Electronic Medical Records Optimize Clinical Data Management in the Outpatient Cardiological Clinic

A system based on a relational database with administrative and clinical information and integrated with an Information System, where the system covers the role of a Functional Island, is routinely used in our Institution. To analyze how Electronic Medical Records (EMR) may help physicians in organizing and reducing time waste in a busy outpatient clinic, a sample of 1000 reports were evaluated for system performance. The time needed for building new clinical histories or modifying the already acquired ones, to create physical examination and biochemical and instrumental exams reports, was assessed. Cardio-pulmonary tests, basal, dynamic and effort EKG, chest X-ray, Echo Doppler studies, nuclear medicine procedures, invasive techniques, were collected. Clinical management was integrated with the administrative system (ADT), to correctly identify each patient. This system provided not only easy retrieving of stored data such as clinical history, physical examination, instrumental exams reports but also the results of new exams performed in the same day of patient visit with a time lapse of 1 to 20\u27. Graphical interface structure contained preformatted fields which allowed selection or modifications of data/text models without additional waste of time. EMR represents an important tool for organization and synergy of different Laboratories in a outpatient clinic, optimizing the time needed for data entry and leading to an overall better quality of care

Data Integration in Cardiac Surgery and Resource Management

At "G. Pasquinucci" Hospital in Massa, a section of CNR Institute of Clinical Physiology, an information system for cardiac surgery has been in use during the last years. This system was integrated with the Hospital Information System, already set up at the head of our institute in Pisa. Anesthesia data are recorded in the Operating Room (OR) as well as materials used during cardiac surgery operations. From the OR, data are transferred into the central clinical database, creating surgery reports in the medical record and filling in standardized clinical registers. Since 2000 a total of 2185 adult and 956 pediatric cardiac surgery operations were recorded

A New Web Score to Predict Health Status in Paediatric Patients with Chronic Diseases: Design and Development of the PENSAMI Study

Paediatric chronic diseases (CD) are characterised by their ongoing duration and the fact that they are often managed throughout the lifespan, with the need to adjust lifestyle and expectations with the limitations coming from the CD. The aim of the PENSAMI study is to not only cure the disease, but to also care for the person from a clinical and psychosocial perspective. Data will be collected from 150 paediatric patients affected by heart disease, diabetes, and asthma admitted during in-hospital stay or outpatient visits, and from 200 healthy control subjects. The protocol will consist of two phases. The first one will aim at elaborating the predictive model by detecting (clinical, anthropometric at birth, environmental, lifestyle, social context, emotional state, and mental abilities) in order to develop a model predictive of the events considered: (1) re-hospitalisation; (2) severity and progression of the disease; (3) adherence to therapy; (4) HRQoL; (5) obesity and metabolic syndrome; (6) illness-stress related; (7) school drop-out; (8) school performance. The second one will address validating the previous predictive model. This model will aim to: (1) understand, prevent, and halt the progression of childhood CD; (2) develop new and improved diagnostic tools; (3) pave the way for innovative treatments and additional therapies to traditional clinical practice; and (4) create truly personalised therapeutic and preventive strategies in various sectors, such as cardiology, diabetes, and respiratory diseases

Data Integration in Cardiac Surgery Health Care Institution: Experience at G. Pasquinucci Heart Hospital

During the last ten years the Hospital Information System (HIS) was developed at the Institute of Clinical Physiology of National Research Council (IFC-CNR), recently reorganized on clinical side into the "Gabriele Monasterio Foundation" (FGM) by joint efforts of CNR, Tuscany Region and Universities. At G.Pasquinucci Heart Hospital (GPH), currently FGM\u27s section in Massa, the HIS was adapted and extended to Cardiac Surgery and Pediatric Cardiology. Data archiving and middleware integration through HIS network, connecting GPH with head institution in Pisa, allowed to achieve full secure access to patient information from any workstation within hospital or outside. PACS was developed using Open Source DICOM utilities. Electronic Medical Record is daily used since 2005 on both inpatients and outpatients. Recently telediagnosis was set up between Balkan countries and GPH in Massa

Integred record system for standard reporting operations in pediatric cardiac surgey and complexity estimation

The Hospital Information System, first developed at our main institute for the integration of clinical, administrative and management resources in Cardiology, has been recently extended for use at our section specialised in Cardiac Surgery. Extension of the electronic medical record (EMR) to the management of patients admitted in Pediatric Cardiac Surgery started with the development of a system for reporting operations in structured form and for estimating their complexity, according to a model set up in a previous study involving our institute and other two pediatric cardiac surgery centers. The international congenital heart surgery nomenclature, promoted in Europe by the Pediatric European Cardiac Surgical Registry (ECSUR) project, was adopted. The ECSUR data set with associated short lists (translated into Italian) of pre-operative risk factors, diagnoses, procedures and complications was implemented in our EMR. Minor coding expansions were suggested by both surgeons and cardiologists. EMR interface was developed to record, for each operation, diagnoses and procedures, patient findings and conditions, operative events and methods. Information on patient history and on follow-up was also recorded. From the combination of underlying diagnosis and procedure each operation was classified in terms of 3-level complexity according to the developed multicenter model. The system is used daily for reporting operations in our Pediatric Cardiac Surgery department. All operations since January 2000 were archived (a total of 547 in two years) and data were periodically exported and submitted to the ECSUR database center. A comprehensive data bank is being developed allowing both clinical management and research as well as risk stratification and outcome analysis. Moreover estimation of operation complexity is useful to evaluate DRG\u27s, often underestimated in Pediatric Cardiac Surgery

C3: Java-based Medical Record System for Cardiology

This paper describes a system for electronic medical record (EMR) we have developed for use in our health care institution, mainly dealing with diagnosis and treatment of cardiovascular pathologies. This activity is part of the project SPERIGEST, supported by Health Ministry of Italy, for the management of health care delivery, as concerns both clinical and administrative aspects. A networked computer-based information system was realized to integrate the different heterogeneous sources of patient information. Both clinical and administrative patient relevant data are provided from the various systems and stored into a central database. The EMR system was designed using World Wide Web (WWW) technology (Java, HTML). The system is currently under clinical evaluation

Cartella clinica per la cardiochirurgia pediatrica: refertazione dell\u27intervento e stima della complessit? chirurgica

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