Waiting on clinicians to catch up

Outcomes assessment tools like data repositories and benchmarking databases can help cut the cost of care. More tools are on the way. But clinicians who can't catch up may be the biggest barrier to more widespread use.

Strategies for improving information management in emergency medicine to meet clinical, research, and administrative needs. The Information Management Work Group

The emergency department of the future will require the effective integration of information technologies into clinical care. This article proposes strategies for improving information management in emergency medicine to facilitate patient care, public health surveillance, clinical research, medical education, and health care management. Cordell WH, Overhage JM, Waeckerle JF, for the Information Management Work Group: Strategies for improving information management in emergency medicine to meet clinical, research, and administrative needs.

Strategies for improving information management in emergency medicine to meet clinical, research, and administrative needs. Information Management Work Group

The ED of the future will require the effective integration of information technologies into clinical care. This article proposes strategies for improving information management in emergency medicine to facilitate patient care, public health surveillance, clinical research, medical education, and health care management.

Managing in an age of modularity

Modularity is a familiar principle in the computer industry. Different companies can independently design and produce components, suck as disk drives or operating software, and those modules will fit together into a complex and smoothly functioning product because the module makers obey a given set of design rules. Modularity in manufacturing is already common in many companies. But now a number of them are beginning to extend the approach into the design of their products and services. Modularity in design should tremendously boost the rate of innovation in many industries as it did in the computer industry. As businesses as diverse as auto manufacturing and financial services move toward modular designs, the authors say, competitive dynamics will change enormously. No longer will assemblers control the final product: suppliers of key modules will gain leverage and even take on responsibility for design rules. Companies will compete either by specifying the dominant design rules (as Microsoft does) or by producing excellent modules (as disk drive maker Quantum does). Leaders in a modular industry will control less, so they will have to watch the competitive environment closely for opportunities to link up with other module makers. They will also need to know more: engineering details that seemed trivial at the corporate level may now play a large part in strategic decisions. Leaders will also become knowledge managers internally because they will need to coordinate the efforts of development groups in order to keep them focused on the modular strategies the company is pursuing.

Health care unplugged. Small but mighty, wireless computers promise instant access to data--at half the cost of PCs

Wireless computers, long held back by technical snags and entrenched work patterns, are breaking out of the realm of fantasy. They promise to give doctors and nurses instant access to data--at half the cost of installing PCs. Those are two good reasons why health care information technology executives are bullish on wireless.

Cyberspaced

It's weird science-a chore to challenge even the likes of IBM and Microsoft. Hospital computer systems can't be easily extended to outpatient satellites. But despite the odds and expense, a few are making headway.

Telecommunication in the medical environment

Health care providers need access to high-level telecommunication technology to give patients efficient care. With ever-increasing processor performance in both computing and networking technology, information from many sources is now available electronically. For example, transmission of computer-enhanced images from remote facilities is now routine in some centers. As processor power increases, so does the bandwidth requirement for transmission to people in remote sites. This article discusses developments in telecommunication technology, as well as the geographic obstacles that confront us, on the island continent of Australia.

The microprocessor and medicine

Technology continues to accelerate at an amazing pace. Where have we been, where are we going, and what do these technology enhancements mean to the health care industry? We are entering the era of the personal computer becoming the window to the multimedia digital world of cyberspace. Microprocessors will continue to improve from one generation to the next to make cyberspace as realistic as possible-and with their improving capabilities will come myriad applications for health care services, either not cost-effective, or not even contemplated, until now. As a leader of an organization, one who approves substantial budgets for information technology, you must ask yourself what new products and services these startling technological advances will create. How will they change health and medical care?

Information systems. T-minus 34 months and counting. The year 2000 has ominous implications for computer systems

The countdown has started to the year 2000, which has ominous implications for computer systems. Healthcare executives are discovering that changes in their industry further complicate solving the "century date" problem. Meanwhile, a survey of healthcare executives shows they are refocusing on the nuts and bolts of information technology and reining in their ambition to have it all at once.

A-OK by Y2K? Pennsylvanians cope with a computer bug

Health care organizations throughout Pennsylvania are scrambling to cope with the "Year 2000 bug," a potentially serious software glitch that affects almost all existing machines, whether mainframes or desktop PCs. State agencies and most large institutions say that the problems are difficult but manageable. Individual physicians may have less to worry about, but can't afford complacency.

To your computer, the world really will end soon

As the year 2000 approaches, we see it as a time filled with great promise. Our computer sees it as the year 1900. Systems will begin to fail as date-sensitive materials start to clog the works. Are existing lines of code being rewritten or is a new calculator-application being plugged into your computer system to handle the situation?

Network architectures and configuration choices

Network architectures that take advantage of new, switch-based building blocks have just begun to appear. Some are designed to relieve specific bottlenecks; others revitalize the entire network.

Can computer-aided systems engineering tools enhance the development of health care information systems? A critical analysis

Computer-aided systems engineering (CASE) is a software technology that helps systems developers write complex application programs. CASE has been identified as having the potential to help health information systems developers complete large-scale projects such as the computer-based patient record or community health information network. The article evaluates the current use of CASE in health care and other settings through a review of the literature. There is no consensus on the value of CASE. Many experts believe that it is an emerging technology that will become widespread, whereas others see it as expensive and cumbersome to use.

Protecting individual privacy: a pothole on the information superhighway?

Ensuring that our society continues to protect both patient privacy and individual rights in the pursuit of the computer-based patient record requires that we also recognize the potential threats of the emerging systems and technology. Simultaneous parallel trends and advances in high technology could jeopardize underlying democratic principles if they converge without adequate protections in place.