presentation of the hypothesis This paper presents a theory about what consciousness is and how it can be measured. According to the theory, consciousness corresponds to the capacity of a system to integrate information. This claim is motivated by two key phenomenological properties of consciousness: differentiation – the availability of a very large number of conscious experiences; and integration – the unity of each such experience. The theory states that the quantity of consciousness available to a system can be measured as the Φ value of a complex of elements. Φ is the amount of causally effective information that can be integrated across the informational weakest link of a subset of elements. A complex is a subset of elements with Φ>0 that is not part of a subset of higher Φ. The theory also claims that the quality of consciousness is determined by the informational relationships among the elements of a complex, which are specified by the values of effective information among them. Finally, each particular conscious experience is specified by the value, at any given time, of the variables mediating informational interactions among the elements of a complex. Testing the hypothesis The information integration theory accounts, in a principled manner, for several neurobiological observations

INEL Waste and Environmental Information Integration Project approach and concepts

International Nuclear Information System (INIS)

Dean, L.A.; Fairbourn, P.J.; Randall, V.C.; Riedesel, A.M.

1994-06-01

The Idaho National Engineering, Laboratory (INEL) Waste and Environmental Information integration Project (IWEIIP) was established in December 1993 to address issues related to INEL waste and environmental information including: Data quality; Data redundancy; Data accessibility; Data integration. This effort includes existing information, new development, and acquisition activities. Existing information may not be a database record; it may be an entire document (electronic, scanned, or hard-copy), a video clip, or a file cabinet of information. The IWEIIP will implement an effective integrated information framework to manage INEL waste and environmental information as an asset. This will improve data quality, resolve data redundancy, and increase data accessibility; therefore, providing more effective utilization of the dollars spent on waste and environmental information

Using integrated information systems in supply chain management

Science.gov (United States)

Gonzálvez-Gallego, Nicolás; Molina-Castillo, Francisco-Jose; Soto-Acosta, Pedro; Varajao, Joao; Trigo, Antonio

2015-02-01

The aim of this paper is to empirically test not only the direct effects of information and communication technology (ICT) capabilities and integrated information systems (IS) on firm performance, but also the moderating role of IS integration along the supply chain in the relationship between ICT external and capabilities and business performance. Data collected from 102 large Iberian firms from Spain and Portugal are used to test the research model. The hierarchical multiple regression analysis is employed to test the direct effects and the moderating relationships proposed. Results show that external and internal ICT capabilities are important drivers of firm performance, while merely having integrated IS do not lead to better firm performance. In addition, a moderating effect of IS integration in the relationship between ICT capabilities and business performance is found, although this integration only contributes to firm performance when it is directed to connect with suppliers or customers rather than when integrating the whole supply chain.

Possibility of Integrated Data Mining of Clinical Data

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Akinori Abe

2007-03-01

Full Text Available In this paper, we introduce integrated data mining. Because of recent rapid progress in medical science as well as clinical diagnosis and treatment, integrated and cooperative research among medical researchers, biology, engineering, cultural science, and sociology is required. Therefore, we propose a framework called Cyber Integrated Medical Infrastructure (CIMI. Within this framework, we can deal with various types of data and consequently need to integrate those data prior to analysis. In this study, for medical science, we analyze the features and relationships among various types of data and show the possibility of integrated data mining.

Preferred information sources for clinical decision making: critical care nurses' perceptions of information accessibility and usefulness.

Science.gov (United States)

Marshall, Andrea P; West, Sandra H; Aitken, Leanne M

2011-12-01

Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access

SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

Science.gov (United States)

Wright, Adam; Sittig, Dean F

2008-12-01

In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

Directory of Open Access Journals (Sweden)

Saw PS

2015-03-01

information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion: This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed. Keywords: pharmacist integration, private clinic, general practitioners, health care consumer, Malaysia

[Research on medical instrument information integration technology based on IHE PCD].

Science.gov (United States)

Zheng, Jianli; Liao, Yun; Yang, Yongyong

2014-06-01

Integrating medical instruments with medical information systems becomes more and more important in healthcare industry. To make medical instruments without standard communication interface possess the capability of interoperating and sharing information with medical information systems, we developed a medical instrument integration gateway based on Integrating the Healthcare Enterprise Patient Care Device (IHE PCD) integration profiles in this research. The core component is an integration engine which is implemented according to integration profiles and Health Level Seven (HL7) messages defined in IHE PCD. Working with instrument specific Javascripts, the engine transforms medical instrument data into HL7 ORU message. This research enables medical instruments to interoperate and exchange medical data with information systems in a standardized way, and is valuable for medical instrument integration, especially for traditional instruments.

Interpreting and Integrating Clinical and Anatomic Pathology Results.

Science.gov (United States)

Ramaiah, Lila; Hinrichs, Mary Jane; Skuba, Elizabeth V; Iverson, William O; Ennulat, Daniela

2017-01-01

The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.

[Clinical evaluation of female pelvic tumors : Application fields of integrated PET/MRI].

Science.gov (United States)

Grueneisen, J; Umutlu, L

2016-07-01

Integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) scanning has recently become established in clinical imaging. Various studies have demonstrated the great potential of this new hybrid imaging procedure for applications in the field of oncology and the diagnostics of inflammatory processes. With initial studies demonstrating the feasibility and high diagnostic potential of PET/MRI comparable to PET-computed tomography (CT), the focus of future studies should be on the identification of application fields with a potential diagnostic benefit of PET/MRI over other established diagnostic tools. Both MRI and PET/CT are widely used in the diagnostic algorithms for malignancies of the female pelvis. A simultaneous acquisition of PET and MRI data within a single examination provides complementary information which can be used for a more comprehensive evaluation of the primary tumor as well as for whole body staging. Therefore, the aim of this article is to outline potential clinical applications of integrated PET/MRI for the diagnostic work-up of primary or recurrent gynecological neoplasms of the female pelvis.

Integrating Information & Communications Technologies into the Classroom

Science.gov (United States)

Tomei, Lawrence, Ed.

2007-01-01

"Integrating Information & Communications Technologies Into the Classroom" examines topics critical to business, computer science, and information technology education, such as: school improvement and reform, standards-based technology education programs, data-driven decision making, and strategic technology education planning. This book also…

Developing a Workflow Composite Score to Measure Clinical Information Logistics. A Top-down Approach.

Science.gov (United States)

Liebe, J D; Hübner, U; Straede, M C; Thye, J

2015-01-01

Availability and usage of individual IT applications have been studied intensively in the past years. Recently, IT support of clinical processes is attaining increasing attention. The underlying construct that describes the IT support of clinical workflows is clinical information logistics. This construct needs to be better understood, operationalised and measured. It is therefore the aim of this study to propose and develop a workflow composite score (WCS) for measuring clinical information logistics and to examine its quality based on reliability and validity analyses. We largely followed the procedural model of MacKenzie and colleagues (2011) for defining and conceptualising the construct domain, for developing the measurement instrument, assessing the content validity, pretesting the instrument, specifying the model, capturing the data and computing the WCS and testing the reliability and validity. Clinical information logistics was decomposed into the descriptors data and information, function, integration and distribution, which embraced the framework validated by an analysis of the international literature. This framework was refined selecting representative clinical processes. We chose ward rounds, pre- and post-surgery processes and discharge as sample processes that served as concrete instances for the measurements. They are sufficiently complex, represent core clinical processes and involve different professions, departments and settings. The score was computed on the basis of data from 183 hospitals of different size, ownership, location and teaching status. Testing the reliability and validity yielded encouraging results: the reliability was high with r(split-half) = 0.89, the WCS discriminated between groups; the WCS correlated significantly and moderately with two EHR models and the WCS received good evaluation results by a sample of chief information officers (n = 67). These findings suggest the further utilisation of the WCS. As the WCS does not

Broad knowledge of information technologies: a prerequisite for the effective management of the integrated information system

Energy Technology Data Exchange (ETDEWEB)

Landau, H.B.

1980-09-01

There is a trend towards the bringing together of various information technologies into integrated information systems. The managers of these total systems therefore must be familiar with each of the component technologies and how they may be combined into a total information system. To accomplish this, the effective manager should first define the overall system as an integrated flow of information with each step identified; then, the alternate technologies applicable to each step may be selected. Methods of becoming technologically aware are suggested and examples of integrated systems are discussed.

Core Themes in Music Therapy Clinical Improvisation: An Arts-Informed Qualitative Research Synthesis.

Science.gov (United States)

Meadows, Anthony; Wimpenny, Katherine

2017-07-01

Although clinical improvisation continues to be an important focus of music therapy research and practice, less attention has been given to integrating qualitative research in this area. As a result, this knowledge base tends to be contained within specific areas of practice rather than integrated across practices and approaches. This qualitative research synthesis profiles, integrates, and re-presents qualitative research focused on the ways music therapists and clients engage in, and make meaning from, clinical improvisation. Further, as a conduit for broadening dialogues, opening up this landscape fully, and sharing our response to the analysis and interpretation process, we present an arts-informed re-presentation of this synthesis. Following an eight-step methodological sequence, 13 qualitative studies were synthesized. This included reciprocal and refutational processes associated with synthesizing the primary studies, and additional steps associated with an arts-informed representation. Three themes, professional artistry, performing self, and meaning-making, are presented. Each theme is explored and exemplified through the selected articles, and discussed within a larger theoretical framework. An artistic re-presentation of the data is also presented. Music therapists use complex frameworks through which to engage clients in, and make meaning from, improvisational experiences. Artistic representation of the findings offers an added dimension to the synthesis process, challenging our understanding of representation, and thereby advancing synthesis methodology. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Mapping query terms to data and schema using content based similarity search in clinical information systems.

Science.gov (United States)

Safari, Leila; Patrick, Jon D

2013-01-01

This paper reports on the issues in mapping the terms of a query to the field names of the schema of an Entity Relationship (ER) model or to the data part of the Entity Attribute Value (EAV) model using similarity based Top-K algorithm in clinical information system together with an extension of EAV mapping for medication names. In addition, the details of the mapping algorithm and the required pre-processing including NLP (Natural Language Processing) tasks to prepare resources for mapping are explained. The experimental results on an example clinical information system demonstrate more than 84 per cent of accuracy in mapping. The results will be integrated into our proposed Clinical Data Analytics Language (CliniDAL) to automate mapping process in CliniDAL.

Integrating clinical performance improvement across physician organizations: the PhyCor experience.

Science.gov (United States)

Loeppke, R; Howell, J W

1999-02-01

There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. Key resources supporting CPI initiatives include information/knowledge management, education and training, and patient education and consumer decision support. Localized efforts in both the asthma care and diabetes management initiatives have led to some preliminary improvements in quality of care indicators. Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.

Principles and core functions of integrated child health information systems.

Science.gov (United States)

Hinman, Alan R; Atkinson, Delton; Diehn, Tonya Norvell; Eichwald, John; Heberer, Jennifer; Hoyle, Therese; King, Pam; Kossack, Robert E; Williams, Donna C; Zimmerman, Amy

2004-11-01

Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

Positioning for vertical integration through clinics "without walls".

Science.gov (United States)

Johnson, B A; Schryver, D L

1994-01-01

Authors Bruce A. Johnson, J.D., M.P.A., and Darrell Schryver, D.P.A., offer the clinic without walls model as a transitory step to full vertical integration. They write that this model "may enable physicians to address the key issues associated with managed care and integration in a more gradual, controlled fashion.

Curriculum integrated information literacy: a challenge

DEFF Research Database (Denmark)

Bønløkke, Mette; Kobow, Else; Kristensen, Anne-Kirstine Østergaard

2012-01-01

Information literacy is a competence needed for students and for practitioners in the nursing profession. A curriculum integrated intervention was qualitatively evaluated by focus group interviews of students, lecturers and the university librarian. Information literacy makes sense for students...... when it is linked to assignments, timed right, prepared, systematic and continuous. Support is needed to help students understand the meaning of seeking information, to focus their problem and to make them reflect on their search and its results. Feedback on materials used is also asked for...

Does integrating research into the prosthetics and orthotics undergraduate curriculum enhance students' clinical practice? An interview study on students' perception.

Science.gov (United States)

Al Qaroot, Bashar S; Sobuh, Mohammad

2016-06-01

Problem-based learning (where rather than feeding students the knowledge, they look for it themselves) has long been thought of as an ideal approach in teaching because it would encourage students to acquire knowledge from an undetermined medium of wrong and right answers. However, the effect of such approach in the learning experience of prosthetics and orthotics students has never been investigated. This study explores the implications of integrating problem-based learning into teaching on the students' learning experience via implementing a research-informed clinical practice module into the curriculum of last year prosthetics and orthotics undergraduate students at the University of Jordan (Amman, Jordan). Qualitative research pilot study. Grounded theory approach was used based on the data collected from interviewing a focus group of four students. Students have identified a number of arguments from their experience in the research-informed clinical practice where, generally speaking, students described research-informed clinical practice as a very good method of education. Integrating problem-based learning into teaching has many positive implications. In particular, students pointed out that their learning experience and clinical practice have much improved after the research-informed clinical practice. Findings from this investigation demonstrate that embedding problem-based learning into prosthetics and orthotics students' curriculum has the potential to enhance students' learning experience, particularly students' evidence-based practice. This may lead to graduates who are more knowledgeable and thus who can offer the optimal patient care (i.e. clinical practice). © The International Society for Prosthetics and Orthotics 2014.

Integration of an OWL-DL knowledge base with an EHR prototype and providing customized information.

Science.gov (United States)

Jing, Xia; Kay, Stephen; Marley, Tom; Hardiker, Nicholas R

2014-09-01

When clinicians use electronic health record (EHR) systems, their ability to obtain general knowledge is often an important contribution to their ability to make more informed decisions. In this paper we describe a method by which an external, formal representation of clinical and molecular genetic knowledge can be integrated into an EHR such that customized knowledge can be delivered to clinicians in a context-appropriate manner.Web Ontology Language-Description Logic (OWL-DL) is a formal knowledge representation language that is widely used for creating, organizing and managing biomedical knowledge through the use of explicit definitions, consistent structure and a computer-processable format, particularly in biomedical fields. In this paper we describe: 1) integration of an OWL-DL knowledge base with a standards-based EHR prototype, 2) presentation of customized information from the knowledge base via the EHR interface, and 3) lessons learned via the process. The integration was achieved through a combination of manual and automatic methods. Our method has advantages for scaling up to and maintaining knowledge bases of any size, with the goal of assisting clinicians and other EHR users in making better informed health care decisions.

Integrated information in discrete dynamical systems: motivation and theoretical framework.

Directory of Open Access Journals (Sweden)

David Balduzzi

2008-06-01

Full Text Available This paper introduces a time- and state-dependent measure of integrated information, phi, which captures the repertoire of causal states available to a system as a whole. Specifically, phi quantifies how much information is generated (uncertainty is reduced when a system enters a particular state through causal interactions among its elements, above and beyond the information generated independently by its parts. Such mathematical characterization is motivated by the observation that integrated information captures two key phenomenological properties of consciousness: (i there is a large repertoire of conscious experiences so that, when one particular experience occurs, it generates a large amount of information by ruling out all the others; and (ii this information is integrated, in that each experience appears as a whole that cannot be decomposed into independent parts. This paper extends previous work on stationary systems and applies integrated information to discrete networks as a function of their dynamics and causal architecture. An analysis of basic examples indicates the following: (i phi varies depending on the state entered by a network, being higher if active and inactive elements are balanced and lower if the network is inactive or hyperactive. (ii phi varies for systems with identical or similar surface dynamics depending on the underlying causal architecture, being low for systems that merely copy or replay activity states. (iii phi varies as a function of network architecture. High phi values can be obtained by architectures that conjoin functional specialization with functional integration. Strictly modular and homogeneous systems cannot generate high phi because the former lack integration, whereas the latter lack information. Feedforward and lattice architectures are capable of generating high phi but are inefficient. (iv In Hopfield networks, phi is low for attractor states and neutral states, but increases if the networks

Integrated information in discrete dynamical systems: motivation and theoretical framework.

Science.gov (United States)

Balduzzi, David; Tononi, Giulio

2008-06-13

This paper introduces a time- and state-dependent measure of integrated information, phi, which captures the repertoire of causal states available to a system as a whole. Specifically, phi quantifies how much information is generated (uncertainty is reduced) when a system enters a particular state through causal interactions among its elements, above and beyond the information generated independently by its parts. Such mathematical characterization is motivated by the observation that integrated information captures two key phenomenological properties of consciousness: (i) there is a large repertoire of conscious experiences so that, when one particular experience occurs, it generates a large amount of information by ruling out all the others; and (ii) this information is integrated, in that each experience appears as a whole that cannot be decomposed into independent parts. This paper extends previous work on stationary systems and applies integrated information to discrete networks as a function of their dynamics and causal architecture. An analysis of basic examples indicates the following: (i) phi varies depending on the state entered by a network, being higher if active and inactive elements are balanced and lower if the network is inactive or hyperactive. (ii) phi varies for systems with identical or similar surface dynamics depending on the underlying causal architecture, being low for systems that merely copy or replay activity states. (iii) phi varies as a function of network architecture. High phi values can be obtained by architectures that conjoin functional specialization with functional integration. Strictly modular and homogeneous systems cannot generate high phi because the former lack integration, whereas the latter lack information. Feedforward and lattice architectures are capable of generating high phi but are inefficient. (iv) In Hopfield networks, phi is low for attractor states and neutral states, but increases if the networks are optimized

The Role of Technical Advances in the Adoption and Integration of Patient-Reported Outcomes in Clinical Care

Science.gov (United States)

Jensen, Roxanne E.; Rothrock, Nan E.; DeWitt, Esi Morgan; Spiegel, Brennan; Tucker, Carole A.; Crane, Heidi M.; Forrest, Christopher B.; Patrick, Donald L.; Fredericksen, Rob; Shulman, Lisa M.; Cella, David; Crane, Paul K.

2016-01-01

Background Patient-reported outcomes (PROs) are gaining recognition as key measures for improving the quality of patient care in clinical care settings. Three factors have made the implementation of PROs in clinical care more feasible: increased use of modern measurement methods in PRO design and validation, rapid progression of technology (e.g., touch screen tablets, Internet accessibility, and electronic health records (EHRs)), and greater demand for measurement and monitoring of PROs by regulators, payers, accreditors, and professional organizations. As electronic PRO collection and reporting capabilities have improved, the challenges of collecting PRO data have changed. Objectives To update information on PRO adoption considerations in clinical care, highlighting electronic and technical advances with respect to measure selection, clinical workflow, data infrastructure, and outcomes reporting. Methods Five practical case studies across diverse healthcare settings and patient populations are used to explore how implementation barriers were addressed to promote the successful integration of PRO collection into the clinical workflow. The case studies address selecting and reporting of relevant content, workflow integration, pre-visit screening, effective evaluation, and EHR integration. Conclusions These case studies exemplify elements of well-designed electronic systems, including response automation, tailoring of item selection and reporting algorithms, flexibility of collection location, and integration with patient health care data elements. They also highlight emerging logistical barriers in this area, such as the need for specialized technological and methodological expertise, and design limitations of current electronic data capture systems. PMID:25588135

Pediatric travel consultation in an integrated clinic.

Science.gov (United States)

Christenson , J C; Fischer , P R; Hale , D C; Derrick , D

2001-01-01

In May 1997, a pediatric travel service was created within a larger integrated University-County Health Department international travel clinic. The purpose of the service was to further enhance the travel advice and care provided to children and their parents or guardians. The current study was designed to describe the care of children in this setting and to compare the care of children seen in the Pediatric Travel Service with that of children seen by other providers. All pediatric patients (defined as individuals Mexico, South America, and Southeast Asia. When compared to travelers seen in the Regular Clinic, individuals in the Pediatric Travel Service group were more likely to travel for humanitarian work, and for parental work relocation. Persons in the Regular Clinic were more likely to travel to Mexico and Central America. They were also more likely to travel on vacation and for missionary work or study. Hepatitis B and tetanus-diphtheria booster vaccinations were given more frequently to travelers seen in the Regular Clinic. Also, ciprofloxacin and antimotility agents were more commonly prescribed in this group. No differences were noted in the duration of travel or in the time interval between clinic visit and departure. While general travel advice was considered to be similar in both clinic groups, some differences were observed in the frequency of administration of certain vaccines and prescriptions of medications. These differences were likely due to a difference in age in the two study groups. The high volume and success of the clinic suggest that integrated pediatric and adult travel services in a coordinated setting can be effective.

Earth science information: Planning for the integration and use of global change information

Science.gov (United States)

Lousma, Jack R.

1992-01-01

Activities and accomplishments of the first six months of the Consortium for International Earth Science Information Network (CIESIN's) 1992 technical program have focused on four main missions: (1) the development and implementation of plans for initiation of the Socioeconomic Data and Applications Center (SEDAC) as part of the EOSDIS Program; (2) the pursuit and development of a broad-based global change information cooperative by providing systems analysis and integration between natural science and social science data bases held by numerous federal agencies and other sources; (3) the fostering of scientific research into the human dimensions of global change and providing integration between natural science and social science data and information; and (4) the serving of CIESIN as a gateway for global change data and information distribution through development of the Global Change Research Information Office and other comprehensive knowledge sharing systems.

[Development of an ophthalmological clinical information system for inpatient eye clinics].

Science.gov (United States)

Kortüm, K U; Müller, M; Babenko, A; Kampik, A; Kreutzer, T C

2015-12-01

In times of increased digitalization in healthcare, departments of ophthalmology are faced with the challenge of introducing electronic clinical health records (EHR); however, specialized software for ophthalmology is not available with most major EHR sytems. The aim of this project was to create specific ophthalmological user interfaces for large inpatient eye care providers within a hospitalwide EHR. Additionally the integration of ophthalmic imaging systems, scheduling and surgical documentation should be achieved. The existing EHR i.s.h.med (Siemens, Germany) was modified using advanced business application programming (ABAP) language to create specific ophthalmological user interfaces for reproduction and moreover optimization of the clinical workflow. A user interface for documentation of ambulatory patients with eight tabs was designed. From June 2013 to October 2014 a total of 61,551 patient contact details were documented. For surgical documentation a separate user interface was set up. Digital clinical orders for documentation of registration and scheduling of operations user interfaces were also set up. A direct integration of ophthalmic imaging modalities could be established. An ophthalmologist-orientated EHR for outpatient and surgical documentation for inpatient clinics was created and successfully implemented. By incorporation of imaging procedures the foundation of future smart/big data analyses was created.

Information delivery manuals to integrate building product information into design

DEFF Research Database (Denmark)

Berard, Ole Bengt; Karlshøj, Jan

2011-01-01

Despite continuing BIM progress, professionals in the AEC industry often lack the information they need to perform their work. Although this problem could be alleviated by information systems similar to those in other industries, companies struggle to model processes and information needs...... them in information systems. BIM implies that objects are bearers of information and logic. The present study has three main aims: (1) to explore IDMs capability to capture all four perspectives, (2) to determine whether an IDM’s collaborative methodology is valid for developing standardized processes......, and (3) to ascertain whether IDM’s business rules can support the development of information and logic-bearing BIM objects. The research is based on a case study of re-engineering the bidding process for a design-build project to integrate building product manufacturers, subcontractors...

Integrated plant information technology design support functionality

International Nuclear Information System (INIS)

Kim, Yeon Seung; Kim, Dae Jin; Barber, P. W.; Goland, D.

1996-06-01

This technical report was written as a result of Integrated Plant Information System (IPIS) feasibility study on CANDU 9 project which had been carried out from January, 1994 to March, 1994 at AECL (Atomic Energy Canada Limited) in Canada. From 1987, AECL had done endeavour to change engineering work process from paper based work process to computer based work process through CANDU 3 project. Even though AECL had a lot of good results form computerizing the Process Engineering, Instrumentation Control and Electrical Engineering, Mechanical Engineering, Computer Aided Design and Drafting, and Document Management System, but there remains the problem of information isolation and integration. On this feasibility study, IPIS design support functionality guideline was suggested by evaluating current AECL CAE tools, analyzing computer aided engineering task and work flow, investigating request for implementing integrated computer aided engineering and describing Korean request for future CANDU design including CANDU 9. 6 figs. (Author)

Integrated plant information technology design support functionality

Energy Technology Data Exchange (ETDEWEB)

Kim, Yeon Seung; Kim, Dae Jin [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Barber, P W; Goland, D [Atomic Energy Canada Ltd., (Canada)

1996-06-01

This technical report was written as a result of Integrated Plant Information System (IPIS) feasibility study on CANDU 9 project which had been carried out from January, 1994 to March, 1994 at AECL (Atomic Energy Canada Limited) in Canada. From 1987, AECL had done endeavour to change engineering work process from paper based work process to computer based work process through CANDU 3 project. Even though AECL had a lot of good results form computerizing the Process Engineering, Instrumentation Control and Electrical Engineering, Mechanical Engineering, Computer Aided Design and Drafting, and Document Management System, but there remains the problem of information isolation and integration. On this feasibility study, IPIS design support functionality guideline was suggested by evaluating current AECL CAE tools, analyzing computer aided engineering task and work flow, investigating request for implementing integrated computer aided engineering and describing Korean request for future CANDU design including CANDU 9. 6 figs. (Author).

