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Index
Cover image
Title page
Table of Contents
Dedication
Copyright
Preface
Introduction
Memorization of information intended for a single category of actors or a single specialty is of little added value
The complexity of human activity cannot find satisfactory answers in siloed systems
Confronting the heterogeneity of data and systems
Reusing data is necessary and provides high added value
Design and implementation of flexible information systems
Modeling as a way of responding to issues of flexibility
Modeling to develop
Principles for analyzing and implementing flexible information systems
Current implementation of these principles
Strategic alignment of information systems is confirmed but all too often not achieved
1: Understanding the Fundamental Nature of Information and its Processing
Abstract
1.1 Introduction
1.2 Data, knowledge and information
1.3 Data structures
1.4 Data models
1.5 Qualities that make information valuable
1.6 Improving the quality of data
1.7 Uses of patient data
1.8 Processing information, applications, components and processes
2: A Few Questions on Information Sharing
Abstract
2.1 Introduction
2.2 Twelve questions for better defining sharing and its objectives
2.3 Organization of information sharing is a prerequisite of technological choice
2.4 Summary and conclusion
3: The Place of Healthcare Delivery Processes in Information Systems
Abstract
3.1 Introduction
3.2 The concept of the process
3.3 Modeling and the presentation of processes
3.4 Processes and procedures
3.5 Interests and limitations of the process-based approach
3.6 Conclusion
4: The Quality of the Urbanization of the Information System is Central to its Performance
Abstract
4.1 Introduction
4.2 Changes to the scope of information systems must be anticipated
4.3 The dimensions of interoperability
4.4 Interoperability is central to the development of practices
4.5 The shared reference terminology of information systems
4.6 Conclusion
5: Reference Terminologies in Healthcare Information Systems
Abstract
5.1 Introduction
5.2 The management of reference terminologies must comply with the rules of best practice
5.3 Specialized reference terminologies
5.4 General purpose reference terminologies
5.5 Implementing reference terminologies in the context of urbanizing information systems
5.6 Conclusion
6: Patient Identification in Healthcare Information Systems
Abstract
6.1 Introduction
6.2 Basic concepts in patient identification
6.3 Establishing a unique, common and universal identifying number would be ideal
6.4 The proposed solutions focus on a simple identification model and efficient and reliable matching of identities
6.5 The de-identification of data
7: Information System Security and Data Protection
Abstract
7.1 Introduction: the need for security
7.2 Security policies as protection against threats to information systems
7.3 Risk assessment and choosing the measures to be taken
7.4 Protecting personal data
7.5 Conclusion
8: Knowledge Management and Medical Decision Support
Abstract
8.1 Introduction
8.2 A brief historical overview and the lessons learned [GRE 07]
8.3 Intelligent systems
8.4 Evidence-based medicine: from literature to clinical action
8.5 Standards for representing knowledge are essential to integrating best-practice guidelines into care processes
8.6 Conclusion
9: Managing and Integrating Clinical Data: Health Records
Abstract
9.1 Introduction
9.2 A wealth of terminology to refer to patient data and how it is managed
9.3 Access to patient data is essential to improving the care process
9.4 The a priori structuring of records has kept methodologists and healthcare professionals busy for 40 years
9.5 Data description, use of reference terminologies and professional access
9.6 The interoperability of data and knowledge in care processes is central to designing health records
9.7 The characteristics of new generations of health record management systems
9.8 The Continuity of Care Maturity Model
9.9 Conclusion
10: Managing and Integrating Laboratory Data and Functional Investigations
Abstract
10.1 Introduction
10.2 The laboratory information system (LIS)
10.3 Development of the regulatory context for biology laboratories
10.4 Having a reference terminology for biological procedures is central to designing LIS
10.5 Have a knowledge base (engine for prescription rules, act protocols, etc.)
10.6 Integrating biological data in patient records
11: Managing and Integrating Medical Images
Abstract
11.1 Introduction
11.2 The picture archiving and communication system (PACS)
11.3 Managing medical images
11.4 The mutualization of image management and the functions of PACS
12: Managing and Integrating Telemedicine and Telehealth
Abstract
12.1 Introduction
12.2 Clinical communication and telemedicine
12.3 Healthcare services on the Web, e-health
12.4 Regional telehealth platforms
12.5 Connected health tools
12.6 Conclusion
13: Integrating Extra-hospital Care Data
Abstract
13.1 Introduction
13.2 Highlights from the USA
13.3 Some initiatives and programs in France
13.4 Conclusion
14: Reusing Data in Healthcare
Abstract
14.1 Introduction
14.2 Making healthcare data usable in order to be useful
14.3 A standard, comprehensible, interoperable data model
14.4 Means of integrating data
14.5 Reuse of big data, connected objects, social networks
14.6 Conclusion
15: Integrating Data for Management and Decision Analysis
Abstract
15.1 Introduction
15.2 The processing chain of decision-making analysis
15.3 Building data warehouses
15.4 The dashboard of an establishment or an institution
15.5 Hospital financing and its national management in France
15.6 Other examples of indicators for other kinds of management: international experiences in regulating quality and efficiency
15.7 Conclusion
16: Data for Epidemiology and Public Health, and Big Data
Abstract
16.1 Introduction
16.2 Multi-source monitoring systems
16.3 The challenges and opportunities of big data for public health
16.4 Epidemiology and big data
16.5 Multiple and heterogeneous data sources
16.6 The contribution of big data and e-health to prevention, monitoring and health vigilance
16.7 The heterogeneity of data, a feature of big data, underlines the importance of interoperability standards
16.8 Conclusion
17: Integrating Bioinformatics Data
Abstract
17.1 Introduction
17.2 The importance of integrating databases in bioinformatics
17.3 Ontologies and gene annotation
17.4 The Gene Ontology (GO) consortium
17.5 Conclusion
18: Clinical Research Data
Abstract
18.1 Introduction
18.2 The clinical research (CR) situation
18.3 The worlds of care activity data and clinical research data are different
18.4 The tools and methods that contribute to a synergetic approach
18.5 Information system initiatives and tools in clinical research
18.6 Conclusion
19: Evaluating Information Systems
Abstract
19.1 Introduction
19.2 “Pre-implementation” evaluation of an information system
19.3 Evaluation of “post-implementation” information systems
19.4 Asset value and use value of information systems
19.5 Case studies
19.6 Some lessons
20: The Governance of Healthcare Information Systems, the Hospital, Outpatient and Industrial Contexts
Abstract
20.1 Introduction
20.2 Meaningful use, a tool of governance in the USA
20.3 Emerging governance of healthcare information systems in France
20.4 A rapid change in hospital and outpatient information systems, as well as their governance, is needed
20.5 An extra-hospital offer overly focused on professions with little integration of regional organization
20.6 Industrial offer
20.7 Discussion
Appendix 1: Management of Selected International Terminologies
Other terminologies used in France
Appendix 2: Further Information on DICOM Standards
Appendix 3: Further Information on the système national des données de santé (National Healthcare Data System – SNDS) in France
Appendix 4: Metadata
Definition, presentation
A simple example showing the use of metadata
Appendix 5: Clinical Observation Specifications
Clinical data acquisition standards harmonization (CDASH)
Next-generation platforms
Appendix 6: Ontologies
Definition
Why ontologies?
How do ontologies work?
Appendix 7: Document Banks – Medication Data
The different types of document databases
Some examples of medication data banks
The functions and integration of these bases in information systems
Appendix 8: Hosting Health Data in France
Appendix 9: Developing an Information System Master Plan
Information system master plans
Methodology for developing an information system master plan
Bibliography
Index
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