Subscribe to RSS
DOI: 10.1055/s-0038-1634380
From Passive to Active Electronic Healthcare Records
Publication History
Publication Date:
08 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035037/200305/lookinside/thumbnails/10-1055-s-0038-1634380-1.jpg)
Summary
Objectives: The provision of patient data to clinicians as and when it becomes available is a general objective of information systems in healthcare. It is known that the timely receipt of patient data can have a significant bearing on healthcare outcomes. One of the on-going tasks is to provide this data in the form of an Electronic Healthcare Record according to some agreed standard. The aim in this paper is to provide patient data in electronic form by pushing the information to the end users as soon it becomes available, in advance of any explicit request from the users.
Methods: This paper describes how an existing record system, the Synapses Federated Healthcare Records Server, has been extended to incorporate active functionality to facilitate pushing the information to end-user applications. The user must specify the information of interest to him, so that the system pushes only information useful to the final user. The approach proposed here relies solely on the use of callbacks through the middleware layer being used, a mechanism available in all existing middleware implementations.
Results: The Synapses Federated Healthcare Records Server which has resulted from this research is a more flexible and scaleable system, capable of fulfilling the needs of a wider range of healthcare organisation than when a strictly passive approach is used.
Conclusions: It is shown that healthcare organisation can incorporate a healthcare record system with active functionality without any large investment or significant risk to their existing information systems.
-
References
- 1 Grimson J, Stephens G, Jung B, Grimson W, Berry D, Pardon S. Sharing health-care records over the internet. IEEE Internet Computing 2001; 5: 49-58.
- 2 Kohane IS, Greenspun P, Fackler J, Cimino C, Szolovits P. Building national electronic medical record systems via the World Wide Web. Journal of the American Medical Informatics Association 1996; 3: 197-206.
- 3 Pinciroli F, Portoni L, Combi C, Violante FF. WWW-based access to object-oriented clinical databases: the KHOSPAD Project. Computers in Biology and Medicine 1998; 25: 531-52.
- 4 Grimson W, Berry D, Grimson J, Stephens G, Felton E, Given P, O’Moore R. Federated healthcare record server – the Synapses paradigm. International Journal of Medical Informatics 1998; 52: 3-27.
- 5 Grimson J, Grimson W, Berry D, Stephens G, Kalra D, Felton E, Toussaint P, Weier OW. A CORBA-based integration of distributed electronic healthcare records using the Synapses approach. IEEE Transactions on Information Technology in Biomedicine 1998; 2: 124-38.
- 6 Franklin MJ, Zdonik SB. ‘Data in your face’: push technology in perspective. In Haas LM, Tiwary A. editors. SIGMOD’98. Proceedings of the ACM SIGMOD International Conference on Management of Data;. 1998 Jun 2-4; Seattle, United States. New York: ACM Press; 1998. p. 516-519.
- 7 Gordon C, Veloso M. Guidelines in healthcare: the experience of the Prestige project. In Kokol P, Zupan Blaz Stare J, Premik M, Engelbrecht R. editors. MIE’99. Proceedings of Medical Informatics Europe;. 1999 Aug 22-26; Ljubljana, Slovenia. Amsterdam: IOS Press; 1999. p. 733-738.
- 8 Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn’t. British Medical Journal 1996; 312: 71-2.
- 9 Schadow G, Russler DC, McDonald CJ. Conceptual integration of guidelines and workflow into the electronic health record. In Hasman A, Blobel B, Dudeck J, Engelbrecht R, Gell G, Prokosch HU. editors. MIE’00. Proceedings of Medical Informatics Europe;. 2000 Aug 27 – Sep 1; Hannover, Germany. Amsterdam: IOS Press; 2000. p. 807-811.
- 10 Grimson J. Delivering the electronic healthcare record for the 21st century. International Journal of Medical Informatics 2001; 64: 111-27.
- 11 Franklin MJ, Zdonik SB. A Framework for scalable dissemination-based systems. In Berman AM, Loomis M, Bloom T. editors. OOPSLA’97. Proceedings of the ACM SIG-PLAN Conference on Object-oriented Programming Systems, Languages and Applications;. 1997 Oct 5-7; Georgia, United States. New York: ACM Press; 1997. p. 94-105.
