Use Of Hospital Information Systems Research Articles

A Framework for Data Warehouse Using Data Mining and Knowledge Discovery for a Network of Hospitals in Pakistan

Now-a-days, in Pakistan especially in strategic, military and private sector hospitals, there is an increasing use of hospital information systems. It has been seemed that a localize approach for developing HMIS is prevailing i.e. conventional use of relational database system, which are isolated from others hospitals or remote data collection centers. In this, paper a framework is proposed for establishment of data warehouse to centralize data from remote hospitals and collection centers. Data mining and knowledge discovery modal is also discussed.

Level of Knowledge regarding the Use of Hospital Information Systems among Healthcare Personnel in Hospital Practices

Introduction: The objective of this paper is to compare the level of knowledge of hospital information systems and the extent of utilization of this knowledge by staff employed in the gynecological department of a public healthcare hospital and those in a private gynecological hospital. Materials and Methods: Data was collected from the software packages being used in two healthcare institutions. These packages are easy to use and capable of processing large volumes of information. A prospective study design was applied using an anonymous questionnaire, and the study period extended from 05/01/2013 to 01/06/2013. Results: Based on the study results, it was concluded that despite implementation of specific hospital information systems in both institutions, there were flaws in the daily work. In the PHI Clinical hospital there was no access to computers in a majority of the workplaces and use of the internet in the daily work of the healthcare personnel was almost absent. Moreover, communication between departments, exchange of certain data between the healthcare staff, connectivity between institutions and data usage were all seen to be functioning inefficiently. There was better access to information and network connectivity among the departments at Plodnost, Bitola, which is a PHI. Hospital specializing in gynecology and obstetrics and is also an in vitro fertilization (IVF) center for assisted human reproduction. This could be due to the younger age structure of the healthcare personnel and because they are generally exposed to wider opportunities for education and the nurses. Conclusion: The healthcare system and information technology are closely related, and in future, proper functioning of the medical staff will not be possible without continuous use of healthcare information systems.

Factors influencing nurses' acceptance of hospital information systems in Iran: application of the Unified Theory of Acceptance and Use of Technology.

User acceptance is a precondition for successful implementation of hospital information systems (HISs). Increasing investment in information technology by healthcare organisations internationally has made user acceptance an important issue in technology implementation and management. Despite the increased focus on hospital information systems, there continues to be user resistance. The present study aimed to investigate the factors affecting hospital information systems nurse-user acceptance of HISs, based on the Unified Theory of Acceptance and Use of Technology (UTAUT), in the Shiraz University of Medical Sciences teaching hospitals. A descriptive-analytical research design was employed to study nurses' adoption and use of HISs. Data collection was undertaken using a cross-sectional survey of nurses (n=303). The research model was examined using the LISREL path confirmatory modeling. The results demonstrated that the nurses' behavioural intention (BI) to use hospital information systems was predicted by Performance Expectancy (PE) (β= 2.34, p<0.01), Effort Expectancy (EE) (β= 2.21, p<0.01), Social Influence (SI) (β= 2.63, p<0.01) and Facilitating Conditions (FC) (β= 2.84, p<0.01). The effects of these antecedents of BI explained 72.8% of the variance in nurses' intention to use hospital information systems (R2 = 0.728). Application of the research model suggested that nurses' acceptance of HISs was influenced by performance expectancy, effort expectancy, social influence and facilitating conditions, with performance expectancy having the strongest effect on user intention.

