Abstract：
OBJECTIVES:To discuss the advantages and disadvantages of an interfaced approach to clinical information systems architecture. METHODS:After many years of internally building almost all components of a hospital clinical information system (HELP) at Intermountain Health Care, we changed our architectural approach as we chose to encompass ambulatory as well as acute care. We now seek to interface applications from a variety of sources (including some that we build ourselves) to a clinical data repository that contains a longitudinal electronic patient record. RESULTS:We have a total of 820 instances of interfaces to 51 different applications. We process nearly 2 million transactions per day via our interface engine and feel that the reliability of the approach is acceptable. Interface costs constitute about four percent of our total information systems budget. The clinical database currently contains records for 1.45 m patients and the response time for a query is 0.19 sec. DISCUSSION:Based upon our experience with both integrated (monolithic) and interfaced approaches, we conclude that for those with the expertise and resources to do so, the interfaced approach offers an attractive alternative to systems provided by a single vendor. We expect the advantages of this approach to increase as the costs of interfaces are reduced in the future as standards for vocabulary and messaging become increasingly mature and functional.
journal_name
Methods Inf Medjournal_title
Methods of information in medicineauthors
Clayton PD,Narus SP,Huff SM,Pryor TA,Haug PJ,Larkin T,Matney S,Evans RS,Rocha BH,Bowes WA 3rd,Holston FT,Gundersen MLkeywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
1-7issue
1eissn
0026-1270issn
2511-705Xpii
03010001journal_volume
42pub_type
杂志文章abstract：BACKGROUND:In the past decade, Medical Informatics (MI) and Bioinformatics (BI) have converged towards a new discipline, called Biomedical Informatics (BMI) bridging informatics methods across the spectrum from genomic research to personalized medicine and global healthcare. This convergence still raises challenging re...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME11-01-0060
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems". OBJECTIVES:The aim of this study is to assess the reliability of the estimated Nocturnal Heart Rate (HR), recorded through a be...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME13-02-0053
更新日期：2014-01-01 00:00:00
abstract：OBJECTIVES:GTDS is a documentation system used by more than 40 German hospital cancer registries. This paper discusses the factors that contributed to its success concerning design, development, and routine use. METHODS:Success is measured in terms of the system's financial independence of public grants and its succes...
journal_title：Methods of information in medicine
pub_type： 杂志文章,评审
doi：
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVE:Recent results published by Coste et al. in discriminant analysis with ordinal responses showed the superiority of optimal discriminating analysis for ordinal responses (ODAO) both in terms of classification and simplicity of implementation compared to classic methods (Fisher's discrimination, logistic regres...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:The medical information systems of the future will probably include the entire medical record as well as a knowledge base, providing decision support for the physician during patient care. Data dictionaries will play an important role in integrating the medical knowledge bases with the clinical databases. This article...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
abstract：OBJECTIVE:Record linkage of patient data originating from various data sources and record linkage for checking uniqueness of patient registration are common tasks for every cancer registry. In Austria, there is no unique person identifier in use in the medical system. Hence, it was necessary and the goal of this work t...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:The use of computers in the health sector has increased significantly during the last few years in Nigeria. This paper addresses the integration of health and informatics education, or health education and informatics education, or informatics education in health care delivery. It gives an introduction to the status o...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVES:The main objective of the research is an application of the clustering and cluster validity methods to estimate the number of clusters in cancer tumor datasets. A weighed voting technique is going to be used to improve the prediction of the number of clusters based on different data mining techniques. These ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：:Rapid development of community health information networks raises the issue of semantic interoperability between distributed and heterogeneous systems. Indeed, operational health information systems originate from heterogeneous teams of independent developers and have to cooperate in order to exchange data and service...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1998-11-01 00:00:00
abstract：:A Bayesian decision support system was developed for the diagnosis of rheumatic disorders. Knowledge in this system is represented as evidential weights of findings. Simple weights were calculated as the logarithm of likelihood ratios on the basis of 1,000 consecutive patients from a rheumatological clinic. The effect...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：:Natural language understanding systems have to exploit various kinds of knowledge in order to represent the meaning behind texts. Getting this knowledge in place is often such a huge enterprise that it is tempting to look for systems that can discover such knowledge automatically. We describe how the distinction betwe...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1998-11-01 00:00:00
abstract：:In this study, we attempted to discriminate the acceleration signal for horizontal level and stairway walking using wavelet-based fractal analysis method. The acceleration signal was measured close to the center of gravity of the body, while the subjects walked continuously in the corridor and up and down the stairs. ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2000-06-01 00:00:00
abstract：OBJECTIVES:Hospital information systems (HIS) are the hospital's nervous system. The HIS are mostly grown over several years, dedicated to specific needs and comprise individual workarounds. Changes to such complex systems may cause a variety of differ-ent negative side-effects. In order to understand the nature of inc...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME9220
