International journal of medical informatics
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The Veterans Health Administration of the U. S. Department of Veterans Affairs has a long, successful, and interesting history of using information technology to meet its mission. ⋯ A sophisticated national infrastructure has been developed to replicate, support, and evolve single-center successes. With advances in inter-facility networking, data sharing, and specialized central support and technical tools, VistA is becoming a single, highly scalable national health information system (HIS) solution. In this paper, we present an historical overview of VistA's development, describe its current functionality, and discuss its emergence as a national-scale hospital information system.
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In this contribution some comments are given regarding an article of Haux et al., which is published in the same issue. After discussing some general aspects of the paper, the comments focus on patient-centred care and genomics. Trends that are observed today are used to predict the situation with respect of the use of ICT in healthcare in the year 2013. ⋯ The role of the patient in the management of her disease will be much larger than it is now. The impact of new knowledge coming from the field of genomics will be large. It is not possible to predict the impact on functionality and the use of healthcare information systems in 2013.
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This paper aims at further expanding the vision of future health care delivery systems presented by Haux et al. (2002). Starting from the observation that information and communication technology (ICT) is deeply transforming the shape of organizations as expected, we argue that the coordination of work activities is a fundamental need for any organization. This is even more important for health care organizations since there is an increasing pressure to increase quality of care they deliver without further increasing its costs. ⋯ Thus the paper focuses on the need of developing intense research efforts in the fields of knowledge management and workflow modelling, which have been identified as fundamental to provide suitable solutions to the problems of designing and building innovative health care information systems. Moreover, the paper discusses the role of mobile communication systems. Moreover, the paper discusses the role of mobile communication and speech understanding technologies to support a satisfactory user-system interaction in daily work.
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In this paper, the implementation of an Internet-based telematic service for medical support is presented, which was developed and operated in pilot form within the INTRANET HEALTH CLINIC project--a 2-year project supported by the European Commission under the Health Telematics Programme. The aim of the application is to offer high quality care to users of health services over inexpensive communication pathways, using Internet-based, interactive communication tools, like remote access to medical records and transmission of multimedia information. The XML technology was employed to achieve customised views on patient data, according to the access rights of different user profiles. ⋯ The system was designed to collaborate with existing clinical patient record systems and to be adjustable to different medical applications. Current implementations include the fields of Oncology, Lupus Erythrematosis, Obstetrics and Chronic Obstructive Pulmonary disease. The results of the pilot operation with oncological patients in Greece were encouraging, so that the refining of the system and its expansion to a large number of patients is already in progress.