An investigation on physicians’ acceptance of hospital information systems: A case study

PurposeInformation technology is used to support a wide range of highly specified healthcare tasks and services. There is, therefore, a need to understand the factors affecting the acceptance of this technology by healthcare professionals. Physicians are key providers of healthcare services and are among the principal users of hospital information systems. Their acceptance of hospital information systems is hence of great significance when evaluating the success of those systems. MethodThe survey methodology was employed to targeted physicians in the selected case hospital for investigating factors affecting physicians’ acceptance of hospital information systems. A total of 202 questionnaires were sent out, with 124 completed copies returned, indicating a valid response rate of 61.4%. We used structural equation modeling to analyze the data. ResultsThe results indicated that top management support (γ=0.431, p<0.001) had a significant impact on perceived usefulness. Project team competency (γ=0.381, p<0.001) and system quality (γ=0.369, p<0.001) had a significant impact on physicians’ perceived ease of use of hospital information systems. Physicians’ perceptions of the usefulness (β=0.132, p<0.05, R2=0.296) and ease of use (β=0.952, p<0.001, R2=0.784) of hospital information systems had a significant impact on the acceptance of the systems, accounting for 81.4% of total explained variance. ConclusionsThrough the understanding of the identified critical factors affecting physicians’ HIS acceptance, the planners and managers should ensure that hospital information systems to be introduced into a hospital are useful and ease to use. Effort should be focuses on providing sufficient top management support, selecting qualified project team members, and delivering higher system quality in addressing physicians’ clinical needs. Thus, our research results can help planners and managers understand key considerations affecting HIS development and use, and may be used as a reference for system design, development and implementation.

Clinicopathologic Profile of Breast Cancer Patients in Pakistan: Ten Years Data of a Local Cancer Hospital

Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of 47±12 years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.

Nurses’ perceptions and attitudes towards computerisation in a private hospital

To explore nurses' attitudes and level of satisfaction in using the Hospital Information System in clinical practice. Application of the Hospital Information System is increasing and there is substantial evidence suggesting that the successful implementation of Hospital Information System is significantly related to nurses' attitudes. However, little information is currently available on the factors influencing those attitudes and their level of satisfaction in Hospital Information System use. Cross-sectional survey. A stratified, random sampling of 342 nurses working in a Hong Kong private hospital and using Hospital Information System was recruited. A questionnaire was used to collect data on perceptions, level of satisfaction and attitudes towards Hospital Information System usage. Correlations and linear regressions were used to analyse the data. Multiple linear regression analysis showed that work units, perceived usefulness and information technology support are the three predictors of nurses' attitudes and level of satisfaction with the system. In addition, nurses who have higher perceived ease of use and better satisfaction towards using the system are associated with positive attitude. The study results serve to guide the nurse managers to develop information systems based on the nurses' needs. Previous studies regarded nurses' level of satisfaction as a part of nurses' attitude. What is of interest in this study is that nurses' satisfaction level can be viewed as an individual factor affecting nurses' attitudes. With a user-friendly system, nurses tend to be more satisfied and therefore potentially more engaged in its use. This may indirectly improve patient care by saving time on documentation and enhancing communication among departments. The nurse managers should promote an institutional culture to motivate staff towards positive acceptance of innovation. An effective collaboration with the information technology team would enhance a more efficient exchange of information to understand the complex factors of IT implementation.

Sistemas de informação hospitalar no âmbito do SUS: revisão integrativa de pesquisas

The use of hospital information systems is an important management tool. This integrative review aimed to identify and analyze the scientific production about hospital information systems, between 1988 and August, 2009. Data were collected in electronic databases (LILACS, MEDLINE and BDENF), registered on specific form and the study population consisted of 31 articles. Articles were grouped in three categories, organized by similarity of content: epidemiological/demographic profile of hospitalizations (51.6%); analysis of information quality (25.9%) and organizational aspects of hospital services (22.6%). Results evidence the potential use of databases covering Brazilian literature, with administrative or epidemiological approach, as important source of information on the occurrence of hospitalizations and other health-related events. These databases have the advantage of covering all regions of the country, and the disadvantage of the low quality of information, due to the impossibility of leveling the local differences of human and material resources that handle them. There is only one publication in nursing periodical, evidencing the low adherence of nurses to the research of the theme, which is very pertinent, since it permits following the tendencies/perspectives of hospitalizations, giving support to the organization of human, material and physical space resources needed for hospital care. Descriptors: Hospital Information Systems; Single Health System; Hospitalization; Organization and Administration; Nursing.

