Development Of Hospital Information Systems Research Articles

Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran

BackgroundHealthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study.MethodsIn this quantitative study, we externally evaluated the incidence rate and accuracy of the routine surveillance system in one of the main hospitals by an active follow-up of patients from September to December 2021. We used in-depth interviews with 18 experts to identify the barriers of the routine surveillance system.ResultsAmong 404 hospitalized patients, 88 HAIs were detected. The estimated rate of HAIs was 17.1 (95% Confidence Intervals 95: 14.1, 21.1) per 1000 patient-days follow-up. However, in the same period, 116 HAIs were reported by the routine surveillance system, but the agreement between the two approaches was low (sensitivity = 61.4%, specificity = 82.6%, negative predictive value = 89.7%, and positive predictive validity = 46.5%). The minimum and maximum positive predictive values were observed in urinary tract infection (32.3%) and surgical site infection (60.9%). The main barrier of reporting HAIs was lack of cooperation in reporting HAIs by infection control link nurses and laboratory supervisors.ConclusionsThe discrepancy between the longitudinal study findings and the routine surveillance might be related to the inaccessibility of the surveillance system to clinical information of patients. In this regard, decreasing the barriers, increasing the knowledge of infection control nurses and other nurses, as well as the development of hospital information systems are necessary.

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective

Background: The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff’s perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff’s perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering. Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre- and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff’s opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS. [GMJ.2021;10:e1830]

Oscillogram processing algorithm when monitoring cardiac patients’ conditions

The development of hospital information system requires the improvement of diagnostic and monitoring tools. The tools should provide extensive diagnostics and automatic data processing. In that respect volumetric compression oscillometry is considered a promising technique. However, at present diagnostic findings need to be adjusted by qualified healthcare professionals. The article deals with a process model when measuring arterial blood pressure, compares experimental findings and presents a blood pressure measurement algorithm. The devices designed on the algorithm will allow to conduct an advanced monitoring of patients’ conditions without healthcare professionals directly involved. Implementing algorithm-based devices into hospital system will allow to respond to change in patients’ conditions urgently.

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective.

Background: The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff’s perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff’s perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering.Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre- and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff’s opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS.

Analisis SIMRS Dengan Metode PIECES Di RSU Dr. H. Koesnadi Bondowoso

Hospital Information System (HIS) is an important component to improve hospital service quality. HIS at General Hospital Dr. H. Koesnadi Bondowoso has been running for about 5 years since 2015. HIS implementation is not optimal because there are still various problems in its implementation. The problem such as errors in printing reports so users must create reports manually. This research was aimed to analyze the application of hospital information systems using the PIECES method. This type of research is qualitative. It showed that the information Hospital Information System (HIS) performance results based on aspects of performance Hospital Information System (HIS) performance goes according to user needs, information aspects of information generated accurately, aspects of economics have produced economic value, running control aspects related to control and system security, efficiency aspects have provided efficiencies in its application, service aspect has made it easy for system users. Based on aspects of Performance, Information, Economic, Control, Efficiency, and Service Hospital Information System (HIS) performance has been running according to user needs, but it is not free from various problems, so there needs a efforts to improvement and development of Hospital Information System (HIS) through the recommendation of researchers so that Hospital Information System (HIS) can maintain quality and improve service quality to patients.

Online Survey for supportingand developing IT Master Plan: The case of HVA Toelongredjo Hospital

The IT master plan is a long-term plan in an organization in terms of developing Information Technology to support the organization’s vision and mission. The IT master plan is important for hospitals because it will provide direction on how hospital information systems are built. However, because the main business of a hospital is not IT, it is often the development of hospital information systems without a master plan that the application of information systems that are made does not fit the hospital’s needs. The purpose of this research is to design an online survey system that is used to support the preparation of the IT master plan, especially in hospitals so that it will be easy to get an evaluation of the conditions of implementing IT in hospitals. The online survey system was built using the Unified Software Development Process (USDP) approach. By using this method, it turns out that it is easy to model the system, so that the system analysis and design process can be made quickly. This research was conducted in the HVA Toeloengredjo hospital. The survey application that was built has been used to get a response to the IT conditions at HVA Hospital. On the results of online survey processing analyzed using a Likert scale. It was found that 42 respondents of HVA Hospital stated that 84.30% of IT master plan conditions were ideal supported by good IT conditions of 73.40%, resulting in a level of IT implementation in HVA Hospital is very good.