Integrated occupational radiation exposure information system

International Nuclear Information System (INIS)

Hunt, H.W.

1983-06-01

The integrated (Occupational Radiation Exposure) data base information system has many advantages. Radiation exposure information is available to operating management in a more timely manner and in a more flexible mode. The ORE system has permitted the integration of scattered files and data to be stored in a more cost-effective method that permits easy and simultaneous access by a variety of users with different data needs. The external storage needs of the radiation exposure source documents are several orders of magnitude less through the use of the computer assisted retrieval techniques employed in the ORE system. Groundwork is being layed to automate the historical files, which are maintained to help describe the radiation protection programs and policies at any one point in time. The file unit will be microfilmed for topical indexing on the ORE data base

Using hub technology to facilitate information system integration in a health-care enterprise.

Science.gov (United States)

Gendler, S M; Friedman, B A; Henricks, W H

1996-04-01

The deployment and maintenance of multiple point-to-point interfaces between a clinical information system, such as a laboratory information system, and other systems within a healthcare enterprise is expensive and time consuming. Moreover, the demand for such interfaces is increasing as hospitals consolidate and clinical laboratories participate in the development of regional laboratory networks and create host-to-host links with laboratory outreach clients. An interface engine, also called a hub, is an evolving technology that could replace multiple point-to-point interfaces from a laboratory information system with a single interface to the hub, preferably HL7 based. The hub then routes and translates laboratory information to other systems within the enterprise. Changes in application systems in an enterprise where a centralized interface engine has been implemented then amount to thorough analysis, an update of the enterprise's data dictionary, purchase of a single new vendor-supported interface, and table-based parameter changes on the hub. Two other features of an interface engine, support for structured query language and information store-and-forward, will facilitate the development of clinical data repositories and provide flexibility when interacting with other host systems. This article describes the advantages and disadvantages of an interface engine and lists some problems not solved by the technology. Finally, early developmental experience with an interface engine at the University of Michigan Medical Center and the benefits of the project on system integration efforts are described, not the least of which has been the enthusiastic adoption of the HL7 standard for all future interface projects.

Refining and validating a conceptual model of Clinical Nurse Leader integrated care delivery.

Science.gov (United States)

Bender, Miriam; Williams, Marjory; Su, Wei; Hites, Lisle

2017-02-01

To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Sequential mixed methods. A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. © 2016 John Wiley & Sons Ltd.

Changes in information behavior in clinical teams after introduction of a clinical librarian service

Science.gov (United States)

Urquhart, Christine; Turner, Janet; Durbin, Jane; Ryan, Jean

2007-01-01

Objectives: The eighteen-month evaluation of a clinical librarian project (October 2003–March 2005) conducted in North Wales, United Kingdom (UK) assessed the benefits of clinical librarian support to clinical teams, the impact of mediated searching services, and the effectiveness of information skills training, including journal club support. Methods: The evaluation assessed changes in teams' information-seeking behavior and their willingness to delegate searching to a clinical librarian. Baseline (n = 69 responses, 73% response rate) and final questionnaire (n = 57, 77% response rate) surveys were complemented by telephone and face-to-face interviews (n = 33) among 3 sites served. Those attending information skills training sessions (n = 130) completed evaluations at the session and were surveyed 1 month after training (n = 24 questionnaire responses, n = 12 interviews). Results: Health professionals in clinical teams reported that they were more willing to undertake their own searching, but also more willing to delegate some literature searching, than at the start of the project. The extent of change depended on the team and the type of information required. Information skills training was particularly effective when organized around journal clubs. Conclusions: Collaboration with a clinical librarian increased clinician willingness to seek information. Clinical librarian services should leverage structured training opportunities such as journal clubs. PMID:17252062

Clinical, information and business process modeling to promote development of safe and flexible software.

Science.gov (United States)

Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

2006-09-01

Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

48 CFR 9.104-6 - Federal Awardee Performance and Integrity Information System.

Science.gov (United States)

2010-10-01

... Performance and Integrity Information System. 9.104-6 Section 9.104-6 Federal Acquisition Regulations System... Contractors 9.104-6 Federal Awardee Performance and Integrity Information System. (a) Before awarding a... Federal Awardee Performance and Integrity Information System (FAPIIS), (available at www.ppirs.gov, then...

Assessment of Integrated Information System (IIS) in organization ...

African Journals Online (AJOL)

Assessment of Integrated Information System (IIS) in organization. ... to enable the Information System (IS) managers, as well as top management to understand the ... since organisational and strategic aspects in IIS should also be considered.

Design of the Hospital Integrated Information Management System Based on Cloud Platform.

Science.gov (United States)

Aijing, L; Jin, Y

2015-12-01

At present, the outdated information management style cannot meet the needs of hospital management, and has become the bottleneck of hospital's management and development. In order to improve the integrated management of information, hospitals have increased their investment in integrated information management systems. On account of the lack of reasonable and scientific design, some hospital integrated information management systems have common problems, such as unfriendly interface, poor portability and maintainability, low security and efficiency, lack of interactivity and information sharing. To solve the problem, this paper carries out the research and design of a hospital information management system based on cloud platform, which can realize the optimized integration of hospital information resources and save money.

Development of Integrated Information System for Travel Bureau Company

Science.gov (United States)

Karma, I. G. M.; Susanti, J.

2018-01-01

Related to the effectiveness of decision-making by the management of travel bureau company, especially by managers, information serves frequent delays or incomplete. Although already computer-assisted, the existing application-based is used only handle one particular activity only, not integrated. This research is intended to produce an integrated information system that handles the overall operational activities of the company. By applying the object-oriented system development approach, the system is built with Visual Basic. Net programming language and MySQL database package. The result is a system that consists of 4 (four) separated program packages, including Reservation System, AR System, AP System and Accounting System. Based on the output, we can conclude that this system is able to produce integrated information that related to the problem of reservation, operational and financial those produce up-to-date information in order to support operational activities and decisionmaking process by related parties.

Clinical experience of integrative cancer immunotherapy with GcMAF.

Science.gov (United States)

Inui, Toshio; Kuchiike, Daisuke; Kubo, Kentaro; Mette, Martin; Uto, Yoshihiro; Hori, Hitoshi; Sakamoto, Norihiro

2013-07-01

Immunotherapy has become an attractive new strategy in the treatment of cancer. The laboratory and clinical study of cancer immunotherapy is rapidly advancing. However, in the clinical setting, the results of cancer immunotherapy are mixed. We therefore contend that cancer immunotherapy should be customized to each patient individually based on their immune status and propose an integrative immunotherapy approach with second-generation group-specific component macrophage activating factor (GcMAF)-containing human serum. The standard protocol of our integrative cancer immunotherapy is as follows: i) 0.5 ml GcMAF-containing human serum is administered intramuscularly or subcutaneously once or twice per week for the duration of cancer therapy until all cancer cells are eradicated; ii) hyper T/natural killer (NK) cell therapy is given once per week for six weeks; iii) high-dose vitamin C is administered intravenously twice per week; iv) alpha lipoic acid (600 mg) is administered orally daily; v) vitamin D3 (5,000-10,000 IU) is administered orally daily. By March 2013, Saisei Mirai have treated over 345 patients with GcMAF. Among them we here present the cases of three patients for whom our integrative immunotherapy was remarkably effective. The results of our integrative immunotherapy seem hopeful. We also plan to conduct a comparative clinical study.>

Review of Statistical Learning Methods in Integrated Omics Studies (An Integrated Information Science).

Science.gov (United States)

Zeng, Irene Sui Lan; Lumley, Thomas

2018-01-01

Integrated omics is becoming a new channel for investigating the complex molecular system in modern biological science and sets a foundation for systematic learning for precision medicine. The statistical/machine learning methods that have emerged in the past decade for integrated omics are not only innovative but also multidisciplinary with integrated knowledge in biology, medicine, statistics, machine learning, and artificial intelligence. Here, we review the nontrivial classes of learning methods from the statistical aspects and streamline these learning methods within the statistical learning framework. The intriguing findings from the review are that the methods used are generalizable to other disciplines with complex systematic structure, and the integrated omics is part of an integrated information science which has collated and integrated different types of information for inferences and decision making. We review the statistical learning methods of exploratory and supervised learning from 42 publications. We also discuss the strengths and limitations of the extended principal component analysis, cluster analysis, network analysis, and regression methods. Statistical techniques such as penalization for sparsity induction when there are fewer observations than the number of features and using Bayesian approach when there are prior knowledge to be integrated are also included in the commentary. For the completeness of the review, a table of currently available software and packages from 23 publications for omics are summarized in the appendix.

[Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

Science.gov (United States)

Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

2010-04-01

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

Nuclear plants gain integrated information systems

International Nuclear Information System (INIS)

Villavicencio-Ramirez, A.; Rodriquez-Alvarez, J.M.

1994-01-01

With the objective of simplifying the complex mesh of computing devices employed within nuclear power plants, modern technology and integration techniques are being used to form centralized (but backed up) databases and distributed processing and display networks. Benefits are immediate as a result of the integration and the use of standards. The use of a unique data acquisition and database subsystem optimizes the high costs of engineering, as this task is done only once for the life span of the system. This also contributes towards a uniform user interface and allows for graceful expansion and maintenance. This article features an integrated information system, Sistema Integral de Informacion de Proceso (SIIP). The development of this system enabled the Laguna Verde Nuclear Power plant to fully use the already existing universe of signals and its related engineering during all plant conditions, namely, start up, normal operation, transient analysis, and emergency operation. Integrated systems offer many advantages over segregated systems, and this experience should benefit similar development efforts in other electric power utilities, not only for nuclear but also for other types of generating plants

Attributes of clinical leadership in contemporary nursing: an integrative review.

Science.gov (United States)

Mannix, Judy; Wilkes, Lesley; Daly, John

2013-08-01

Effective clinical leadership is offered as the key to healthy, functional and supportive work environments for nurses and other health professionals. However, as a concept it lacks a standard definition and is poorly understood. This paper reports on an integrative review undertaken to uncover current understandings of defining attributes of contemporary clinical leadership in nursing. Data collection involved a search of relevant electronic databases for a 10-year period. Keywords for the search were 'clinical leadership' and 'nursing'. Ten research papers met the inclusion criteria for the integrative review. Analysis of these studies indicated clinical leadership attributes had a clinical focus, a follower/team focus or a personal qualities focus; attributes necessary to sustain supportive workplaces and build the capacity and resilience of nursing workforces. The small number of research-based studies yielded for the review indicates the need for further research in the area of clinical leadership.

The impact of IAIMS on the work of information experts. Integrated Advanced Information Management Systems.

Science.gov (United States)

Ash, J

1995-10-01

Integrated Advanced Information Management Systems (IAIMS) programs differ but have certain characteristics in common. Technological and organizational integration are universal goals. As integration takes place, what happens to those implementing the vision? A survey of 125 staff members, or information experts, involved in information or informatics at an IAIMS-funded institution was conducted during the last year of the implementation phase. The purpose was to measure the impact of IAIMS on the jobs of those in the library and related service units, and the computing, telecommunications, and health informatics divisions. The researchers used newly developed scales measuring levels of integration (knowledge of and involvement with other departments), customer orientation (focus on the user), and informatedness (changes in the nature of work beyond automation of former routines). Ninety-four percent of respondents indicated that their jobs had changed a great deal; the changes were similar regardless of division. To further investigate the impact of IAIMS on librarians in particular, a separate skills survey was conducted. The IAIMS librarians indicated that technology and training skills are especially needed in the new, integrated environment.

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

Science.gov (United States)

Team, Victoria; Canaway, Rachel; Manderson, Lenore

2011-01-01

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Integrating complex business processes for knowledge-driven clinical decision support systems.

Science.gov (United States)

Kamaleswaran, Rishikesan; McGregor, Carolyn

2012-01-01

This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

Clinical social networking--a new revolution in provider communication and delivery of clinical information across providers of care?

Science.gov (United States)

Kolowitz, Brian J; Lauro, Gonzalo Romero; Venturella, James; Georgiev, Veliyan; Barone, Michael; Deible, Christopher; Shrestha, Rasu

2014-04-01

The adoption of social media technologies appears to enhance clinical outcomes through improved communications as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). The ability of providers to more effectively, directly, and rapidly communicate among themselves as well as with patients should strengthen collaboration and treatment as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). This paper is a case study in one organization's development of an internally designed and developed social technology solution termed "Unite." The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization. Modeling Unite as a social technology may ease adoption barriers. Developing a social network that is integrated with healthcare information systems in the clinical space opens the doors to capturing and studying the way in which providers communicate. The Unite system appears to have the potential to breaking down existing communication paradigms. With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care.

Information Science and integrative Science. A sistemic approach to information units

Directory of Open Access Journals (Sweden)

Rita Dolores Santaella Ruiz

2006-01-01

Full Text Available Structured in two parts: The Documentation like integrating science and Systematics approach to the documentary units, this work understands the Documentation from a brought integrating perspective of the twinning that supposes same modus operandi in the information systems through the use of the technologies of the communication. From the General Theory of Systems, the present work interprets this science to multidiscipline like a system formed by the technical subsystems, of elements and individuals

The integrated approach methodology for operator information evaluation

International Nuclear Information System (INIS)

Stroube, K.; Modarres, M.; Roush, M.; Hunt, N.; Pearce, R.

1986-01-01

The Integrated Approach has developed a complete method for evaluating the relative importance of operation information improvements. By use of decision trees the impact of information on success probability of a function or system can be evaluated. This approach couples goal trees and human success likelihoods to estimate anticipated consequences of a given information system

Conceptual information processing: A robust approach to KBS-DBMS integration

Science.gov (United States)

Lazzara, Allen V.; Tepfenhart, William; White, Richard C.; Liuzzi, Raymond

1987-01-01

Integrating the respective functionality and architectural features of knowledge base and data base management systems is a topic of considerable interest. Several aspects of this topic and associated issues are addressed. The significance of integration and the problems associated with accomplishing that integration are discussed. The shortcomings of current approaches to integration and the need to fuse the capabilities of both knowledge base and data base management systems motivates the investigation of information processing paradigms. One such paradigm is concept based processing, i.e., processing based on concepts and conceptual relations. An approach to robust knowledge and data base system integration is discussed by addressing progress made in the development of an experimental model for conceptual information processing.

Development of the Integrated Information Technology System

National Research Council Canada - National Science Library

2005-01-01

The Integrated Medical Information Technology System (IMITS) Program is focused on implementation of advanced technology solutions that eliminate inefficiencies, increase utilization and improve quality of care for active duty forces...

Clinical case in digital technology for nursing students' learning: An integrative review.

Science.gov (United States)

Hara, Cristina Yuri Nakata; Aredes, Natália Del Angelo; Fonseca, Luciana Mara Monti; Silveira, Renata Cristina de Campos Pereira; Camargo, Rosangela Andrade Aukar; de Goes, Fernanda Santos Nogueira

2016-03-01

This review aimed to analyze the available evidences in literature about clinical case studies inserted in digital technologies for nursing education, characterizing the technology resources and cognitive, procedural and attitudinal learnings. Integrative review of literature with the following steps: development of the research problem, data collection, data extraction and critic evaluation, data analysis and interpretation and presentation of results. The research question was: how does the clinical case study inserted in educational digital technology collaborate for cognitive, attitudinal and procedural learning of nursing students? data bases LILACS, PUBMED, CINAHL and Scopus. the search resulted in 437 studies: 136 from LILACS, 122 from PUBMED, 104 from Scopus and 75 from CINAHL. Of these, 143 did not meet the including criteria, 93 were duplicated and four studies were unavailable. After analyzing all abstracts based on inclusion and exclusion criteria, there were selected 197 studies and after full text analysis the final sample resulted in 21 primary studies. Case study use in educational digital technologies allowed the students to build different types of learning: cognitive learning (n 16 studies), attitudinal learning (n=12 studies) and procedural learning (n=8 studies). It is possible to conclude that case studies can collaborate with the students to develop different learnings which can be built integrate, continuous, informative and formative, aiming integral formation and aligned to policies of formation in nursing, both national and international. Copyright © 2015 Elsevier Ltd. All rights reserved.

Management of information in development projects – a proposed integrated model

Directory of Open Access Journals (Sweden)

C. Bester

2008-11-01

Full Text Available The first section of the article focuses on the need for development in Africa and the specific challenges of development operations. It describes the need for a holistic and integrated information management model as part of the project management body of knowledge aimed at managing the information flow between communities and development project teams. It is argued that information, and access to information, is crucial in development projects and can therefore be seen as a critical success factor in any development project. In the second section of the article, the three information areas of the holistic and integrated information management model are described. In the section thereafter we suggest roles and actions for information managers to facilitate information processes integral to the model. These processes seek to create a developing information community that aligns itself with the development project, and supports and sustains it.

Measuring integrated care

DEFF Research Database (Denmark)

Strandberg-Larsen, Martin

2011-01-01

respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... differences were found in the perception of clinical integration in the two settings. More primary care clinicians in the Northern California region of Kaiser Permanente reported being part of a clinical integrated environment than did Danish general practitioners. By measuring the level of clinical...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...

Classification Method in Integrated Information Network Using Vector Image Comparison

Directory of Open Access Journals (Sweden)

Zhou Yuan

2014-05-01

Full Text Available Wireless Integrated Information Network (WMN consists of integrated information that can get data from its surrounding, such as image, voice. To transmit information, large resource is required which decreases the service time of the network. In this paper we present a Classification Approach based on Vector Image Comparison (VIC for WMN that improve the service time of the network. The available methods for sub-region selection and conversion are also proposed.

[Which research is needed to support clinical decision-making on integrative medicine? Can comparative effectiveness research close the gap?].

Science.gov (United States)

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Berman, Brian M

2013-08-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of best care options. This evidence, more generalizable than evidence generated by traditional randomized clinical trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on CER is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

Integrated and Gender-Affirming Transgender Clinical Care and Research

Science.gov (United States)

Radix, Asa; Deutsch, Madeline B.

2016-01-01

Abstract: Transgender (trans) communities worldwide, particularly those on the trans feminine spectrum, are disproportionately burdened by HIV infection and at risk for HIV acquisition/transmission. Trans individuals represent an underserved, highly stigmatized, and under-resourced population not only in HIV prevention efforts but also in delivery of general primary medical and clinical care that is gender affirming. We offer a model of gender-affirmative integrated clinical care and community research to address and intervene on disparities in HIV infection for transgender people. We define trans terminology, briefly review the social epidemiology of HIV infection among trans individuals, highlight gender affirmation as a key social determinant of health, describe exemplar models of gender-affirmative clinical care in Boston MA, New York, NY, and San Francisco, CA, and offer suggested “best practices” for how to integrate clinical care and research for the field of HIV prevention. Holistic and culturally responsive HIV prevention interventions must be grounded in the lived realities the trans community faces to reduce disparities in HIV infection. HIV prevention interventions will be most effective if they use a structural approach and integrate primary concerns of transgender people (eg, gender-affirmative care and management of gender transition) alongside delivery of HIV-related services (eg, biobehavioral prevention, HIV testing, linkage to care, and treatment). PMID:27429189

Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system.

Science.gov (United States)

Strandberg-Larsen, Martin; Schiøtz, Michaela L; Silver, Jeremy D; Frølich, Anne; Andersen, John S; Graetz, Ilana; Reed, Mary; Bellows, Jim; Krasnik, Allan; Rundall, Thomas; Hsu, John

2010-04-08

Integration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in practice. Our objective was to compare primary care clinicians' perceptions of clinical integration and three sub-aspects in two healthcare systems: Kaiser Permanente, Northern California (KPNC) and the Danish healthcare system (DHS). Further, we examined the associations between specific organizational factors and clinical integration within each system. Comparable questionnaires were sent to a random sample of primary care clinicians in KPNC (n = 1103) and general practitioners in DHS (n = 700). Data were analysed using multiple logistic regression models. More clinicians in KPNC perceived to be part of a clinical integrated environment than did general practitioners in the DHS (OR = 3.06, 95% CI: 2.28, 4.12). Further, more KPNC clinicians reported timeliness of information transfer (OR = 2.25, 95% CI: 1.62, 3.13), agreement on roles and responsibilities (OR = 1.79, 95% CI: 1.30, 2.47) and established coordination mechanisms in place to ensure effective handoffs (OR = 6.80, 95% CI: 4.60, 10.06). None of the considered organizational factors in the sub-country analysis explained a substantial proportion of the variation in clinical integration. More primary care clinicians in KPNC reported clinical integration than did general practitioners in the DHS. Focused measures of clinical integration are needed to develop the field of clinical integration and to create the scientific foundation to guide managers searching for evidence based approaches.

A RuleML Study on Integrating Geographical and Health Information

DEFF Research Database (Denmark)

Gao, Sheng; Mioc, Darka; Boley, Harold

2008-01-01

To facilitate health surveillance, flexible ways to represent, integrate, and deduce health information become increasingly important. In this paper, an ontology is used to support the semantic definition of spatial, temporal and thematic factors of health information. The ontology is realized...... as an interchangeable RuleML knowledge base, consisting of facts and rules. Rules are also used for integrating geographical and health information. The implemented eHealthGeo system uses the OO jDREW reasoning engine to deduce implicit information such as spatial relationships. The system combines this with spatial...

Research on monitoring and management information integration technique in waste treatment and management

International Nuclear Information System (INIS)

Kong Jinsong; Yu Ren; Mao Wei

2013-01-01

The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

A meta schema for evidence information in clinical practice guidelines as a basis for decision-making.

Science.gov (United States)

Kaiser, Katharina; Martini, Patrick; Miksch, Silvia; Oztürk, Alime

2007-01-01

Clinical practice guidelines are an important instrument to aid physicians during medical diagnosis and treatment. Currently, different guideline developing organizations try to define and integrate evidence information into such guidelines. However, the coding schemas and taxonomies used for the evidence information differ widely, which makes the use cumbersome and demanding. We explored these various schemas and developed a meta schema for the evidence information, which covers the most important components of the existing ones, is comprehensible, and easy to understand for the users. We developed and assessed the usefulness and applicability of our meta schema with guideline developers and physicians.

The Effect of Information Security Management on Organizational Processes Integration in Supply Chain

Directory of Open Access Journals (Sweden)

Mohsen Shafiei Nikabadi

2012-03-01

Full Text Available : The major purpose of this article was that how information security management has effect on supply chain integration and the effect of implementing "information security management system" on enhancing supplies chain integration. In this respect, current research was seeking a combination overview to these tow approaches (Information Security Management and Organizational Processes Integration by Enterprise Resources Planning System and after that determined factors of these two important issue by factor analysis. Researchers using a series of comments in the automotive experts (production planning and management and supply chain experts and caregivers car makers and suppliers in the first level and second level supply chain industry. In this way, it has been done that impact on how information security management processes enterprise supply chain integration with the help of statistical correlation analysis. The results of this investigation indicated effect of "information security management system" various dimensions that were coordination of information, prevent human errors and hardware, the accuracy of information and education for users on two dimensions of internal and external integration of business processes, supply chain and finally, it can increased integration of business processes in supply chain. At the end owing to quite these results, deployment of "information security management system" increased the integration of organizational processes in supply chain. It could be demonstrate with the consideration of relation of organizational integration processes whit the level of coordination of information, prevent errors and accuracy of information throughout the supply chain.

Capital planning for clinical integration.

Science.gov (United States)

Grauman, Daniel M; Neff, Gerald; Johnson, Molly Martha

2011-04-01

When assessing the financial implications of a physician alignment and clinical integration initiative, a hospital should measure the initiative's potential ROI, perhaps best using a combination of net present value and payback period. The hospital should compare its own historical and projected performance with rating agency median benchmarks for key financial indicators of profitability, debt service, capital and cash flow, and liquidity. The hospital should also consider potential indirect benefits, such as retained outpatient/ancillary revenue, increased inpatient revenue, improved cost control, and improved quality and reporting transparency.

Health Information Systems.

Science.gov (United States)

Sirintrapun, S Joseph; Artz, David R

2015-06-01

This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. Copyright © 2015 Elsevier Inc. All rights reserved.

BRIDG: a domain information model for translational and clinical protocol-driven research.