Confidence in the use of information management and technology (IM&T) in radiography: Is age a barrier?

Introduction Age has been reported as a barrier to the use of Information Management and Technology (IM&T). Radiographers' confidence and ability in IM&T may be related to age and it is the aim of this research to investigate this relationship. Method An online survey method gathered views from the radiographic population, between 31st August 2008 and 10th October 2008. The questionnaire encompassed IM&T ability, work based IM&T usage, personal IM&T usage, security & governance issues, education & training experience, the future and demographic details. For the purpose of this paper the first three sections and demographic section were considered. Results Radiographers showed a good level of ability and confidence in the use of IM&T. Some general applications such as word processing showed a decreased confidence with age. Confidence in all radiography specific applications was scored highly although confidence in the use of Hospital Information Systems (HIS) and radiotherapy Treatment Planning Systems (TPS) showed the least confidence. Statistical analysis did not reveal a strong link between age and confidence in all applications. Discussion While a link between age and confidence was not found in this study, frequency of use and training in IM&T require further investigation in relation to specific roles.

5 Jahre e-Medikationsprozess: vom ersten Test zum spitalweiten Data Warehouse

Summary Computerized physician order entry, and mostly drug order entry, is considered as a major component in the daily use of hospital information systems. Such a system is in use at the Hospital of Thun since 2002. In parallel, an electronic drug distribution system has been introduced subsequently in all wards. The combination of both systems, tightly integrated in the daily workflow, with a stepwise implementation and the highest possible interoperability, reached high acceptance. The architecture based on standardized systems and processes allowed getting not only a robust basis for clinical work, but also systematic exploitation of data. Where only opinions and quotations about prescription habits were known, facts are now available in a structured data warehouse that can help answer both clinical and economical questions.

Development of decision support systems

Use of hospital information systems (HIS) are no longer limited to administrative functions. The addition to these systems of decision support capability is now a necessity. Development of the decision support modules requires a different software architecture than that employed by most HIS systems today. This paper describes the generic uses of decision support throughout the many hospital applications. Several levels of decision support are outlined with examples to illustrate the many areas where decision support is useful. At LDS Hospital in Salt Lake City, Utah we have developed an HIS using a new software architecture which supports the creation of decision support applications. This system uses a frame structure to represent knowledge. Examples of the frames and their syntax is presented. Using the frame tools which are provided, an application developer can easily develop and test decision support modules which interact directly with the clinical user and the patient database.

Use of a Hospital Database to Determine the Characteristics of Diagnostic Tests

Test indices are often determined by comparing test results of healthy persons with test results of patients known to have the disease. However, the patient population for which the test is ordered in clinical practice often differs from the study population on which the test indices are based. Hence, these indices are not applicable to clinical practice and should be recalculated using data from daily clinical practice. Two major problems of using routinely collected data are discussed: the assessment of the final health status and tracing the reason for ordering the test. Prior considerations are given to the use of hospital information systems (HIS) to sample the patient population that is desired and to collect the necessary data for calculating test indices. We investigated whether the HIS of Leiden University Hospital (which is presented as an example) can be used to calculate the indices of clinical laboratory tests, histopathologic examinations and radiodiagnostic investigations. The results indicate that the registration of diagnoses must be improved and that a way must be found to capture the implicit reasoning for ordering diagnostic tests.

A structural model of the impact of physicians' perceptions of computers on the use of hospital information systems

Abstract A structural model is developed to specify the effects of physician perceptions of the impact of computers on their use of a computer-based hospital information system (HIS). The overall model consists of a measurement model, which assumes that the observed variables are generated by a small number of unobserved variables or factors, and a structural equation model that relates exogenous and endogenous variables hypothesized as characterizing physician use of the HIS Parameters of the model are estimated with data from 477 physicians. This approach demonstrates a powerful means of modelling processes involving variables of theoretical interest that cannot be directly observed.