Healthcare Information Management Research Articles

Leading the Way on Healthcare Information Management

Leading the Way on Healthcare Information Management

Biomedical and health informatics in Peru: significance for public health

IntroductionThis issue of the feature column reports on developments in Peru on the use of information and communication technologies to improve public health. The authors describe how cell phones and hand‐held devices are being deployed to monitor diseases. Recent concerns about the spread of swine flu highlight the importance of robust public health systems in developing countries.1Jeannete MurphyReference1. British Journal of Healthcare Computing and Information Management, 30 April 2009. http://www.bjhcim.co.uk/news/2009/n904046.htm (accessed 18/05/09).

Chains of Trust and Duty in Health Information Management

In this paper I propose that the special duty of care present in the doctor-patient relationship is passed along the chain of professionals involved in modern healthcare. A chain of duty arises from knowledge of intended use and requires a system of trust between patient, doctor and non-clinical professionals. The first part of the paper introduces the concepts of duty of care and the requirement for trustworthiness in medical ethics, and extends these, via chains of duty and chains of trust, to non-clinical professions. The second part demonstrates the application of this in one field of information management in healthcare: decision support systems.

A computer literacy skills profile of pharmacists residing in two counties of England

Pharmacy is an information intensive profession and a pharmacist has to be proficient in health care information management. The advance in information technology and the use of computers to access, retrieve and analyse this information is increasingly important. Yet little is known about pharmacists' computer literacy or information technology skills. To gain a better understanding of pharmacists' basic computer skills and their ability to use standard software. Self-administered postal survey to 747 registered pharmacists residing in two counties of England. A total of 386 (52%) pharmacists responded after two mailings. Most responding pharmacists used computers at work and at home. They believed their basic computing skills to be high, although acknowledged that they were skill deficient in using certain software packages. Internet use at work was low (43%) as too was awareness and use of online medical databases; this was reflected in online medical database training being identified as of greatest need. Pharmacists were confident in operating computer systems but identified a training need for particular software applications. Of concern is the limited knowledge they possessed and access they had on medical databases.

Towards open information management in health care.

The utilization of information technology as tool in health care is increasing. The main benefits stem from the fact that information in electronic form can be transferred to different locations rapidly and from the possibility to automate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the limitations of the current technological approach and present a viewpoint, grounded on previous research and the authors’ own experiences, on how to progress. We present that a bottleneck in the automation of the management of constantly evolving clinical information is caused by the fact that the current technological approach requires the formal coding of information to be static in nature. This inherently hinders the expandability of the information case space to be managed. We present a new paradigm entitled open information management targeting unlimited case spaces. We also present a conceptual example from clinical medicine demonstrating open information management principles and mechanisms.

Engineering a Policy-Based System for Federated Healthcare Databases

Policy-based management for federated healthcare systems has recently gained increasing attention due to strict privacy and disclosure rules. Although the work on privacy languages and enforcement mechanisms, such as Hippocratic databases, has advanced our understanding of designing privacy-preserving policies for healthcare databases, the need to integrate these policies in a practical healthcare framework is becoming acute. Additionally, although most work in this area has been organization oriented, dealing with the exchange of information between healthcare organizations (such as referrals), the requirements for the emerging area of personal healthcare information management have so far not been adequately addressed. These shortcomings arise from the lack of a sophisticated policy specification language and enforcement architecture that can capture the requirement for 1) the integration of privacy and disclosure policies with well-known healthcare standards used in the industry in order to specify the precise requirements of a practical healthcare system and 2) the provision of ubiquitous healthcare services to patients using the same infrastructure that enables federated healthcare management for organizations. In this paper, we have designed a policy-based system to mitigate these concerns. First, we have designed our disclosure and privacy policies by using a requirements specification based on a set of use cases for the Clinical Document Architecture (CDA) standard proposed by the community. Second, we present a context-aware policy specification language, which allows encoding of CDA-based requirements use cases into privacy and disclosure policy rules. We have shown that our policy specification language is effective in terms of handling a variety of expressive constraints on CDA-encoded document contents. Our language enables specification of privacy-aware access control for federated healthcare information across organizational boundaries, whereas the use of contextual constraints allows the incorporation of user and environment context in the access control mechanism for personal healthcare information management. Moreover, the declarative syntax of the policy rules makes the policy adaptable to changes in privacy regulations or patient preferences. We also present an enforcement architecture for the federated healthcare framework proposed in this paper.

