Information resource management in emergency room medicine: A case study

The emergency room is one of the fastest-paced, intense places a person can find. Because many of the cases in the ER involve life-or-death decisions, accurate data in a useful format is critical for immediate access of necessary information. Over the last several years, this simple fact has sparked major interest in emergency room information resource management. While traditional paper methods are still widely used, the electronic capabilities provided by information technology are revolutionizing the way emergency rooms and trauma centers function. An ideal state-of-the-art emergency department is integrated with the rest of the healthcare enterprise for access to all patient information via electronic media. This means doctors offices, remote clinics, and hospitals will all be linked by fiber optics or some other means of communication technology, eliminating islands of automation in which information is unable to be shared. Instead, all authorized medical personnel can access and share patient information at any wired location. This shared information includes all information gathered at the primary care physician\u27s office as well as all information gathered at all treatment facilities. Additionally, all software and hardware used in the ER will be fully integrated and designed to support the medical decisions made by the ER staff This integration will allow medical information to be available to medical staff at the touch of a button. As a result, the quality of patient treatment is increasing as is the probability of patient survival. A case study of Covenant Medical Center (CMC) will allow an assessment of one hospital\u27s ER compared to a state-of-the-art ER facility. Covenant Medical Center is a 366-bed health facility, employing approximately 270 physicians and 608 nurses, as well as 28 information technology professionals. Located in Waterloo, Iowa, CMC offers many services including a Cancer Treatment Center, Dialysis Center, Sports Injury Center, Rehabilitation Center, Mental Health Services, and the 24-hour Emergency Trauma and Treatment Center (ETTC). Each year, this healthcare organization has approximately 12,000 inpatient hospitalizations and performs about 400,000 outpatient procedures. 1 CMC\u27s Emergency Trauma and Treatment Center is classified as a Level 2 trauma center, meaning all types of emergency cases are handled, with a few exceptions. CMC\u27s ETTC does not treat patients for open-heart procedures, limb reattachments, or major burns. However, all other types of medical emergencies are treated at this facility. The emergency department is staffed with 7 full-time and 4 part-time physicians, 30-35 nurses, and 6 technicians. Physicians work 12- hour shifts, with 2 working the noon to midnight shift and 1 working from midnight to noon. Nurses work either 8- or 12-hour shifts, depending on individual circumstances and schedules. CMC\u27s Emergency Trauma and Treatment Center sees 30,000 patients annually. Over 50% of hospitalized patients come from the emergency room (ER), and 24% of patients seen in the ER are admitted directly to the hospital. A comparison will be made between the latest modern technology available and the technology used by Covenant in its emergency department. Specific comparisons will be made in the following areas: strategic management, technical equipment, electronic medical records, and patient tracking (tracking and logging, vital signs, pharmacy, clinical documentation, discharge, planning, and scheduling). Within each of these major areas, two elements will be addressed. First, some of the latest technological information systems and processes and their uses in an emergency department are explained. Then, I discuss how Covenant Medical Center\u27s Emergency Trauma and Treatment Center is progressing in the modernization of its ER department and utilizing some of these latest technological innovations to improve patient treatment. The need for information anytime and anywhere in critical situations has prompted researchers to examine how medical information is being used in emergency rooms

Innhenting av kritisk informasjon i akuttmottak : en kvalitativ studie av sykepleiers betingelser for bruk av informasjonssystemer ved innhenting av kritisk informasjon i akuttmottak

Master's thesis in Health informatics (HSI501)Background: Healthcare professionals need quick and easy access to health-and patient related information in emergency departments. There is a need for ICT tools that support the work processes and provide access to the information. At the same time the information need must be provided quickly. Critical information or alert information is a particularly important basis for decision-making. If this information is missing or otherwise incomplete, the risk of incorrect or delayed treatment increases. Purpose and goals: The knowledge acquired will provide a deeper understanding of the workflow of nurses in the emergency department and the work processes and practices for obtaining critical information. The aim is to understand the criteria for using the information systems in obtaining critical-or alert information. Keywords: information retrieval, emergency room, nurse, workflow, health information technology, health information system, critical information, alert informatio

Iowa Immunization Program Annual Report 2013, April 30, 2014

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program

Iowa Immunization Program Annual Report 2010, March 31, 2011

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program

Iowa Immunization Program Annual Report 2012, February 20, 2012

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program

Iowa Immunization Program Annual Report 2011, February 20, 2012

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program

Iowa Immunization Program Annual Report 2018, July 26, 2019

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program

Distributed Object Medical Imaging Model

Abstract- Digital medical informatics and images are commonly used in hospitals today,. Because of the interrelatedness of the radiology department and other departments, especially the intensive care unit and emergency department, the transmission and sharing of medical images has become a critical issue. Our research group has developed a Java-based Distributed Object Medical Imaging Model(DOMIM) to facilitate the rapid development and deployment of medical imaging applications in a distributed environment that can be shared and used by related departments and mobile physiciansDOMIM is a unique suite of multimedia telemedicine applications developed for the use by medical related organizations. The applications support realtime patients’ data, image files, audio and video diagnosis annotation exchanges. The DOMIM enables joint collaboration between radiologists and physicians while they are at distant geographical locations. The DOMIM environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the DOMIM resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL ORB, Event Service, IIOP JDBC/ODBC, legacy system wrapping and Java implementation are explored. This paper explores a distributed collaborative CORBA/JDBC based framework that will enhance medical information management requirements and development. It encompasses a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes

