Cowan Informatics for the Clinical Laboratory

A Practical Guide for the Pathologist
1. Auflage 2007
ISBN: 978-0-387-22629-3
Verlag: Springer-Verlag
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 324 Seiten

This series is directed to healthcare professionals who are leading the tra- formation of health care by using information and knowledge. Launched in 1988 as Computers in Health Care, the series offers a broad range of titles: some addressed to specific professions such as nursing, medicine, and health administration; others to special areas of practice such as trauma and radi- ogy. Still other books in the series focus on interdisciplinary issues, such as the computer-based patient record, electronic health records, and networked healthcare systems. Renamed Health Informatics in 1998 to reflect the rapid evolution in the discipline now known as health informatics, the series will continue to add titles that contribute to the evolution of the field. In the series, eminent - perts, serving as editors or authors, offer their accounts of innovations in health informatics. Increasingly, these accounts go beyond hardware and so- ware to address the role of information in influencing the transformation of healthcare delivery systems around the world. The series also increasingly focuses on “peopleware” and the organizational, behavioral, and societal changes that accompany the diffusion of information technology in health services environments.

Autoren/Hrsg.

Cowan, Daniel

Inhaltsverzeichnis

1;Series Preface;5
2;Preface;6
3;Contents;8
4;Contributors;10
5;Laboratory Informatics and the Laboratory Information System;12
5.1;Business of Pathology;14
5.1.1;Information Product of the Laboratory;14
5.1.2;Pathologist as Information Manager;15
5.2;Information Management in the Laboratory Organization;16
5.2.1;What Is Information?;17
5.2.2;Information Technology in the Laboratory;18
5.2.3;Evolving Role of the Computer;18
5.2.4;Cost, Quality, and Efficiency Considerations;19
5.2.5;Study of Information;20
5.3;Laboratory Information Management;21
5.3.1;Responsiveness to Needs;22
5.3.2;Confidentiality, Security, and Integrity of Records;22
5.3.3;Uniform Data Definitions and Data Capture Methods;23
5.3.4;Defining, Capturing, Analyzing, Transforming, Transmitting, and Reporting of Patient- Specific Data and Information;24
5.4;Laboratory Information System;24
5.4.1;Database;25
5.4.2;Electronic Data Processing;26
5.5;Summary;28
5.6;Chapter Glossary;29
5.7;References;30
6;Developing the Laboratory Information System;32
6.1;Planning for Purchase of a Vendor- Supplied System;33
6.2;Request for Proposal;34
6.2.1;Questions to Be Asked in the RFP;36
6.2.2;User Definability vs. Customization;38
6.3;Functional Requirements of the System;38
6.3.1;Structure of the Database;39
6.3.2;Transaction Logging ( Event- Level Processing);40
6.3.3;Evolution of the Database;42
6.3.4;Encoding;44
6.3.5;Security and Confidentiality;44
6.4;Site Visit;45
6.5;Developing a Contract;45
6.6;Problem Resolution;47
6.7;Build or Buy?;49
6.8;Application Service Providers ( ASP);49
6.8.1;Risks of Using an ASP;50
6.8.2;Benefits of Using an ASP;50
6.8.3;Types of ASP;51
6.9;Summary;51
6.10;Chapter Glossary;52
6.11;References;53
7;Validation of the Laboratory Information System;54
7.1;General Validation Issues;55
7.1.1;Validation for Quality Assurance and Improvement;55
7.1.2;Vendor Validation Testing;57
7.2;General Process of User Validation;58
7.2.1;Identification and Description of the System to be Validated;58
7.2.2;Specification of the Stage in the System Life Cycle;58
7.2.3;Formalization of the Process for Prioritizing and Deciding;59
7.2.4;Development of Hazard Analyses;59
7.2.5;Identification of Regulatory Concerns;59
7.2.6;Documentation;59
7.3;Validation Plan;60
7.3.1;Initial Validation Program;60
7.3.2;Continuing Validation Plan;65
7.4;Chapter Glossary;67
7.5;References;68
8;Security and Confidentiality on Laboratory Computer Systems;70
8.1;Objectives of a Security System for Patient Records;70
8.2;Security Interests;71
8.3;Protecting Data and Information;71
8.4;Sensitive Data;71
8.5;Risks Associated with Computerization of Records;72
8.6;Limits of Security;72
8.7;Security in Systems and Networks;73
8.8;Practical Security Measures;74
8.9;General Security Responsibilities for the User;74
8.10;Security and Control Guidelines;76
8.11;Types of Security Deficiencies or “ Holes”;77
8.12;Selecting Good Passwords;78
8.13;Summary;79
8.14;Laboratory Information System Security at UTMB;80
8.15;Confidentiality: Patient Privacy;81
8.16;Access to the Laboratory Record;82
8.17;Medical Information on the Internet;84
8.18;Legal Protection of Information on the Internet;84
8.19;Security Considerations for the Internet;89
8.20;E- Mail Communication of Health Information;90
8.21;Computer Viruses;91
8.22;WEB Crackers;94
8.23;Chapter Glossary;95
8.24;References;97
