Users’ satisfaction with the primary health care information system in Croatia: a cross-sectional study

AIM: To evaluate the primary health care information system from the general practitioner's (GP) point of view. ----- METHODS: Sixty-seven Croatian GPs were distributed a questionnaire about characteristics of the GP's office, overall impression of the application, handling of daily routine information, more sophisticated information needs, and data security, and rated their satisfaction with each component from 1 to 5. We also compared two most frequently used applications--application with distantly installed software (DIS) and that with locally installed software (LIS, personal computer-based application). ----- RESULTS: GPs were most satisfied with the daily procedures and the reminder component of the health information system (rating 4.1). The overall impression ranked second (3.5) and flexibility of applications followed closely (3.4). The most questionable aspect of applications was data security (3.0). LIS system received better overall rate than DIS (4.2 vs 3.2). ----- CONCLUSION: Applications received better ratings for daily routine use than for overall impression and ability to get specific information according the GPs' needs. Poor ratings on the capability of the application, complaints about unreliable links, and doubts about data security point to a need for more user-friendly interfaces, more information on the capability of the application, and a valid certificate of assessment for every application

Stanje informatizacije zdravstva u Hrvatskoj

U hrvatskom je zdravstvu informatizacija započela još u drugoj polovini prošlog stoljeća (kompjutorizacija Republičkog registra za rak u Zagrebu; automatska obrada podataka (AOP) zdravstveno neosiguranih osoba; AOP u području izvanbolničke zaštite i medicine rada u Varaždinu; AOP u Domu zdravlja Remetinec; idejni projekt Zajedničkog informacijskog sustava zdravstvenog osiguranja i zdravstva Zagreb, itd.). Razvijen je i niz lokalnih informatičkih rješenja po bolnicama, poliklinikama, ordinacijama, laboratorijima itd. Nepovezivost postojećih rješenja razvijenih na različitim platformama (negativno) i kvalitativni napredak u razvoju suvremenih informacijskih tehnologija u svijetu (pozitivno) izrodili su potrebu za novim sustavnim pristupom. Sustavni pristup u izgradnji zdravstvenog informacijskog sustava u Hrvatskoj koji treba povezati sve informacije relevantne za zdravstveni sustav (o korisniku zdravstvene zaštite, o zdravstvenom osiguranju, poslovanju zdravstvenih ustanova i sl.) započeo je u dvadeset i prvom stoljeću kao projekt informacijskog sustava za primarnu zdravstvenu zaštitu (danas: CEZIH – Centralni zdravstveni informacijski sustav Republike Hrvatske; aktualne informacije o CEZIH-u dostupne su na www.cezih.hr ). Ideja sustava opisana je u radu (Končar, Gvozdanović) objavljenom u međunarodnom medicinskoinformatičkom časopisu 2006. godine. Razgovaramo s jednim od autora Darkom Gvozdanovićem, danas voditeljem poslovnog područja eZdravstva u tvrtki Ericsson Nikola Tesla d.d.. ----------------------------------------------------------------------------------------------------------------

Matching records in multiple databases using a hybridization of several technologies.

A major problem with integrating information from multiple databases is that the same data objects can exist in inconsistent data formats across databases and a variety of attribute variations, making it difficult to identify matching objects using exact string matching. In this research, a variety of models and methods have been developed and tested to alleviate this problem. A major motivation for this research is that the lack of efficient tools for patient record matching still exists for health care providers. This research is focused on the approximate matching of patient records with third party payer databases. This is a major need for all medical treatment facilities and hospitals that try to match patient treatment records with records of insurance companies, Medicare, Medicaid and the veteran\u27s administration. Therefore, the main objectives of this research effort are to provide an approximate matching framework that can draw upon multiple input service databases, construct an identity, and match to third party payers with the highest possible accuracy in object identification and minimal user interactions. This research describes the object identification system framework that has been developed from a hybridization of several technologies, which compares the object\u27s shared attributes in order to identify matching object. Methodologies and techniques from other fields, such as information retrieval, text correction, and data mining, are integrated to develop a framework to address the patient record matching problem. This research defines the quality of a match in multiple databases by using quality metrics, such as Precision, Recall, and F-measure etc, which are commonly used in Information Retrieval. The performance of resulting decision models are evaluated through extensive experiments and found to perform very well. The matching quality performance metrics, such as precision, recall, F-measure, and accuracy, are over 99%, ROC index are over 99.50% and mismatching rates are less than 0.18% for each model generated based on different data sets. This research also includes a discussion of the problems in patient records matching; an overview of relevant literature for the record matching problem and extensive experimental evaluation of the methodologies, such as string similarity functions and machine learning that are utilized. Finally, potential improvements and extensions to this work are also presented

An integrated management system for quality and information security in healthcare

Health service organizations are increasingly required to deliver quality healthcare services without increasing costs. The adoption of health information technologies can assist these organizations to deliver a quality service; however, this again exposes the health information to threats. The protection of personal health information is critical to ensure the privacy of patients in the care of health service organizations. Therefore both quality and information security are of importance in healthcare. Organisations commonly use management system standards to assist them to improve a particular function (e.g. quality or security) through structured organizational processes to establish, maintain and optimise a management system for the particular function. In the healthcare sector, the ISO 9001, ISO 9004 and IWA 1 standards may be used for the purpose of improving quality management through the establishment of a quality management system. Similarly, the ISO 27001 and ISO 27799 standards may be used to improve information security management through the establishment of an information security management system. However, the concurrent implementation of multiple standards brings confusion and complexity within organisations. A possible solution to the confusion is to introduce an integrated management system that addresses the requirements of multiple management systems. In this research, various standards relevant to the establishment of management systems for quality and security are studied. Additionally, literature on integrated management systems is reviewed to determine a possible approach to establishing an IMS for quality and information security in healthcare. It will be shown that the quality management and information security management standards contain commonalities that an integration approach can be based on. A detailed investigation of these commonalities is done in order to present the final proposal of the IMSQS, the Integrated Management System for Quality and Information Security in healthcare

An integrated management system for quality and information security in healthcare

Health service organizations are increasingly required to deliver quality healthcare services without increasing costs. The adoption of health information technologies can assist these organizations to deliver a quality service; however, this again exposes the health information to threats. The protection of personal health information is critical to ensure the privacy of patients in the care of health service organizations. Therefore both quality and information security are of importance in healthcare. Organisations commonly use management system standards to assist them to improve a particular function (e.g. quality or security) through structured organizational processes to establish, maintain and optimise a management system for the particular function. In the healthcare sector, the ISO 9001, ISO 9004 and IWA 1 standards may be used for the purpose of improving quality management through the establishment of a quality management system. Similarly, the ISO 27001 and ISO 27799 standards may be used to improve information security management through the establishment of an information security management system. However, the concurrent implementation of multiple standards brings confusion and complexity within organisations. A possible solution to the confusion is to introduce an integrated management system that addresses the requirements of multiple management systems. In this research, various standards relevant to the establishment of management systems for quality and security are studied. Additionally, literature on integrated management systems is reviewed to determine a possible approach to establishing an IMS for quality and information security in healthcare. It will be shown that the quality management and information security management standards contain commonalities that an integration approach can be based on. A detailed investigation of these commonalities is done in order to present the final proposal of the IMSQS, the Integrated Management System for Quality and Information Security in healthcare