Towards developing a national health information standards framework for South Africa

An outline is given of the development of a health information standards framework for South Africa. The main emphasis has been in the development of data standards including coding schemes. Choices for diagnostic, procedure, and reason for encounter codes are given as well as options for personal identifiers, telemedicine, and pharmaceutical codes and messaging standards.     

The Internet as a resource for healthcare information

The Internet provides an additional means for healthcare providers to reach their patients. As more and more healthcare providers and patients get on-line and learn to use the Internet, the value of being on-line will increase. The Internet and other healthcare computing technologies will challenge us to look to the future for new ways to create partnerships with our patients. On-line skills and technological literacy will not replace more traditional approaches to patient care, but they most likely will change the model of how care is provided. Technology is an adjunct that will serve us well if it is incorporated as part of a multidimensional patient care environment. Above all, we will need to continue to foster good interpersonal relationships with patients to encourage ongoing dialogues about information obtained from all resources.     

Creating a population-based linked health database: a new resource for health services research

Cytologically, the distinction between bronchioalveolar carcinoma and reactive/reparative processes of respiratory epithelium can be difficult. Retrospectively, we have identified 11 consecutive cases of bronchioalveolar carcinoma from the cytology files of University Missouri-Kansas City/Truman Medical Center. On average, a combined 5.71 cytologic/histologic procedures were performed before reaching a definitive diagnosis for this group. An additional seven random cases of reactive/reparative respiratory cases of adult respiratory distress syndrome patients were used as a control. Cytomorphometric analysis was performed. The mean average nuclear diameter for the carcinoma group was 13.76 microns and for the reactive/reparative group was 13.29 microns. There was no statistical difference between the two groups (paired student t test, P > .05). It appears from our data that mean nuclear diameter is not a discriminator for the cytologic distinction between bronchioalveolar carcinoma and reactive/reparative respiratory epithelium and that the accepted cytologic parameters of for bronchioalveolar carcinoma are more valid.     

标准文献信息资源的搜集和标准信息服务

从传统方式和网络环境下标准文献的搜集方法,介绍了几个主要的国内标准信息网站,并简单阐述了标准信息服务的现状和发展目标、标准信息服务人员应具备的素质条件。     

More information on infectious diseases provided by a national information system

The Infectious Diseases Information System (ISIS) was established to improve the exchange of information about infectious diseases among those combating these diseases. Information about infectious diseases is obtained from municipal health services by means of a data processing system elaborated by the National Institute for Public Health and the Environment. After adjustment to the new Act on Combating and Tracing of Infectious Diseases it will be introduced nation-wide in 1998. Information about pathogens is obtained from medical microbiological laboratories (MMLs) through automatic storage of positive and negative results in a central data bank. After a pilot project had shown that the data from one MML, Arnhem, were complete and reliable, the MMLs of Roermond and Tilburg were also connected. For feedback of information to medical microbiologists and infectious diseases specialists, but also to, for instance, GPs, data from the whole country are presented daily on a public Internet site (http:/(/)www.isis.rivm.nl).     

Panel I: Epidemiology of minority health.

Collecting epidemiologic data by ethnicity and race is a highly useful undertaking; but "benchmark" comparisons relative to majority Americans should not take priority over defining the determinants of health status within a minority group. Thus, it is necessary to identify factors contributing to the measured health status and to modify the environment, lifestyles, and behaviors to diminish the likelihood of undesirable health outcomes. This article presents an overview of the health status of African Americans, Asians and Pacific Islanders, and Hispanics. The goals are to provide a framework for the rational interpretation of both health status data and its determinants both within and between minority groups. This approach recognizes the heterogeneity of health status that exists within a minority group and encourages investigators to place more emphasis on the within-group health status differentials as they search for modifiable factors that underlie the risk for undesirable health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of a national plan for disaster mental health.

In this article, the author provides a history of the development of the national plan for disaster mental health, discusses its present state, and provides some suggestions for the future of theory, research, and practice in the field. The focus is on the provision of mental health services in the emergency phase of a disaster, rather than on the long-term follow-up. Consequently, the focus is on the American Red Cross's disaster mental health program and, to a lesser extent, the American Psychological Association's Disaster Response Network. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trends toward a national health care marketplace

In the last two decades, the term "quality-of-life" has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health or prolongation of life as such, but preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can--but need not always--come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term "quality-of-life." The use and the meaning of the term turn out to depend on the contexts of medical decision-making in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of quality-of-life, health and happiness.     

The Military Medical Academy--the national property of Russia

Article by the Chief of the Academy has been based on its history of 200 years. One of the oldest establishments of medical education has played a great role in the development of the national and world medicine. Among the Academy graduates of highest merit was N. I. Pirogov, a famous surgeon, who marked a new age in the medical science and education and introduced important innovations in the casualty treatment on the battlefield. He was the first to apply ether anaesthesia and plaster bandage and to have women taking care of the wounded on the theater of operations. Academy graduates S. P. Botkin, G. F. Lang and F. I. Komarov had founded their own schools of therapy. E. N. Pavlovski? developed a study on the focus nativeness of infection and parasite disease process. Every year the Academy scientists implement more than 150 research projects for the government, ministries and different agencies, defend up to 75 theses on 30 specialties, conduct more than 20 national and international conferences, symposiums and meetings. For the last 35 years the Academy has been training medical doctors, scientists and healthcare specialists for 35 countries in Europe, Asia, Africa and Latin America.     