Australian Health Review call for papers

Technology in health care: are we delivering on the promise? Australian Health Review invites contributions for an upcoming issue on information management and information and communication technology in health care. Submission deadline: 15 May 2007 Despite a reputation for less spending on information and communication technologies (ICT), the health care sector has an imperative to ensure the ?right? information has been made available and accessible to the ?right? person at the ?right? time. While there is increasing evidence that the strategic application of ICT in innovative ways can improve the effectiveness of health care delivery, we don?t often discuss the substantial changes to the way health care organisations operate that are required for best practice information management. In an upcoming issue, Australian Health Review is looking to publish feature articles, research papers, case studies and commentaries related to information management and information and communication technologies in health care. We are particularly interested in papers that report on the successes, or failures, of initiatives in Australia and New Zealand that have brought together the research, the technology and the clinical, managerial and organisational expertise. Submissions related to international initiatives with lessons for Australia and New Zealand will also be welcomed. Submissions can be short commentaries of 1000 to 2000 words, or more comprehensive reviews of 2000 to 4000 words. Please consult the AHR Guidelines for Authors for information on formatting and submission. The deadline for submission is 15 May 2007.

Multiple Image Watermarking Applied to Health Information Management

Information technology advances have brought forth new challenges in healthcare information management, due to the vast amount of medical data that needs to be efficiently stored, retrieved, and distributed, and the increased security threats that explicitly have to be addressed. The paper discusses the perspectives of digital watermarking in a range of medical data management and distribution issues, and proposes a complementary and/or alternative tool that simultaneously addresses medical data protection, archiving, and retrieval, as well as source and data authentication. The scheme imperceptibly embeds in medical images multiple watermarks conveying patient's personal and examination data, keywords for information retrieval, the physician's digital signature for authentication, and a reference message for data integrity control. Experimental results indicate the efficiency and transparency of the scheme, which conforms to the strict requirements that apply to regions of diagnostic significance.

Enhancing entrepreneurship and professionalism in medical informatics instruction: a collaborative training model

This report describes an innovative training program designed to foster entrepreneurship and professionalism in students interested in the field of medical informatics. The course was developed through a private–public interinstitutional collaboration involving four academic institutions, one private firm specializing in health care information management systems, and a philanthropic organization. The program challenged students to serve in multiple roles on multidisciplinary teams and develop an innovative hand-held solution for drug information retrieval. Although the course was technically and behaviorally rigorous and required extensive hands-on experience in a nontraditional learning environment, both students and faculty responded positively.

An Informatics Blueprint for Healthcare Quality Information Systems

There is a critical gap in our nation's ability to accurately measure and manage the quality of medical care. A robust healthcare quality information system (HQIS) has the potential to address this deficiency through the capture, codification, and analysis of information about patient treatments and related outcomes. Because non-technical issues often present the greatest challenges, this paper provides an overview of these socio-technical issues in building a successful HQIS, including the human, organizational, and knowledge management (KM) perspectives. Through an extensive literature review and direct experience in building a practical HQIS (the National Comprehensive Cancer Network Outcomes Research Database system), we have formulated an "informatics blueprint" to guide the development of such systems. While the blueprint was developed to facilitate healthcare quality information collection, management, analysis, and reporting, the concepts and advice provided may be extensible to the development of other types of clinical research information systems.