- 12 MacDonald C, Wilson GA, McCabe GP. Physician response to computer reminders. Journal of the American Medical Association 1980; 244: 1579-81.
- 13 Zahlmann G, Obermaier M, Ritzke C, Scherf M. Knowledge-based monitoring of glaucoma patients - a connectionist’s approach. In: Brender J, Scherrer JR, Christensen JP, McNair P. editors. MIE’96. Proceedings of Medical Informatics Europe;. 1996 Aug 19-22; Copenhagen, Denmark. Amsterdam: IOS Press; 1996. pp. 555-9.
- 14 Tang P, Hammond WA. Progress report on computer-based patient records in the United States. In Dick RS, Steen EB, and Detmer DE. editors. The Computer-based Patient Record: An Essential Technology for Healthcare. Washington D.C.: Institute of Medicine, National Academies Press; 1997. p. 1-20.
- 15 Sailors RM, East TD. Clinical informatics: 2000 and beyond. In Lorenzi NM. editor. AMIA’99. Proceedings of the American Medical Informatics Association Annual Symposium;. 1999 Nov 6-10; Washington, United States. Bethesda, Maryland: American Medical Informatics Association.; p. 609-613.
- 16 Connectivity Industry Consortium.. Universal connectivity standard for point of care draft – Technical specifications. 2001 Jan. Available from http://www.poccic.org/pdfs/cic_drafts_1_8_01.pdf. Accessed September 29, 2003
- 17 Institute of Electrical and Electronics Engineers.. 1073 Standard for medical device communications: overview and framework. 1996 March. Available from http://standards.ieee.org/. Accessed April 8, 2003
- 18 Bisbal J, Lawless D, Wu B, Grimson J. Legacy information systems: issues and directions. IEEE Software 1999; 16: 103-11.
- 19 Orfali R, Harkey D, Edwards J. The essential distributed objects survival guide. New York: John Wiley & Sons; 1996
- 20 Bisbal J, Stephens G, Grimson J. Generic access to Synapses EHCR data. Proceedings of the 4th Annual Conference and Scientific Symposium of the Health Informatics Society of Ireland: 1999
- 21 Ronan E. Mastering Enterprise JavaBeans. 2nd ed. New York: John Wiley & Sons; 1999
- 22 Richter J. Applied Microsoft.NET framework programming. Microsoft Press; 2002
- 23 Knuth DE. The art of computer programming, volume 1: Fundamental algorithms. 3rd ed. Reading: Addison-Wesley; 1997
- 24 Fowler M, Scott K. UML distilled: applying the standard object modeling language. Reading: Addison-Wesley; 1997
- 25 Orfali R, Harkey D, Edwards J. Instant CORBA. New York: John Wiley & Sons; 1997
- 26 Paton NW, Diaz O. Active database systems. ACM Computing Surveys 2001; 31: 63-103.
- 27 Altinel M, Aksoy D, Baby T, Franklin MJ, Shapiro W, Zdonik S. DBIS-Toolkit: Adaptable middleware for large scale data delivery. In Delis A, Faloutsos C, Ghandeharizadeh S. editors. SIGMOD’99. Proceedings of the ACM SIGMOD International Conference on Management of Data;. 1999 June 1-3; Philadelphia, United States. New York: ACM Press; 1999. p. 544-546.
- 28 Hederman L, Smutek D, Wade V, Knape T. Representing clinical guidelines in UML: a comparative study. In Surjan G, Engelbrecht R, McNair P. editors. MIE’02. Proceedings of Medical Informatics Europe;. 2002 August 25-29; Budapest, Hungary. Amsterdam: IOS Press; 2002. p. 471-477.
- 29 Hayes R, Grimson B, Pacini G, Nolan J. A strategy to enhance the usability of the minimal model as used with the intravenous glucose tolerance test in diabetes research and clinical management. In Surjan G, Engelbrecht R, Mc-Nair P. editors. MIE’02. Proceedings of Medical Informatics Europe;. 2002 August 25-29; Budapest, Hungary. Amsterdam: IOS Press; 2002. pp. 519-524.