Automatic consultation system for patients with cardiac implantable electronic devices undergoing magnetic resonance imaging

BackgroundSafety evaluation for patients with cardiac implantable electronic devices (CIEDs) undergoing magnetic resonance imaging (MRI) scanning is often overlooked. We developed an automatic consultation system (ACS) to improve the screening rate in these patients.MethodsACS was developed by the Hospital Information System Development Department of Seoul National University Bundang Hospital. It was designed to automatically request pre-MRI cardiac evaluation in patients with CIED when MRI orders are issued. The proportion of the patients without pre-MRI cardiologic evaluation was evaluated before and after the ACS application.ResultsFrom January 2016 to June 2018, a total of 157 patients with CIEDs [pacemaker 136 (86.6%), ICD or CRT-D 21 (13.4%), MR-conditional 117 (74.5%)] visited the MRI facility. Before the ACS application, 23 out of 84 patients (27.4%) did not have adequate pre-MRI cardiologic evaluation. Despite urgent request for pre-MRI cardiac evaluation, MRI examination was postponed or cancelled in 14 (60.8%) cases. After the ACS application, all 73 patients underwent proper cardiologic evaluation before their MRI examinations (P < 0.001). The proportion of immediate request for pre-MRI evaluation at the moment of MRI order also improved with the ACS application (before ACS 57.1%, after ACS 100%, P < 0.001).ConclusionsThe newly developed ACS helped the patients with CIED receive MRI scan safely on the schedule, improving the quality of care in this population.

Using neural attention networks to detect adverse medical events from electronic health records.

The detection of Adverse Medical Events (AMEs) plays an important role in disease management in ensuring efficient treatment delivery and quality improvement of health services. Recently, with the rapid development of hospital information systems, a large volume of Electronic Health Records (EHRs) have been produced, in which AMEs are regularly documented in a free-text manner. In this study, we are concerned with the problem of AME detection by utilizing a large volume of unstructured EHR data. To address this challenge, we propose a neural attention network-based model to incorporate the contextual information of words into AME detection. Specifically, we develop a context-aware attention mechanism to locate salient words with respect to the target AMEs in patient medical records. And then we combine the proposed context attention mechanism with the deep learning tactic to boost the performance of AME detection. We validate our proposed model on a real clinical dataset that consists of 8845 medical records of patients with cardiovascular diseases. The experimental results show that our proposed model advances state-of-the-art models and achieves competitive performance in terms of AME detection.

A data-driven framework of typical treatment process extraction and evaluation

BackgroundA clinical pathway (CP) defines a standardized care process for a well-defined patient group that aims to improve patient outcomes and promote patient safety. However, the construction of a new pathway from scratch is a time-consuming task for medical staff because it involves many factors, including objects, multidisciplinary collaboration, sequential design, and outcome measurements. Recently, the rapid development of hospital information systems has allowed the storage of large volumes of electronic medical records (EMRs), and this information constitutes an abundant data resource for building CPs using data-mining methods. MethodsWe provide an automatic method for extracting typical treatment processes from EMRs that consists of four key steps. First, a novel similarity method is proposed to measure the similarity of two treatment records. Then, we perform an affinity propagation (AP) clustering algorithm to cluster doctor order set sequences (DOSSs). Next, a framework is proposed to extract a high-level description of each treatment cluster. Finally, we evaluate the extracted typical treatment processes by matching the treatment cluster with external information, such as the treatment efficacy, length of stay, and treatment cost. ResultsBy experiments on EMRs of 8287 cerebral infarction patients, it is concluded that our proposed method can effectively extract typical treatment processes from treatment records, and also has great potential to improve treatment outcome by personalizing the treatment process for patients with different conditions. ConclusionThe extracted typical treatment processes are intuitive and can provide managerial guidance for CP redesign and optimization. In addition, our work can assist clinicians in clearly understanding their routine treatment processes and recommend optimal treatment pathways for patients.