Science.gov (United States)

Becnel, Lauren B; Hastak, Smita; Ver Hoef, Wendy; Milius, Robert P; Slack, MaryAnn; Wold, Diane; Glickman, Michael L; Brodsky, Boris; Jaffe, Charles; Kush, Rebecca; Helton, Edward

2017-09-01

It is critical to integrate and analyze data from biological, translational, and clinical studies with data from health systems; however, electronic artifacts are stored in thousands of disparate systems that are often unable to readily exchange data. To facilitate meaningful data exchange, a model that presents a common understanding of biomedical research concepts and their relationships with health care semantics is required. The Biomedical Research Integrated Domain Group (BRIDG) domain information model fulfills this need. Software systems created from BRIDG have shared meaning "baked in," enabling interoperability among disparate systems. For nearly 10 years, the Clinical Data Standards Interchange Consortium, the National Cancer Institute, the US Food and Drug Administration, and Health Level 7 International have been key stakeholders in developing BRIDG. BRIDG is an open-source Unified Modeling Language-class model developed through use cases and harmonization with other models. With its 4+ releases, BRIDG includes clinical and now translational research concepts in its Common, Protocol Representation, Study Conduct, Adverse Events, Regulatory, Statistical Analysis, Experiment, Biospecimen, and Molecular Biology subdomains. The model is a Clinical Data Standards Interchange Consortium, Health Level 7 International, and International Standards Organization standard that has been utilized in national and international standards-based software development projects. It will continue to mature and evolve in the areas of clinical imaging, pathology, ontology, and vocabulary support. BRIDG 4.1.1 and prior releases are freely available at https://bridgmodel.nci.nih.gov . © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Information Security and Integrity Systems

Science.gov (United States)

1990-01-01

Viewgraphs from the Information Security and Integrity Systems seminar held at the University of Houston-Clear Lake on May 15-16, 1990 are presented. A tutorial on computer security is presented. The goals of this tutorial are the following: to review security requirements imposed by government and by common sense; to examine risk analysis methods to help keep sight of forest while in trees; to discuss the current hot topic of viruses (which will stay hot); to examine network security, now and in the next year to 30 years; to give a brief overview of encryption; to review protection methods in operating systems; to review database security problems; to review the Trusted Computer System Evaluation Criteria (Orange Book); to comment on formal verification methods; to consider new approaches (like intrusion detection and biometrics); to review the old, low tech, and still good solutions; and to give pointers to the literature and to where to get help. Other topics covered include security in software applications and development; risk management; trust: formal methods and associated techniques; secure distributed operating system and verification; trusted Ada; a conceptual model for supporting a B3+ dynamic multilevel security and integrity in the Ada runtime environment; and information intelligence sciences.

Integrated Reporting and Assurance of Sustainability Information: An Experimental Study on Professional Investors’ Information Processing

NARCIS (Netherlands)

Reimsbach, D.; Hahn, R.; Gürtürk, A.

2018-01-01

Sustainability-related non-financial information is increasingly deemed value relevant. Against this background, two recent trends in non-financial reporting are frequently discussed: integrated reporting and assurance of sustainability information. Using an established framework of information

Clinical capabilities of graduates of an outcomes-based integrated medical program

Directory of Open Access Journals (Sweden)

Scicluna Helen A

2012-06-01

Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland.

Science.gov (United States)

Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

2016-07-08

Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

Legacy system integration using web technology

Science.gov (United States)

Kennedy, Richard L.; Seibert, James A.; Hughes, Chris J.

2000-05-01

As healthcare moves towards a completely digital, multimedia environment there is an opportunity to provide for cost- effective, highly distributed physician access to clinical information including radiology-based imaging. In order to address this opportunity a Universal Clinical Desktop (UCD) system was developed. A UCD provides a single point of entry into an integrated view of all types of clinical data available within a network of disparate healthcare information systems. In order to explore the application of a UCD in a hospital environment, a pilot study was established with the University of California Davis Medical Center using technology from Trilix Information Systems. Within this pilot environment the information systems integrated under the UCD include a radiology information system (RIS), a picture archive and communication system (PACS) and a laboratory information system (LIS).

Understanding Information Systems Integration Deficiencies in Mergers and Acquisitions

DEFF Research Database (Denmark)

Henningsson, Stefan; Kettinger, William J.

2017-01-01

Information systems (IS) integration is a critical challenge for value-creating mergers and acquisitions. Appropriate design and implementation of IS integration is typically a precondition for enabling a majority of the anticipated business benefits of a combined organization. Often...

[Development method of healthcare information system integration based on business collaboration model].

Science.gov (United States)

Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

2015-02-01

Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

Integrated Information System for Higher Education Qualifications

Directory of Open Access Journals (Sweden)

Catalin Ionut SILVESTRU

2012-10-01

Full Text Available In the present article we aim to study thoroughly and detail aspects related to architectures specific for e-learning and management of human resources training interconnected to management of qualifications. In addition, we take into consideration combining e-learning architectures with software in an e-learning system interconnected with the National Registry of Qualifications of Higher Education, in view of developing and information system that correlates educational supply from higher education from Romania with labor market demands through qualifications. The scientific endeavor consists of original architectural solutions to integrate data, systems, processes, services from various sources and to use them in the proposed system. The practical result of the scientific endeavor is represented by design of architectures required for developing an e-learning system interconnected with the National Registry of Qualifications from Romania, which involve in first stage the qualifications provided by higher education. The proposed innovative solution consists in the fact that the proposed information system combines the advantages of content management system (CMS with learning content management system (LCMS and with reusable learning objects (RLO. Thus, the architecture proposed in the research ensures the integration of a content management system with a portal for information, guidance and support in making a professional project. The integration enables correlation of competences with content areas and specific items from various teaching subjects, thus evaluating the usefulness for this registry from learning/educational perspective. Using the proposed information system in enables correlation among qualifications, content of educational program and continuous self-evaluation opportunities, which facilitate monitoring of progress and adjustment of learning content.

Clinical information in drug package inserts in India

Directory of Open Access Journals (Sweden)

Shivkar Y

2009-01-01

Full Text Available Background: It is widely recognized that accurate and reliable product information is essential for the safe and effective use of medications. Pharmaceutical companies are the primary source of most drug information, including package inserts. Package inserts are printed leaflets accompanying marketed drug products and contain information approved by the regulatory agencies. Studies on package inserts in India, in 1996, had shown that crucial information was often missing and they lacked uniformity. Aim: To assess the presentation and completeness of clinically important information provided in the currently available package inserts in India. Materials and Methods: Package inserts accompanying allopathic drug products marketed by pharmaceutical companies in India were collected. These package inserts were analyzed for the content of clinically important information in various sections. Statistical Analysis: The results were expressed as absolute numbers and percentages. Results: Preliminary analyses revealed that most package inserts did contain information under headings, such as, therapeutic indications, contraindications, undesirable effects, etc., listed in the Drugs and Cosmetics Rules 1945. The findings indicated considerable improvement in package inserts since 1996. However, on critical evaluation it was revealed that clinically important information was not well presented and was often incomplete. Information with regard to pediatric and geriatric use was present in only 44% and 13% of the package inserts, respectively. Only five of the inserts had information on the most frequent adverse drug reactions associated with the drug. Also, information on interactions and overdosage was often missing. Conclusion: Although the package inserts appear to have improved over the past decade there is still a definite need to further refine the clinical information contained, to minimize the risks to patients. This could be brought about by self

CLARA: an integrated clinical research administration system

Science.gov (United States)

Bian, Jiang; Xie, Mengjun; Hogan, William; Hutchins, Laura; Topaloglu, Umit; Lane, Cheryl; Holland, Jennifer; Wells, Thomas

2014-01-01

Administration of human subject research is complex, involving not only the institutional review board but also many other regulatory and compliance entities within a research enterprise. Its efficiency has a direct and substantial impact on the conduct and management of clinical research. In this paper, we report on the Clinical Research Administration (CLARA) platform developed at the University of Arkansas for Medical Sciences. CLARA is a comprehensive web-based system that can streamline research administrative tasks such as submissions, reviews, and approval processes for both investigators and different review committees on a single integrated platform. CLARA not only helps investigators to meet regulatory requirements but also provides tools for managing other clinical research activities including budgeting, contracting, and participant schedule planning. PMID:24778201

Visualization and Integrated Data Mining of Disparate Information

Energy Technology Data Exchange (ETDEWEB)

Saffer, Jeffrey D.(OMNIVIZ, INC); Albright, Cory L.(BATTELLE (PACIFIC NW LAB)); Calapristi, Augustin J.(BATTELLE (PACIFIC NW LAB)); Chen, Guang (OMNIVIZ, INC); Crow, Vernon L.(BATTELLE (PACIFIC NW LAB)); Decker, Scott D.(BATTELLE (PACIFIC NW LAB)); Groch, Kevin M.(BATTELLE (PACIFIC NW LAB)); Havre, Susan L.(BATTELLE (PACIFIC NW LAB)); Malard, Joel (BATTELLE (PACIFIC NW LAB)); Martin, Tonya J.(BATTELLE (PACIFIC NW LAB)); Miller, Nancy E.(BATTELLE (PACIFIC NW LAB)); Monroe, Philip J.(OMNIVIZ, INC); Nowell, Lucy T.(BATTELLE (PACIFIC NW LAB)); Payne, Deborah A.(BATTELLE (PACIFIC NW LAB)); Reyes Spindola, Jorge F.(BATTELLE (PACIFIC NW LAB)); Scarberry, Randall E.(OMNIVIZ, INC); Sofia, Heidi J.(BATTELLE (PACIFIC NW LAB)); Stillwell, Lisa C.(OMNIVIZ, INC); Thomas, Gregory S.(BATTELLE (PACIFIC NW LAB)); Thurston, Sarah J.(OMNIVIZ, INC); Williams, Leigh K.(BATTELLE (PACIFIC NW LAB)); Zabriskie, Sean J.(OMNIVIZ, INC); MG Hicks

2001-05-11

The volumes and diversity of information in the discovery, development, and business processes within the chemical and life sciences industries require new approaches for analysis. Traditional list- or spreadsheet-based methods are easily overwhelmed by large amounts of data. Furthermore, generating strong hypotheses and, just as importantly, ruling out weak ones, requires integration across different experimental and informational sources. We have developed a framework for this integration, including common conceptual data models for multiple data types and linked visualizations that provide an overview of the entire data set, a measure of how each data record is related to every other record, and an assessment of the associations within the data set.

[The Development of Information Centralization and Management Integration System for Monitors Based on Wireless Sensor Network].

Science.gov (United States)

Xu, Xiu; Zhang, Honglei; Li, Yiming; Li, Bin

2015-07-01

Developed the information centralization and management integration system for monitors of different brands and models with wireless sensor network technologies such as wireless location and wireless communication, based on the existing wireless network. With adaptive implementation and low cost, the system which possesses the advantages of real-time, efficiency and elaboration is able to collect status and data of the monitors, locate the monitors, and provide services with web server, video server and locating server via local network. Using an intranet computer, the clinical and device management staffs can access the status and parameters of monitors. Applications of this system provide convenience and save human resource for clinical departments, as well as promote the efficiency, accuracy and elaboration for the device management. The successful achievement of this system provides solution for integrated and elaborated management of the mobile devices including ventilator and infusion pump.

Clinical and Outcome Research in oncology The need for integration

Directory of Open Access Journals (Sweden)

Apolone Giovanni

2003-04-01

Full Text Available Abstract Cancer is one of the main healthcare problems in Europe. Although significant progress has recently been made, long-term survival is still disappointing for most common solid tumours. The explosion of information has strengthened the need to create and sustain coordinated interaction between technology, biology, clinical research, clinical practice and health policy. A simple process based on automatic and passive translation from bench to clinical research and eventually to the bed side is usually assumed but cannot be taken for granted. A critical role might be played by Outcome Research (OR, defined as the discipline that describes, interprets, and predicts the impact of various influences, especially interventions, on final endpoints (from survival to satisfaction with care that matter to decision makers (from patients to society at large, with special emphasis on the use of patient-reported outcomes (PRO. Recently, under pressure from several parts of society, the FDA, recognizing the need for faster drug approval, has modified existing regulations and created new rules to allow anti-cancer drugs to be approved more quickly and, in certain but quite common circumstances, single arm trials and surrogate endpoints to be used as measures of clinical benefit. In this context, the faster approval process may lead to drugs being marketed without there being a complete picture of how effective or safe they are. The FDA move to speed up drug approval, together with the use of not fully validated surrogate endpoints, give OR the unique opportunity to help understand the value of drugs that have received accelerated approval. Despite this opportunity, OR has yet to demonstrate its role in this specific setting and provide proof of the validity, reliability and added value of its primary endpoint measures when evaluated in a broader context. The implementation of lines of OR in the development and evaluation of anti-cancer drugs hinges upon

Testing can counteract proactive interference by integrating competing information

Science.gov (United States)

Wahlheim, Christopher N.

2015-01-01

Testing initially learned information before presenting new information has been shown to counteract the deleterious effects of proactive interference by segregating competing sources of information. The present experiments were conducted to demonstrate that testing can also have its effects in part by integrating competing information. Variations of classic A–B, A–D paired-associate learning paradigms were employed that included two lists of word pairs and a cued-recall test. Repeated pairs appeared in both lists (A–B, A–B), control pairs appeared in List 2 only (A–B, C–D), and changed pairs appeared with the same cue in both lists but with different responses (A–B, A–D). The critical manipulation was whether pairs were tested or restudied in an interpolated phase that occurred between Lists 1 and 2. On a final cued-recall test, participants recalled List 2 responses and then indicated when they recollected that responses had earlier changed between lists. The change recollection measure indexed the extent to which competing responses were integrated during List 2. Change was recollected more often for tested than for restudied pairs. Proactive facilitation was obtained in cued recall when change was recollected, whereas proactive interference was obtained when change was not recollected. These results provide evidence that testing counteracted proactive interference in part by making List 1 responses more accessible during List 2, thus promoting integration and increasing later recollection of change. These results have theoretical implications because they show that testing can counteract proactive interference by integrating or segregating competing information. PMID:25120241

Testing can counteract proactive interference by integrating competing information.

Science.gov (United States)

Wahlheim, Christopher N

2015-01-01

Testing initially learned information before presenting new information has been shown to counteract the deleterious effects of proactive interference by segregating competing sources of information. The present experiments were conducted to demonstrate that testing can also have its effects in part by integrating competing information. Variations of classic A-B, A-D paired-associate learning paradigms were employed that included two lists of word pairs and a cued-recall test. Repeated pairs appeared in both lists (A-B, A-B), control pairs appeared in List 2 only (A-B, C-D), and changed pairs appeared with the same cue in both lists but with different responses (A-B, A-D). The critical manipulation was whether pairs were tested or restudied in an interpolated phase that occurred between Lists 1 and 2. On a final cued-recall test, participants recalled List 2 responses and then indicated when they recollected that responses had earlier changed between lists. The change recollection measure indexed the extent to which competing responses were integrated during List 2. Change was recollected more often for tested than for restudied pairs. Proactive facilitation was obtained in cued recall when change was recollected, whereas proactive interference was obtained when change was not recollected. These results provide evidence that testing counteracted proactive interference in part by making List 1 responses more accessible during List 2, thus promoting integration and increasing later recollection of change. These results have theoretical implications because they show that testing can counteract proactive interference by integrating or segregating competing information.

Integrating information systems : linking global business goals to local database applications

NARCIS (Netherlands)

Dignum, F.P.M.; Houben, G.J.P.M.

1999-01-01

This paper describes a new approach to design modern information systems that offer an integrated access to the data and knowledge that is available in local applications. By integrating the local data management activities into one transparent information distribution process, modern organizations

[The informed consent in international clinical trials including developing countries].

Science.gov (United States)

Montenegro Surís, Alexander; Monreal Agüero, Magda Elaine

2008-01-01

The informed consent procedure has been one of the most important controversies of ethical debates about clinical trials in developing countries. In this essay we present our recommendations about important aspects to consider in the informed consent procedure for clinical trials in developing countries. We performed a full publications review identified by MEDLINE using these terms combinations: informed consent, developing countries, less developed countries and clinical trials. To protect volunteers in less developed countries should be valuated the importance of the community in the informed consent proceeding. The signing and dating of the informed consent form is not always the best procedure to document the informed consent. The informed consent form should be written by local translators. Alternative medias of communications could be needed for communicatios of the information to volunteers. Comparing with developed countries the informed consent proceeding in clinical trials in developing countries frequently require additional efforts. The developing of pragmatic researches is needed to implement informed consent proceedings assuring subjects voluntarily in each developing country. The main aspects to define in each clinical trial for each country are the influence of the community, the effective communication of the information, the documentation of the informed consent and local authority's control.

Information-integration category learning and the human uncertainty response.

Science.gov (United States)

Paul, Erick J; Boomer, Joseph; Smith, J David; Ashby, F Gregory

2011-04-01

The human response to uncertainty has been well studied in tasks requiring attention and declarative memory systems. However, uncertainty monitoring and control have not been studied in multi-dimensional, information-integration categorization tasks that rely on non-declarative procedural memory. Three experiments are described that investigated the human uncertainty response in such tasks. Experiment 1 showed that following standard categorization training, uncertainty responding was similar in information-integration tasks and rule-based tasks requiring declarative memory. In Experiment 2, however, uncertainty responding in untrained information-integration tasks impaired the ability of many participants to master those tasks. Finally, Experiment 3 showed that the deficit observed in Experiment 2 was not because of the uncertainty response option per se, but rather because the uncertainty response provided participants a mechanism via which to eliminate stimuli that were inconsistent with a simple declarative response strategy. These results are considered in the light of recent models of category learning and metacognition.

QUANTITATIVE СHARACTERISTICS OF COMPLEMENTARY INTEGRATED HEALTH CARE SYSTEM AND INTEGRATED MEDICATION MANAGEMENT INFORMATION SYSTEM

Directory of Open Access Journals (Sweden)

L. Yu. Babintseva

2015-05-01

i mportant elements of state regulation of the pharmaceutical sector health. For the first time creation of two information systems: integrated medication management infor mation system and integrated health care system in an integrated medical infor mation area, operating based on th e principle of complementarity was justified. Global and technological coefficients of these systems’ functioning were introduced.

THE IMPORTANCE OF THE IMPLEMENTATION OF INTEGRATED INFORMATION SYSTEMS IN THE RESTRUCTURING AND EUROPEAN INTEGRATION PROCESS OF ORGANIZATIONS

Directory of Open Access Journals (Sweden)

Steliac Nela

2010-12-01

Full Text Available Many of the organizations that are part of the public and private domain in Romania have reached the stage in which the existing information systems can no longer comply with the requests of users. Therefore, we are compelled by necessity to use integrated information systems which should be able to control all kinds of data and to allow access to them, to ensure the coherence and consistency of the stored information. Managers must be aware of the importance of the implementation of integrated information systems in the background restructuring of the organization, which can thus become consistent and competitive with the European Union one, so the integration process becomes a real and possible one.

Clinical Computer Systems Survey (CLICS): learning about health information technology (HIT) in its context of use.

Science.gov (United States)

Lichtner, Valentina; Cornford, Tony; Klecun, Ela

2013-01-01

Successful health information technology (HIT) implementations need to be informed on the context of use and on users' attitudes. To this end, we developed the CLinical Computer Systems Survey (CLICS) instrument. CLICS reflects a socio-technical view of HIT adoption, and is designed to encompass all members of the clinical team. We used the survey in a large English hospital as part of its internal evaluation of the implementation of an electronic patient record system (EPR). The survey revealed extent and type of use of the EPR; how it related to and integrated with other existing systems; and people's views on its use, usability and emergent safety issues. Significantly, participants really appreciated 'being asked'. They also reminded us of the wider range of administrative roles engaged with EPR. This observation reveals pertinent questions as to our understanding of the boundaries between administrative tasks and clinical medicine - what we propose as the field of 'administrative medicine'.

Integrative Mental Health (IMH): paradigm, research, and clinical practice.

Science.gov (United States)

Lake, James; Helgason, Chanel; Sarris, Jerome

2012-01-01

This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

Integration of Administrative, Clinical, and Environmental Data to Support the Management of Type 2 Diabetes Mellitus: From Satellites to Clinical Care.

Science.gov (United States)

Dagliati, Arianna; Marinoni, Andrea; Cerra, Carlo; Decata, Pasquale; Chiovato, Luca; Gamba, Paolo; Bellazzi, Riccardo

2015-12-01

A very interesting perspective of "big data" in diabetes management stands in the integration of environmental information with data gathered for clinical and administrative purposes, to increase the capability of understanding spatial and temporal patterns of diseases. Within the MOSAIC project, funded by the European Union with the goal to design new diabetes analytics, we have jointly analyzed a clinical-administrative dataset of nearly 1.000 type 2 diabetes patients with environmental information derived from air quality maps acquired from remote sensing (satellite) data. Within this context we have adopted a general analysis framework able to deal with a large variety of temporal, geo-localized data. Thanks to the exploitation of time series analysis and satellite images processing, we studied whether glycemic control showed seasonal variations and if they have a spatiotemporal correlation with air pollution maps. We observed a link between the seasonal trends of glycated hemoglobin and air pollution in some of the considered geographic areas. Such findings will need future investigations for further confirmation. This work shows that it is possible to successfully deal with big data by implementing new analytics and how their exploration may provide new scenarios to better understand clinical phenomena. © 2015 Diabetes Technology Society.

A New Multi-Sensor Track Fusion Architecture for Multi-Sensor Information Integration

National Research Council Canada - National Science Library

Jean, Buddy H; Younker, John; Hung, Chih-Cheng

2004-01-01

.... This new technology will integrate multi-sensor information and extract integrated multi-sensor information to detect, track and identify multiple targets at any time, in any place under all weather conditions...

Exploring the structure and organization of information within nursing clinical handovers.

Science.gov (United States)

Johnson, Maree; Jefferies, Diana; Nicholls, Daniel

2012-10-01

Clinical handover is the primary source of patient information for nurses; however, inadequate information transfer compromises patient safety. We investigated the content and organization of information conveyed at 81 handovers. A structure that captures and presents the information transferred at handover emerged: identification of the patient and clinical risks, clinical history/presentation, clinical status, care plan and outcomes/goals of care (ICCCO). This approach covers essential information while allowing for prioritization of information when required. Further research into the impact of ICCCO on patient safety is in progress. © 2012 Wiley Publishing Asia Pty Ltd.

Integrating SAP to Information Systems Curriculum: Design and Delivery

Science.gov (United States)

Wang, Ming

2011-01-01

Information Systems (IS) education is being transformed from the segmented applications toward the integrated enterprise-wide system software Enterprise Resource Planning (ERP). ERP is a platform that integrates all business functions with its centralized data repository shared by all the business operations in the enterprise. This tremendous…

Information on blinding in registered records of clinical trials

Directory of Open Access Journals (Sweden)

Viergever Roderik F

2012-11-01

Full Text Available Abstract Information on blinding is part of the data that should be provided upon registration of a trial at a clinical trials registry. Reporting of blinding is often absent or of low quality in published articles of clinical trials. This study researched the presence and quality of information on blinding in registered records of clinical trials and highlights the important role of data-recording formats at clinical trial registries in ensuring high-quality registration.

Integrated system of production information processing for surface mines

Energy Technology Data Exchange (ETDEWEB)

Li, K.; Wang, S.; Zeng, Z.; Wei, J.; Ren, Z. [China University of Mining and Technology, Xuzhou (China). Dept of Mining Engineering

2000-09-01

Based on the concept of geological statistic, mathematical program, condition simulation, system engineering, and the features and duties of each main department in surface mine production, an integrated system for surface mine production information was studied systematically and developed by using the technology of data warehousing, CAD, object-oriented and system integration, which leads to the systematizing and automating of the information management, data processing, optimization computing and plotting. In this paper, its overall object, system design, structure and functions and some key techniques were described. 2 refs., 3 figs.

The integration of Information and Communication Technology into nursing.

Science.gov (United States)

Lupiáñez-Villanueva, Francisco; Hardey, Michael; Torrent, Joan; Ficapal, Pilar

2011-02-01

To identify and characterise different profiles of nurses' utilization of Information and Communication Technology (ICT) and the Internet and to identify factors that can enhance or inhibit the use of these technologies within nursing. An online survey of the 13,588 members of the Nurses Association of Barcelona who had a registered email account in 2006 was carried out. Factor analysis, cluster analysis and binomial logit model was undertaken. Although most of the nurses (76.70%) are utilizing the Internet within their daily work, multivariate statistics analysis revealed two profiles of the adoption of ICT. The first profile (4.58%) represents those nurses who value ICT and the Internet so that it forms an integral part of their practice. This group is thus referred to as 'integrated nurses'. The second profile (95.42%) represents those nurses who place less emphasis on ICT and the Internet and are consequently labelled 'non-integrated nurses'. From the statistical modelling, it was observed that undertaking research activities an emphasis on international information and a belief that health information available on the Internet was 'very relevant' play a positive and significant role in the probability of being an integrated nurse. The emerging world of the 'integrated nurse' cannot be adequately understood without examining how nurses make use of ICT and the Internet within nursing practice and the way this is shaped by institutional, technical and professional opportunities and constraints. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Analyzing Statistical Mediation with Multiple Informants: A New Approach with an Application in Clinical Psychology

Directory of Open Access Journals (Sweden)

Lesther ePapa

2015-11-01

Full Text Available Testing mediation models is critical for identifying potential variables that need to be targeted to effectively change one or more outcome variables. In addition, it is now common practice for clinicians to use multiple informant (MI data in studies of statistical mediation. By coupling the use of MI data with statistical mediation analysis, clinical researchers can combine the benefits of both techniques. Integrating the information from MIs into a statistical mediation model creates various methodological and practical challenges. The authors review prior methodological approaches to MI mediation analysis in clinical research and propose a new latent variable approach that overcomes some limitations of prior approaches. An application of the new approach to mother, father, and child reports of impulsivity, frustration tolerance, and externalizing problems (N = 454 is presented. The results showed that frustration tolerance mediated the relationship between impulsivity and externalizing problems. Advantages and limitations of the new approach are discussed. The new approach can help clinical researchers overcome limitations of prior techniques. It allows for a more comprehensive and effective use of MI data when testing mediation models.