CASPER toolkit

"Following any type of disaster, public health and emergency management professionals must be prepared to respond to and meet the needs of the affected public. The Community Assessment for Public Health Emergency Response (CASPER) enables public health practitioners and emergency management officials to determine rapidly the health status and basic needs of the affected community. CASPER uses valid statistical methods to gather information about health and basic needs, allowing public health and emergency managers to prioritize their response and distribution of resources accurately. Without information on the community, public health officials may make decisions based on anecdotal information; such decisions may not accurately reflect the need of the entire community. The Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch (HSB) published the first edition of the CASPER toolkit in 2009 and widely distributed the toolkit to the public health community. HSB developed this second edition to address partner feedback on the first edition and include advancements in technology and refinements in the methodology. This second edition is an updated guideline for field staff conducting CASPER. Public health department personnel, emergency management officials, academics, or other disaster responders who wish to assess household-level public health needs will find this toolkit useful for rapid data collection during a disaster response. CASPER may also be used for conducting Health Impact Assessments (HIAs) or other community-level surveys during non-emergency situations." - p. 11. Executive summary -- 2. Background -- 3. Phase I: Prepare for CASPER -- 4. Phase II: Conduct the assessment -- 5. Phase III: Data entry and analyses -- 6. Phase IV: Write the report -- 7. CDC support -- 8. Conclusion -- 9. References -- 10. Additional sources of information -- Appendix A: Steps to merge the two Excel files downloaded from Census 2010 and to calculate cumulative housing units for selection of census blocks -- Appendix B: Question bank -- Appendix C: CASPER preparedness template -- Appendix D: Example questionnaire -- Appendix E: CASPER tracking form (sample) -- Appendix F: Confidential referral form (sample) -- Appendix G: Introduction and consent script (sample) -- Appendix H: Agenda for just-in-time training of field interview teams -- Appendix I: Sample Interview teamsThe first edition of the Community Assessment for Public Health Emergency Response (CASPER) Toolkit was developed by the Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch (HSB) in 2009. HSB has now developed this second edition to expand instruction and refine methodological procedures, including describing and incorporating advances in technology and recognizing the release of the U.S. Census 2010 data. HSB acknowledges the following individuals for their collaboration and commitment in the development of the second edition of the CASPER toolkit: Primary authors: Tesfaye Bayleyegn, Sara Vagi, Amy Schnall, Michelle Podgornik, Rebecca Noe, and Amy WolkinMode of access: Internet. (Acrobat .pdf file: 3.91 MB, 103 p.).Includes bibliographical references.Centers for Disease Control and Prevention (CDC). Community Assessment for Public Health Emergency Response (CASPER) Toolkit: Second edition. Atlanta (GA): CDC; 2012.

Clinical decision support in emergency medicine : exploring the prerequisites

A clinical decision support system is a technical system that combines individual patient data and evidence-based clinical knowledge to give advice and support to clinicians. For quite a long time, the emergence of such systems has been predicted and expected to impact health care dramatically by improving both quality and productivity. Three factors make Swedish emergency medicine an interesting context which could be mature for the introduction of clinical decision support systems. Firstly, Sweden is a leader in the implementation of health care information technology, and the coverage of electronic health records is around 100% in the country. Secondly, emergency medicine is a field with high patient turnover, frequent decisions, and substantial impact on patient outcome. Thirdly, although there are abundant publications on clinical decision support system development and implementation in general, there is less knowledge of such systems in the urgent care context. Therefore, this doctoral project aimed to explore the prerequisites prior to implementation of clinical decision support systems in emergency medicine. This thesis is based on a mixed-methods design and consists of four individual studies. Proctor’s conceptual model of implementation research was used as a framework for the project. Study I included semi-structured interviews with 16 medical doctors and nurses from nine Swedish emergency departments. Content analysis was used to describe factors affecting vital sign data quality in emergency care. Study II extracted vital signs from 330 000 emergency department visits to assess the effects of different documentation workflows on data quality. Study III prospectively explored 200 vital sign measurements from 50 emergency care visits to evaluate the impact of manual and automated documentation on vital sign data quality. Study III also used data from an adapted NASA TLX questionnaire to compare the workload of clinical staff (n=70) in manual and automatic documentation. Study IV used semi-structured interviews with 14 emergency medicine physicians from three different sites. Content analysis was used to explore participants’ expectations and concerns regarding clinical decision support systems. There are three main results and conclusions from the research. Firstly, documentation of vital signs in the emergency department is still surprisingly paper-based, which makes vital sign data unfit for reuse in clinical decision support. Secondly, automation of vital sign documentation is feasible in emergency care and should improve data quality and reduce workload. Thirdly, enthusiasts towards decision support are at risk of disappointment with the level of innovation in the currently available decision support systems, and this may affect the implementation strategy negatively