9;Total Cost of Ownership;98
9.1;Types of Costs ;99
9.1.1;Direct and Indirect Costs;99
9.1.2;Selection;101
9.1.3;Purchase and Installation;102
9.1.4;Operation;103
9.2;Ways to Manage TCO;104
9.2.1;Standardize;104
9.2.2;Maintain and Upgrade;105
9.2.3;Plan Support Carefully;106
9.2.4;Systematically Replace Manual Systems;106
9.2.5;Maintain Openness;106
9.2.6;Exercise Good Routine Business Practices;106
9.3;Justifications Based on Value Added;107
9.4;Chapter Glossary;108
9.5;References;108
10;Computer Basics;109
10.1;Definitions and Descriptions;109
10.1.1;Bits and Bytes;113
10.1.2;Memory;114
10.1.3;Codes;114
10.1.4;Chips;115
10.2;Hardware;117
10.3;Operating Systems;122
10.4;Microcomputer Operating Systems;123
10.4.1;Adding Memory;124
10.4.2;Cache;125
10.4.3;Minicomputers and Mainframes;126
10.5;Distributed vs. Central Processing;128
10.6;Chapter Glossary;132
10.7;References;135
11;Computer Networks;136
11.1;Physical Topology;138
11.2;“ Logical Topology”—The Communications Protocol;144
11.3;Network Manager;146
11.4;The Internet;151
11.5;Chapter Glossary;152
11.6;References;154
12;Interfaces;155
12.1;Interface Protocols;157
12.2;Health Level 7 ( HL7);157
12.3;Interface Standards;158
12.4;Interfaces in the Diagnostic Laboratory;160
12.4.1;Parallel Interfaces;160
12.4.2;Serial Interfaces;161
12.5;Interfaces for Instruments in the 2000s;164
12.6;Chapter Glossary;165
12.7;References;166
13;Bar Coding in the Laboratory;167
13.1;One- Dimensional Codes;168
13.2;Two- Dimensional Codes;171
13.3;The Bar Code System;174
13.3.1;Defining Information;174
13.3.2;Bar Code Software;174
13.3.3;Labels;174
13.3.4;Bar Code Printers;174
13.3.5;Laser Printers;175
13.3.6;Print Density;175
13.3.7;Bar Code Readers;176
13.4;Bar Coding in the Laboratory;176
13.5;Chapter Glossary;178
13.6;References;179
14;Wireless Communication Networks in the Laboratory;180
14.1;Conventional LAN;181
14.2;Wireless LAN;182
14.2.1;Wireless Technology;183
14.2.2;Applicability of Wireless LAN Technology;183
14.2.3;Connecting the Node;184
14.2.4;Diffuse Infrared Systems;185
14.2.5;Radio Frequency Systems;186
14.2.6;Installing Wireless Technology;188
14.2.7;Security;189
14.2.8;Battery Power Management;191
14.2.9;Safety Considerations;191
14.3;Chapter Glossary;192
14.4;References;193
15;Essential Software;194
15.1;Software Categories;194
15.2;Selecting Software Products;197
15.3;Matching the Product to the Task At Hand;199
15.4;Additional Commentary on Medical Informatics;203
15.5;Summary;203
15.6;Chapter Glossary;204
16;Clinical and Anatomic Pathology Database Design;205
16.1;Designing a Database;206
16.1.1;Data Analysis and Logical Design;207
16.2;Practice Example;209
16.2.1;Physical Design;212
16.3;Data Normalization Applied to Clinical and Laboratory Informatics;214
16.3.1;Rule 1: Eliminate Repeating Groups;214
16.3.2;Rule 2: Eliminate Redundant Data;215
16.3.3;Rule 3: Eliminate Columns Not Dependent on Key;216
16.3.4;Rule 4: Isolate Independent Multiple Relationships;217
16.3.5;Rule 5: Isolate Semantically Related Multiple Relationships;218
16.4;Summary;219
16.5;Chapter Glossary;220
17;Process Modeling;222
17.1;What Is Simulation?;223
17.2;Why Use Computer Simulation for Laboratory Management?;224
17.3;How Is Simulation Done?;225
17.4;Simulating the Receiving and Processing Area of a Laboratory;226
17.5;Case Study;232
17.6;Conclusion;239
17.7;Chapter Glossary;240
17.8;References;240
18;Artificial Intelligence and Expert Systems;241
18.1;Artifical Intelligence;241
18.2;Expert Systems;243
18.2.1;Chaining;244
18.2.2;Commercial Expert System Software;245
18.3;Reasoning with Uncertainty;245
18.4;Neural Networks;248
18.5;Genetic Algorithms;250
18.5.1;Modeling Assumptions;250
18.5.2;Genetic Operators;251
18.5.3;Execution Cycle;251
18.6;Data Warehouse;252
18.6.1;Development of the Data Warehouse;253
18.6.2;Making Data Accessible and Usable;254
18.7;Knowledge Discovery Process;257
18.7.1;Definition of the Business Problem to Be Addressed;258
18.7.2;Collection and Preparation of the Data;258
18.7.3;Development of the Model;259
18.7.4;Use of the Model;259
18.7.5;Monitoring Performance of the Model;260
18.8;Chapter Glossary;260
18.9;References;261
19;Imaging, Image Analysis and Computer- Assisted Quantitation;262
19.1;Mechanics of Imaging;263
19.1.1;Image Acquisition;263
19.1.2;Image Display;266
19.1.3;Image Transfer, Storage and Archiving;268
19.2;Image Analysis;269
19.3;Typical Imaging Systems;271
19.4;Image Files;272
19.5;Chapter Glossary;275
19.6;Cited References;277
19.7;Additional References;278
20;Introduction to Telepathology;279
20.1;Telepathology Systems;280
20.1.1;Acquiring the Image;280
20.1.2;Image Storage and Compression;282
20.1.3;Transmitting the Image;284
20.1.4;Display of the Received Image;286
20.2;Telepathology System Formats;287
20.3;Legal Issues;290
20.4;Economic Issues;291
20.5;Future of Telepathology;292
20.6;Chapter Glossary;293
20.7;References;295
21;Index;316