Information Technology Integration in Higher Education: A Novel Approach for Impact Assessment

Directory of Open Access Journals (Sweden)

Abdulkareem Al-Alwani

2014-12-01

Full Text Available In the current technological world of Information services, academic systems are also in the process of adapting information technology solutions. Information systems vary for different applications and specifically in academia domain, a range of information systems are available for different institutions worldwide. Integration of e-learning can optimize implementation of computer-based and computer-assisted educational processes at all levels. Therefore it is imperative to assess and evaluate integration of these information systems because they have serious impact on e-learning processes. In this study an instrument survey is presented for evaluating integration of information technology systems and practices in an educational environment. Survey is constructed using descriptive questions related to information technology tools to assess qualitative impact and usage of such tools. Critical feedback, analysis and suggestions from 25 educationists played a pivotal role in finalizing proposed survey questionnaire. A subsequent test evaluation by teachers and students is also carried out to assess adequate utilization of information systems in Yanbu University College. The results showed that feedback using this survey can help in identifying technological gaps and facilitate effective integration of information technology in an educational environment. Survey instrument proposed in this research can greatly enhance integration of IT tools as it can identify shortcomings by collecting statistical data from feedback of both faculty and students. Solution to these problems is deterministic and can be easily implemented to optimize overall performance of e-learning systems.

The evolution of integration: innovations in clinical skills and ethics in first year medicine.

Science.gov (United States)

Brunger, Fern; Duke, Pauline S

2012-01-01

Critical self-reflection, medical ethics and clinical skills are each important components of medical education but are seldom linked in curriculum development. We developed a curriculum that builds on the existing integration of ethics education into the clinical skills course to more explicitly link these three skills. The curriculum builds on the existing integration of clinical skills and ethics in first year medicine. It refines the integration through scheduling changes; adds case studies that emphasise the social, economic and political context of our province's patient population; and introduces reflection on the "culture of medicine" as a way to have students articulate and understand their own values and moral decision making frameworks. This structured Clinical Skills course is a model for successfully integrating critical self-reflection, reflection on the political, economic and cultural contexts shaping health and healthcare, and moral decision making into clinical skills training.

Which research is needed to support clinical decision-making on integrative medicine?- Can comparative effectiveness research close the gap?

Science.gov (United States)

Witt, Claudia M; Huang, Wen-jing; Lao, Lixing; Bm, Berman

2012-10-01

In clinical research on complementary and integrative medicine, experts and scientists have often pursued a research agenda in spite of an incomplete understanding of the needs of end users. Consequently, the majority of previous clinical trials have mainly assessed the efficacy of interventions. Scant data is available on their effectiveness. Comparative effectiveness research (CER) promises to support decision makers by generating evidence that compares the benefits and harms of the best care options. This evidence, more generalizable than the evidence generated by traditional randomized controlled trials (RCTs), is better suited to inform real-world care decisions. An emphasis on CER supports the development of the evidence base for clinical and policy decision-making. Whereas in most areas of complementary and integrative medicine data on comparative effectiveness is scarce, available acupuncture research already contributes to CER evidence. This paper will introduce CER and make suggestions for future research.

The Integrated Information System for Natural Disaster Mitigation

Directory of Open Access Journals (Sweden)

Junxiu Wu

2007-08-01

Full Text Available Supported by the World Bank, the Integrated Information System for Natural Disaster Mitigation (ISNDM, including the operational service system and network telecommunication system, has been in development for three years in the Center of Disaster Reduction, Chinese Academy of Sciences, based on the platform of the GIS software Arcview. It has five main modules: disaster background information, socio- economic information, disaster-induced factors database, disaster scenarios database, and disaster assessment. ISNDM has several significant functions, which include information collection, information processing, data storage, and information distribution. It is a simple but comprehensive demonstration system for our national center for natural disaster reduction.

Automated granularity to integrate digital information: the "Antarctic Treaty Searchable Database" case study

Directory of Open Access Journals (Sweden)

Paul Arthur Berkman

2006-06-01

Full Text Available Access to information is necessary, but not sufficient in our digital era. The challenge is to objectively integrate digital resources based on user-defined objectives for the purpose of discovering information relationships that facilitate interpretations and decision making. The Antarctic Treaty Searchable Database (http://aspire.nvi.net, which is in its sixth edition, provides an example of digital integration based on the automated generation of information granules that can be dynamically combined to reveal objective relationships within and between digital information resources. This case study further demonstrates that automated granularity and dynamic integration can be accomplished simply by utilizing the inherent structure of the digital information resources. Such information integration is relevant to library and archival programs that require long-term preservation of authentic digital resources.

Integrating hospital information systems in healthcare institutions: a mediation architecture.

Science.gov (United States)

El Azami, Ikram; Cherkaoui Malki, Mohammed Ouçamah; Tahon, Christian

2012-10-01

Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.

Tools in a clinical information system supporting clinical trials at a Swiss University Hospital.

Science.gov (United States)

Weisskopf, Michael; Bucklar, Guido; Blaser, Jürg

2014-12-01

Issues concerning inadequate source data of clinical trials rank second in the most common findings by regulatory authorities. The increasing use of electronic clinical information systems by healthcare providers offers an opportunity to facilitate and improve the conduct of clinical trials and the source documentation. We report on a number of tools implemented into the clinical information system of a university hospital to support clinical research. In 2011/2012, a set of tools was developed in the clinical information system of the University Hospital Zurich to support clinical research, including (1) a trial registry for documenting metadata on the clinical trials conducted at the hospital, (2) a patient-trial-assignment-tool to tag patients in the electronic medical charts as participants of specific trials, (3) medical record templates for the documentation of study visits and trial-related procedures, (4) online queries on trials and trial participants, (5) access to the electronic medical records for clinical monitors, (6) an alerting tool to notify of hospital admissions of trial participants, (7) queries to identify potentially eligible patients in the planning phase as trial feasibility checks and during the trial as recruitment support, and (8) order sets to facilitate the complete and accurate performance of study visit procedures. The number of approximately 100 new registrations per year in the voluntary trial registry in the clinical information system now matches the numbers of the existing mandatory trial registry of the hospital. Likewise, the yearly numbers of patients tagged as trial participants as well as the use of the standardized trial record templates increased to 2408 documented trial enrolments and 190 reports generated/month in the year 2013. Accounts for 32 clinical monitors have been established in the first 2 years monitoring a total of 49 trials in 16 clinical departments. A total of 15 months after adding the optional feature of

Assessing Extinction Risk: Integrating Genetic Information

Directory of Open Access Journals (Sweden)

Jason Dunham

1999-06-01

Full Text Available Risks of population extinction have been estimated using a variety of methods incorporating information from different spatial and temporal scales. We briefly consider how several broad classes of extinction risk assessments, including population viability analysis, incidence functions, and ranking methods integrate information on different temporal and spatial scales. In many circumstances, data from surveys of neutral genetic variability within, and among, populations can provide information useful for assessing extinction risk. Patterns of genetic variability resulting from past and present ecological and demographic events, can indicate risks of extinction that are otherwise difficult to infer from ecological and demographic analyses alone. We provide examples of how patterns of neutral genetic variability, both within, and among populations, can be used to corroborate and complement extinction risk assessments.

START: an advanced radiation therapy information system.

Science.gov (United States)

Cocco, A; Valentini, V; Balducci, M; Mantello, G

1996-01-01

START is an advanced radiation therapy information system (RTIS) which connects direct information technology present in the devices with indirect information technology for clinical, administrative, information management integrated with the hospital information system (HIS). The following objectives are pursued: to support decision making in treatment planning and functional and information integration with the rest of the hospital; to enhance organizational efficiency of a Radiation Therapy Department; to facilitate the statistical evaluation of clinical data and managerial performance assessment; to ensure the safety and confidentiality of used data. For its development a working method based on the involvement of all operators of the Radiation Therapy Department, was applied. Its introduction in the work activity was gradual, trying to reuse and integrate the existing information applications. The START information flow identifies four major phases: admission, visit of admission, planning, therapy. The system main functionalities available to the radiotherapist are: clinical history/medical report linking function; folder function; planning function; tracking function; electronic mail and banner function; statistical function; management function. Functions available to the radiotherapy technician are: the room daily list function; management function: to the nurse the following functions are available: patient directing function; management function. START is a departmental client (pc-windows)-server (unix) developed on an integrated database of all information of interest (clinical, organizational and administrative) coherent with the standard and with a modular architecture which can evolve with additional functionalities in subsequent times. For a more thorough evaluation of its impact on the daily activity of a radiation therapy facility, a prolonged clinical validation is in progress.

Information Extraction, Data Integration, and Uncertain Data Management: The State of The Art

NARCIS (Netherlands)

Habib, Mena Badieh; van Keulen, Maurice

2011-01-01

Information Extraction, data Integration, and uncertain data management are different areas of research that got vast focus in the last two decades. Many researches tackled those areas of research individually. However, information extraction systems should have integrated with data integration

Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy.

Science.gov (United States)

Eguzkiza, Aitor; Trigo, Jesús Daniel; Martínez-Espronceda, Miguel; Serrano, Luis; Andonegui, José

2015-08-01

Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient representatives? views on patient information in clinical cancer trials

OpenAIRE

Dellson, Pia; Nilbert, Mef; Carlsson, Christina

2016-01-01

Background Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives? views and perceptions on the written trial information used in clinical cancer trials. Methods Written patient information leaflet...

Integrating query of relational and textual data in clinical databases: a case study.

Science.gov (United States)

Fisk, John M; Mutalik, Pradeep; Levin, Forrest W; Erdos, Joseph; Taylor, Caroline; Nadkarni, Prakash

2003-01-01

The authors designed and implemented a clinical data mart composed of an integrated information retrieval (IR) and relational database management system (RDBMS). Using commodity software, which supports interactive, attribute-centric text and relational searches, the mart houses 2.8 million documents that span a five-year period and supports basic IR features such as Boolean searches, stemming, and proximity and fuzzy searching. Results are relevance-ranked using either "total documents per patient" or "report type weighting." Non-curated medical text has a significant degree of malformation with respect to spelling and punctuation, which creates difficulties for text indexing and searching. Presently, the IR facilities of RDBMS packages lack the features necessary to handle such malformed text adequately. A robust IR+RDBMS system can be developed, but it requires integrating RDBMSs with third-party IR software. RDBMS vendors need to make their IR offerings more accessible to non-programmers.

Patient representatives' views on patient information in clinical cancer trials

DEFF Research Database (Denmark)

Dellson, Pia; Nilbert, Mef; Carlsson, Christina

2016-01-01

of future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language......BACKGROUND: Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed...... consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. METHODS: Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I...

Mediator infrastructure for information integration and semantic data integration environment for biomedical research.

Science.gov (United States)

Grethe, Jeffrey S; Ross, Edward; Little, David; Sanders, Brian; Gupta, Amarnath; Astakhov, Vadim

2009-01-01

This paper presents current progress in the development of semantic data integration environment which is a part of the Biomedical Informatics Research Network (BIRN; http://www.nbirn.net) project. BIRN is sponsored by the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). A goal is the development of a cyberinfrastructure for biomedical research that supports advance data acquisition, data storage, data management, data integration, data mining, data visualization, and other computing and information processing services over the Internet. Each participating institution maintains storage of their experimental or computationally derived data. Mediator-based data integration system performs semantic integration over the databases to enable researchers to perform analyses based on larger and broader datasets than would be available from any single institution's data. This paper describes recent revision of the system architecture, implementation, and capabilities of the semantically based data integration environment for BIRN.

A Framework for Understanding Post-Merger Information Systems Integration

DEFF Research Database (Denmark)

Alaranta, Maria; Kautz, Karlheinz

2012-01-01

This paper develops a theoretical framework for the integration of information systems (IS) after a merger or an acquisition. The framework integrates three perspectives: a structuralist, an individualist, and an interactive process perspective to analyze and understand such integrations....... The framework is applied to a longitudinal case study of a manufacturing company that grew through an acquisition. The management decided to integrate the production control IS via tailoring a new system that blends together features of existing IS. The application of the framework in the case study confirms...... several known impediments to IS integrations. It also identifies a number of new inhibitors, as well as known and new facilitators that can bring post-merger IS integration to a success. Our findings provide relevant insights to researching and managing post-merger IS integrations. They emphasize...

The MedSeq Project: a randomized trial of integrating whole genome sequencing into clinical medicine.

Science.gov (United States)

Vassy, Jason L; Lautenbach, Denise M; McLaughlin, Heather M; Kong, Sek Won; Christensen, Kurt D; Krier, Joel; Kohane, Isaac S; Feuerman, Lindsay Z; Blumenthal-Barby, Jennifer; Roberts, J Scott; Lehmann, Lisa Soleymani; Ho, Carolyn Y; Ubel, Peter A; MacRae, Calum A; Seidman, Christine E; Murray, Michael F; McGuire, Amy L; Rehm, Heidi L; Green, Robert C

2014-03-20

illuminate the impact of integrating genomic medicine into the clinical care of patients but also inform the design of future studies. ClinicalTrials.gov identifier NCT01736566.

The Effect of Information Security Management on Organizational Processes Integration in Supply Chain

OpenAIRE

Mohsen Shafiei Nikabadi; Ahmad Jafarian; Azam Jalili Bolhasani

2012-01-01

: The major purpose of this article was that how information security management has effect on supply chain integration and the effect of implementing "information security management system" on enhancing supplies chain integration. In this respect, current research was seeking a combination overview to these tow approaches (Information Security Management and Organizational Processes Integration by Enterprise Resources Planning System) and after that determined factors of these two import...

Revisioning Clinical Psychology: Integrating Cultural Psychology into Clinical Research and Practice with Portuguese Immigrants

OpenAIRE

James, Susan; Harris, Sara; Foster, Gary; Clarke, Juanne; Gadermann, Anne; Morrison, Marie; Bezanson, Birdie Jane

2013-01-01

This article outlines a model for conducting psychotherapy with people of diverse cultural backgrounds. The theoretical foundation for the model is based on clinical and cultural psychology. Cultural psychology integrates psychology and anthropology in order to provide a complex understanding of both culture and the individual within his or her cultural context. The model proposed in this article is also based on our clinical experience and mixed method research with the Portuguese communi...

Analysis of Factors Affect to Organizational Performance In Using Accounting Information Systems Through Users Satisfaction and Integration Information Systems

Directory of Open Access Journals (Sweden)

Anton Arisman

2017-09-01

Full Text Available The aim of this research is to investigate the factors affecting organizational performance in using accounting information system through users satisfaction and integration information systems. The research respondents were 447 companies that listed in Indonesian Stock Exchange. The data are gathered through consensus method and in total there are 176 responses with complete data. Structural Equation Model (SEM is used in analyzing the data and system theory is utilized in this research. The result shows that knowledge management systems and management control system have significant influence on users satisfaction and integration information systems.  Integration information system and users satisfaction has positive significant on organizational performance.

On the effects of multimodal information integration in multitasking.

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Stock, Ann-Kathrin; Gohil, Krutika; Huster, René J; Beste, Christian

2017-07-07

There have recently been considerable advances in our understanding of the neuronal mechanisms underlying multitasking, but the role of multimodal integration for this faculty has remained rather unclear. We examined this issue by comparing different modality combinations in a multitasking (stop-change) paradigm. In-depth neurophysiological analyses of event-related potentials (ERPs) were conducted to complement the obtained behavioral data. Specifically, we applied signal decomposition using second order blind identification (SOBI) to the multi-subject ERP data and source localization. We found that both general multimodal information integration and modality-specific aspects (potentially related to task difficulty) modulate behavioral performance and associated neurophysiological correlates. Simultaneous multimodal input generally increased early attentional processing of visual stimuli (i.e. P1 and N1 amplitudes) as well as measures of cognitive effort and conflict (i.e. central P3 amplitudes). Yet, tactile-visual input caused larger impairments in multitasking than audio-visual input. General aspects of multimodal information integration modulated the activity in the premotor cortex (BA 6) as well as different visual association areas concerned with the integration of visual information with input from other modalities (BA 19, BA 21, BA 37). On top of this, differences in the specific combination of modalities also affected performance and measures of conflict/effort originating in prefrontal regions (BA 6).

A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.

Science.gov (United States)

Brody, Janet L; Scherer, David G; Turner, Charles W; Annett, Robert D; Dalen, Jeanne

2017-06-07

Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices. These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy. This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated. © 2017 The Authors. Family Process published by Wiley Periodicals, Inc. on behalf of Family Process Institute.

The clinically-integrated randomized trial: proposed novel method for conducting large trials at low cost

Directory of Open Access Journals (Sweden)

Scardino Peter T

2009-03-01

Full Text Available Abstract Introduction Randomized controlled trials provide the best method of determining which of two comparable treatments is preferable. Unfortunately, contemporary randomized trials have become increasingly expensive, complex and burdened by regulation, so much so that many trials are of doubtful feasibility. Discussion Here we present a proposal for a novel, streamlined approach to randomized trials: the "clinically-integrated randomized trial". The key aspect of our methodology is that the clinical experience of the patient and doctor is virtually indistinguishable whether or not the patient is randomized, primarily because outcome data are obtained from routine clinical data, or from short, web-based questionnaires. Integration of a randomized trial into routine clinical practice also implies that there should be an attempt to randomize every patient, a corollary of which is that eligibility criteria are minimized. The similar clinical experience of patients on- and off-study also entails that the marginal cost of putting an additional patient on trial is negligible. We propose examples of how the clinically-integrated randomized trial might be applied in four distinct areas of medicine: comparisons of surgical techniques, "me too" drugs, rare diseases and lifestyle interventions. Barriers to implementing clinically-integrated randomized trials are discussed. Conclusion The proposed clinically-integrated randomized trial may allow us to enlarge dramatically the number of clinical questions that can be addressed by randomization.

Emotional health: on the applicability of affective science to the integration of clinical psychology

Directory of Open Access Journals (Sweden)

Ewa Trzebińska

2017-09-01

Full Text Available The aim of the article is to outline the concept of emotional health and its integrative potential in the field of clinical psychology. It is a well-known fact that the transdiagnostic approach and psychotherapy integration – the two most influential integrative movements in clinical psychology – search for a sound conceptual foundation of the efforts to organize a plethora of theories and data relating to the psychological aspects of physical and mental health. Following a short presentation of general discrepancies afflicting clinical psychology and the main ideas of both the transdiagnostic approach and psychotherapy integration, the notion of emotional health is introduced and its unifying convenience, as well as limitations, is discussed.

FEMA's Integrated Emergency Management Information System (IEMIS)

International Nuclear Information System (INIS)

Jaske, R.T.; Meitzler, W.

1987-01-01

FEMA is implementing a computerized system for use in optimizing planning, and for supporting exercises of these plans. Called the Integrated Emergency Management Information System (IEMIS), it consists of a base geographic information system upon which analytical models are superimposed in order to load data and report results analytically. At present, it supports FEMA's work in offsite preparedness around nuclear power stations, but is being developed to deal with a full range of natural and technological accident hazards for which emergency evacuation or population movement is required

Integrating knowledge based functionality in commercial hospital information systems.

Science.gov (United States)

Müller, M L; Ganslandt, T; Eich, H P; Lang, K; Ohmann, C; Prokosch, H U

2000-01-01

Successful integration of knowledge-based functions in the electronic patient record depends on direct and context-sensitive accessibility and availability to clinicians and must suit their workflow. In this paper we describe an exemplary integration of an existing standalone scoring system for acute abdominal pain into two different commercial hospital information systems using Java/Corba technolgy.

KISTI at TREC 2014 Clinical Decision Support Track: Concept-based Document Re-ranking to Biomedical Information Retrieval

Science.gov (United States)

2014-11-01

sematic type. Injury or Poisoning inpo T037 Anatomical Abnormality anab T190 Given a document D, a concept vector = {1, 2, … , ...integrating biomedical terminology . Nucleic acids research 32, Database issue (2004), 267–270. 5. Chapman, W.W., Hillert, D., Velupillai, S., et...Conference (TREC), (2011). 9. Koopman, B. and Zuccon, G. Understanding negation and family history to improve clinical information retrieval. Proceedings

Integrating reasoning and clinical archetypes using OWL ontologies and SWRL rules.

Science.gov (United States)

Lezcano, Leonardo; Sicilia, Miguel-Angel; Rodríguez-Solano, Carlos

2011-04-01

Semantic interoperability is essential to facilitate the computerized support for alerts, workflow management and evidence-based healthcare across heterogeneous electronic health record (EHR) systems. Clinical archetypes, which are formal definitions of specific clinical concepts defined as specializations of a generic reference (information) model, provide a mechanism to express data structures in a shared and interoperable way. However, currently available archetype languages do not provide direct support for mapping to formal ontologies and then exploiting reasoning on clinical knowledge, which are key ingredients of full semantic interoperability, as stated in the SemanticHEALTH report [1]. This paper reports on an approach to translate definitions expressed in the openEHR Archetype Definition Language (ADL) to a formal representation expressed using the Ontology Web Language (OWL). The formal representations are then integrated with rules expressed with Semantic Web Rule Language (SWRL) expressions, providing an approach to apply the SWRL rules to concrete instances of clinical data. Sharing the knowledge expressed in the form of rules is consistent with the philosophy of open sharing, encouraged by archetypes. Our approach also allows the reuse of formal knowledge, expressed through ontologies, and extends reuse to propositions of declarative knowledge, such as those encoded in clinical guidelines. This paper describes the ADL-to-OWL translation approach, describes the techniques to map archetypes to formal ontologies, and demonstrates how rules can be applied to the resulting representation. We provide examples taken from a patient safety alerting system to illustrate our approach. Copyright © 2010 Elsevier Inc. All rights reserved.

Analyzing Statistical Mediation with Multiple Informants: A New Approach with an Application in Clinical Psychology.

Science.gov (United States)

Papa, Lesther A; Litson, Kaylee; Lockhart, Ginger; Chassin, Laurie; Geiser, Christian

2015-01-01

Testing mediation models is critical for identifying potential variables that need to be targeted to effectively change one or more outcome variables. In addition, it is now common practice for clinicians to use multiple informant (MI) data in studies of statistical mediation. By coupling the use of MI data with statistical mediation analysis, clinical researchers can combine the benefits of both techniques. Integrating the information from MIs into a statistical mediation model creates various methodological and practical challenges. The authors review prior methodological approaches to MI mediation analysis in clinical research and propose a new latent variable approach that overcomes some limitations of prior approaches. An application of the new approach to mother, father, and child reports of impulsivity, frustration tolerance, and externalizing problems (N = 454) is presented. The results showed that frustration tolerance mediated the relationship between impulsivity and externalizing problems. The new approach allows for a more comprehensive and effective use of MI data when testing mediation models.

ABOUT APPROACHES OF CREATION OF INTEGRATED INFORMATION SYSTEM PDM-ERP

Directory of Open Access Journals (Sweden)

V. G. Mikhailov

2016-01-01

Full Text Available The problems which has added in the field of creation of systems PDM and their integration with ERP is considered. The analysis of the reasons of low efficiency existing PDM is carried out: insufficiency of the primary information brought in PDM unit, structures of a DB, entering of designations in one field, application of referential character of guiding of composition that leads to lowering of its functionality and creates problems with integration with ERP.It is shown that the uniform integrated information system created on uniform databases is necessary for the enterprises with a full stroke, using as the primary document card part-bom-unit, instead of a file. For it other is necessary in difference from databases existing the general-purpose structure in which it is possible to bring any information.Implementation of the new system CDRP, uniting on functional PDM-ERP and providing enterprise basic needs is offered.

Unifying Kohlberg with Information Integration: The Moral Algebra of Recompense and of Kohlbergian Moral Informers

Directory of Open Access Journals (Sweden)

Wilfried Hommers

2010-01-01

Full Text Available In order to unify two major theories of moral judgment, a novel task is employed which combines elements of Kohlberg's stage theory and of the theory of information integration. In contrast to the format of Kohlberg's moral judgment interview, a nonverbal and quantitative response which makes low demands on verbal facility was used . Moral informers differing in value, i.e. high and low, are presented. The differences in effect of those two pieces of information should be substantial for a person at that specific moral stage, but small for a person at a different stage. Hence, these differences may diagnose the person's moral stage in the simplest possible way as the two levels of each of the thoughts were about typical content of the four Kohlbergian preconventional and conventional stages. The novel task allowed additionally to measure the influence of another moral concept which was about the non-Kohlbergian moral concept of recompense. After a training phase, pairs of those thoughts were presented to allow for the study of integration and individual differences. German and Korean children, 8, 10, and 12 years in age, judged deserved punishment. The patterns of means, correlations and factor loadings showed that elements of both theories can be unified, but produced unexpected results also. Additive integration of each of the two pairs of moral informers appeared, either with two Kohlbergian moral informers or with another Kohlbergian moral informer in combination with information about recompense. Also cultural independence as well as dependence, developmental changes between 8 and 10 years, and an outstanding moral impact of recompense in size and distinctiveness were observed.

