Health information and information systems

The author gives an account of the contents of medical and health informatics. Information systems are the second most important area of health informatics and their contribution to the functions of hospitals, policlinics and individual surgeries is substantial. The position in this country as regards implementation and communication of hospital information systems is not simple and the implementation of completely functional systems will still need considerable efforts. Probably it will be also essential to have a new category of university trained workers which exists in other countries, so-called health care administrators or managers.     

The role of general systems and information theory in multi-factor individuality theory.

Concepts and principles from general systems and information theory are brought to bear on individuality theory. J. G. Miller's conceptual framework for the organism as a general system is singled out for special consideration in relation to the organism as viewed by individuality theory. Individuality theory involves mapping out the dimensions of individual differences in diverse domains (abilities, temperament, styles, values, interests, etc.), organizing the within domain and between-domain relationships into an integrated hierarchical structure, and attempting to explain the interaction and integration of the separate components. Systems and information theory are particularly potent in aiding the accomplishment of the latter two aspects. Thus, factor-identified dimensions of individual differences are viewed as information processors or mediators. Information flow occurs both within and between the sensory, cognitive, affective, style, evaluative, and motor systems, and the integration of the organism depends upon such systemic properties as hierarchical structure, hierarchy of values, steady states, and systems interactions. In this way an attempt is made to bridge three theoretical perspectives, cross-fertilizations of which may produce a vigorous offspring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding the needs of children following large-scale disasters and the role of government

No one who experiences a disaster is untouched by it. Children and their families are often among the most affected. This article explains how mental health and medical professionals can assist families and communities in dealing with common disaster-related stress reactions in children. An overview of disaster research and examples of special concerns about children are given. In addition, an overview of the role of local, state, and federal governments, as well as other organizations, is provided.     

The role of the Federal government in financing health and medical services

A detailed examination on a group of oxen naturally infested with Parafilaria bovicola suggested a prepatent period varying from 238 to 250 days. In these animals 54% of all lesions bled only once, 22% a second time and 24% more than twice. Of all active lesions 42% occurred in the shoulder region and decreased from this area both cranially and caudally. The same tendency was noticeable on carcasses after slaughter. During the observation period May 1974 to February 1975 the number of positive animals increased, reaching peak values during September - October 1974, after which a decline was noticed. The filaricidal effects of nine compounds were tested. These were suramin (used in combination with diethylcarbamazine citrate), thiacetarsamide sodium, fenchlorphos, phosmet, mebendazole, fenbendazole, levamisole hydrochloride and trichlorphon.     

Health visiting and the case manager role

In 1990 East Berkshire health authority jointly with Berkshire social services carried out a 15 month project on five sites to pilot case management in preparation for the implementation of the community care reforms. Health visitor Catherine Squire describes her experience of working as a case manager in one of the pilots and argues for better career opportunities for health visitors in this field.     

Different approaches to the tasks of educating and training information systems professionals, within the National Health Service (UK)

In 1994, La Sainte Union College of Higher Education (LSU) developed an MSc in Health Informatics course, in conjunction with Southampton University NHS Trust (SUHT). The original part-time, 1 day per week mode of delivery has since been broadened to include a distance leaning route and recently a block release mode, by which students combine usage of the distance learning materials with attendance in College for an intensive 2-day taught element. Because the course was designed in close co-operation with a major teaching hospital, it has always been 'market led' to meet the needs both of the individual students and of the organisations that they work for. At the same time, students acquire a quality-assured qualification from a premier UK university, a qualification that holds credence outside the National Health Service (NHS). At the same time as LSU and SUHT were developing the MSc in Health Informatics, the UK NHS Training Division (NHSTD) started to promote a professional qualification for health service professionals. the so-called 'Statement of Recognition' (SoR). In contrast to the academic format of an MSc, the SoR was not a formal course, but a combination of modules designed to help candidates demonstrate their competence and achievement at work by portfolio evidence. This approach has national standing throughout the UK in a set of qualifications known as NVQs (National Vocational Qualifications). The NHSTD, through its successor, the Institute of Health Care Development (IHCD), has further refined this competency based model, culminating in the launch in 1996 of the Diploma and Advanced Diploma in Information and Technology (Health). Professionals within the area of Information Management and Technology (IM&T) in the NHS now have the alternatives of an academic or a competency route to achieve their goals. This paper traces the development of and the relationship between, these two approaches to the educational and training of healthcare professionals. It will illustrate the shift from Information Technology (IT) to Information Management skills, which is a pre-requisite to satisfy the changing needs of information users. It will also consider how a single Master's course can lead to a range of courses which meet the needs of professionals at various levels. Finally, it makes some recommendations for future developments of the programmes, suggestions which may have some relevance outside of the UK.     