Woman-centered information on menopause for health care providers: findings from the Midlife Women's Health Survey

Despite their growing numbers, midlife women continue to feel marginalized by a health care system that is unresponsive to their needs for current information about the perimenopausal experience and for egalitarian, woman-centered care. In this article, the authors call upon physicians, health educators, nurses, counselors, and other health providers to meet the consumer needs of this ever-growing clientele. To this end, they provide data-based information derived from the responses of more than 400 middle-aged women from across the United States to annual Midlife Women's Health Surveys from 1990 to 1993. The authors focus on enhancing the sensitivity of health care providers toward their midlife clients by offering data describing the normal menopausal transition and the feelings and concerns of this group.     

The BC health information standards council

The establishment of a British Columbia (BC) Health Information Standards Council is one of the strategies that is helping to develop and implement BCs vision for health information management. This vision is of effectively and efficiently managed information that enables informed decision making to achieve the results desired in our health system. The Council focuses on the identification of standards and guidelines that will enable, facilitate and promote effective health information sharing. This focus has resulted in approved and mandated informatics standards for use across the health system in the areas of data, applications, technology, security, confidentiality and privacy.     

An evidence-based approach to interactive health communication: a challenge to medicine in the information age. Science Panel on Interactive Communication and Health

OBJECTIVE: To examine the current status of interactive health communication (IHC) and propose evidence-based approaches to improve the quality of such applications. PARTICIPANTS: The Science Panel on Interactive Communication and Health, a 14-member, nonfederal panel with expertise in clinical medicine and nursing, public health, media and instructional design, health systems engineering, decision sciences, computer and communication technologies, and health communication, convened by the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. EVIDENCE: Published studies, online resources, expert panel opinions, and opinions from outside experts in fields related to IHC. CONSENSUS PROCESS: The panel met 9 times during more than 2 years. Government agencies and private-sector experts provided review and feedback on the panel's work. CONCLUSIONS: Interactive health communication applications have great potential to improve health, but they may also cause harm. To date, few applications have been adequately evaluated. Physicians and other health professionals should promote and participate in an evidence-based approach to the development and diffusion of IHC applications and endorse efforts to rigorously evaluate the safety, quality, and utility of these resources. A standardized reporting template is proposed to help developers and evaluators of IHC applications conduct evaluations and disclose their results and to help clinicians, purchasers, and consumers judge the quality of IHC applications.     

Medical ethics teaching. Report of a National Medical School Survey

Medical ethics teaching was surveyed at American medical schools. Of 107 schools that responded, 97 indicated some kind of medical ethics teaching. This included, however, 19 schools where teaching was only by discussion of ethical issues in courses not primarily identified as ethics courses. Fifty-six institutions (up from 17 in 1972) reported that they conducted special conferences, lectures, or seminars on issues in medical ethics. Specific medical ethics electives were offered in 47 schools; some kind of required course existed at six institutions. The number of faculties with major commitments to medical ethics teaching increased approximately 50% (from 19 to 31). Several schools now have departments or interdepartmental teaching programs with formal structure and permanent staff.     

Using information management to implement a clinical resource management program

BACKGROUND: This article provides a consultant's account of a 250-bed community hospital's experience in implementing the Clinical Resource Management (CRM) program, a four-stage process of using information to identify opportunities for improvement, developing an effective resource management team, implementing process improvement activities, and measuring the impact on outcomes of care. CASE STUDY EXAMPLE--CONGESTIVE HEART FAILURE: The chair of the departments of internal medicine and family practice selected congestive heart failure for in-depth study. A task force focused on treatment and patient disposition in the emergency room (ER), where most of the nonelective admissions originated. A set of standardized ER orders was developed that emphasized rapid and effective diuresis through the initiation of a progressive diuretic dosing schedule directly linked to patient response. LESSONS AND REFLECTIONS: Factors critical to the success of the CRM program included allocating adequate time to promote and sell the value and importance of the program, as well as securing the support of both information systems and physicians. The main barriers to success involved limitations in the information system infrastructure and delays attributable to committee review. Short-term results from the CRM program were encouraging, with average lengths of stay reduced by 0.5 days and average costs of care reduced by 12% for the ten diagnoses studied with no adverse results. Nonstudy diagnoses showed no notable improvement. CONCLUSIONS: Recognizing the growing importance of information management not only for clinical decision support but for accommodating all the necessary internal and external reporting requirements will require a significant commitment and investment in technology and personnel resources.     

The use of paraprofessionals in university mental health settings; a national survey

A national survey of 218 counseling centers was conducted to determine the extent and nature of paraprofessional use. Responses from 119 centers indicated that only 38% employ paraprofessionals. Those programs that do exist tended to be at larger, public institutions. Paraprofessionals were generally salaried, and they functioned in multiple roles. The selection procedure most frequently employed was professional staff interviews with an emphasis on "interpersonal characteristics" as the selection criterion. Training and evaluation procedures were usually conducted on an ongoing rather than on a "one-shot" basis. Reasons for not employing paraprofessionals varied considerably from center to center.