Patient representatives' views on patient information in clinical cancer trials.

Science.gov (United States)

Dellson, Pia; Nilbert, Mef; Carlsson, Christina

2016-02-01

Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I-III trials, randomized and non-randomized trials that evaluated chemotherapy/targeted therapy in the neoadjuvant, adjuvant and palliative settings. Data were collected through focus groups and were analysed using inductive content analysis. Two major themes emerged: emotional responses and cognitive responses. Subthemes related to the former included individual preferences and perceptions of effect, while subthemes related to the latter were comprehensibility and layout. Based on these observations the patient representatives provided suggestions for improvement, which largely included development of future simplified and more attractive informed consent forms. The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials.

Ethical communication in clinical trials. Issues faced by data managers in obtaining informed consent.

Science.gov (United States)

Loh, Winnie Y; Butow, Phyllis N; Brown, Richard F; Boyle, Frances

2002-12-01

clinical trials, particularly the need for an integrated, multidisciplinary approach at all levels of the informed-consent process. Copyright 2002 American Cancer Society.DOI 10.1002/cncr.2002;10994

Advancing medication infusion safety through the clinical integration of technology.

Science.gov (United States)

Gerhart, Donald; O'Shea, Kristen; Muller, Sharon

2013-01-01

Adverse drug events resulting from errors in prescribing or administering medications are preventable. Within a hospital system, numerous technologies are employed to address the common sources of medication error, including the use of electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. Infusion safety is inherently risky because of the high-risk medications administered and the lack of integration among the stand-alone systems in most institutions. Intravenous clinical integration (IVCI) is a technology that connects electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. It combines the safety features of an automatically programmed infusion pump (drug, concentration, infusion rate, and patient weight, all auto-programmed into the device) with software that provides visibility to real-time clinical infusion data. Our article describes the characteristics of IVCI at WellSpan Health and its impact on patient safety. The integrated infusion system has the capability of reducing medication errors, improving patient care, reducing in-facility costs, and supporting asset management. It can enhance continuous quality improvement efforts and efficiency of clinical work flow. After implementing IVCI, the institution realized a safer patient environment and a more streamlined work flow for pharmacy and nursing.

Public information about clinical trials and research.

Science.gov (United States)

Plétan, Yannick; Zannad, Faïez; Jaillon, Patrice

2003-01-01

Be it to restore the confused image of clinical research in relation to the lay public, or to develop new ways of accruing healthy volunteers or patients for clinical trials, there is a need to draft some guidance on how best to provide information on research. Although the French legal and regulatory armamentarium in this area is essentially liberal, there is currently little-justified reluctance among study sponsors to advertise publicly. A group of academic and pharmaceutical industry researchers, assembled for a workshop, together with regulators, journalists, representatives from ethics committees, social security, patient and health consumer groups and other French institutional bodies, has suggested the following series of recommendations: there is no need for additional legal or regulatory constraints; sponsors should be aware of and make use of direct public information on trials; a 'good practice charter' on public communication about clinical trials should be developed; all professionals should be involved in this communication platform; communication in the patient's immediate vicinity should be preferred (primary-care physician, local press); clinical databases and websites accessible to professionals, but also to patients and non-professionals, should be developed; genuine instruction on clinical trials for physicians and health professionals unfamiliar with such trials should be developed and disseminated; media groups should receive at least some training in the fundamentals of clinical research.

An integrated model of clinical reasoning: dual-process theory of cognition and metacognition.

Science.gov (United States)

Marcum, James A

2012-10-01

Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non-analytic and analytic processes of cognition, along with metacognition. The dual-process theory of cognition (system 1 non-analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning. In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations. The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills. © 2012 Blackwell Publishing Ltd.

Identifying appropriate reference data models for comparative effectiveness research (CER) studies based on data from clinical information systems.

Science.gov (United States)

Ogunyemi, Omolola I; Meeker, Daniella; Kim, Hyeon-Eui; Ashish, Naveen; Farzaneh, Seena; Boxwala, Aziz

2013-08-01

The need for a common format for electronic exchange of clinical data prompted federal endorsement of applicable standards. However, despite obvious similarities, a consensus standard has not yet been selected in the comparative effectiveness research (CER) community. Using qualitative metrics for data retrieval and information loss across a variety of CER topic areas, we compare several existing models from a representative sample of organizations associated with clinical research: the Observational Medical Outcomes Partnership (OMOP), Biomedical Research Integrated Domain Group, the Clinical Data Interchange Standards Consortium, and the US Food and Drug Administration. While the models examined captured a majority of the data elements that are useful for CER studies, data elements related to insurance benefit design and plans were most detailed in OMOP's CDM version 4.0. Standardized vocabularies that facilitate semantic interoperability were included in the OMOP and US Food and Drug Administration Mini-Sentinel data models, but are left to the discretion of the end-user in Biomedical Research Integrated Domain Group and Analysis Data Model, limiting reuse opportunities. Among the challenges we encountered was the need to model data specific to a local setting. This was handled by extending the standard data models. We found that the Common Data Model from the OMOP met the broadest complement of CER objectives. Minimal information loss occurred in mapping data from institution-specific data warehouses onto the data models from the standards we assessed. However, to support certain scenarios, we found a need to enhance existing data dictionaries with local, institution-specific information.

Specification of an integrated information architecture for a mobile teleoperated robot for home telecare.

Science.gov (United States)

Iannuzzi, David; Grant, Andrew; Corriveau, Hélène; Boissy, Patrick; Michaud, Francois

2016-12-01

The objective of this study was to design effectively integrated information architecture for a mobile teleoperated robot in remote assistance to the delivery of home health care. Three role classes were identified related to the deployment of a telerobot, namely, engineer, technology integrator, and health professional. Patients and natural caregivers were indirectly considered, this being a component of future field studies. Interviewing representatives of each class provided the functions, and information content and flows for each function. Interview transcripts enabled the formulation of UML (Universal Modeling Language) diagrams for feedback from participants. The proposed information architecture was validated with a use-case scenario. The integrated information architecture incorporates progressive design, ergonomic integration, and the home care needs from medical specialist, nursing, physiotherapy, occupational therapy, and social worker care perspectives. The integrated architecture iterative process promoted insight among participants. The use-case scenario evaluation showed the design's robustness. Complex innovation such as a telerobot must coherently mesh with health-care service delivery needs. The deployment of integrated information architecture bridging development, with specialist and home care applications, is necessary for home care technology innovation. It enables continuing evolution of robot and novel health information design in the same integrated architecture, while accounting for patient ecological need.

06. Facilitating Collection of Research and Quality Data in Integrative Medicine Clinical Settings: Views From Academic, Health System and Private Clinics

Science.gov (United States)

Dolor, Rowena; Victorson, David; Amoils, Steve

2013-01-01

Focus Areas: Integrative Approaches to Care The purpose of this panel discussion is to share successful efforts from a practice-based research network (PBRN) including ten integrative medicine clinics. The BraveNet PBRN includes integrative medicine clinics with academic health centers, large health systems, and a stand-alone private practice clinic. While clinical care is prioritized across all of these centers, introducing research into clinical sites oriented to providing care poses challenges that vary by clinic environment. We will highlight some of the unique issues encountered when trying to standardize data collection in sites practicing a patient-centered, whole-systems approach to healing as well as the solutions used to overcome these issues. We will present some operational solutions and data collected from the PBRN's ongoing data registry, entitled PRIMIER. The panel will engage attendees in a dialogue centering on potential for future analyses of existing results, ideas for possible upcoming studies, and creative ways to expand the PBRN data registry to include additional sites that may have expertise and interest in participating.

A Critical Review of the Integration of Geographic Information System and Building Information Modelling at the Data Level

Directory of Open Access Journals (Sweden)

Junxiang Zhu

2018-02-01

Full Text Available The benefits brought by the integration of Building Information Modelling (BIM and Geographic Information Systems (GIS are being proved by more and more research. The integration of the two systems is difficult for many reasons. Among them, data incompatibility is the most significant, as BIM and GIS data are created, managed, analyzed, stored, and visualized in different ways in terms of coordinate systems, scope of interest, and data structures. The objective of this paper is to review the relevant research papers to (1 identify the most relevant data models used in BIM/GIS integration and understand their advantages and disadvantages; (2 consider the possibility of other data models that are available for data level integration; and (3 provide direction on the future of BIM/GIS data integration.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

Science.gov (United States)

Oh, Eui Geum; Kim, Sunah; Kim, So Sun; Kim, Sue; Cho, Eun Yong; Yoo, Ji-Soo; Kim, Hee Soon; Lee, Ju Hee; You, Mi Ae; Lee, Hyejung

2010-07-01

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum. Copyright 2010, SLACK Incorporated.

Implementation of an advanced clinical and administrative hospital information system.

Science.gov (United States)

Vegoda, P R; Dyro, J F

1986-01-01

Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications

Representation and Integration of Scientific Information

Science.gov (United States)

1998-01-01

The objective of this Joint Research Interchange with NASA-Ames was to investigate how the Tsimmis technology could be used to represent and integrate scientific information. The main goal of the Tsimmis project is to allow a decision maker to find information of interest from such sources, fuse it, and process it (e.g., summarize it, visualize it, discover trends). Another important goal is the easy incorporation of new sources, as well the ability to deal with sources whose structure or services evolve. During the Interchange we had research meetings approximately every month or two. The funds provided by NASA supported work that lead to the following two papers: Fusion Queries over Internet Databases; Efficient Query Subscription Processing in a Multicast Environment.

Advanced integrated real-time clinical displays.

Science.gov (United States)

Kruger, Grant H; Tremper, Kevin K

2011-09-01

Intelligent medical displays have the potential to improve patient outcomes by integrating multiple physiologic signals, exhibiting high sensitivity and specificity, and reducing information overload for physicians. Research findings have suggested that information overload and distractions caused by patient care activities and alarms generated by multiple monitors in acute care situations, such as the operating room and the intensive care unit, may produce situations that negatively impact the outcomes of patients under anesthesia. This can be attributed to shortcomings of human-in-the-loop monitoring and the poor specificity of existing physiologic alarms. Modern artificial intelligence techniques (ie, intelligent software agents) are demonstrating the potential to meet the challenges of next-generation patient monitoring and alerting. Copyright © 2011 Elsevier Inc. All rights reserved.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

Science.gov (United States)

Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

Integrating an Information Literacy Quiz into the Learning Management System

Science.gov (United States)

Lowe, M. Sara; Booth, Char; Tagge, Natalie; Stone, Sean

2014-01-01

The Claremont Colleges Library Instruction Services Department developed a quiz that could be integrated into the consortial learning management software to accompany a local online, open-source information literacy tutorial. The quiz is integrated into individual course pages, allowing students to receive a grade for completion and improving…

Semantic integration of medication data into the EHOP Clinical Data Warehouse.

Science.gov (United States)

Delamarre, Denis; Bouzille, Guillaume; Dalleau, Kevin; Courtel, Denis; Cuggia, Marc

2015-01-01

Reusing medication data is crucial for many medical research domains. Semantic integration of such data in clinical data warehouse (CDW) is quite challenging. Our objective was to develop a reliable and scalable method for integrating prescription data into EHOP (a French CDW). PN13/PHAST was used as the semantic interoperability standard during the ETL process, and to store the prescriptions as documents in the CDW. Theriaque was used as a drug knowledge database (DKDB), to annotate the prescription dataset with the finest granularity, and to provide semantic capabilities to the EHOP query workbench. the system was evaluated on a clinical data set. Depending on the use case, the precision ranged from 52% to 100%, Recall was always 100%. interoperability standards and DKDB, document approach, and the finest granularity approach are the key factors for successful drug data integration in CDW.

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

Science.gov (United States)

Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

Stress affects the neural ensemble for integrating new information and prior knowledge.

Science.gov (United States)

Vogel, Susanne; Kluen, Lisa Marieke; Fernández, Guillén; Schwabe, Lars

2018-06-01

Prior knowledge, represented as a schema, facilitates memory encoding. This schema-related learning is assumed to rely on the medial prefrontal cortex (mPFC) that rapidly integrates new information into the schema, whereas schema-incongruent or novel information is encoded by the hippocampus. Stress is a powerful modulator of prefrontal and hippocampal functioning and first studies suggest a stress-induced deficit of schema-related learning. However, the underlying neural mechanism is currently unknown. To investigate the neural basis of a stress-induced schema-related learning impairment, participants first acquired a schema. One day later, they underwent a stress induction or a control procedure before learning schema-related and novel information in the MRI scanner. In line with previous studies, learning schema-related compared to novel information activated the mPFC, angular gyrus, and precuneus. Stress, however, affected the neural ensemble activated during learning. Whereas the control group distinguished between sets of brain regions for related and novel information, stressed individuals engaged the hippocampus even when a relevant schema was present. Additionally, stressed participants displayed aberrant functional connectivity between brain regions involved in schema processing when encoding novel information. The failure to segregate functional connectivity patterns depending on the presence of prior knowledge was linked to impaired performance after stress. Our results show that stress affects the neural ensemble underlying the efficient use of schemas during learning. These findings may have relevant implications for clinical and educational settings. Copyright © 2018 Elsevier Inc. All rights reserved.

A generic, web-based clinical information system architecture using HL7 CDA: successful implementation in dermatological routine care.

Science.gov (United States)

Schuler, Thilo; Boeker, Martin; Klar, Rüdiger; Müller, Marcel

2007-01-01

The requirements of highly specialized clinical domains are often underrepresented in hospital information systems (HIS). Common consequences are that documentation remains to be paper-based or external systems with insufficient HIS integration are used. This paper presents a solution to overcome this deficiency in the form of a generic framework based on the HL7 Clinical Document Architecture. The central architectural idea is the definition of customized forms using a schema-controlled XML language. These flexible form definitions drive the user interface, the data storage, and standardized data exchange. A successful proof-of-concept application in a dermatologic outpatient wound care department has been implemented, and is well accepted by the clinicians. Our work with HL7 CDA revealed the need for further practical research in the health information standards realm.

MedEx: a medication information extraction system for clinical narratives

Science.gov (United States)

Stenner, Shane P; Doan, Son; Johnson, Kevin B; Waitman, Lemuel R; Denny, Joshua C

2010-01-01

Medication information is one of the most important types of clinical data in electronic medical records. It is critical for healthcare safety and quality, as well as for clinical research that uses electronic medical record data. However, medication data are often recorded in clinical notes as free-text. As such, they are not accessible to other computerized applications that rely on coded data. We describe a new natural language processing system (MedEx), which extracts medication information from clinical notes. MedEx was initially developed using discharge summaries. An evaluation using a data set of 50 discharge summaries showed it performed well on identifying not only drug names (F-measure 93.2%), but also signature information, such as strength, route, and frequency, with F-measures of 94.5%, 93.9%, and 96.0% respectively. We then applied MedEx unchanged to outpatient clinic visit notes. It performed similarly with F-measures over 90% on a set of 25 clinic visit notes. PMID:20064797

The evolution of radiology information management

International Nuclear Information System (INIS)

Patacsil, L.

2002-01-01

Aim: The use of PACS and the need for images and clinical data is increasing exponentially. This presentation will provide a historical overview of radiology information systems (RIS) and their interaction with hospital information systems (HIS), PACS systems and modalities. Materials and Methods: The various approaches to interfacing and integrating RIS and PACS systems will be described as well as their impact on radiology departmental work-flow and the productivity of radiologists, technologists and other RIS users. Specifically, the image-centric and RIS-centric approaches to PACS will be compared. Results: Instant access to vital clinical information enables radiology departments to go beyond simply managing processes to making fundamental improvements in productivity and care processes. Unity of design translates into simplicity of operations. Integration of historically separate applications makes the environment easier to support, reduces turnaround time, and improves patient care. Conclusion: Finally, insight on new technologies and future trends in PACS, system integration and work-flow strategies will be presented in light of delivery of both clinical images and clinical data

Healthcare information systems: data mining methods in the creation of a clinical recommender system

Science.gov (United States)

Duan, L.; Street, W. N.; Xu, E.

2011-05-01

Recommender systems have been extensively studied to present items, such as movies, music and books that are likely of interest to the user. Researchers have indicated that integrated medical information systems are becoming an essential part of the modern healthcare systems. Such systems have evolved to an integrated enterprise-wide system. In particular, such systems are considered as a type of enterprise information systems or ERP system addressing healthcare industry sector needs. As part of efforts, nursing care plan recommender systems can provide clinical decision support, nursing education, clinical quality control, and serve as a complement to existing practice guidelines. We propose to use correlations among nursing diagnoses, outcomes and interventions to create a recommender system for constructing nursing care plans. In the current study, we used nursing diagnosis data to develop the methodology. Our system utilises a prefix-tree structure common in itemset mining to construct a ranked list of suggested care plan items based on previously-entered items. Unlike common commercial systems, our system makes sequential recommendations based on user interaction, modifying a ranked list of suggested items at each step in care plan construction. We rank items based on traditional association-rule measures such as support and confidence, as well as a novel measure that anticipates which selections might improve the quality of future rankings. Since the multi-step nature of our recommendations presents problems for traditional evaluation measures, we also present a new evaluation method based on average ranking position and use it to test the effectiveness of different recommendation strategies.

Information Integration in Risky Choice: Identification and Stability

OpenAIRE

Stewart, Neil

2011-01-01

How is information integrated across the\\ud attributes of an option when making risky\\ud choices? In most descriptive models of\\ud decision under risk, information about\\ud risk, and reward is combined multiplicatively\\ud (e.g., expected value; expected utility\\ud theory, Bernouli, 1738/1954; subjective\\ud expected utility theory, Savage, 1954;\\ud Edwards, 1955; prospect theory, Kahneman\\ud and Tversky, 1979; rank-dependent utility,\\ud Quiggin, 1993; decision field theory,\\ud Busemeyer and To...

Entropy-based analysis and bioinformatics-inspired integration of global economic information transfer.

Directory of Open Access Journals (Sweden)

Jinkyu Kim

Full Text Available The assessment of information transfer in the global economic network helps to understand the current environment and the outlook of an economy. Most approaches on global networks extract information transfer based mainly on a single variable. This paper establishes an entirely new bioinformatics-inspired approach to integrating information transfer derived from multiple variables and develops an international economic network accordingly. In the proposed methodology, we first construct the transfer entropies (TEs between various intra- and inter-country pairs of economic time series variables, test their significances, and then use a weighted sum approach to aggregate information captured in each TE. Through a simulation study, the new method is shown to deliver better information integration compared to existing integration methods in that it can be applied even when intra-country variables are correlated. Empirical investigation with the real world data reveals that Western countries are more influential in the global economic network and that Japan has become less influential following the Asian currency crisis.

Entropy-based analysis and bioinformatics-inspired integration of global economic information transfer.

Science.gov (United States)

Kim, Jinkyu; Kim, Gunn; An, Sungbae; Kwon, Young-Kyun; Yoon, Sungroh

2013-01-01

The assessment of information transfer in the global economic network helps to understand the current environment and the outlook of an economy. Most approaches on global networks extract information transfer based mainly on a single variable. This paper establishes an entirely new bioinformatics-inspired approach to integrating information transfer derived from multiple variables and develops an international economic network accordingly. In the proposed methodology, we first construct the transfer entropies (TEs) between various intra- and inter-country pairs of economic time series variables, test their significances, and then use a weighted sum approach to aggregate information captured in each TE. Through a simulation study, the new method is shown to deliver better information integration compared to existing integration methods in that it can be applied even when intra-country variables are correlated. Empirical investigation with the real world data reveals that Western countries are more influential in the global economic network and that Japan has become less influential following the Asian currency crisis.

Corporate governance and the adoption of health information technology within integrated delivery systems.

Science.gov (United States)

Baird, Aaron; Furukawa, Michael F; Rahman, Bushra; Schneller, Eugene S

2014-01-01

Although several previous studies have found "system affiliation" to be a significant and positive predictor of health information technology (IT) adoption, little is known about the association between corporate governance practices and adoption of IT within U.S. integrated delivery systems (IDSs). Rooted in agency theory and corporate governance research, this study examines the association between corporate governance practices (centralization of IT decision rights and strategic alignment between business and IT strategy) and IT adoption, standardization, and innovation within IDSs. Cross-sectional, retrospective analyses using data from the 2011 Health Information and Management Systems Society Analytics Database on adoption within IDSs (N = 485) is used to analyze the correlation between two corporate governance constructs (centralization of IT decision rights and strategic alignment) and three IT constructs (adoption, standardization, and innovation) for clinical and supply chain IT. Multivariate fractional logit, probit, and negative binomial regressions are applied. Multivariate regressions controlling for IDS and market characteristics find that measures of IT adoption, IT standardization, and innovative IT adoption are significantly associated with centralization of IT decision rights and strategic alignment. Specifically, centralization of IT decision rights is associated with 22% higher adoption of Bar Coding for Materials Management and 30%-35% fewer IT vendors for Clinical Data Repositories and Materials Management Information Systems. A combination of centralization and clinical IT strategic alignment is associated with 50% higher Computerized Physician Order Entry adoption, and centralization along with supply chain IT strategic alignment is significantly negatively correlated with Radio Frequency Identification adoption : Although IT adoption and standardization are likely to benefit from corporate governance practices within IDSs, innovation is

Multi-method laboratory user evaluation of an actionable clinical performance information system: Implications for usability and patient safety.

Science.gov (United States)

Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

2018-01-01

Electronic audit and feedback (e-A&F) systems are used worldwide for care quality improvement. They measure health professionals' performance against clinical guidelines, and some systems suggest improvement actions. However, little is known about optimal interface designs for e-A&F, in particular how to present suggested actions for improvement. We developed a novel theory-informed system for primary care (the Performance Improvement plaN GeneratoR; PINGR) that covers the four principal interface components: clinical performance summaries; patient lists; detailed patient-level information; and suggested actions. As far as we are aware, this is the first report of an e-A&F system with all four interface components. (1) Use a combination of quantitative and qualitative methods to evaluate the usability of PINGR with target end-users; (2) refine existing design recommendations for e-A&F systems; (3) determine the implications of these recommendations for patient safety. We recruited seven primary care physicians to perform seven tasks with PINGR, during which we measured on-screen behaviour and eye movements. Participants subsequently completed usability questionnaires, and were interviewed in-depth. Data were integrated to: gain a more complete understanding of usability issues; enhance and explain each other's findings; and triangulate results to increase validity. Participants committed a median of 10 errors (range 8-21) when using PINGR's interface, and completed a median of five out of seven tasks (range 4-7). Errors violated six usability heuristics: clear response options; perceptual grouping and data relationships; representational formats; unambiguous description; visually distinct screens for confusable items; and workflow integration. Eye movement analysis revealed the integration of components largely supported effective user workflow, although the modular design of clinical performance summaries unnecessarily increased cognitive load. Interviews and

A State-of-the-Art Review on the Integration of Building Information Modeling (BIM and Geographic Information System (GIS

Directory of Open Access Journals (Sweden)

Xin Liu

2017-02-01

Full Text Available The integration of Building Information Modeling (BIM and Geographic Information System (GIS has been identified as a promising but challenging topic to transform information towards the generation of knowledge and intelligence. Achievement of integrating these two concepts and enabling technologies will have a significant impact on solving problems in the civil, building and infrastructure sectors. However, since GIS and BIM were originally developed for different purposes, numerous challenges are being encountered for the integration. To better understand these two different domains, this paper reviews the development and dissimilarities of GIS and BIM, the existing integration methods, and investigates their potential in various applications. This study shows that the integration methods are developed for various reasons and aim to solve different problems. The parameters influencing the choice can be summarized and named as “EEEF” criteria: effectiveness, extensibility, effort, and flexibility. Compared with other methods, semantic web technologies provide a promising and generalized integration solution. However, the biggest challenges of this method are the large efforts required at early stage and the isolated development of ontologies within one particular domain. The isolation problem also applies to other methods. Therefore, openness is the key of the success of BIM and GIS integration.

Interorganisational Integration

DEFF Research Database (Denmark)

Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Frølich, Anne

2016-01-01

INTRODUCTION: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration...... at a university hospital in the Capital Region of Denmark. RESULTS AND DISCUSSION: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner...... and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration...

Informal sources of supervision in clinical training.

Science.gov (United States)

Farber, Barry A; Hazanov, Valery

2014-11-01

Although formal, assigned supervision is a potent source of learning and guidance for psychotherapy trainees, many beginning psychotherapists use other, informal sources of supervision or consultation for advice and support. Results of an online survey of beginning trainees (N = 146) indicate that other than their formally assigned supervisor, trainees most often consult with colleagues in their program, their own psychotherapist, and their significant other; that they're most likely to seek these other sources of help when they're feeling stuck or feel they've made a clinical mistake; that they do so because they need extra reassurance and suggestions; that they feel the advice given from these sources is helpful; and that they don't especially regret sharing this information. Several case examples are used to illustrate these points. Discussing clinical material with informal sources is, apparently, a great deal more common than typically acknowledged, and as such, has implications for training programs (including discussions of ethics) and formal supervision. © 2014 Wiley Periodicals, Inc.

