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TLets282655
Design and implementation of integrated clinical record systems :
[Thesis]
Steif, Jacob.
a multidisciplinary approach.
London School of Economics and Political Science (University of London)
1987
Ph.D.
London School of Economics and Political Science (University of London)
1987
In this work new approaches to the design and implementationof clinical record systems are examined. Although informationtechnology has long been successfully used in specific areas ofmedicine, very few situations exist where information systemsare routinely used to support the medical record. The underlyingthesis of this work is that the major reasons for this failureare the complexity and vastness of the medical field and thelimitations of traditional methodologies and models for informationsystems development. I contend that there is need of aninterdisciplinary basis for information systems developmentmethodologies, which account for the multiple characteristicsof medical care and for the related information systems.The research has been done from the perspective of a realhospital where the present goal of computerisation has seen theintroduction of information systems in routine clinical practice.First, the problem of developing information systems forclinical laboratories is addressed, and a proposed, entity-basedmethodology developed and implemented. Then, a different entitybasedapproach is devised for the area of clinical records. Thishas been successfuly implemented in several clinical applications.However, due to limitations of this approach the naturallanguage paradigm was selected as a basis for a different methodology.A multi-functional information model and system is devised,where information is represented and manipulated by meansof different models and representations.These models correspond to three semiotic functions whichclinical record systems should support. First, there is the Atomic Object Model which manipulates 'atomic' predications.This model is used primarily for the recording of simple facts(both knowledge and data). Second, there is the Medical RecordModel which encompasses mostly structural and temporal propertiesof information and its major semiotic function is communication.It utilises abstraction principles such as 'generalisation'and 'aggregation'. The third model, the Clinical Model,is designed to incorporate different roles'that information canplay in reasoning for clinical problem-solving. An informationsystem was developed in which special care was given to problemsof man-machine interaction, both in regard to information modellingand to manipulation of patient information.An integrated information system was developed graduallyusing different database management systems. A dozen differentclinical applications have been developed and implemented andhundreds of physicians and nurses utilise the system in routineclinical work
Medical records
Steif, Jacob.
London School of Economics and Political Science (University of London)
مطالعه متن کتاب p
[Thesis]
276903
a
Y