更新日期：2009-01-01 00:00:00
abstract：:Surgical fluid replacement is a critical issue in medicine as the fluid volume excess or deficit can both complicate the patient's condition. Currently, the administration of fluid volume is carried out primarily based on the experience and expertise of the anaesthetist as there is no analytical method available to es...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2001-03-01 00:00:00
abstract：:Appropriateness and necessity research of various procedures in medicine may be the most complex field of innovation in healthcare and technology assessment. Nevertheless, the appropriateness of the indication of any medical intervention is probably more important than the outcome since even ideal quality components o...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2000-08-01 00:00:00
abstract：:Four tabular and two graphical techniques for the presentation of laboratory test results were evaluated in a reaction time experiment with 25 volunteers. Artificial variables and values were used to represent sets of 12 laboratory tests to eliminate the possible effects of clinical experience. Analyses focused on fou...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：OBJECTIVE:Joint data analysis is a key requirement in medical research networks. Data are available in heterogeneous formats at each network partner and their harmonization is often rather complex. The objective of our paper is to provide a generic approach for the harmonization process in research networks. We applied...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME14-02-0030
更新日期：2015-01-01 00:00:00
abstract：:This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Computational Electrocardiography: Revisiting Holter ECG Monitoring" written by Thomas M. Deserno and Nikolaus Marx. It is introduced by an editorial. This article contains the combined commentaries invited to indep...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME15-15-0009
更新日期：2016-08-05 00:00:00
abstract：OBJECTIVES:To provide a comprehensive bottom-up categorization of model-based segmentation techniques that allows to select, implement, and apply well-suited active contour models for segmentation of medical images, where major challenges are the high variability in shape and appearance of objects, noise, artifacts, pa...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：OBJECTIVES:The interpretation of endoscopic findings by gastroenterologists is still a difficult and highly subjective task. Despite important developments such as chromo-endoscopy, pit pattern analysis, fluorescence imaging as well as narrow band imaging it still requires lots of experience and training with a certain...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME9230
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:The cause-of-death register at the Southern Urals Biophysics Institute (SUBI), Ozyorsk, Russia, was established to document the number and causes of deaths in the Mayak workers cohort, which includes all persons (N = 22,377) employed at Mayak nuclear facility between 1948 and 1982. Most workers were occupati...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME11-01-0049
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Multi-class molecular cancer classification has great potential clinical implications. Such applications require statistical methods to accurately classify cancer types with a small subset of genes from thousands of genes in the data. OBJECTIVES:This paper presents a new functional gradient descent boosting...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME11-02-0020
更新日期：2012-01-01 00:00:00
abstract：:Information processing in hospitals, especially in university hospitals, is currently faced with two major issues: low-cost hardware and progress in networking technology leads to a further decentralization of computing capacity, due to the increasing need for information processing in hospitals and due to economic re...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1995-09-01 00:00:00
abstract：:There are three grand challenges for medical informatics policy: (1) What is it? (2) What should it be? (3) How can we influence its development? To address these challenges requires: (1) an historical analysis of medical informatics policies in a representative sample of countries. This should include an account of m...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1999-12-01 00:00:00
abstract：:A Template Definition Language (TDL) was developed to share knowledge of how to construct an electronic patient record (EPR) template. Based on the extensible markup language XML, TDL has been designed to be independent of EPR platforms or databases. Our research of TDL was conducted through evaluation of the descript...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：INTRODUCTION:This article is part of the Focus Theme of Methods of Information in Medicine on "Big Data and Analytics in Healthcare". BACKGROUND:Hospital readmissions raise healthcare costs and cause significant distress to providers and patients. It is, therefore, of great interest to healthcare organizations to pred...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME14-02-0017
更新日期：2015-01-01 00:00:00
abstract：:Validation of expert system knowledge bases has proved to be difficult. This paper presents a description of a system called ScriptGen that generates test data for validating the knowledge base of the ONCOCIN cancer therapy planning system. Because of the size and complexity of the ONCOCIN knowledge base, we require t...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:Clinical guidelines are special types of plans realized by collective agents. We provide an ontological theory of such plans that is designed to support the construction of a framework in which guideline-based information systems can be employed in the management of workflow in health care organizations. MET...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVES:The traditional techniques of data analysis are often not sufficient to characterize the complex dynamics of respiration. In this study the respiratory pattern variability was analyzed using symbolic dynamics. METHODS:A group of 20 patients on weaning trials from mechanical ventilation were studied at two d...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2004-01-01 00:00:00
abstract：OBJECTIVES:Several researchers have proposed the use of logical ontologies as 'reference terminologies'. However, there are a number of unresolved issues. This article describes the development of a logical ontology for nursing interventions and presents the results of evaluation. METHODS:Initially this study involved...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