Moral Judgment as Information Processing: An Integrative Review

Directory of Open Access Journals (Sweden)

Steve eGuglielmo

2015-10-01

Full Text Available This article reviews dominant models of moral judgment, organizing them within an overarching framework of information processing. This framework poses two fundamental questions: (1 What input information guides moral judgments?; and (2 What psychological processes generate these judgments? Information Models address the first question, identifying critical information elements (including causality, intentionality, and mental states that shape moral judgments. A subclass of Biased Information Models holds that perceptions of these information elements are themselves driven by prior moral judgments. Processing Models address the second question, and existing models have focused on the relative contribution of intuitive versus deliberative processes. This review organizes existing moral judgment models within this framework, critically evaluates them on empirical and theoretical grounds, outlines a general integrative model grounded in information processing, and offers conceptual and methodological suggestions for future research. The information processing perspective provides a useful theoretical framework for organizing extant and future work in the rapidly growing field of moral judgment.

A framework for integrating heterogeneous clinical data for a disease area into a central data warehouse.

Science.gov (United States)

Karmen, Christian; Ganzinger, Matthias; Kohl, Christian D; Firnkorn, Daniel; Knaup-Gregori, Petra

2014-01-01

Structured collection of clinical facts is a common approach in clinical research. Especially in the analysis of rare diseases it is often necessary to aggregate study data from several sites in order to achieve a statistically significant cohort size. In this paper we describe a framework how to approach an integration of heterogeneous clinical data into a central register. This enables site-spanning queries for the occurrence of specific clinical facts and thus supports clinical research. The framework consists of three sequential steps, starting from a formal data harmonization process, to the data transformation methods and finally the integration into a proper data warehouse. We implemented reusable software templates that are based on our best practices in several projects in integrating heterogeneous clinical data. Our methods potentially increase the efficiency and quality for future data integration projects by reducing the implementation effort as well as the project management effort by usage of our approaches as a guideline.

Integration of basic sciences and clinical sciences in oral radiology education for dental students.

Science.gov (United States)

Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

2013-06-01

Educational research suggests that cognitive processing in diagnostic radiology requires a solid foundation in the basic sciences and knowledge of the radiological changes associated with disease. Although it is generally assumed that dental students must acquire both sets of knowledge, little is known about the most effective way to teach them. Currently, the basic and clinical sciences are taught separately. This study was conducted to compare the diagnostic accuracy of students when taught basic sciences segregated or integrated with clinical features. Predoctoral dental students (n=51) were taught four confusable intrabony abnormalities using basic science descriptions integrated with the radiographic features or taught segregated from the radiographic features. The students were tested with diagnostic images, and memory tests were performed immediately after learning and one week later. On immediate and delayed testing, participants in the integrated basic science group outperformed those from the segregated group. A main effect of learning condition was found to be significant (pbasic sciences integrated with clinical features produces higher diagnostic accuracy in novices than teaching basic sciences segregated from clinical features.

Integrated environmental monitoring and information system

International Nuclear Information System (INIS)

Klinda, J.; Lieskovska, Z.

1998-01-01

The concept of the environmental monitoring within the territory of the Slovak Republic and the concept of the integrated environmental information system of the Slovak Republic were accepted and confirmed by the Government Order No. 449/1992. The state monitoring system covering the whole territory of Slovakia is the most important and consists of 13 Partial Monitoring Systems (PMSs). List of PMSs is included. The listed PMSs are managed according to the concept of the Sectoral Information System (SIS) of the Ministry of the Environment of the Slovak Republic (MESR) which was established by the National Council Act No. 261/1995 Coll. on the SIS. The SIS consists of 18 subsystems which are listed. The overviews of budget of PMSs as well as of environmental publications and periodicals of the MESR are included

Clinical trials integrity: a CRO perspective.

Science.gov (United States)

Beach, J E

2001-01-01

When contract research organizations (CROs) were first formed, pharmaceutical companies outsourced to them only certain aspects of the conduct of their clinical trials. At first CROs were highly specialized entities, providing, for example, either biostatistical advice, clinical research associates who monitored investigational sites for regulatory compliance, or regulatory support. Gradually, full service CROs emerged, offering a full range of services for clinical trials, including the selection of investigators and investigational sites, assistance with patient recruitment, safety surveillance and reporting, site audits, and data management and biostatistics. This evolving relationship between CROs and the pharmaceutical and medical device industries has resulted in CROs assuming more and more of the regulatory and ethical risks and responsibilities inherent in the conduct of clinical trials. In this full service role, CROs, unlike sponsors, are not interested in the outcome of study, but like sponsors, are subject to heavy regulation by the federal government, must follow applicable state laws, must respect international guidelines, and are obliged to follow their own operating procedures. Moreover, they are judged by the industry on the basis of the scope and quality of services provided, including the degree of adherence to the research protocol, regulatory requirements, and timelines; the quality of the professional working relationships with investigators and institutions, both academic and community-based; and the validity of the data. Further, CROs are subject to comprehensive audits by sponsoring companies, FDA, and other regulatory authorities. For all these reasons, CROs are being tasked with strict vigilance of all stages of the clinical trial process to ensure that the laws, regulations, and industry standards designed for the protection of human subjects and data integrity are maintained.

Information integration for a sky survey by data warehousing

Science.gov (United States)

Luo, A.; Zhang, Y.; Zhao, Y.

The virtualization service of data system for a sky survey LAMOST is very important for astronomers The service needs to integrate information from data collections catalogs and references and support simple federation of a set of distributed files and associated metadata Data warehousing has been in existence for several years and demonstrated superiority over traditional relational database management systems by providing novel indexing schemes that supported efficient on-line analytical processing OLAP of large databases Now relational database systems such as Oracle etc support the warehouse capability which including extensions to the SQL language to support OLAP operations and a number of metadata management tools have been created The information integration of LAMOST by applying data warehousing is to effectively provide data and knowledge on-line

Clinical governance in practice: closing the loop with integrated audit systems.

Science.gov (United States)

Taylor, L; Jones, S

2006-04-01

Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision

Simplification improves understanding of informed consent information in clinical trials regardless of health literacy level.

Science.gov (United States)

Kim, Eun Jin; Kim, Su Hyun

2015-06-01

This study evaluated the effect of a simplified informed consent form for clinical trials on the understanding and efficacy of informed consent information across health literacy levels. A total of 150 participants were randomly assigned to one of two groups and provided with either standard or simplified consent forms for a cancer clinical trial. The features of the simplified informed consent form included plain language, short sentences, diagrams, pictures, and bullet points. Levels of objective and subjective understanding were significantly higher in participants provided with simplified informed consent forms relative to those provided with standard informed consent forms. The interaction effects between type of consent form and health literacy level on objective and subjective understanding were nonsignificant. Simplified informed consent was effective in enhancing participant's subjective and objective understanding regardless of health literacy. © The Author(s) 2015.

An optimized workflow for the integration of biological information into radiotherapy planning: experiences with T1w DCE-MRI

International Nuclear Information System (INIS)

Neff, T; Kiessling, F; Brix, G; Baudendistel, K; Zechmann, C; Giesel, F L; Bendl, R

2005-01-01

Planning of radiotherapy is often difficult due to restrictions on morphological images. New imaging techniques enable the integration of biological information into treatment planning and help to improve the detection of vital and aggressive tumour areas. This might improve clinical outcome. However, nowadays morphological data sets are still the gold standard in the planning of radiotherapy. In this paper, we introduce an in-house software platform enabling us to combine images from different imaging modalities yielding biological and morphological information in a workflow driven approach. This is demonstrated for the combination of morphological CT, MRI, functional DCE-MRI and PET data. Data of patients with a tumour of the prostate and with a meningioma were examined with DCE-MRI by applying pharmacokinetic two-compartment models for post-processing. The results were compared with the clinical plans for radiation therapy. Generated parameter maps give additional information about tumour spread, which can be incorporated in the definition of safety margins

The integration of weighted gene association networks based on information entropy.

Science.gov (United States)

Yang, Fan; Wu, Duzhi; Lin, Limei; Yang, Jian; Yang, Tinghong; Zhao, Jing

2017-01-01

Constructing genome scale weighted gene association networks (WGAN) from multiple data sources is one of research hot spots in systems biology. In this paper, we employ information entropy to describe the uncertain degree of gene-gene links and propose a strategy for data integration of weighted networks. We use this method to integrate four existing human weighted gene association networks and construct a much larger WGAN, which includes richer biology information while still keeps high functional relevance between linked gene pairs. The new WGAN shows satisfactory performance in disease gene prediction, which suggests the reliability of our integration strategy. Compared with existing integration methods, our method takes the advantage of the inherent characteristics of the component networks and pays less attention to the biology background of the data. It can make full use of existing biological networks with low computational effort.

Integration of decentralized clinical data in a data warehouse: a service-oriented design and realization.

Science.gov (United States)

Hanss, Sabine; Schaaf, T; Wetzel, T; Hahn, C; Schrader, T; Tolxdorff, T

2009-01-01

In this paper we present a general concept and describe the difficulties for the integration of data from various clinical partners in one data warehouse using the Open European Nephrology Science Center (OpEN.SC) as an example. This includes a requirements analysis of the data integration process and also the design according to these requirements. This conceptual approach based on the Rational Unified Process (RUP) and paradigm of Service-Oriented Architecture (SOA). Because we have to enhance the confidence of our partners in the OpEN.SC system and with this the willingness of them to participate, important requirements are controllability, transparency and security for all partners. Reusable and fine-grained components were found to be necessary when working with diverse data sources. With SOA the requested reusability is implemented easily. A key step in the development of a data integration process within such a health information system like OpEN.SC is to analyze the requirements. And to show that this is not only a theoretical work, we present a design - developed with RUP and SOA - which fulfills these requirements.

Effects of integrated designs of alarm and process information on diagnosis performance in digital nuclear power plants.

Science.gov (United States)

Wu, Xiaojun; She, Manrong; Li, Zhizhong; Song, Fei; Sang, Wei

2017-12-01

In the main control rooms of nuclear power plants (NPPs), operators frequently switch between alarm displays and system-information displays to incorporate information from different screens. In this study, we investigated two integrated designs of alarm and process information - integrating alarm information into process displays (denoted as Alarm2Process integration) and integrating process information into alarm displays (denoted as Process2Alarm integration). To analyse the effects of the two integration approaches and time pressure on the diagnosis performance, a laboratory experiment was conducted with ninety-six students. The results show that compared with the non-integrated case, Process2Alarm integration yields better diagnosis performance in terms of diagnosis accuracy, time required to generate correct hypothesis and completion time. In contrast, the Alarm2Process integration leads to higher levels of workload, with no improvement in diagnosis performance. The diagnosis performance of Process2Alarm integration was consistently better than that of Alarm2Process integration, regardless of the levels of time pressure. Practitioner Summary: To facilitate operator's synthesis of NPP information when performing diagnosis tasks, we proposed to integrate process information into alarm displays. The laboratory validation shows that the integration approach significantly improves the diagnosis performance for both low and high time-pressure levels.

Health Management Information System in Private Clinics in Ilorin ...

African Journals Online (AJOL)

This descriptive survey was conducted among private clinics located in Ilorin, Kwara State, Nigeria to determine the awareness and level of involvement of private clinic operators towards the National Health Management Information System. A total of 37 functional clinics responded to the survey. Structured questionnaire ...

[Clinical study of integrative medicine in treatment of nephropathy: strategy and innovation].

Science.gov (United States)

Chen, Yi-Ping

2008-05-01

The author analyzed the main issues in current clinical study of integrative medicine in treatment of renal diseases, and proposed the target-oriented strategy for clinical study of different renal diseases, emphasizing the importance of method improvement for academic innovation.

Using remote sensing to inform integrated coastal zone management

CSIR Research Space (South Africa)

Roberts, W

2010-06-01

Full Text Available TO INFORM INTERGRATED COASTAL ZONE MANAGEMENT GISSA Western Cape Regional Meeting Wesley Roberts & Melanie Luck-Vogel 2 June 2010 CSIR NRE Ecosystems Earth Observation Group What is Integrated Coastal Zone Management? Integrated coastal management... D1D1 B a n d 1 Band 2 Quick theory of CVA Magnitude Direction ( ) ( )22 xaxbyaybM ?+?= Quadrant 1 (++) Accretion Quadrant 2 (-+) Quadrant 4 (+-) Quadrant 3 (--) Erosion CVA Results & Conclusions ? Change in image time series...

Integrated Modeling Approach for the Development of Climate-Informed, Actionable Information

Directory of Open Access Journals (Sweden)

David R. Judi

2018-06-01

Full Text Available Flooding is a prevalent natural disaster with both short and long-term social, economic, and infrastructure impacts. Changes in intensity and frequency of precipitation (including rain, snow, and rain-on-snow events create challenges for the planning and management of resilient infrastructure and communities. While there is general acknowledgment that new infrastructure design should account for future climate change, no clear methods or actionable information are available to community planners and designers to ensure resilient designs considering an uncertain climate future. This research demonstrates an approach for an integrated, multi-model, and multi-scale simulation to evaluate future flood impacts. This research used regional climate projections to drive high-resolution hydrology and flood models to evaluate social, economic, and infrastructure resilience for the Snohomish Watershed, WA, USA. Using the proposed integrated modeling approach, the peaks of precipitation and streamflows were found to shift from spring and summer to the earlier winter season. Moreover, clear non-stationarities in future flood risk were discovered under various climate scenarios. This research provides a clear approach for the incorporation of climate science in flood resilience analysis and to also provides actionable information relative to the frequency and intensity of future precipitation events.

Evaluating Information System Integration approaches for fixed asset management framework in Tanzania

Directory of Open Access Journals (Sweden)

Theophil Assey

2017-10-01

Full Text Available Information systems are developed based on different requirements and different technologies. Integration of these systems is of vital importance as they cannot work in isolation, they need to share and exchange data with other information systems. The Information Systems handle data of different types and formats’, finding a way to make them communicate is important as they need to exchange data during transactions, communication and different aspects which may require their interactions. In Tanzanian Local Government Authorities (LGAs, fixed asset data are not centralized, individual Local Government Authority stores their own data in isolation yet accountability is required through the provision of centralized storage for easy data access and easier data integration with other Information Systems in order to enhance fixed asset accountability. The study was carried out through reviewing of literature on the existing Information System integration approaches in order to identify and propose the best approach to be used in fixed asset management systems in LGA’s in Tanzania. The different approaches which are used for systems integration such as Service Oriented Architecture (SOA, Common Object Request Broker (CORBA, Common Object Model (COM and eXtensible Markup Language (XML were evaluated under the factors considered at the LGA. The XML was preferred over SOA, CORBA and COM because of some challenges in governance, data security, availability of expertise for support, maintenance, implementation cost, performance, compliance with government changing policies and service reliability. The proposed approach integrates data for all the Local Government Authorities at a centralized location and middleware transforms the centralized data into XML so it can easily be used by other Information Systems.

Understanding latent structures of clinical information logistics: A bottom-up approach for model building and validating the workflow composite score.

Science.gov (United States)

Esdar, Moritz; Hübner, Ursula; Liebe, Jan-David; Hüsers, Jens; Thye, Johannes

2017-01-01

Clinical information logistics is a construct that aims to describe and explain various phenomena of information provision to drive clinical processes. It can be measured by the workflow composite score, an aggregated indicator of the degree of IT support in clinical processes. This study primarily aimed to investigate the yet unknown empirical patterns constituting this construct. The second goal was to derive a data-driven weighting scheme for the constituents of the workflow composite score and to contrast this scheme with a literature based, top-down procedure. This approach should finally test the validity and robustness of the workflow composite score. Based on secondary data from 183 German hospitals, a tiered factor analytic approach (confirmatory and subsequent exploratory factor analysis) was pursued. A weighting scheme, which was based on factor loadings obtained in the analyses, was put into practice. We were able to identify five statistically significant factors of clinical information logistics that accounted for 63% of the overall variance. These factors were "flow of data and information", "mobility", "clinical decision support and patient safety", "electronic patient record" and "integration and distribution". The system of weights derived from the factor loadings resulted in values for the workflow composite score that differed only slightly from the score values that had been previously published based on a top-down approach. Our findings give insight into the internal composition of clinical information logistics both in terms of factors and weights. They also allowed us to propose a coherent model of clinical information logistics from a technical perspective that joins empirical findings with theoretical knowledge. Despite the new scheme of weights applied to the calculation of the workflow composite score, the score behaved robustly, which is yet another hint of its validity and therefore its usefulness. Copyright © 2016 Elsevier Ireland

Integrating Records Management (RM) and Information Technology (IT)

Energy Technology Data Exchange (ETDEWEB)

NUSBAUM,ANNA W.; CUSIMANO,LINDA J.

2000-03-02

Records Managers are continually exploring ways to integrate their services with those offered by Information Technology-related professions to capitalize on the advantages of providing customers a total solution to managing their records and information. In this day and age, where technology abounds, there often exists a fear on the part of records management that this integration will result in a loss of identity and the focus of one's own mission - a fear that records management may become subordinated to the fast-paced technology fields. They need to remember there is strength in numbers and it benefits RM, IT, and the customer when they can bring together the unique offerings each possess to reach synergy for the benefit of all the corporations. Records Managers, need to continually strive to move ''outside the records management box'', network, expand their knowledge, and influence the IT disciplines to incorporate the concept of ''management'' into their customer solutions.

Knowledge-Intensive Gathering and Integration of Statistical Information on European Fisheries

NARCIS (Netherlands)

Klinkert, M.; Treur, J.; Verwaart, T.; Loganantharaj, R.; Palm, G.; Ali, M.

2000-01-01

Gathering, maintenance, integration and presentation of statistics are major activities of the Dutch Agricultural Economics Research Institute LEI. In this paper we explore how knowledge and agent technology can be exploited to support the information gathering and integration process. In

45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Confidentiality of Healthcare Integrity and Protection Data Bank information. 61.14 Section 61.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON...

MelanomaDB: a Web Tool for Integrative Analysis of Melanoma Genomic Information to Identify Disease-Associated Molecular Pathways

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Alexander Joseph Trevarton

2013-07-01

Full Text Available Despite on-going research, metastatic melanoma survival rates remain low and treatment options are limited. Researchers can now access a rapidly growing amount of molecular and clinical information about melanoma. This information is becoming difficult to assemble and interpret due to its dispersed nature, yet as it grows it becomes increasingly valuable for understanding melanoma. Integration of this information into a comprehensive resource to aid rational experimental design and patient stratification is needed. As an initial step in this direction, we have assembled a web-accessible melanoma database, MelanomaDB, which incorporates clinical and molecular data from publically available sources, which will be regularly updated as new information becomes available. This database allows complex links to be drawn between many different aspects of melanoma biology: genetic changes (e.g. mutations in individual melanomas revealed by DNA sequencing, associations between gene expression and patient survival, data concerning drug targets, biomarkers, druggability and clinical trials, as well as our own statistical analysis of relationships between molecular pathways and clinical parameters that have been produced using these data sets. The database is freely available at http://genesetdb.auckland.ac.nz/melanomadb/about.html . A subset of the information in the database can also be accessed through a freely available web application in the Illumina genomic cloud computing platform BaseSpace at http://www.biomatters.com/apps/melanoma-profiler-for-research . This illustrates dysregulation of specific signalling pathways, both across 310 exome-sequenced melanomas and in individual tumours and identifies novel features about the distribution of somatic variants in melanoma. We suggest that this database can provide a context in which to interpret the tumour molecular profiles of individual melanoma patients relative to biological information and available

The Effects of Inquiry-Based Integrated Information Literacy Instruction: Four-Year Trends

Directory of Open Access Journals (Sweden)

Lin Ching Chen

2014-07-01

Full Text Available The purpose of this study was to examine the effects of four-year integrated information literacy instruction via a framework of inquiry-based learning on elementary students’ memory and comprehension. Moderating factors of students’ academic achievement was another focus of this study. The subjects were 72 students who have participated in this study since they entered an elementary school in Chiayi district. This elementary school adopted the integrated information literacy instruction, designed by the researchers and elementary school teachers, and integrated it into various subject matters via a framework of inquiry-based learning, such as Super 3 and Big6 models. A series of inquiry-based integrated information literacy instruction has been implemented since the second semester of the subjects’ first grade. A total of seven inquiry learning projects has been implemented from grade one through grade four. Fourteen instruments were used as pretests and posttests to assess students’ factual recall and conceptual understanding of subject contents in different projects. The results showed that inquiry-based integrated information literacy instruction couldhelp students memorize facts and comprehend concepts of subject contents. Regardless ofacademic achievements, if students would like to devote their efforts to inquiry processes, their memory and comprehension of subject contents improvedeffectively. However, students of low-academic achievement might need more time to be familiar with the inquiry-based learning strategy.

How Qualitative Research Informs Clinical and Policy Decision Making in Transplantation: A Review.

Science.gov (United States)

Tong, Allison; Morton, Rachael L; Webster, Angela C

2016-09-01

Patient-centered care is no longer just a buzzword. It is now widely touted as a cornerstone in delivering quality care across all fields of medicine. However, patient-centered strategies and interventions necessitate evidence about patients' decision-making processes, values, priorities, and needs. Qualitative research is particularly well suited to understanding the experience and perspective of patients, donors, clinicians, and policy makers on a wide range of transplantation-related topics including organ donation and allocation, adherence to prescribed therapy, pretransplant and posttransplant care, implementation of clinical guidelines, and doctor-patient communication. In transplantation, evidence derived from qualitative research has been integrated into strategies for shared decision-making, patient educational resources, process evaluations of trials, clinical guidelines, and policies. The aim of this article is to outline key concepts and methods used in qualitative research, guide the appraisal of qualitative studies, and assist clinicians to understand how qualitative research may inform their practice and policy.

Integrating information for better environmental decisions.

Energy Technology Data Exchange (ETDEWEB)

MacDonell, M.; Morgan, K.; Newland, L.; Environmental Assessment; Texas Christian Univ.

2002-01-01

As more is learned about the complex nature and extent of environmental impacts from progressive human disturbance, scientists, policy analysts, decision makers, educators, and communicators are increasingly joining forces to develop strategies for preserving and protecting the environment. The Eco-Informa Foundation is an educational scientific organization dedicated to promoting the collaborative development and sharing of scientific information. The Foundation participated in a recent international conference on environmental informatics through a special symposium on integrating information for better environmental decisions. Presentations focused on four general themes: (1) remote sensing and data interpretation, including through new knowledge management tools; (2) risk assessment and communication, including for radioactively contaminated facilities, introduced biological hazards, and food safety; (3) community involvement in cleanup projects; and (4) environmental education. The general context for related issues, methods and applications, and results and recommendations from those discussions are highlighted here.

Effect of clinical information in brain CT scan interpretation : a blinded double crossover study

International Nuclear Information System (INIS)

Zhianpour, M.; Janghorbani, M.

2004-01-01

Errors and variations in interpretation can happen in clinical imaging. Few studies have examined the biased effect of clinical information on reporting of brain CT scans. In a blinded double crossover design, we studied whether three radiologists were biased by clinical information when making CT scan diagnosis of the brain. Three consultant radiologists in three rounds with at least a one month interval assessed 100 consecutive cases of brain CT scan. In the first round, clinical information was not available and 100 films without clinical information were given to radiologists. In the second round, the same 100 films were given and true clinical information was available. In the third round, the same 100 films were given and false clinical information was allocated. In 180 cases (60%) the evaluation resulted in the same diagnosis on all three occasions (95% confidence interval (CI): 54.5, 65.5), whereas 120(40%; 95% CI:34.5, 45.5) sets were evaluated differently. 48 cases (16%; 95% CI:11.9,20.1) had discordant evaluation with true and 33 (11%; 95% CI:7.5, 14.5) with false clinical information. Discordance without and with true and false clinical information was 39 (13%; 95% CI:9.2, 16.8). Correct clinical information improves the brain CT report, while the report became less accurate false clinical information was allocated. These results indicate that radiologists are biased by clinical information when reporting brian CT scans

Integration of Information Literacy into the Curriculum: Constructive Alignment from Theory into Practice

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Claes Dahlqvist

2016-12-01

Full Text Available Librarian-teacher cooperation is essential for the integration of information literacy into course syllabi. Therefore, a common theoretical and methodological platform is needed. As librarians at Kristianstad University we have had the opportunity to develop such a platform when teaching information literacy in a basic course for teachers in higher education pedagogy. Information literacy is taught in context with academic writing, distance learning and teaching, and development of course syllabi. Constructive Alignment in Theory: We used constructive alignment in designing our part of the course. John Biggs’ ideas tell us that assessment tasks (ATs should be aligned to what is intended to be learned. Intended learning outcomes (ILOs specify teaching/learning activities (TLAs based on the content of learning. TLAs should be designed in ways that enable students to construct knowledge from their own experience. The ILOs for the course are to have arguments for the role of information literacy in higher education and ideas of implementing them in TLAs. The content of learning is for example the concept of information literacy, theoretical perspectives and constructive alignment for integration in course syllabi. TLAs are written pre-lecture reflections on the concept of information literacy, used as a starting point for the three-hour seminar. Learning reflections are written afterwards. The AT is to revise a syllabus (preferably using constructive alignment for a course the teacher is responsible for, where information literacy must be integrated with the other parts and topics of the course. Constructive Alignment in Practice: Using constructive alignment has taught us that this model serves well as the foundation of the theoretical and methodological platform for librarian-teacher cooperation when integrating information literacy in course syllabi. It contains all important aspects of the integration of information literacy in course

Social Information Is Integrated into Value and Confidence Judgments According to Its Reliability.