The Security and Privacy Protection of Hospital Information System

The privacy security and defence measures of hospital information system are analyzed, according to the status quo of the development of hospital information system. By investigation of literature, privacy protection system and informationization are introduced and summarized. The suggestions of personal privacy protection are put forward to strengthen hospital information, including strengthening the legislation of privacy protection and cross-border cooperation of multi-organization.

Application of big data analysis with decision tree for the foot disorder

In medical field, massive data sets is generated by rapid development of hospital information system. For analysis of these medical big data, this study showed analysis process of the clinical data to acquire significant information effectively between the foot disorder groups and biomechanical parameters related to symptom by developing a prediction model of the decision tree. The first clinical health records of 1523 patients diagnosed with foot disorder were used for analysis, in total 6610 records. The dependent variable in the analysis data was consisted of five complex disorder groups, and the independent variable was composed of 24 attributes. The decision tree was applied to analyze pattern of the foot disorder. The measured prediction rate was Correct: 72.96 % and Wrong: 27.04 % in the training data, and Correct: 68.66 % and Wrong: 31.34 % in the test data. As a result of analysis on the five foot complex foot disorder groups by using C5.0 algorithm, 12 rules were generated. To improve accuracy of classification, the detailed preprocessing and other data mining algorithms will be applied from now on.

Effects of Security Policies, Security Awareness of Hospital Employee to Patients' Personal Information Protection

With the development of hospital information systems and digitalization of patient records, the importance of protecting patient information is steadily increasing. In order to develop policies for patient information protection, this study conducted empirical analysis on the effects of security policies, security awareness and employees’ individual characteristics on security effectiveness in local public hospitals. The results indicated that security policies have a significant effect on security awareness and individual characteristics, but have no effect on security effectiveness. Therefore, it is important to establish security policies that can positively affect security effectiveness. This study also suggests additional multilateral research on administrative security factors.

On mining latent treatment patterns from electronic medical records

Clinical pathway (CP) analysis plays an important role in health-care management in ensuring specialized, standardized, normalized and sophisticated therapy procedures for individual patients. Recently, with the rapid development of hospital information systems, a large volume of electronic medical records (EMRs) has been produced, which provides a comprehensive source for CP analysis. In this paper, we are concerned with the problem of utilizing the heterogeneous EMRs to assist CP analysis and improvement. More specifically, we develop a probabilistic topic model to link patient features and treatment behaviors together to mine treatment patterns hidden in EMRs. Discovered treatment patterns, as actionable knowledge representing the best practice for most patients in most time of their treatment processes, form the backbone of CPs, and can be exploited to help physicians better understand their specialty and learn from previous experiences for CP analysis and improvement. Experimental results on a real collection of 985 EMRs collected from a Chinese hospital show that the proposed approach can effectively identify meaningful treatment patterns from EMRs.

Development of hospital information systems: user participation and factors affecting it.

Introduction:Given the large volume of data generated in hospitals, in order to efficiently management them; using hospital information system (HIS) is critical. User participation is one of the major factors in the success of HIS that in turn leads Information needs and processes to be correctly predicted and also their commitment to the development of HIS to be augmented. The purpose of this study is to investigate the participation rate of users in different stages of HIS development as well as to identify the factors affecting it.Method and materials:This is a descriptive–cross sectional study which was inducted in 2014. The study population consists of 140 HIS users (from different types of job including physicians, nurses, laboratory, radiology and HIM staffs) from Teaching Hospitals Affiliated to Urmia University of Medical Sciences. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics (t-test and chi-square).Results:The highest participation rate of users in the four-stage development of the HIS was related to the implementation phase (2.88) and the lowest participation rate was related to analysis (1.23). The test results showed that the rate of user participation was not satisfactory in none of the stages of development (P< 0.05). The most important factors in increasing user participation include established teamwork from end-users and the support of top managers from HIS development.Conclusion:According to the results obtained from the study, it seems that health care administrators must have a detailed plan for user participation prior to the development and purchase of HIS so that they identify the real needs as well as increase their commitment and motivations to develop, maintain and upgrade the system, and in this way, the success of the system will be assured.