Work of large information systems

The problem of application of informational ideas to the study of large informational systems, such as brain, is considered. Analysis follows some ideas of Winograd and Kowan's theory of reliable computations in the presence of noise. In the beginning of paper the "material analogy" for intuitive understanding of Shannon's results is proposed. Afterwards there is given the formulation of coding theorem for the case of "informational collective"--a large group of informational sources and receivers. In conclusion it is shown that such properties of neuronal structures as "stochastic" neural connections are reasonable from the point of information theory.     

Toward implementation of an urban health agenda: the role of government

Government has several essential roles in the implementation of an urban health agenda. Government acts as a direct agent in the financing and delivery of services, as a rule maker for the financing and provision of care by others, and as a forum for political debate. Discussions of access to care, control of health care costs, and the maintenance of quality all include a role for government. A period of apparent rejection of comprehensive governmental health care policy has nevertheless included numerous examples of the persistence of government's many roles.     

Liver assist systems: state of the art

Attempts to develop liver support systems for the treatment of patients with liver failure have ranged from use of plasma exchange to utilization of charcoal columns and extracorporeal devices loaded with liver tissue. However, no system has achieved wide clinical use and - in the absence of liver transplantation - severe hepatic failure continues to be associated with significant morbidity and mortality. In this paper, the authors review the current status of liver assist systems and summarize their clinical experience with a xenogeneic cell based-bioartificial liver.     

Preoperative information: the role of the ward nurse

Many health care professionals are becoming increasingly aware of the benefits of giving preoperative information to patients. However, many nurses still view the provision of such information as a luxury, only to be afforded when all the 'proper' work is done.     

Health On the Net automated database of health and medical information

With the number of World Wide Web sites growing every day, the problem is not just to find information, but to locate the right piece of information. Current World Wide Web search engines have not resolved this problem as they most often return a long list of documents. The search result is then unusable because of the large number of answers from different domains and topics. Only complex queries may, in a given situation, produce a limited number of potentially relevant documents. To make searches more efficient and usable by common users, we now need intelligent and specialised search engines on the Net [1,2]. Health On the Net Foundation and the Molecular Imaging and Bioinformatics Laboratory at Geneva University Hospital have developed Multi-Agent Retrieval Vagabond on Information Networks (MARVIN), a robot that searches sites and documents specifically related to a given specialised field. One such robot has already been implemented and used for the medical and the 2D electrophoresis domains. Health On the Net Foundation has implemented the corresponding search engines, MedHunt (http://www.hon.ch/cgi-bin/find) for the medical field and 2DHunt (http://www.hon.ch/cgi-bin/2DHunt/find) for the 2D electrophoresis field.     

The barriers and benefits of nursing information systems

Nursing informatics is a growing field with many opportunities for nursing involvement. Because nurses are involved increasingly in the design, installation, and use of nursing information systems (NIS) it is important that they are aware of the barriers to and benefits of nursing information systems. This article describes the evolution of nursing information systems and the design goals for current systems. The lack of a unified nursing language and individual and organizational factors such as characteristics of the nurse, the unit, the administrative philosophy, and workload issues are discussed as barriers to NIS development. Increased nurse involvement, education, research, and recognition of the benefits of computerization are suggested to overcome the barriers. A review of the literature provides the reader with evidence of improved efficiency, patient safety and satisfaction, and ability to measure quality as benefits of NIS. Areas for further research are identified: outcomes measurement using NIS, decision support and expert systems, point-of-care documentation, interagency and interdisciplinary communication, and further work on individual and organizational factors.     

Health state preferences of persons with anxiety

We have described a program that integrates clinical approaches of infant mental health to infants and toddlers in foster care. The juxtaposition of a mental health program in a forensic setting creates a number of special features that we have highlighted. Unique from the clinical perspective, the team is explicitly relationship-focused, attempting to understand all of the young child's caregiving relationships as they affect development. We strive to enhance the quality of all of relationships in which infants participate, fostering healthy attachments and development. Also unique is the emphasis on system liaison, and making programmatic efforts to affect various systems involved in making custody determinations about infants and toddlers. Unique from the forensic perspective, we offer multidisciplinary expertise about an especially high-risk population, a comprehensive service delivery system in which we provide or coordinate and monitor all intervention efforts for a given family, a prevention orientation, and clinical follow-up with infants for as long as they are in care. The goals of the program include expediting permanency planning decisions, increasing continuity in high-quality foster care placements, increasing court satisfaction with mental health consultation, decreasing the number of court-ordered evaluations for adjudicated families, and increasing CPS satisfaction with available treatment and continuity of care. We believe that this approach integrates delivery of services to the youngest and most vulnerable victims of maltreatment and expedites permanency planning.     

The role of library and information services in the modular curriculum

Radical changes in nurse education, accompanied by advances in library and information services (LIS), set against a background of ever-expanding nursing literature and information, have favoured the development of good practices in curriculum development and student-centred learning. This paper discusses the experience at Keele University of enhanced collaborative effort between curriculum planners and LIS staff, and aims to show how LIS can facilitate student learning and contribute to curriculum planning and delivery, quality resource provision, evaluation processes and life-long learning.