Introducing Information Management: An Information Research Reader

PART A: GENERAL PAPERS 1. Information in organizations: directions for information management - Joyce Kirk 2. The development of the information management research area - Elena Maceviciute and T. D. Wilson 3. Business information culture: a qualitative study of the information culture in the Finnish insurance industry - Gunilla Widen-Wulff PART B: INFORMATION BEHAVIOUR 4. Determining organizational information needs: the critical success factors approach - Maija-Leena Huotari and T. D. Wilson 5. Critical success factors and information needs in industry: an Estonian study - Aiki Tibar 6. Experiencing information seeking and learning: research on patterns of variation - Louise Limberg PART C: ENVIRONMENTAL SCANNING AND DECISION MAKING 7. Environmental scanning as information seeking and organizational learning - Chun Wei Choo 8. Scanning the business environment: from perceived environmental change to strategic change - Zita Correia and T. D. Wilson 9. Managerial information seeking and use behaviour: a case study of Singapore - Shrianjani M. (Gina) de Alwis and Susan Higgins 10. The balanced scorecard, strategy, information and intellectual capital - Judith Broady-Preston PART D: KNOWLEDGE MANAGEMENT 11. Knowledge management and information management: review of empirical evidence = France Bouthillier and Kathleen Shearer 12. 'The nonsense of knowledge management' revisited - T. D. Wilson PART E: INFORMATION STRATEGY 13. Information systems strategy formation in higher education institutions: lateral trust - David Allen 14. Healthcare information management and technology strategy: the story so far - Hugh Preston 15. National information infrastructure and the realization of the Singapore IT2000 initiative - Cheryl Marie Cordeiro and Suliman Al-Hawamdeh.

Knowledge Management for the healthcare sector: lessons from a case study

The notion of incorporating knowledge management (KM) in the healthcare sector has recently witnessed a lot of interest, both from healthcare practitioners and scholars. KM for healthcare is a new issue for stakeholders, so there exists very limited research (particularly empirical) to provide guidance, either from an academic or an organisational perspective. This paper attempts to contribute to the adoption of KM in the clinical and healthcare sectors by collecting and analysing relevant data on technological, organisational and managerial perspectives on KM. This paper provides an analysis of a case study which examines current practices towards healthcare information management. The outcome of the study has been the creation of a detailed picture of the information mechanisms that currently are being used, and which will continue to be used in the future, to provide KM solutions for the healthcare sector.

Strategic information management in health care - myth or reality?

This paper uses data gathered from a case NHS Trust in Scotland to demonstrate progress in terms of operational and strategic information management and to highlight some of the problems currently experienced in the health-care environment in striving to comply with governmental policies relating to information sharing. Progress has certainly been made and there is recognition of the potential to be achieved from more efficient and effective information management in health care. Problems exist, however, and there is still a considerable gap to be filled between the policy objectives and what is actually achievable in reality on a day-to-day basis. Data have been gathered from a hospital and a health centre to illustrate information flow between two of the Trust entities and a benchmark has been provided, showing that best practice can be achieved and how it can be achieved.

HIPAA for psychiatrists.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established federal regulations governing the management of health care information.1 Although the first phase of HIPAA regul...

Healthcare information systems outsourcing

Information systems (IS) outsourcing is a major decision for health care organizations. Analysis of outsourcing costs and benefits have to be made for the departmental or function-specific application of each system. Limited empirical studies have examined healthcare information managers preferences for IS outsourcing. In this paper we report findings from a national survey of more than 16,000 healthcare information managers in the United States, assessing preferences for outsourcing information systems. This included measures of: (1) IS functions most likely to be outsourced, (2) level of satisfaction with performance of healthcare information management (HIM) tasks, (3) factors influencing IS outsourcing decisions, (4) how a healthcare organization's degree of computerized patient record adoption affects the preference for IS outsourcing, and (5) regional differences in outsourcing policies. Six factors were found to influence managers IS outsourcing decisions, including improved patient care, cost savings, regulations, competition, trained staff availability and space considerations. Implications of the findings for healthcare information management outsourcing are discussed.

Assessing graduate programs for healthcare information management/technology (HIM/T) executives

This paper describes a methodology to assess health/medical informatics graduate-level education curricula. The authors used the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS) as the basis for their assessment. The authors compared the 69 CPHIMS exam objectives against four health/medical informatics program course objectives as stated in the selected program’s online graduate catalog. Results showed that the two programs with management as a focus addressed the majority (67 and 59%) of the CPHIMS objectives within core and elective courses combined. Overall, the other two programs addressed closer to a third of the CPHIMS objectives (36 and 32%). This methodology could prove to be useful in assisting students interested in graduate-level training programs with a tool by which to measure the congruence of the curricula of different programs with the mission of the programs and with their own professional interests.

