Sophisticated hospital information system/radiology information system/picture archiving and communications system (PACS) integration in a large-scale traumatology PACS.
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Picture archiving and communications system (PACS) in the context of an outpatient trauma care center asks for a high level of interaction between information systems to guarantee rapid image acquisition and distribution to the surgeon. During installation of the Innsbruck PACS, special aspects of traumatology had to be realized, such as imaging of unconscious patients without identification, and transferred to the electronic environment. Even with up-to-date PACS hardware and software, special solutions had to be developed in-house to tailor the PACS/hospital information system (HIS)/radiology information system (RIS) interface to the needs of radiologic and clinical users. An ongoing workflow evaluation is needed to realize the needs of radiologists and clinicians. These needs have to be realized within a commercially available PACS, whereby full integration of information systems may sometimes only be achieved by special in-house solutions. (+info)
AKA unknown male Foxtrot 23/4: alias assignment for unidentified emergency room patients.
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OBJECTIVES: To introduce a unique system of alias assignment for patients whose identity is initially unknown at time of admission to the emergency unit; to prevent confusion and cases of mistaken identity. METHODS: At the triage area the "unknown" patient is given a "forename" using the phonetic alphabet according to the stage of the current name cycle. The sex of the patient is included as well as the unknown status and a "surname" is added as the numerical date. Thus an unknown male patient admitted on the 24th of April at the start of a new name cycle would be known as "unknown male Alpha 24/4". RESULTS: Ten thousand alias assignments have been issued to patients since the introduction of the system in 1985. CONCLUSION: This system is a simple yet effective, tried and tested method for the unique identification of unknown patients, which allows easy communication and retrieval of data for inquiries. (+info)
MediSign: using a web-based SignOut System to improve provider identification.
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Continuity of care necessitates communication between the primary providers of inpatient and outpatient care. Communication requires identification of providers in addition to clinical information. We have constructed a web-based SignOut System to improve provider identification. The web-based SignOut System correctly identified the provider for 100% (34/34) of patients in 1997 and 93% (37/40) of patients in 1998. The hospital bed census correctly identified the attending provider for 50% (17/34) of patients in 1997 and 73% (29/40) in 1998. When analyzed by attending type (i.e., service and private,) the SignOut System correctly identified 86% of service providers in contrast to the hospital bed census that correctly identified 57% of service providers. Both the SignOut System (100%) and the hospital bed census (95%) had superior results in identifying private attendings. The web-based technology provides a familiar user interface and ubiquitous workstation access. (+info)
Merging multiple institutions: information architecture problems and solutions.
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Amalgamating organizations face great challenges when trying to merge their formerly separate information systems. An architectural approach is essential in order to understand the business process and data implications of the new organization's business decisions and application choices. HL7 is useful as a common messaging standard, but does not help to reconcile conflicting local identifier coding systems. The Information Services department has an important role in catalyzing decisions about inconsistent business processes and conflicting universal coding systems within an enterprise framework. (+info)
Financing reforms for the Thai health card scheme.
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The Thai health card scheme originated from a pilot study on community financing and primary health care in maternal and child health in 1983. The scheme later changed to one of voluntary health insurance and finally received a matching subsidy from the government. The coverage of the scheme is described by a U-curve, i.e. it started with 5% of the total population in 1987, declined to 3% in 1992, with an upturn to 14% in 1997. The upturn has been the result of concerns about universal coverage policy, together with reforms of fund management. The provincial fund is responsible for basic health, basic medical, referral, and accident and emergency services. The central fund takes 2.5% of the total fund to manage cross-boundary services and high cost care (a reinsurance policy). On average, the utilization rate of the voluntary health card was higher than that of the compulsory (social security) scheme. And amongst three variants of health cards, the voluntary health card holders used health services twice to three times more than the community and health volunteer card holders. Cost recovery was low, especially in the provinces with low coverage. In the province with highest coverage, cost recovery was as high as 90% of the non-labour recurrent cost. Only 10% of the budgeted fund for reinsurance was disbursed, implying considerable management inefficiency. The management information system as well as the management capacity of the Health Insurance Office should be strengthened. After comparing the health card with other insurance schemes in terms of coverage, cost recovery, utilization and management cost, it is recommended that this voluntary health insurance should be modified to be a compulsory insurance, with some other means of premium collection and minimal co-payment at the point of delivery. (+info)
Federation of the Person Identification Service between enterprises.
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The Person Identification Service (PIDS) is a standard that has been adopted by the Object Management Group for managing identities of persons within a particular domain. That standard includes an interface that supports the ability to connect multiple PIDS servers together in a federated manner. The specification leaves great flexibility as to how to accomplish the federation. In this paper, we examine some of the federated approaches being considered by the Government Computer-based Patient Record Framework (G-CPR) project and discuss their advantages and disadvantages and the details of a specific, scalable approach to federation. (+info)
Standards for privacy of individually identifiable health information. Office of the Assistant Secretary for Planning and Evaluation, DHHS. Final rule.
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This rule includes standards to protect the privacy of individually identifiable health information. The rules below, which apply to health plans, health care clearinghouses, and certain health care providers, present standards with respect to the rights of individuals who are the subjects of this information, procedures for the exercise of those rights, and the authorized and required uses and disclosures of this information. The use of these standards will improve the efficiency and effectiveness of public and private health programs and health care services by providing enhanced protections for individually identifiable health information. These protections will begin to address growing public concerns that advances in electronic technology and evolution in the health care industry are resulting, or may result in, a substantial erosion of the privacy surrounding individually identifiable health information maintained by health care providers, health plans and their administrative contractors. This rule implements the privacy requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996. (+info)
Quality improvement report: Effect of a formal education programme on safety of transfusions.
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PROBLEM: Failure of correct identification and insufficient monitoring of patients receiving transfusions continue to be appreciable and avoidable causes of morbidity and mortality. DESIGN: A study by a regional transfusion service and a transfusion nurse specialist of the effects of an education programme based on the current national guidelines on identification and monitoring of patients receiving transfusions. SETTING: A large United Kingdom teaching hospital which houses the headquarters of the regional transfusion service. KEY MEASURES FOR IMPROVEMENT: Improvement in compliance with published national guidelines on the prescription and administration of blood transfusions. STRATEGY FOR CHANGE: An audit of current compliance followed by dissemination by a transfusion nurse specialist of a clinical skills package (based on the best practice for transfusion) to all staff involved in giving transfusions. This was supported by trained instructors and the display of standard operating procedures for transfusion in all clinical areas. EFFECT OF CHANGE: An improvement in compliance with the national guidelines to over 95% in six out of seven of the recommendations on best practice was seen 18 months after the initial intervention. LESSONS LEARNT: The study shows that education of those who prescribe and administer transfusions, as recommended by bodies concerned with the hazards of transfusion, can improve the safety of transfusions. (+info)