Science.gov (United States)

De Martino, Benedetto; Bobadilla-Suarez, Sebastian; Nouguchi, Takao; Sharot, Tali; Love, Bradley C

2017-06-21

How much we like something, whether it be a bottle of wine or a new film, is affected by the opinions of others. However, the social information that we receive can be contradictory and vary in its reliability. Here, we tested whether the brain incorporates these statistics when judging value and confidence. Participants provided value judgments about consumer goods in the presence of online reviews. We found that participants updated their initial value and confidence judgments in a Bayesian fashion, taking into account both the uncertainty of their initial beliefs and the reliability of the social information. Activity in dorsomedial prefrontal cortex tracked the degree of belief update. Analogous to how lower-level perceptual information is integrated, we found that the human brain integrates social information according to its reliability when judging value and confidence. SIGNIFICANCE STATEMENT The field of perceptual decision making has shown that the sensory system integrates different sources of information according to their respective reliability, as predicted by a Bayesian inference scheme. In this work, we hypothesized that a similar coding scheme is implemented by the human brain to process social signals and guide complex, value-based decisions. We provide experimental evidence that the human prefrontal cortex's activity is consistent with a Bayesian computation that integrates social information that differs in reliability and that this integration affects the neural representation of value and confidence. Copyright © 2017 De Martino et al.

Moral judgment as information processing: an integrative review.

Science.gov (United States)

Guglielmo, Steve

2015-01-01

How do humans make moral judgments about others' behavior? This article reviews dominant models of moral judgment, organizing them within an overarching framework of information processing. This framework poses two distinct questions: (1) What input information guides moral judgments? and (2) What psychological processes generate these judgments? Information Models address the first question, identifying critical information elements (including causality, intentionality, and mental states) that shape moral judgments. A subclass of Biased Information Models holds that perceptions of these information elements are themselves driven by prior moral judgments. Processing Models address the second question, and existing models have focused on the relative contribution of intuitive versus deliberative processes. This review organizes existing moral judgment models within this framework and critically evaluates them on empirical and theoretical grounds; it then outlines a general integrative model grounded in information processing, and concludes with conceptual and methodological suggestions for future research. The information-processing framework provides a useful theoretical lens through which to organize extant and future work in the rapidly growing field of moral judgment.

Moral judgment as information processing: an integrative review

Science.gov (United States)

Guglielmo, Steve

2015-01-01

How do humans make moral judgments about others’ behavior? This article reviews dominant models of moral judgment, organizing them within an overarching framework of information processing. This framework poses two distinct questions: (1) What input information guides moral judgments? and (2) What psychological processes generate these judgments? Information Models address the first question, identifying critical information elements (including causality, intentionality, and mental states) that shape moral judgments. A subclass of Biased Information Models holds that perceptions of these information elements are themselves driven by prior moral judgments. Processing Models address the second question, and existing models have focused on the relative contribution of intuitive versus deliberative processes. This review organizes existing moral judgment models within this framework and critically evaluates them on empirical and theoretical grounds; it then outlines a general integrative model grounded in information processing, and concludes with conceptual and methodological suggestions for future research. The information-processing framework provides a useful theoretical lens through which to organize extant and future work in the rapidly growing field of moral judgment. PMID:26579022

Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

Directory of Open Access Journals (Sweden)

Sen Ananda

2011-06-01

/day from pre- to post-intervention (t = (36 = 4.13, p Conclusions Providers successfully referred patients using the SUH provider interface, but were less willing to monitor patient compliance in the program. Patients who completed the program significantly increased their step counts. Future research is needed to test the effectiveness of integrating SUH with clinical information systems over a longer evaluation period.

Integration of technology-based outcome measures in clinical trials of Parkinson and other neurodegenerative diseases.

Science.gov (United States)

Artusi, Carlo Alberto; Mishra, Murli; Latimer, Patricia; Vizcarra, Joaquin A; Lopiano, Leonardo; Maetzler, Walter; Merola, Aristide; Espay, Alberto J

2018-01-01

We sought to review the landscape of past, present, and future use of technology-based outcome measures (TOMs) in clinical trials of neurodegenerative disorders. We systematically reviewed PubMed and ClinicalTrials.gov for published and ongoing clinical trials in neurodegenerative disorders employing TOMs. In addition, medical directors of selected pharmaceutical companies were surveyed on their companies' ongoing efforts and future plans to integrate TOMs in clinical trials as primary, secondary, or exploratory endpoints. We identified 164 published clinical trials indexed in PubMed that used TOMs as outcome measures in Parkinson disease (n = 132) or other neurodegenerative disorders (n = 32). The ClinicalTrials.gov search yielded 42 clinical trials using TOMs, representing 2.7% of ongoing trials. Sensor-based technology accounted for over 75% of TOMs applied. Gait and physical activity were the most common targeted domains. Within the next 5 years, 83% of surveyed pharmaceutical companies engaged in neurodegenerative disorders plan to deploy TOMs in clinical trials. Although promising, TOMs are underutilized in clinical trials of neurodegenerative disorders. Validating relevant endpoints, standardizing measures and procedures, establishing a single platform for integration of data and algorithms from different devices, and facilitating regulatory approvals should advance TOMs integration into clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Integrated Information Retrieval Support System for Campus Network

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

This paper presents a new integrated information retrieval support system (IIRSS) which can help Web search engines retrieve cross-lingual information from heterogeneous resources stored in multi-databases in Intranet. The IIRSS, with a three-layer architecture, can cooperate with other application servers running in Intranet. By using intelligent agents to collect information and to create indexes on-the-fly, using an access control strategy to confine a user to browsing those accessible documents for him/her through a single portal, and using a new cross-lingual translation tool to help the search engine retrieve documents, the new system provides controllable information access with different authorizations, personalized services, and real-time information retrieval.

Integrated Engineering Information Technology, FY93 accommplishments

Energy Technology Data Exchange (ETDEWEB)

Harris, R.N.; Miller, D.K.; Neugebauer, G.L.; Orona, J.R.; Partridge, R.A.; Herman, J.D.

1994-03-01

The Integrated Engineering Information Technology (IEIT) project is providing a comprehensive, easy-to-use computer network solution or communicating with coworkers both inside and outside Sandia National Laboratories. IEIT capabilities include computer networking, electronic mail, mechanical design, and data management. These network-based tools have one fundamental purpose: to help create a concurrent engineering environment that will enable Sandia organizations to excel in today`s increasingly competitive business environment.

International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines

DEFF Research Database (Denmark)

Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W

2017-01-01

Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decisio......-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning....... that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability......, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality...

Integrating research into clinical internship training bridging the science/practice gap in pediatric psychology.

Science.gov (United States)

McQuaid, Elizabeth L; Spirito, Anthony

2012-03-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a "capstone experience"; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the "business of science." Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists.

Integrating Research Into Clinical Internship Training Bridging the Science/Practice Gap in Pediatric Psychology

Science.gov (United States)

Spirito, Anthony

2012-01-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a “capstone experience”; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the “business of science.” Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists. PMID:22286345

Development of an Information Database for the Integrated Airline Management System (IAMS

Directory of Open Access Journals (Sweden)

Bogdane Ruta

2017-08-01

Full Text Available In present conditions the activity of any enterprise is represented as a combination of operational processes. Each of them corresponds to relevant airline management systems. Combining two or more management systems, it is possible to obtain an integrated management system. For the effective functioning of the integrated management system, an appropriate information system should be developed. This article proposes a model of such an information system.

ACCOUNTING INFORMATION INTEGRATION TROUGH AN ENTERPRISE PORTAL

Directory of Open Access Journals (Sweden)

Gianina RIZESCU

2014-06-01

Full Text Available If companies are lacking integrated enterprise software applications, or they simply do not use them on a large scale, accounting departments have to face lots of difficulties, concerning both the inflexibility in achieving good results and the limited possibility of communicating these results. Thus, most times, accounting departments are limited to generating predefined reports provided by a software application and the most they can do is export these reports into Microsoft Excel. Another cause which leads to late obtaining and publishing of accounting information is the lack of data from other departments and their corresponding software applications. That is why, in many enterprises, accounting data becomes irrelevant for the users. The main goal of this article is to show how accounting can benefit from an integrated software solution, namely an enterprise portal.

Behavior Selection of Mobile Robot Based on Integration of Multimodal Information

Science.gov (United States)

Chen, Bin; Kaneko, Masahide

Recently, biologically inspired robots have been developed to acquire the capacity for directing visual attention to salient stimulus generated from the audiovisual environment. On purpose to realize this behavior, a general method is to calculate saliency maps to represent how much the external information attracts the robot's visual attention, where the audiovisual information and robot's motion status should be involved. In this paper, we represent a visual attention model where three modalities, that is, audio information, visual information and robot's motor status are considered, while the previous researches have not considered all of them. Firstly, we introduce a 2-D density map, on which the value denotes how much the robot pays attention to each spatial location. Then we model the attention density using a Bayesian network where the robot's motion statuses are involved. Secondly, the information from both of audio and visual modalities is integrated with the attention density map in integrate-fire neurons. The robot can direct its attention to the locations where the integrate-fire neurons are fired. Finally, the visual attention model is applied to make the robot select the visual information from the environment, and react to the content selected. Experimental results show that it is possible for robots to acquire the visual information related to their behaviors by using the attention model considering motion statuses. The robot can select its behaviors to adapt to the dynamic environment as well as to switch to another task according to the recognition results of visual attention.

High-end clinical domain information systems for effective healthcare delivery.

Science.gov (United States)

Mangalampalli, Ashish; Rama, Chakravarthy; Muthiyalian, Raja; Jain, Ajeet K

2007-01-01

The Electronic Health Record (EHR) provides doctors with a quick, reliable, secure, real-time and user-friendly source of all relevant patient data. The latest information system technologies, such as Clinical Data Warehouses (CDW), Clinical Decision-Support (CDS) systems and data-mining techniques (Online Analytical Processing (OLAP) and Online Transactional Processing (OLTP)), are used to maintain and utilise patient data intelligently, based on the users' requirements. Moreover, clinical trial reports for new drug approvals are now being submitted electronically for faster and easier processing. Also, information systems are used in educating patients about the latest developments in medical science through the internet and specially configured kiosks in hospitals and clinics.

Perceived Educational Needs of the Integrated Care Psychiatric Consultant.

Science.gov (United States)

Ratzliff, Anna; Norfleet, Kathryn; Chan, Ya-Fen; Raney, Lori; Unützer, Jurgen

2015-08-01

With the increased implementation of models that integrate behavioral health with other medical care, there is a need for a workforce of integrated care providers, including psychiatrists, who are trained to deliver mental health care in new ways and meet the needs of a primary care population. However, little is known about the educational needs of psychiatrists in practice delivering integrated care to inform the development of integrated care training experiences. The educational needs of the integrated care team were assessed by surveying psychiatric consultants who work in integrated care. A convenience sample of 52 psychiatrists working in integrated care responded to the survey. The majority of the topics included in the survey were considered educational priorities (>50% of the psychiatrists rated them as essential) for the psychiatric consultant role. Psychiatrists' perspectives on educational priorities for behavioral health providers (BHPs) and primary care providers (PCPs) were also identified. Almost all psychiatrists reported that they provide educational support for PCPs and BHPs (for PCP 92%; for BHP 96%). The information provided in this report suggests likely educational needs of the integrated care psychiatric consultant and provides insight into the learning needs of other integrated care team members. Defining clear priorities related to the three roles of the integrated care psychiatric consultant (clinical consultant, clinical educator, and clinical team leader) will be helpful to inform residency training programs to prepare psychiatrists for work in this emerging field of psychiatry.

Health information exchanges--Unfulfilled promise as a data source for clinical research.

Science.gov (United States)

Parker, Carol; Weiner, Michael; Reeves, Mathew

2016-03-01

To determine the use of health information exchange organizations (HIEs) to support and conduct clinical research. This scoping review included US-based studies published between January 2003 and March 2014 that used data from an HIE to address at least one of three categories of research: clinical or epidemiological research, financial evaluation, or utilization of health services. Eligibility was not restricted to research on HIEs. Studies with research questions outside of the evaluation of HIEs themselves were sought. Eighteen articles met final study inclusion criteria from an initial list of 847 hits. Fifteen studies addressed a clinical or epidemiological research question, 6 addressed a financial consideration, and 8 addressed a utilization issue. Considerable overlap was found among the research categories: 13 articles addressed more than one category. Of the eighteen included studies, only two used HIE data to answer a research objective that was NOT specific to HIE use. Research designs were varied and ranged from observational studies, such as cohort and cross-sectional studies, to randomized trials. The 18 articles represent the involvement of a small number of HIEs; 7 of the studies were from a single HIE. This review demonstrates that HIE-provided information is available and used to answer clinical or epidemiological, financial, or utilization-based research questions; however, the majority of the studies using HIE data are done with the primary goal of evaluating the use and impact of HIEs on health care delivery and outcomes. As HIEs mature and become integrated parts of the health care industry, the authors anticipate that fewer studies will be published that describe or validate the role of HIEs, and more will use HIEs as multi-institutional data sources for conducting clinical research and improving health services and clinical outcomes. Articles identified in this review indicate the limited extent that HIE data are being used for clinical

Therapeutic self-disclosure in integrative psychotherapy: When is this a clinical error?

Science.gov (United States)

Ziv-Beiman, Sharon; Shahar, Golan

2016-09-01

Ascending to prominence in virtually all forms of psychotherapy, therapist self-disclosure (TSD) has recently been identified as a primarily integrative intervention (Ziv-Beiman, 2013). In the present article, we discuss various instances in which using TSD in integrative psychotherapy might constitute a clinical error. First, we briefly review extant theory and empirical research on TSD, followed by our preferred version of integrative psychotherapy (i.e., a version of Wachtel's Cyclical Psychodynamics [Wachtel, 1977, 1997, 2014]), which we title cognitive existential psychodynamics. Next, we provide and discuss three examples in which implementing TSD constitutes a clinical error. In essence, we submit that using TSD constitutes an error when patients, constrained by their representational structures (object relations), experience the subjectivity of the other as impinging, and thus propels them to "react" instead of "emerge." (PsycINFO Database Record (c) 2016 APA, all rights reserved).

IHE, Solution for integration of information systems and PACS

Directory of Open Access Journals (Sweden)

Milad Janghorban Lariche

2014-10-01

Full Text Available PACS is used as a way to store images and matches well with the workflow in the radiology department and can spread to other parts of hospital. Integration with other PACS and other hospital systems like radiology information system (RIS, hospital information system (HIS, and electronic patient records has been completely done, but there are still problems. PACS also provide good conditions for setting up Tele-radiology. The next step for PACS is where hospitals and health care organizations share photos in integrated electronic patient record. Among the different ways for sharing photos between different hospitals, IHE (integrating the health care enterprise standard indexes the cross-enterprise document sharing profile (XDS and allows sharing photos from various hospitals even if their PACS has different brands and different vendors. Application of XDS is useful for sharing images between health care organizations without duplicating them in a central archive. Images need to be indexed in a central registry. In the XDS profile, IHE defines an indexing mechanism for printing and indexing images in the central document registry. IHE also defines mechanisms to be used by each hospital to retrieve images, regardless of storing them in hospital PACS.

Impact of informal institutions on the development integration processes

Directory of Open Access Journals (Sweden)

Sidorova Alexandra, M.

2015-06-01

Full Text Available The paper deals with the impact of informal institutions on the definition of the vector integration processes and the development of integration processes in the countries of the Customs Union and Ukraine. The degree of scientific development of the phenomenon in different economic schools is determined in this article. Economic mentality is a basic informal institutions, which determines the degree of effectiveness of the integration processes. This paper examines the nature, characteristics and effects of economic mentality on the economic activities of people. Ethnometrichal method allows to quantify the economic mentality that enables deeper understanding and analysis of the formation and functioning of political and economic system, especially business and management, establishing contacts with other cultures. It was measured modern Belarusian economic mentality based on international methodology Hofstede and compared with the economic mentality of Russia, Ukraine and Kazakhstan. With the help of cluster analysis congruence economic mentality of the Customs Union and Ukraine was determined. Economic mentality of these countries was also compared with the economic mentality of other countries in order to identify the main types of economic culture.

Longitudinal Omics Modelling and Integration in Clinical Metabonomics Research: challenges in childhood metabolic health research

Directory of Open Access Journals (Sweden)

Peter eSperisen

2015-08-01

Full Text Available Systems biology is an important approach for deciphering the complex processes in health maintenance and the etiology of metabolic diseases. Such integrative methodologies will help better understand the molecular mechanisms involved in growth and development throughout childhood, and consequently will result in new insights about metabolic and nutritional requirements of infants, children and adults. To achieve this, a better understanding of the physiological processes at anthropometric, cellular and molecular level for any given individual is needed. In this respect, novel omics technologies in combination with sophisticated data modelling techniques are key. Due to the highly complex network of influential factors determining individual trajectories, it becomes imperative to develop proper tools and solutions that will comprehensively model biological information related to growth and maturation of our body functions. The aim of this review and perspective is to evaluate, succinctly, promising data analysis approaches to enable data integration for clinical research, with an emphasis on the longitudinal component. Approaches based on empirical and mechanistic modelling of omics data are essential to leverage findings from high dimensional omics datasets and enable biological interpretation and clinical translation. On the one hand, empirical methods, which provide quantitative descriptions of patterns in the data, are mostly used for exploring and mining datasets. On the other hand, mechanistic models are based on an understanding of the behavior of a system’s components and condense information about the known functions, allowing robust and reliable analyses to be performed by bioinformatics pipelines and similar tools. Herein, we will illustrate current examples, challenges and perspectives in the applications of empirical and mechanistic modelling in the context of childhood metabolic health research.

Integrating Web 2.0-Based Informal Learning with Workplace Training

Science.gov (United States)

Zhao, Fang; Kemp, Linzi J.

2012-01-01

Informal learning takes place in the workplace through connection and collaboration mediated by Web 2.0 applications. However, little research has yet been published that explores informal learning and how to integrate it with workplace training. We aim to address this research gap by developing a conceptual Web 2.0-based workplace learning and…

Optimization of the German integrated information and measurement system (IMIS)

International Nuclear Information System (INIS)

Wirth, E.; Weiss, W.

2002-01-01

The Chernobyl accident led to a widespread contamination of the environment in most European countries. In Germany, like in all other countries, it took some time to evaluate the radiological situation, time which is extremely valuable in the early phases of an accident when decisions on countermeasures like sheltering, iodine prophylaxis or evacuation have to be taken. For a better emergency preparedness the Integrated Information and Measurement System (IMIS) has been developed and established in Germany. In case of a widespread contamination of the environment, the system will provide the decision makers with all information necessary to evaluate the radiological situation and to decide on countermeasures. Presently this system is upgraded due to the adoption of the European decision supporting system RODOS and by the improvement of the national information exchange. For this purpose the web based information system ELAN has been developed. The national systems have to be integrated into the European and international communication systems. In this presentation the IMIS system is briefly described and the new features and modules of the system are discussed in greater detail

Clinical trials information in drug development and regulation : existing systems and standards

NARCIS (Netherlands)

Valkenhoef, Gert van; Tervonen, Tommi; Brock, Bert de; Hillege, Hans

2012-01-01

Clinical trials provide pivotal evidence on drug efficacy and safety. The evidence, information from clinical trials, is currently used by regulatory decision makers in marketing authorization decisions, but only in an implicit manner. For clinical trials information to be used in a transparent and

Integration of clinical chemistry, expression, and metabolite data leads to better toxicological class separation

DEFF Research Database (Denmark)

Spicker, Jeppe; Brunak, Søren; Frederiksen, K.S.

2008-01-01

A large number of databases are currently being implemented within toxicology aiming to integrate diverse biological data, such as clinical chemistry, expression, and other types of data. However, for these endeavors to be successful, tools for integration, visualization, and interpretation...... are needed. This paper presents a method for data integration using a hierarchical model based on either principal component analysis or partial least squares discriminant analysis of clinical chemistry, expression, and nuclear magnetic resonance data using a toxicological study as case. The study includes...... the three toxicants alpha-naphthyl-isothiocyanate, dimethylnitrosamine, and N-methylformamide administered to rats. Improved predictive ability of the different classes is seen, suggesting that this approach is a suitable method for data integration and visualization of biological data. Furthermore...

Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

Directory of Open Access Journals (Sweden)

Talitha Crowley

2014-01-01

Full Text Available Background: The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal.Aim: The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics.Methods: A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization’s guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities.Results: None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure.Conclusion: HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.

Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

Directory of Open Access Journals (Sweden)

Talitha Crowley

2014-08-01

Full Text Available Background: The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal. Aim: The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics. Methods: A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization’s guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities. Results: None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure. Conclusion: HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.

An Accurate Integral Method for Vibration Signal Based on Feature Information Extraction

Directory of Open Access Journals (Sweden)

Yong Zhu

2015-01-01

Full Text Available After summarizing the advantages and disadvantages of current integral methods, a novel vibration signal integral method based on feature information extraction was proposed. This method took full advantage of the self-adaptive filter characteristic and waveform correction feature of ensemble empirical mode decomposition in dealing with nonlinear and nonstationary signals. This research merged the superiorities of kurtosis, mean square error, energy, and singular value decomposition on signal feature extraction. The values of the four indexes aforementioned were combined into a feature vector. Then, the connotative characteristic components in vibration signal were accurately extracted by Euclidean distance search, and the desired integral signals were precisely reconstructed. With this method, the interference problem of invalid signal such as trend item and noise which plague traditional methods is commendably solved. The great cumulative error from the traditional time-domain integral is effectively overcome. Moreover, the large low-frequency error from the traditional frequency-domain integral is successfully avoided. Comparing with the traditional integral methods, this method is outstanding at removing noise and retaining useful feature information and shows higher accuracy and superiority.

Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

Science.gov (United States)

Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

2016-10-01

Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

Informal Leadership in the Clinical Setting: Occupational Therapist Perspectives

Directory of Open Access Journals (Sweden)

Clark Patrick Heard

2018-04-01

Full Text Available Background: Leadership is vital to clinical, organizational, and professional success. This has compelled a high volume of research primarily related to formal leadership concepts. However, as organizations flatten, eliminate departmental structures, or decentralize leadership structures the relevance of informal leaders has markedly enhanced. Methods: Using a qualitative phenomenological methodology consistent with interpretative phenomenological analysis, this study examines the impact of informal leadership in the clinical setting for occupational therapists. Data was collected through the completion of semi-structured interviews with 10 peer-identified informal occupational therapy leaders in Ontario, Canada. Collected data was transcribed verbatim and coded for themes by multiple coders. Several methods were employed to support trustworthiness. Results: The results identify that informal leaders are collaborative, accessible, and considered the “go to” staff. They demonstrate professional competence knowledge, experience, and accountability and are inspirational and creative. Practically, informal leaders organically shape the practice environment while building strength and capacity among their peers. Conclusion: Recommendations for supporting informal leaders include acknowledgement of the role and its centrality, enabling informal leaders time to undertake the role, and supporting consideration of informal leadership concepts at the curriculum and professional level.

Opto-electronic DNA chip-based integrated card for clinical diagnostics.

Science.gov (United States)

Marchand, Gilles; Broyer, Patrick; Lanet, Véronique; Delattre, Cyril; Foucault, Frédéric; Menou, Lionel; Calvas, Bernard; Roller, Denis; Ginot, Frédéric; Campagnolo, Raymond; Mallard, Frédéric

2008-02-01

Clinical diagnostics is one of the most promising applications for microfluidic lab-on-a-chip or lab-on-card systems. DNA chips, which provide multiparametric data, are privileged tools for genomic analysis. However, automation of molecular biology protocol and use of these DNA chips in fully integrated systems remains a great challenge. Simplicity of chip and/or card/instrument interfaces is amongst the most critical issues to be addressed. Indeed, current detection systems for DNA chip reading are often complex, expensive, bulky and even limited in terms of sensitivity or accuracy. Furthermore, for liquid handling in the lab-on-cards, many devices use complex and bulky systems, either to directly manipulate fluids, or to ensure pneumatic or mechanical control of integrated valves. All these drawbacks prevent or limit the use of DNA-chip-based integrated systems, for point-of-care testing or as a routine diagnostics tool. We present here a DNA-chip-based protocol integration on a plastic card for clinical diagnostics applications including: (1) an opto-electronic DNA-chip, (2) fluid handling using electrically activated embedded pyrotechnic microvalves with closing/opening functions. We demonstrate both fluidic and electric packaging of the optoelectronic DNA chip without major alteration of its electronical and biological functionalities, and fluid control using novel electrically activable pyrotechnic microvalves. Finally, we suggest a complete design of a card dedicated to automation of a complex biological protocol with a fully electrical fluid handling and DNA chip reading.