학교정보관리시스템의 개선： 건강관리의 내실화

초<TEX>$.$</TEX>중등학교에서는 교육인적자원부 주관 하에 개발한 ERP시스템인 전국단위 교육행정정보시스템(National Education Information System： NEIS)을 활용하고 있다. 본 논문에서는 NEIS를 교육행정업무뿐만 아니라, 국가인적자원을 평생 관리하는 정보시스템으로도 활용할 수 있음을 보였다. 그동안의 초 중등학교 정보관리시스템은 현장 적합도와 사용자 편이성이 미흡하였다. 이와 같은 문제점을 해결하기 위해서는 시스템의 재구축 또는 개정작업이 필요하다. 개정과 보완의 한 방법으로, 전 국민의 건강정보를 학교와 의원에서 공동으로 활용할 수 있는 구체적인 예를 제시해 보고자 하였다. 이를 위해 NEIS의 학생건강기록부와 의사가 기록하는 전자의무기록부의 건강정보를 통합하여 평생관리 할 수 있는 방안을 모색하였다. 구체적으로는, 학교와 의원에서 공통으로 관리하여야할 건강정보들을 XML로 작성해 보았다. 여기에 수요자의 요구에 적합한 뷰를 제공하기 위하여 각기 다른 XSL 스타일시트를 적용하였다. 이 뷰를 이용하여 건강정보를 효율적으로 관리하고 활용할 수 있음을 알았다. 이에 건강정보관리 비효율성과 유관기관간 연계성 미흡을 해결하고, 국가인적자원을 평생관리 할 수 있는 가능성을 확인하였다. The National Education Information System (NEIS), one of ERP systems developed by Ministry of Education & Human Resources Development, has been utilized in primary and secondary schools. In this paper, we considered the NEIS should be used not only for educational administration affairs, but also for a lifelong management of National Human Resource. The current School Information Management System (SIMS) is unsatisfactory due to the insufficiency of actual field suitability and user's conveniency. For solving such problems, the system rebuilding or revision should be accompanied by. As a guideline of revision and supplement of the SIMS, we suggest an application useful in both schools and clinics by the integrating healthcare management information of people. For this, we propose a lifelong healthcare information management by integrating Student Health Records of the NEIS with Electronic Medical Records of doctors' offices. The healthcare information is designed and represented in XML. We applied different XSL style-sheets to XML documents in order to offer a view suitable for demands of schools and clinics. The healthcare information can be managed and utilized efficiently by using the view. We ascertained that the lifelong Healthcare Information Management System is an improvement to overcome the inefficiency of healthcare information management and the connection inadequacy between schools and medical institutions, and is desirable for a lifelong management of the National Human Resource.

One step forward, one step back? Restructuring, evolving policy, and information management and technology in the New Zealand health sector

Abstract In 2001, the New Zealand government launched an ambitious health care information management and technology strategy that seeks to integrate the health sector, facilitate electronic health records and information portability and give patients greater information access. This article looks at the prospects for the strategy, against a background of extensive public health system restructuring in the 1990s. It notes that through this period, health purchasers and providers developed information systems in isolation from one another and with minimal central oversight. The result is a highly complex and firmly established architecture and an array of problems that need rectifying. Combined with present decentralised health structures, government capacity to influence activities is limited. The article concludes by reviewing current developments noting that advancement on the government's goals is likely to be incremental, across a range of areas, sometimes driven by providers and sometimes by central agencies.

Healthcare information management: the integration of patients’ data

In a dynamic and uncertain business environment, with increasingly intense competition and vibrant globalisation, there is a growing demand by healthcare businesses for both internal and external information, to analyse patients’ information quickly and efficiently, which has led healthcare organisations to embrace customer relationship management (CRM) systems. Data quality and data integration issues facilitate the achievement of CRM business objectives. Data quality is the state of completeness, validity, consistency, timeliness and accuracy that makes data appropriate for CRM business exploitation. A good integration strategy begins with a thorough data assessment study, and relies upon the quality of these data. A framework is proposed for evaluating the quality and integration of patient data for CRM applications in the health care sector. Even though this framework is in an early stage of development, it intends to present existing solutions for evaluating the above issues.

IT in healthcare: progress report

The paper considers how increasing computerization and recent regulatory changes are putting new pressures on healthcare information management. Healthcare providers must interact with many insurers, each with a different set of procedures for filing claims and making payments. To simplify the process and reduce the overhead associated with filing insurance claims, HIPAA provides a standard set of electronic transaction formats as well as regulations to ensure the privacy and security of healthcare-related transactions.