Design and implementation of a hospital information system for the Palestine Red Crescent Society in Lebanon

A case-mix hospital information system was designed and implemented in Palestine Red Crescent Society hospitals in order to support the network of Palestinian hospitals in Lebanon and to improve the health of refugees in the country. The system is based on routine collection of essential administrative and clinical data for each episode of hospitalization, relying on internationally accepted diagnostic codes. It is a computerized, user-friendly information system that is a stepping-stone towards better hospital management and evaluation of quality of care. It is also a useful model for the development of hospital information systems in Lebanon and in the Near East.

Public sector information system project failures: Lessons from a New Zealand hospital organization

Information system (IS) project failures are so common as to be almost expected by planners. There is an expanding literature on IS project failures including both theory and case studies. This literature, however, is largely derived from private sector IS failures, despite the fact that the likelihood of failure appears higher in the public sector. This article seeks to fill the public sector case study void. It details the failure and abandonment of a large New Zealand public hospital IS development. The case corroborates findings from the private sector literature, namely that ill-planned and managed, large and multifaceted projects are more likely to fail and that contextual issues are highly influential. It also shows how much more complex project commissioning and development is in situations of public governance where political and organizational elements come to the fore. Finally, the article offers lessons for public sector IS planners.

Managing hospital databases: can large hospitals really protect patient data?

Between 1998 and 2003 a number of European countries, the UK, Canada, Australia and the US all introduced data privacy legislation that sought to comply with the European Data Privacy Directive of 1995 in protecting the privacy of individuals undergoing treatment in large hospitals. In 2004 we find that hospital administrators within these jurisdictions are still struggling to find ways to implement and maintain hospital databases while complying with the given legislation - where compliance seems to require a whole new approach to database management. This research examines the UK Data Protection Act 1998 and considers whether current database management systems allow the EU Directives contained in the Act to be followed in practice. It finds a number of recurrent problems with hospital systems that would make compliance with the Act difficult. These findings have significant implications for hospital information systems development and design.

The Implications of Data Privacy Legislation for the Development of Hospital Information Systems.

This research provides an analysis of the implementation of medical data privacy law in Australia, with emphasis on the Victorian Health Records Act 2001 (HRA). We examine the ability of health organisations to respond to the requirements of this legislation, and similar health privacy legislation elsewhere, and illustrate that this ability is affected by the quality of their patient data and the structure and security of their databases. This article suggests that compliance with the legislative provisions creates implications for information systems development and design, which large public and private hospitals have so far failed to consider or act upon.

Getting from A to C: lifecycle lessons for e-health deployment

The 35-year history of continuous development of hospital information systems and the current efforts to develop an electronic health record in outpatient settings suggest a lifecycle that must take place before electronic technology is adopted in the highly decentralised US healthcare system. This six-stage lifecycle, called the ABCs of change, involves Acceptance of the need for change, Alignment of the actors to fulfil that need, Breadboard development of the desired, integrated system, a Blueprint for the system to be commercialised, Configuration methods for adapting the system to individual provider and patient needs, and Capital sources for the desired change. This article shows how that six-stage model is relevant to understanding prior development attempts and how current efforts to bring electronic health records to small, primary-care practices follow it. We conclude that it is a useful model for insight and for future planning.

The impact of HIPAA on the development of Electronic Medical Record Systems. Sponsored by SIG CR, DL, HCI

AbstractHIPAA, the Health Insurance Portability and Accountability Act of 1996 states that all healthcare providers must ensure the protection of patient privacy with HIPAA compliance required by April 14, 2003. The other key provision of HIPAA is portability of information and patient access. Compliance with this act may prove a major challenge due to the lack of standardization in existing systems across the industry. This panel will review the impact of the HIPAA compliance on the development of Hospital Information Systems and the ongoing challenges associated with the development of Electronic Medical Records Systems. The topics will include: Guidelines for EMR System Selection Process with HIPAA in mind General Issues Interpretation and Integration of HIPAA Rules Integrated Policies and Procedures Staffing Issues Employee Training Solutions for implementing a HIPAA compliant EMR A case study of the implementation of a EMR system using VIANETA technology will be presented.