Entropy in Postmerger and Acquisition Integration from an Information Technology Perspective

Science.gov (United States)

Williams, Gloria S.

2012-01-01

Mergers and acquisitions have historically experienced failure rates from 50% to more than 80%. Successful integration of information technology (IT) systems can be the difference between postmerger success or failure. The purpose of this phenomenological study was to explore the entropy phenomenon during postmerger IT integration. To that end, a…

Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol.

Science.gov (United States)

Naidoo, Kogieleum; Gengiah, Santhanalakshmi; Yende-Zuma, Nonhlanhla; Padayatchi, Nesri; Barker, Pierre; Nunn, Andrew; Subrayen, Priashni; Abdool Karim, Salim S

2017-11-13

A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa. The study is designed as an open-label cluster randomized controlled trial. Sixteen clinic supervisors who oversee 40 primary health care (PHC) clinics in two rural districts of KwaZulu-Natal, South Africa will be randomized to either the control group (provision of standard government guidance for TB-HIV integration) or the intervention group (provision of standard government guidance with active enhancement of TB-HIV care integration through a quality improvement approach). The primary outcome is all-cause mortality among TB-HIV patients. Secondary outcomes include time to antiretroviral therapy (ART) initiation among TB-HIV co-infected patients, as well as TB and HIV treatment outcomes at 12 months. In addition, factors that may affect the intervention, such as conditions in the clinic and staff availability, will be closely monitored and documented. This study has the potential to address the gap between the establishment of TB-HIV care integration policies and guidelines and their implementation in the provision of integrated care in PHC clinics. If successful, an evidence-based intervention comprising change ideas, tools, and approaches for quality improvement could inform the future rapid scale up, implementation, and sustainability of improved TB-HIV integration across sub-Sahara Africa and other resource

TechIP: A Methodology for Emerging Information Technology Insertion & Integration

National Research Council Canada - National Science Library

Patel, Has

2004-01-01

...) processing and software agents. To implement these requirements, the system designers are required to insert, integrate and manage proven advances in Emerging Information Technology (EIT) in to the...

Waste Information Management System with Integrated Transportation Forecast Data

International Nuclear Information System (INIS)

Upadhyay, H.; Quintero, W.; Shoffner, P.; Lagos, L.

2009-01-01

The Waste Information Management System with Integrated Transportation Forecast Data was developed to support the Department of Energy (DOE) mandated accelerated cleanup program. The schedule compression required close coordination and a comprehensive review and prioritization of the barriers that impeded treatment and disposition of the waste streams at each site. Many issues related to site waste treatment and disposal were potential critical path issues under the accelerated schedules. In order to facilitate accelerated cleanup initiatives, waste managers at DOE field sites and at DOE Headquarters in Washington, D.C., needed timely waste forecast and transportation information regarding the volumes and types of waste that would be generated by the DOE sites over the next 40 years. Each local DOE site has historically collected, organized, and displayed site waste forecast information in separate and unique systems. However, waste and shipment information from all sites needed a common application to allow interested parties to understand and view the complete complex-wide picture. The Waste Information Management System with Integrated Transportation Forecast Data allows identification of total forecasted waste volumes, material classes, disposition sites, choke points, technological or regulatory barriers to treatment and disposal, along with forecasted waste transportation information by rail, truck and inter-modal shipments. The Applied Research Center (ARC) at Florida International University (FIU) in Miami, Florida, has deployed the web-based forecast and transportation system and is responsible for updating the waste forecast and transportation data on a regular basis to ensure the long-term viability and value of this system. (authors)

Revisioning Clinical Psychology: Integrating Cultural Psychology into Clinical Research and Practice with Portuguese Immigrants

Science.gov (United States)

James, Susan; Harris, Sara; Foster, Gary; Clarke, Juanne; Gadermann, Anne; Morrison, Marie; Bezanson, Birdie Jane

2013-01-01

This article outlines a model for conducting psychotherapy with people of diverse cultural backgrounds. The theoretical foundation for the model is based on clinical and cultural psychology. Cultural psychology integrates psychology and anthropology in order to provide a complex understanding of both culture and the individual within his or her cultural context. The model proposed in this article is also based on our clinical experience and mixed-method research with the Portuguese community. The model demonstrates its value with ethnic minority clients by situating the clients within the context of their multi-layered social reality. The individual, familial, socio-cultural, and religio-moral domains are explored in two research projects, revealing the interrelation of these levels/contexts. The article is structured according to these domains. Study 1 is a quantitative study that validates the Agonias Questionnaire in Ontario. The results of this study are used to illustrate the individual domain of our proposed model. Study 2 is an ethnography conducted in the Azorean Islands, and the results of this study are integrated to illustrate the other three levels of the model, namely family, socio-cultural, and the religio-moral levels. PMID:23720642

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

OpenAIRE

Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2010-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

Discovering disease associations by integrating electronic clinical data and medical literature.

Directory of Open Access Journals (Sweden)

Antony B Holmes

Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

Uncertainty analysis of an integrated energy system based on information theory

International Nuclear Information System (INIS)

Fu, Xueqian; Sun, Hongbin; Guo, Qinglai; Pan, Zhaoguang; Xiong, Wen; Wang, Li

2017-01-01

Currently, a custom-designed configuration of different renewable technologies named the integrated energy system (IES) has become popular due to its high efficiency, benefiting from complementary multi-energy technologies. This paper proposes an information entropy approach to quantify uncertainty in an integrated energy system based on a stochastic model that drives a power system model derived from an actual network on Barry Island. Due to the complexity of co-behaviours between generators, a copula-based approach is utilized to articulate the dependency structure of the generator outputs with regard to such factors as weather conditions. Correlation coefficients and mutual information, which are effective for assessing the dependence relationships, are applied to judge whether the stochastic IES model is correct. The calculated information values can be used to analyse the impacts of the coupling of power and heat on power flows and heat flows, and this approach will be helpful for improving the operation of IES. - Highlights: • The paper explores uncertainty of an integrated energy system. • The dependent weather model is verified from the perspective of correlativity. • The IES model considers the dependence between power and heat. • The information theory helps analyse the complexity of IES operation. • The application of the model is studied using an operational system on Barry Island.

76 FR 17145 - Agency Information Collection Activities: Business Transformation-Automated Integrated Operating...

Science.gov (United States)

2011-03-28

... Collection Activities: Business Transformation--Automated Integrated Operating Environment (IOE), New... through efforts like USCIS' Business Transformation initiative. The IOE will be implemented by USCIS and... information collection. (2) Title of the Form/Collection: Business Transformation-- Automated Integrated...

Patience, persistence and pragmatism: experiences and lessons learnt from the implementation of clinically integrated teaching and learning of evidence-based health care - a qualitative study.

Directory of Open Access Journals (Sweden)

Taryn Young

Full Text Available Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.Implementing clinically integrated EBHC curricula requires institutional

Preceptors' perspectives of an integrated clinical learning model in a mental health environment.

Science.gov (United States)

Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg

2018-02-14

Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting. © 2018 Australian College of Mental Health Nurses Inc.

An integration of Emergency Department Information and Ambulance Systems.

Science.gov (United States)

Al-Harbi, Nada; El-Masri, Samir; Saddik, Basema

2012-01-01

In this paper we propose an Emergency Department Information System that will be integrated with the ambulance system to improve the communication, enhance the quality of provided emergency services and facilitate information sharing. The proposed system utilizes new advanced technologies such as mobile web services that overcome the problems of interoperability between different systems, HL7 and GPS. The system is unique in that it allows ambulance officers to locate the nearest specialized hospital and allows access to the patient's electronic health record as well as providing the hospital with required information to prepare for the incoming patient.

Project Integration Architecture: A Practical Demonstration of Information Propagation

Science.gov (United States)

Jones, William Henry

2005-01-01

One of the goals of the Project Integration Architecture (PIA) effort is to provide the ability to propagate information between disparate applications. With this ability, applications may then be formed into an application graph constituting a super-application. Such a super-application would then provide all of the analysis appropriate to a given technical system. This paper reports on a small demonstration of this concept in which a Computer Aided Design (CAD) application was connected to an inlet analysis code and geometry information automatically propagated from one to the other. The majority of the work reported involved not the technology of information propagation, but rather the conversion of propagated information into a form usable by the receiving application.

Semantic integration of information about orthologs and diseases: the OGO system.

Science.gov (United States)

Miñarro-Gimenez, Jose Antonio; Egaña Aranguren, Mikel; Martínez Béjar, Rodrigo; Fernández-Breis, Jesualdo Tomás; Madrid, Marisa

2011-12-01

Semantic Web technologies like RDF and OWL are currently applied in life sciences to improve knowledge management by integrating disparate information. Many of the systems that perform such task, however, only offer a SPARQL query interface, which is difficult to use for life scientists. We present the OGO system, which consists of a knowledge base that integrates information of orthologous sequences and genetic diseases, providing an easy to use ontology-constrain driven query interface. Such interface allows the users to define SPARQL queries through a graphical process, therefore not requiring SPARQL expertise. Copyright © 2011 Elsevier Inc. All rights reserved.

Physician capability to electronically exchange clinical information, 2011.

Science.gov (United States)

Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

2013-10-01

To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

Amotivation in schizophrenia: integrated assessment with behavioral, clinical, and imaging measures.

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Wolf, Daniel H; Satterthwaite, Theodore D; Kantrowitz, Jacob J; Katchmar, Natalie; Vandekar, Lillie; Elliott, Mark A; Ruparel, Kosha

2014-11-01

Motivational deficits play a central role in disability caused by schizophrenia and constitute a major unmet therapeutic need. Negative symptoms have previously been linked to hypofunction in ventral striatum (VS), a core component of brain motivation circuitry. However, it remains unclear to what extent this relationship holds for specific negative symptoms such as amotivation, and this question has not been addressed with integrated behavioral, clinical, and imaging measures. Here, 41 individuals with schizophrenia and 37 controls performed a brief, computerized progressive ratio task (PRT) that quantifies effort exerted in pursuit of monetary reward. Clinical amotivation was assessed using the recently validated Clinical Assessment Interview for Negative Symptoms (CAINS). VS function was probed during functional magnetic resonance imaging using a monetary guessing paradigm. We found that individuals with schizophrenia had diminished motivation as measured by the PRT, which significantly and selectively related to clinical amotivation as measured by the CAINS. Critically, lower PRT motivation in schizophrenia was also dimensionally related to VS hypofunction. Our results demonstrate robust dimensional associations between behavioral amotivation, clinical amotivation, and VS hypofunction in schizophrenia. Integrating behavioral measures such as the PRT will facilitate translational efforts to identify biomarkers of amotivation and to assess response to novel therapeutic interventions. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

i3b3: Infobuttons for i2b2 as a Mechanism for Investigating the Information Needs of Clinical Researchers.

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Kennell, Timothy; Dempsey, Donald M; Cimino, James J

2016-01-01

The information needs of clinicians, as they interact with the EHR, are well-studied. Clinical researchers also interact with the EHR and, while they might be expected to have some similar needs, the unique needs that arise due to nature of their work remain largely unstudied. For clinicians, infobuttons (context-aware hyperlinks) provide a mechanism of studying these information needs. Here we describe the integration of infobuttons into i2b2, a popular data warehouse commonly used by clinical researchers, using a plugin. A preliminary survey of i2b2 developers suggests a general interest in infobuttons for i2b2 and indicates good likelihood for their deployment, where they may be used as a tool for further studying these needs in greater detail.

Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis.

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Sheehan, Barbara; Nigrovic, Lise E; Dayan, Peter S; Kuppermann, Nathan; Ballard, Dustin W; Alessandrini, Evaline; Bajaj, Lalit; Goldberg, Howard; Hoffman, Jeffrey; Offerman, Steven R; Mark, Dustin G; Swietlik, Marguerite; Tham, Eric; Tzimenatos, Leah; Vinson, David R; Jones, Grant S; Bakken, Suzanne

2013-10-01

Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. Copyright © 2013 Elsevier Inc. All rights reserved.

Integrating cancer genomic data into electronic health records

Directory of Open Access Journals (Sweden)

Jeremy L. Warner

2016-10-01

Full Text Available Abstract The rise of genomically targeted therapies and immunotherapy has revolutionized the practice of oncology in the last 10–15 years. At the same time, new technologies and the electronic health record (EHR in particular have permeated the oncology clinic. Initially designed as billing and clinical documentation systems, EHR systems have not anticipated the complexity and variety of genomic information that needs to be reviewed, interpreted, and acted upon on a daily basis. Improved integration of cancer genomic data with EHR systems will help guide clinician decision making, support secondary uses, and ultimately improve patient care within oncology clinics. Some of the key factors relating to the challenge of integrating cancer genomic data into EHRs include: the bioinformatics pipelines that translate raw genomic data into meaningful, actionable results; the role of human curation in the interpretation of variant calls; and the need for consistent standards with regard to genomic and clinical data. Several emerging paradigms for integration are discussed in this review, including: non-standardized efforts between individual institutions and genomic testing laboratories; “middleware” products that portray genomic information, albeit outside of the clinical workflow; and application programming interfaces that have the potential to work within clinical workflow. The critical need for clinical-genomic knowledge bases, which can be independent or integrated into the aforementioned solutions, is also discussed.

45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Requesting information from the Healthcare Integrity and Protection Data Bank. 61.12 Section 61.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION...

Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

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Yang, Jing; Huang, Si-min; Li, Ze-jian; Feng, Lie; Lu, Chun-ting

2018-01-01

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine. Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a…

Immediate integration of prosodic information from speech and visual information from pictures in the absence of focused attention: a mismatch negativity study.

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Li, X; Yang, Y; Ren, G

2009-06-16

Language is often perceived together with visual information. Recent experimental evidences indicated that, during spoken language comprehension, the brain can immediately integrate visual information with semantic or syntactic information from speech. Here we used the mismatch negativity to further investigate whether prosodic information from speech could be immediately integrated into a visual scene context or not, and especially the time course and automaticity of this integration process. Sixteen Chinese native speakers participated in the study. The materials included Chinese spoken sentences and picture pairs. In the audiovisual situation, relative to the concomitant pictures, the spoken sentence was appropriately accented in the standard stimuli, but inappropriately accented in the two kinds of deviant stimuli. In the purely auditory situation, the speech sentences were presented without pictures. It was found that the deviants evoked mismatch responses in both audiovisual and purely auditory situations; the mismatch negativity in the purely auditory situation peaked at the same time as, but was weaker than that evoked by the same deviant speech sounds in the audiovisual situation. This pattern of results suggested immediate integration of prosodic information from speech and visual information from pictures in the absence of focused attention.

Integrated Information Centers within Academic Environments: Introduction and Overview.

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Lunin, Luis F., Ed.; D'Elia, George, Ed.

1991-01-01

Introduces eight articles on the Integrated Information Center (IIC) Project, which investigated significant behavioral, technological, organizational, financial, and legal factors involved in the management of IICs. Four articles address design and management issues of general interest, and four focus on specific design considerations and a…

Phelan-McDermid syndrome data network: Integrating patient reported outcomes with clinical notes and curated genetic reports.

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Kothari, Cartik; Wack, Maxime; Hassen-Khodja, Claire; Finan, Sean; Savova, Guergana; O'Boyle, Megan; Bliss, Geraldine; Cornell, Andria; Horn, Elizabeth J; Davis, Rebecca; Jacobs, Jacquelyn; Kohane, Isaac; Avillach, Paul

2017-09-01

The heterogeneity of patient phenotype data are an impediment to the research into the origins and progression of neuropsychiatric disorders. This difficulty is compounded in the case of rare disorders such as Phelan-McDermid Syndrome (PMS) by the paucity of patient clinical data. PMS is a rare syndromic genetic cause of autism and intellectual deficiency. In this paper, we describe the Phelan-McDermid Syndrome Data Network (PMS_DN), a platform that facilitates research into phenotype-genotype correlation and progression of PMS by: a) integrating knowledge of patient phenotypes extracted from Patient Reported Outcomes (PRO) data and clinical notes-two heterogeneous, underutilized sources of knowledge about patient phenotypes-with curated genetic information from the same patient cohort and b) making this integrated knowledge, along with a suite of statistical tools, available free of charge to authorized investigators on a Web portal https://pmsdn.hms.harvard.edu. PMS_DN is a Patient Centric Outcomes Research Initiative (PCORI) where patients and their families are involved in all aspects of the management of patient data in driving research into PMS. To foster collaborative research, PMS_DN also makes patient aggregates from this knowledge available to authorized investigators using distributed research networks such as the PCORnet PopMedNet. PMS_DN is hosted on a scalable cloud based environment and complies with all patient data privacy regulations. As of October 31, 2016, PMS_DN integrates high-quality knowledge extracted from the clinical notes of 112 patients and curated genetic reports of 176 patients with preprocessed PRO data from 415 patients. © 2017 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.

DESIGN OF INFORMATION MANAGEMENT SYSTEM OF VERTICALLY INTEGRATED AGRICULTURAL HOLDINGS

Directory of Open Access Journals (Sweden)

Александр Витальевич ШМАТКО

2015-05-01

Full Text Available The paper deals with an approach to the design and development of information systems for the management and optimization of the organizational structure of vertically integrated agricultural holdings. A review of the problems of building and improving the organizational structure of vertically integrated agricultural holding is made. A method of constructing a discrete model management structure agricultural holding, which minimizes the costs associated with attracting applicants to work, is proposed.

Integrating information literacy in health sciences curricula: a case study from Québec.

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Clairoux, Natalie; Desbiens, Sylvie; Clar, Monique; Dupont, Patrice; St-Jean, Monique

2013-09-01

To portray an information literacy programme demonstrating a high level of integration in health sciences curricula and a teaching orientation aiming towards the development of lifelong learning skills. The setting is a French-speaking North American university. The offering includes standard workshops such as MEDLINE searching and specialised sessions such as pharmaceutical patents searching. A contribution to an international teaching collaboration in Haiti where workshops had to be thoroughly adapted to the clientele is also presented. Online guides addressing information literacy topics complement the programme. A small team of librarians and technicians taught 276 hours of library instruction (LI) during the 2011-2012 academic year. Methods used for evaluating information skills include scoring features of literature searches and user satisfaction surveys. Privileged contacts between librarians and faculty resulting from embedded LI as well as from active participation in library committees result in a growing reputation of library services across academic departments and bring forth collaboration opportunities. Sustainability and evolution of the LI programme is warranted by frequent communication with partners in the clinical field, active involvement in academic networks and health library associations, and reflective professional strategies. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Integrated care: an Information Model for Patient Safety and Vigilance Reporting Systems.

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Rodrigues, Jean-Marie; Schulz, Stefan; Souvignet, Julien

2015-01-01

Quality management information systems for safety as a whole or for specific vigilances share the same information types but are not interoperable. An international initiative tries to develop an integrated information model for patient safety and vigilance reporting to support a global approach of heath care quality.

Transparency and public accessibility of clinical trial information in Croatia: how it affects patient participation in clinical trials.

Science.gov (United States)

Šolić, Ivana; Stipčić, Ana; Pavličević, Ivančica; Marušić, Ana

2017-06-15

Despite increased visibility of clinical trials through international trial registries, patients often remain uninformed of their existence, especially if they do not have access to adequate information about clinical research, including the language of the information. The aim of this study was to describe the context for transparency of clinical trials in Croatia in relation to countries in Central and Eastern Europe, and to assess how informed Croatian patients are about clinical trials and their accessibility. We assessed the transparency of clinical trials from the data available in the public domain. We also conducted an anonymous survey on a convenience sample of 257 patients visiting two family medicine offices or an oncology department in south Croatia, and members of national patients' associations. Despite legal provisions for transparency of clinical trials in Croatia, they are still not sufficiently visible in the public domain. Among countries from Central and Eastern Europe, Croatia has the fewest number of registered trials in the EU Clinical Trials Registry. 66% of the patients in the survey were aware of the existence of clinical trials but only 15% were informed about possibilities of participating in a trial. Although 58% of the respondents were willing to try new treatments, only 6% actually participated in a clinical trial. Only 2% of the respondents were aware of publicly available trial registries. Our study demonstrates that there is low transparency of clinical trials in Croatia, and that Croatian patients are not fully aware of clinical trials and the possibilities of participating in them, despite reported availability of Internet resources and good communication with their physicians. There is a need for active policy measures to increase the awareness of and access to clinical trials to patients in Croatia, particularly in their own language.

Parent-Adolescent Cross-Informant Agreement in Clinically Referred Samples

DEFF Research Database (Denmark)

Rescorla, Leslie A; Ewing, Grace; Ivanova, Masha Y

2017-01-01

To conduct international comparisons of parent-adolescent cross-informant agreement in clinical samples, we analyzed ratings on the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) for 6,762 clinically referred adolescents ages 11-18 from 7 societies (M = 14.5 years, SD = 2.0 years; 51...

Integrated management of information inside maintenance processes. From the building registry to BIM systems

Directory of Open Access Journals (Sweden)

Cinzia Talamo

2014-10-01

Full Text Available The paper presents objec- tives, methods and results of two researches dealing with the improvement of integrated information management within maintenance processes. Focusing on information needs regarding the last phases of the building process, the two researches draft approaches characterizing a path of progressive improve- ment of strategies for integration: from a building registry, unique for the whole construction process, to an integrated management of the building process with the support of BIM systems.

Gulf of Mexico Integrated Science - Tampa Bay Study - Data Information Management System (DIMS)

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Johnston, James

2004-01-01

The Tampa Bay Integrated Science Study is an effort by the U.S. Geological Survey (USGS) that combines the expertise of federal, state and local partners to address some of the most pressing ecological problems of the Tampa Bay estuary. This project serves as a template for the application of integrated research projects in other estuaries in the Gulf of Mexico. Efficient information and data distribution for the Tampa Bay Study has required the development of a Data Information Management System (DIMS). This information system is being used as an outreach management tool, providing information to scientists, decision makers and the public on the coastal resources of the Gulf of Mexico.

Integration of genomic information with biological networks using Cytoscape.

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Bauer-Mehren, Anna

2013-01-01

Cytoscape is an open-source software for visualizing, analyzing, and modeling biological networks. This chapter explains how to use Cytoscape to analyze the functional effect of sequence variations in the context of biological networks such as protein-protein interaction networks and signaling pathways. The chapter is divided into five parts: (1) obtaining information about the functional effect of sequence variation in a Cytoscape readable format, (2) loading and displaying different types of biological networks in Cytoscape, (3) integrating the genomic information (SNPs and mutations) with the biological networks, and (4) analyzing the effect of the genomic perturbation onto the network structure using Cytoscape built-in functions. Finally, we briefly outline how the integrated data can help in building mathematical network models for analyzing the effect of the sequence variation onto the dynamics of the biological system. Each part is illustrated by step-by-step instructions on an example use case and visualized by many screenshots and figures.

Implementation of integrated heterogeneous electronic electrocardiography data into Maharaj Nakorn Chiang Mai Hospital Information System.

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Khumrin, Piyapong; Chumpoo, Pitupoom

2016-03-01

Electrocardiography is one of the most important non-invasive diagnostic tools for diagnosing coronary heart disease. The electrocardiography information system in Maharaj Nakorn Chiang Mai Hospital required a massive manual labor effort. In this article, we propose an approach toward the integration of heterogeneous electrocardiography data and the implementation of an integrated electrocardiography information system into the existing Hospital Information System. The system integrates different electrocardiography formats into a consistent electrocardiography rendering by using Java software. The interface acts as middleware to seamlessly integrate different electrocardiography formats. Instead of using a common electrocardiography protocol, we applied a central format based on Java classes for mapping different electrocardiography formats which contains a specific parser for each electrocardiography format to acquire the same information. Our observations showed that the new system improved the effectiveness of data management, work flow, and data quality; increased the availability of information; and finally improved quality of care. © The Author(s) 2014.

LORD: a phenotype-genotype semantically integrated biomedical data tool to support rare disease diagnosis coding in health information systems.

Science.gov (United States)

Choquet, Remy; Maaroufi, Meriem; Fonjallaz, Yannick; de Carrara, Albane; Vandenbussche, Pierre-Yves; Dhombres, Ferdinand; Landais, Paul

Characterizing a rare disease diagnosis for a given patient is often made through expert's networks. It is a complex task that could evolve over time depending on the natural history of the disease and the evolution of the scientific knowledge. Most rare diseases have genetic causes and recent improvements of sequencing techniques contribute to the discovery of many new diseases every year. Diagnosis coding in the rare disease field requires data from multiple knowledge bases to be aggregated in order to offer the clinician a global information space from possible diagnosis to clinical signs (phenotypes) and known genetic mutations (genotype). Nowadays, the major barrier to the coding activity is the lack of consolidation of such information scattered in different thesaurus such as Orphanet, OMIM or HPO. The Linking Open data for Rare Diseases (LORD) web portal we developed stands as the first attempt to fill this gap by offering an integrated view of 8,400 rare diseases linked to more than 14,500 signs and 3,270 genes. The application provides a browsing feature to navigate through the relationships between diseases, signs and genes, and some Application Programming Interfaces to help its integration in health information systems in routine.

Integrate offsites management with information systems